Effect of Fat: Assessment of Apparent Diffusion Coefficient

Effect of Fat: Assessment of Apparent Diffusion Coefficient Abstract Objectives: Recent studies have indicated that excessive fat may confound assessment of diffusion in organs with high fat content, such as the liver and breast. However, the extent of this effect in the kidney, which is not considered a major fat deposition site, remains unclear. This study tested the hypothesis that renal fat may impact DWI parameters, and proposes a three-compartment model (TCM) to circumvent this effect. Methods: Using computer simulations, we investigated the effect of fat on assessment of apparent diffusion coefficient (ADC), intravoxel incoherent-motion (IVIM) and TCM-derived pure-diffusivity. In domestic pigs fed a high-cholesterol (Obese) or normal diet (Lean) (n=7 each), DWI parameters were calculated using IVIM and correlated to renal histology. IVIM-derived pure diffusivity was also compared among 15 essential hypertension (EH) patients classified by BMI (high vs. normal). Finally, pure diffusivity was calculated and compared in 8 patients with atherosclerotic renal artery stenosis (ARAS) and 5 healthy subjects using IVIM and TCM. Results: Simulations showed that unaccounted fat results in the underestimation of intravoxel incoherent-motion (IVIM)-derived pure-diffusivity, particularly at lower fat contents. Moreover, TCM, which incorporates highly diffusion-weighted images (b>2500s/mm2), could correct for fat-dependent underestimation. Animal studies confirmed lower ADC and pure-diffusivity in Obese vs. Lean pigs with otherwise healthy kidneys. Similarly, EH patients with high BMI had lower ADC (1.9 vs. 2.110-3 mm2/s) and pure-diffusivity (1.7 vs. 1.910-3mm2/s) than those with normal BMI.   Pure-diffusivity calculated using IVIM was not different between the ARAS and healthy subjects, but TCM revealed significantly lower diffusivity in ARAS. Conclusions: Excessive renal fat may cause underestimation of renal ADC and pure-diffusivity, which may hinder detection of renal pathology. Models accounting for fat contribution may help reduce the variability of diffusivity calculated using DWI. Keywords: Renal adiposity, Diffusion-weighted imaging, intravoxel incoherent motion, obesity.   Ã‚   Over the past two decades, diffusion-weighted imaging (DWI) has evolved to an important tool for studying neurological disorders (1-3), while application of this method for characterization of abdominal pathological conditions awaited improved hardware and robust pulse sequences over nearly a decade (4). In the kidney, DWI has been used to investigate chronic kidney disease (CKD) (5), renal lesions (6), and deteriorating allografts (7). Nevertheless, the contribution of tubular flow and hemodynamics to the apparent diffusion constant (ADC), the diffusion quantitative index of the single compartment mono-exponential model, complicates tissue characterization and renal DWI analysis (8). This encouraged implementation of models incorporating a larger number of compartments to differentiate pure diffusion from pseudo-diffusive components. Indeed, in the kidney the intra-voxel incoherent motion (IVIM) analytical method, which utilizes a two-compartment model associated with pure diffusion and flow, showed superiority over the mono-exponential decay model (9, 10). However, recent studies on hepatic DWI identified fat as a potential third compartment with a significant confounding effect (11, 12), even in non-steatotic livers (13, 14) or other organs (15). Abdominal DWI is typically performed using an echo-planar imaging (EPI) readout, which uses a water-only excitation. Selected excitation or fat suppression methods prevent contribution of the fat signal associated with peaks spectrally distant from water, but cannot effectively eliminate the signal from fat components with resonance frequencies close to water proton frequency. For instance, peaks between 4.2-5.3 ppm associated with triglycerides, which account for nearly 8.7% of the total in vivo fat content, remain unsuppressed (11). Moreover, in the kidney, which is located in the vicinity of bowel, susceptibility artifacts may significantly reduce the efficacy of spectral fat suppression. Because the diffusion constant of lipid molecules is orders of magnitude smaller than that in water an d remains nearly unattenuated over the conventional range of b-values, the amplitude of the fat signal, especially at high b-values, can be prominent compared to the attenuated water signal (16), and therefore has a considerable impact on DWI parameters assessment (17). The epidemic of obesity stresses the importance of characterization of the effect of ectopic fat on DWI parameters, particularly in subjects with high body mass index (BMI). Increased renal adiposity (18, 19) may potentially interfere with interpretation of DWI in the kidney in obese subjects, but to date this effect has not been evaluated. The aim of this study was to explore the effect of renal fat accumulation and suboptimal suppression on DWI parameters. We investigated this effect using computer simulations