Be United, Be Virtuous: Composite Culture and the Growth of Shirdi Sai Baba Devotion

In one popular devotional poster the Indian god-man Shirdi Sai Baba (d. 1918) gazes out at the viewer, his right hand raised in blessing. Behind him are a Hindu temple, a Muslim mosque, a Sikh gurdwara, and a Christian church; above him is the slogan, “Be United, Be Virtuous.” In his lifetime, Shirdi Sai Baba acquired a handful of Hindu and Muslim devotees in western India. Over the past several decades, he has been transformed from a regional figure into a revered persona of pan-Indian significance. While much scholarship on religion in modern India has focused on Hindu nationalist groups, new religious movements seeking to challenge sectarianism have received far less attention. Drawing upon primary devotional materials and ethnographic research, this article argues that one significant reason for the rapid growth of this movement is Shirdi Sai Baba’s composite vision of spiritual unity in diversity, construed by many devotees as a needed corrective to rigid sectarian ideologies.

A modified DRIL procedure by flow reversal of an aborted distal cephalic vein for critical hand ischaemia

Treatment of dialysis access-related hand ischaemia with preservation of the access remains an issue. We report the case of a patient presenting critical hand ischaemia 2 years after proximalisation of a distal radio-cephalic fistula with preservation of the original access. After valvulotomy, the distal cephalic vein was used as in situ bypass and directly anastomosed to the distal brachial artery, providing a direct flow to the hand. This procedure relieved the hand ischaemia without sacrificing the functioning fistula. Six months later, the fistula and bypass were still patent, showing that flow reversal of a previous fistula can be an efficient strategy to correct dialysis access-related hand ischaemia in selected cases.

Im/possible Lives: Gender, Class, Self-Fashioning, and Affinal Solidarity in Modern South Asia

Drawing on ethnographic research and employing a micro-historical approach that recognizes not only the transnational but also the culturally specific manifestations of modernity, this article centers on the efforts of a young woman to negotiate shifting and conflicting discourses about what a good life might consist of for a highly educated and high caste Hindu woman living at the margins of a nonetheless globalized world. Newly imaginable worlds in contemporary Mithila,South Asia, structure feeling and action in particularly gendered and classed ways, even as the capacity of individuals to actualize those worlds and the “modern” selves envisioned within them are constrained by both overt and subtle means. In the context of shifting cultural anchors, new practices of silence, literacy, and even behaviors interpreted as “mental illness” may become tactics in an individual’s negotiation of conflicting self-representations. The confluence of forces at play in contemporary Mithila, moreover, is creating new structures of feeling that may begin to reverse long-standing locally held assumptions about strong solidarities between natal families and daughters, on the one hand, and weak solidarities between affinal families and new daughters-in-law, on the other.

Hand and Wrist Surgery

Despite improved medical treatment of rheumatoid arthritis, carpal tunnel compression, caput ulnae syndrome and palmar and dorsal tenosynovitis with potential tendon rupture represent urgent surgical indications. While diagnostic and therapeutic synovectomy may guide medical treatment, it should be performed before joint instability and destructive arthritis are established. Swan-neck and Boutonniere deformities as well as ulnar or radial drift of metacarpophalangeal (MCP) joints or the wrist can only be corrected when the involved joints are supple and intact. In the presence of destructive arthritis, partial and total wrist fusion, arthroplasties of the MCP joints and arthrodeses of the distal interphalangeal joints are recommended.

Assessment of endothelium and inflammatory response at the onset of reperfusion injury in hand surgery