and verified the error in a large animal model of obesity, and in healthy subjects and in the presence of renal pathological conditions in humans. We hypothesized that residual MR signal from fat causes underestimation of renal ADC and IVIM pure-diffusivity, the magnitude of which may approximate a reduction in these parameters elicited by renal pathology. Moreover, we suggest that the fat-dependency of DWI parameters may be corrected by estimating the MR signal of excessive fat using heavily diffusion-weighted images. Assuming that an unattenuated fat signal acts as an independent compartment, we formulated our model by adding a third exponential decay term to the bi-exponential IVIM model to account for the contribution of fat: (1) In our notation, C and are the fractions of extravascular water and fat in the DWI signal intensity. Dfast, Dslow, andDfat are diffusion coefficients for extravascular water (pure-diffusivity), intravascular flow-dependent component (pseudo-diffusion), and fat, respectively. The product of the fat diffusion coefficient and the b-values, over the conventional range of b-values is small such that the exponential part of the third term can be approximated by one. This simplifies the last term in Equation (1) to a constant signal offset as follows: (2) Considering that at higher b-values (~1000 s/mm2) conventionally used in DWI, the water-component of the signal intensity decays to nearly a few percent of its value at b0 (b=0 s/mm2), while the fat-related fraction (FRF), f, remains nearly unattenuated over the imaging b-value spectrum, the magnitude of FRF and its impact on calculated DWI parameters becomes significant. I. Simulations Simulations in this study pursued four aims. First, to show that in the absence of fat signal, the three-compartment model (TCM) reduces to IVIM. This would essentially verify that a non-zero FRF is not merely a result of overfitting the data of an intrinsically two-compartment system into a three-compartment model, and in fact represents a third independent compartment. Second, to investigate the influence of FRF, as illustrated in equation (1), on the diffusion parameters calculated using the bi-exponential IVIM model. Third, to examine the effect of signal-to-noise ratio (SNR) on the accuracy of DWI parameters assessed using IVIM and TCM, particularly since increasing the degrees of freedom in TCM per se reduces the stability of the regularization methods. Finally, to test if in the presence of fat signal the DWI parameters calculated using IVIM and TCM would be b-value dependent. We simulated the total MR signal using the TCM, including fast and slow decays associated with intra- and extravascular fluid, as well as the FRF signal as a third compartment. Simulations were performed for diffusion parameters similar to DWI values reported for the kidney (10), over a range of FRFs (0-10%) and SNRs (2.5-50dB) (Table 1). IVIM and TCM were used to extract DWI parameters. In TCM, the total MR signal intensity for all b-values was subtracted by the signal intensity from the corresponding voxel of the high b-value (>2500 s/mm2) image, and the data were then fitted to a bi-exponential model. Table 1 shows the values used in the simulations. To verify the b-value dependency, DWI parameters were calculated from a set of b-values with the highest value being either 600, 1000, or 2000 s/mm2. II. Animal study All animal procedures followed the Guideline for the Care and Use of Laboratory Animals (National Research Council, National Academy Press, Washington, DC, 1996) and were approved by the Institutional Animal Care and Use Committee at Mayo Clinic. Fourteen domestic swine in this study were fed ad lib for 16 weeks. Seven animals consumed a normal diet (Controls) and the other half (Obese) a high fat/carbohydrate diet (5B4L; Purina Test Diet, Richmond, IN) containing (in % kcal) 17% protein, 20% complex carbohydrates, 20% fructose, and 43% fat and supplemented with 2% cholesterol and 0.7% sodium cholate. We have recently shown that this diet induces obesity and adiposity (20). Diffusion-weighted MRI scans were performed at the completion of diet. Renal volume and hemodynamics were assessed 2-3 days apart from MR scans, using multi-detector computed tomography (MDCT). Prior to each in vivo study animals were anesthetized (Telazol 5mg/kg and xylazine 2mg/kg in saline), and anesthesia maintained with intravenous ketamine (0.2 mg/kg/min) and xylazine (0.03 mg/kg/min) (for CT), or inhaled 1-2% isoflurane (for MRI) throughout the course of imaging. Blood pressure was measured using an arterial catheter during the MDCT scanning session. Animals were injected with 10cc of heparin and euthanized with a lethal intravenous dose of sodium pentobarbital (100 mg/kg) a few days after the in vivo studies. Then the kidneys were removed and immersed in saline containing heparin. The tissue was stored at -80 °C or preserved in formalin for histology. a. Diffusion-weighted Imaging (DWI) DWI was performed on a 3T scanner (GE Medical Systems, Milwaukee, Wisconsin) using a torso array coil. Images were collected using a single-shot echo-planar sequence with bipolar gradient. In all animals, 4-6 coronal slices in oblique planes were collected for b-values 50, 100, 200, 300, 600, 800 and 1000 s/mm2. MR parameters were set to TR/TE 1800/79ms, field of view 35cm, Bandwidth 648Hz/pixel, Number of averages 3, slice thickness 2.5mm, and matrix size 128128. All acquisitions were performed during suspended respiration. b. MDCT imaging Renal hemodynamics were assessed from contrast-enhanced MDCT images, as previously detailed (21). A pigtail catheter was advanced through the left jugular vein to the superior vena cava to inject contrast media during the scan. Then animals were moved to MDCT unit (Somatom Sensation 64; Siemens Medical Solutions, Forchheim, Germany). Following localization of the kidneys, a bolus of iopamidol (0.5 ml/kg over 2s) was injected, and after a 3-second delay, 140 consecutive scans were acquired over approximately 3 minutes. After the flow scan and an additional contrast injection, a volume study was performed. Axial images were acquired at helical acquisition with thickness of 0.6mm and resolution of 512512, and reconstructed at 5mm thickness. c. Lipid Panel Lipid (total cholesterol, triglyceride, high density lipid (HDL)) was measured (Roche) at the Mayo Immunochemical Core Laboratory from blood samples, and low-density lipid (LDL) was calculated. d. Morphological Studies Images were acquired using an ApoTome microscope (Carl ZEISS SMT, Oberkochen, Germany). Renal fibrosis was quantified by colorimetric measurements in 5 µm slides stained for trichrome. Tubular dilation was measured in Periodic acid-Schiff (PAS)-stained slides counterstained with Hemotoxylin. Intracellular lipid accumulation was assessed by colorimetric measurements in Oil-Red-O stained slides from frozen tissue counterstained with Hematoxylin. III. Human study The study was approved by the Institutional Review Board of the Mayo Clinic, in accordance with the Declaration of Helsinki and the Health Insurance Portability and Accountability Act (HIPAA) guidelines. All patients provided written informed consent before enrollment. Fifteen patients with essential hypertension (EH) were recruited from an on-going study, to study the effect of renal fat on DWI parameters. Patients were divided in two groups based on their BMI: an obese group (n=10, BMI≠¥30kg/m2) and a lean group (n=5, BMI 20-25kg/m2). Additionally, diffusion parameters assessments in healthy vs. impaired (post-stenotic) kidneys, with and without fat correction, were compared in eight patients with atherosclerotic renal artery stenosis (ARAS), and five healthy controls. a. DWI In patients 3-8 axial images were acquired on 3T scanner (GE Medical Systems, Milwaukee, WI and Siemens Medical Systems, Erlangen, Germany) with MR parameters TR/TE, Bandwidth, Slice thickness, matrix size, and b-values were set to 2000-2400/60-94ms, 1953 Hz/pixel, 7mm, 128128 or 160160, and 100, 300, 600, 900 (s/mm2) in the first study with EH patients. In ARAS and Control subjects the TR/TE were 2600-4286/59-112ms. Pure-diffusivity was calculated from b-values ≠¥300 s/mm2 and fat-related fraction was assessed from high b-values, 2000-2500 s/mm2. b. Clinical parameters and Lipid Panel Clinical and laboratory parameters including age, sex, weight, BMI, blood pressure, serum creatinine, estimated glomerular filtration rate (eGFR), and lipid panel levels were evaluated at study entry by standard procedures. IV. Data analysis a. DWI Pixel-by-pixel maps of quantitative indices of mono-exponential model, ADC, and bi- and tri-exponential models, IVIM and TCM parameters, respectively, were generated (Figure 1), as shown previously (22). The threshold for fast vs. slow components was set to 300s/mm2 in both animal and patient studies (23). Large cortical regions of interest (ROIs) were drawn on b0 DWI images and transferred to the maps as detailed before (22). Mean values of ADC and IVIM parameters were calculated by averaging values in all corresponding ROIs for all slices in the subject. b. MDCT Using contrast-enhanced MDCT in animals, single-kidney volume, GFR, perfusion, and renal blood flow (RBF) were calculated. To calculate renal function and hemodynamics, the cortical and medullary signal attenuation vs. time curves were fitted to an extended Γ-variate model. Regional blood volumes and mean transit times were calculated to estimate cortical and medullary perfusion and blood flows (products of perfusion and the corresponding volumes). Total RBF was assessed as the sum of cortical and medullary flows. Finally, GFR was evaluated using the slope of the cortical proximal tubular curve, as previously shown (21). Data Analysis software All analyses were performed in MATLAB ® (MathWork, Natick, MA, USA) and Analyzeâ„ ¢ (Biomedical Imaging Resource, Mayo Clinic, MN, USA). V. Statistical Analysis Simulation results are shown as mean  ± STD, and in vivo results as Median [First Quartile Third Quartile]. Minimum sample size was calculated using power analysis for minimum power value of 0.8. Non-parametric Mann-Whitney was used for comparison among groups. For p values