Background Activation of the endothelium, complement activation and generation of cytokines are known events during ischemia-reperfusion (I/R) that mediate tissue injury. Our aim was to elucidate their respective participation at the onset of the reperfusion phase. Tourniquet application in hand surgery causes short-term ischemia, followed by reperfusion and was therefore used as the model in this study. Methods Ten patients were included in the study after obtaining informed consent. A tourniquet was placed on the upper arm and inflated to 250 mmHg for 116 ± 16 min, during which the surgery was performed. Venous blood and tissue samples from the surgical area were taken at baseline as well as 0, 2, and 10 min after reperfusion and analyzed for the following parameters: Endothelial integrity and/or activation were analyzed by measuring heparan sulfate and syndecan-1 in serum, and vWF, heparan sulfate proteoglycan as well as CD31on tissue. Complement activation was determined by C3a and C4d levels in plasma, levels of C1-inhibitor in serum, and IgG, IgM, C3b/c, and C4b/c deposition on tissue. Cytokines and growth factors IL-5, IL-6, IL-7, IL-8, IL-10, IL-17, G-CSF, GM-CSF, MCP-1, TNFα, VEGF, and PDGF bb were measured in the serum. Finally, CK-MM levels were determined in plasma as a measure for muscle necrosis. Results Markers for endothelial activation and/or integrity as well as complement activation showed no significant changes until 10 min reperfusion. Among the measured cytokines, IL-6, IL-7, IL-17, TNFα, GM-CSF, VEGF, and PDGF bb were significantly increased at 10 min reperfusion with respect to baseline. CK-MM showed a rise from baseline at the onset of reperfusion (p < 0.001) and dropped again at 2 min (p < 0.01) reperfusion, suggesting ischemic muscle damage. Conclusions In this clinical model of I/R injury no damage to the endothelium, antibody deposition or complement activation were observed during early reperfusion. However, an increase of pro-inflammatory cytokines and growth factors was shown, suggesting a contribution of these molecules in the early stages of I/R injury.

Early versus delayed surgical treatment in open hand injuries: a paradigm revisited

To date it remains unclear if a delayed surgical treatment of open hand injuries after more than 6 h may be detrimental to outcome. Previous investigations by McLain et al. (J Hand Surg Am 16:108-112, 1980 9), Nylen and Carlsson (Scand J Plast Reconstr Surg 14:185-189, 1991 10) could not find statistical proof of correlation between infection rate and delayed surgical treatment after open hand injuries up to 18 h. The current study was designed to investigate the outcome of early versus delayed surgical treatment after open hand injury.

[Hand transplantation - fiction or reality?]

Hand transplantation has been indicated in selective patients after traumatic upper extremity amputation and only performed in a few centers around the world for the last decade. In comparison to solid organ transplantation, there is a challenge to overcome the host immunological barrier due to complex antigenicity of the different included tissues, the skin being the most susceptible to rejection. Patients require lifelong immunosuppression for non life-threatening conditions. Minimization of maintenance immunosuppression represents the key step for promoting wider applicability of hand transplantation. Current research is working towards the understanding mechanisms of composite tissue allograft (CTA) rejection. Worldwide, in 51 patients 72 hands (21 double hand transplants) and once both arms have been successfully transplanted since 1998.

Aseptic tissue necrosis and chronic inflammation after irrigation of penetrating hand wounds using Octenisept®

Penetrating hand wounds are common and these are managed by thorough debridement. However, stab wounds without evidence of divided structures are often treated with irrigation using antiseptic substances, antibiotic therapy, and immobilization. Octenisept® (Schülke & Mayr Ltd) is a widely used antiseptic agent for disinfection of acute or chronic wounds. It has a broad spectrum of antiseptic efficacy and has become an antiseptic of first choice in many hospitals. Within a few months, four patients presented to us with chronic inflammation and severe tissue necrosis after irrigation of penetrating hand wounds with Octenisept®. Repeated surgery and debridement was required in all patients. Wound healing was prolonged and patients had persisting oedema. Penetrating hand wounds must not be irrigated with Octenisept®.

[Extraarticular proximal phalangeal fractures of the hand: Functional conservative management using the Lucerne Cast (LuCa) - a preliminary prospective study]

The purpose of our prospective study was to document the clinical and radiological results of conservative-functional treatment of extraarticular proximal phalangeal fractures without immobilisation of the wrist.

Artists' advance: decreased upper alpha power while drawing in artists compared with non-artists

Brain mechanisms associated with artistic talents or skills are still not well understood. This exploratory study investigated differences in brain activity of artists and non-artists while drawing previously presented perspective line-drawings from memory and completing other drawing-related tasks. Electroencephalography (EEG) data were analyzed for power in the frequency domain by means of a Fast Fourier Transform (FFT). Low Resolution Brain Electromagnetic Tomography (LORETA) was applied to localize emerging significances. During drawing and related tasks, decreased power was seen in artists compared to non-artists mainly in upper alpha frequency ranges. Decreased alpha power is often associated with an increase in cognitive functioning and may reflect enhanced semantic memory performance and object recognition processes in artists. These assumptions are supported by the behavioral data assessed in this study and complement previous findings showing increased parietal activations in non-artists compared to artists while drawing. However, due to the exploratory nature of the analysis, additional confirmatory studies will be needed.