The Chocolate War by Robert Cormier :: The Chocolate War

The Chocolate War by Robert Cormier   Ã‚  Ã‚  Ã‚  Ã‚  The Chocolate War by Robert Cormier was a book that we read in class, it was about good and evil. It is about how the to forces battle for superiority over one another. The book tells how one of the sides over powers the other to claim its spot on top. The people are like pawns to two of the characters, Archie and Brother Leon because they use the people to get what they want from them, and will stop at nothing to get it. Both of characters will stop at nothing to have what they want, which is to have the power over the school.   Ã‚  Ã‚  Ã‚  Ã‚  The good characters even though few in number are willing to go the distance (especially for Jerry). Jerry is the main character of the story. He has a struggle with in himself to do the right thing. He mess with the wrong people in the school and they make him pay for it, because no one can mess with the Vigils and get away with it. He was to refuse to take chocolates for ten days. However he still refuses to take the chocolates after the ten days. Brother Jacques is another one of the good guys because he sees that Brother Leon is truely an evil man and abuses his power the power that he has over the kids. He saves Jerry at the of the story from the boxing match. Goober is a good person with a big heart, but is not to smart to get out when in to deep helping Jerry to get out. All that he wanted to do was to play football and to run.   Ã‚  Ã‚  Ã‚  Ã‚  There is more of a power struggle among the evil side for them to want to work together. Archie is the Vigils’ Assigner giver. Archie has a struggle with Brother Leon and Carter. First a struggle with Leon because both are trying to carrie the power of the school. Second with Carter both trying to control the Vigils. Carter the president of the Vigils puts Archie on probation tries to stab him in the back at the boxing match using the black box. He smashes Jerry in practice every day just because he can do the. Brother Leon is a sadistic teacher because of the things that he does to the kid in his class, like when he put Bailey in front of the class and smacked him on the cheek with a pointer.

Alternative Medicine and Conventional medicine

Shahrzad Nikkhah Professor Keafer English 200 29 november 2012 Alternative Medicine Growing up in a family that has been using herbal medicine for years became a motivation for me to further my knowledge of this ancient practice of alternative medicine . The world health organization has announced that about 65 and 80 percent of world’s population uses traditional medicine, since the growing belief is that to get cured of disease you need to get to the root of the problem, and reach beyond the physical body.According to all the research it seems that alternative medicine is more effective , more economical , less invasive and harmful than conventional medicine. While It has been proven that state of mind and body are linked directly , mind body medicine helps in healing the body by changing the person’s attitude which effects the immune endocrine and nervous system, while stressed mind interrupts the functioning of the immune system and causes disease. More and more peo ple are relying on the power of prayers , meditation , and herbal medicine to protect their body from negative effect of stress hormone and proper break down of food in body.It has been shown that alternative medicine has helped many with depression and chronic pain, hypertension, and diabetes. Conventional medicine is a quick fix which prevents the body from stimulating the immune system to fight an infection as in antibiotics which destroys the valuable bacteria that helps with digestion. Since the production of antibodies slows down, it prevents the future healing. CAM ( another name for alternative medicine ) helps promote natural healing process while it has by far less side effects and harm to the other organs resulting in a long term benefit.Due to low cost of CAM higher low income population can afford the health care, while the conventional medicine cost has been on the rise over inflation and wage growth. With the 13 percent of 38 million adults who use CAM in conjunction with conventional medicine in the last year the poorer population with no health insurance has been benefiting from this method of treatment, since herbs is easier to obtain , naturally available and do not to be researched.Although , alternative medicine is not completely reliable to be used on serious illnesses many Americans have turned to alternative practices since they have not seen any positive results from standard medical or surgical treatment or because the traditional treatments are too expensive or dangerous. Most alternative medicine principle is to eradicate the problem from its roots. With serious dedication , discipline , and change of life style alternative medicine is personalized to suit the needs of individual.Works Cited: Grodjesk,Joe. â€Å"Sociology Of Medicine Alternative Medicine. â€Å"customessaymeister, May 5,2001 web. Crisenri. â€Å"Pros and cons of alternative medicine. † page1,June 2008 Diggs, Charles â€Å"Alternative medicine research papp er. † Oct 20,2009 web. Epiro, E. and Nancy Walsh. â€Å"Alternative Medicine–Part Two: Mind Body Medicine–Expanding Health Model. † Patient Care 15 Sept. 1997: 127-145. Smith, Brad. â€Å"Alternative Treatments Gain Acceptance. † Denver Business Journal 18 July 1997: 2B-4B.

Slavery Issue essays

Slavery Issue essays In order for the south to remain strong and compete against other states, cotton had to keep flourishing, and for that to happen slavery was a necessity. Slave labor was required at all times, because it was such a useful crop. Also the South's climate was especially suited to the cultivation of cotton. It also didn't require expensive irrigation canals or costly machinery and so could be made profitable no matter on what scale it was being grown. Although one did not need slaves in order to cultivate cotton, large scale growing did require slaves to manage a farm. As a senator from South Carolina once said, "No! You dare not make war upon cotton; no power on earth dares to make war upon it. Cotton is King. James H. Hammond was born in the year 1807 and he served as Gov. of SC and as U.S. Senate. Hammond was an early believer in secession, but during the turmoil he began to doubt the wisdom of secession, thinking the South could attain its desired ends within the Union. In his speech called Cotton is King, Hammond targets the whites who dread the thought of a general emancipation of slaves, as that would encourage the blacks to entertain ideas of social equality with whites. Hammond also targets the white farm owners, and encourages them to keep the strict hold of the slaves, as abolishing slavery could lead to a downfall in the south. In addition, Hammond argues for the rightness of southern slavery, due to the creation of abundance cotton and its success in trades across Europe. He believed that the old south possessed strong bonds of unity that derived from slavery, and that slavery gave southern society a distinctive cast. Also the, white southerners benefited form the three-fifth s clause of the Constitution, and in order for that to keep on happening slavery was required. The southern state societies economy went through a major boom in the 1850s due the production of three-fourths ...

Free Essays on Mother Courage

Mother Courage and Her Children The story of Mother Courage and Her Children is one of progressive ruin in the face of war and it’s devastating consequence. As each of Courage’s children leave or die, the burden placed upon her is augmented. By the end of Brecht’s tale, Mother Courage is forced to, quite literally, carry her burdens on her own. As a director, a proper approach to the script would take this progression into account. To exemplify the corrosion of Mother Courage’s world, and the expansion of her burden, attention must be drawn to the wagon, the primary symbol of Courage’s hope and her duty. A possible approach to the symbolism of the wagon would be to increase its size from the beginning of the play to the end. By the final scene, Courage would be pulling a far larger burden, both literally and figuratively than at the beginning of her journey. Another dramaturgical element to be accounted for is that of music. Narrative songs of both hope and despair permeate the play, and are integral to its structure and rhythm. Action on stage should not cease during the songs, but continue as normal. As they are sung, sheets should be folded, knives sharpened and other daily tasks completed, thus changing the songs from capricious acts of artistry, to a necessary expression of powerful emotion. As is exemplified in Courage’s mute and mutilated daughter, Kattrin, the fruits of war have their consequence. Though Courage subsists on the ravages of war, it is the same conflict that ultimately destroys all that she loves. It is this irony that presents an inspiring challenge both dramaturgically and directorially.... Free Essays on Mother Courage Free Essays on Mother Courage Mother Courage It’s always important to be touched. Writers know and understand this idea. Whether the audience feels good or bad about whom or what you present is not as important as the fact that they feel something. Bertolt Brecht’s Mother Courage and Her Children is a perfect example of a work that doesn’t leave us in very high spirits but touches us in such a way that it becomes even more powerful than if it had. Throughout the play the title character, Mother Courage, is presented to us in such a way that the reader is usually left not knowing how to feel. We have with two choices. On the one hand she can be a money grubbing, self concerned woman who only cares about herself and those directly related to her money. On the other hand she can be considerate and caring mother who only wants to protect her children. It’s an issue the reader wrestles with many times over the course of the play. If you take everything at face value it seems that all Mother Courage is driven by is profit. But then one has to think . . . What’s is her motive? Is it her children? Are we completely misinterpreting Mother Courage’s intentions? Consider this: Mother Courage throughout the war does what she can to keep her daughter Kattrin â€Å"innocent.† Now as awful as it sounds prostitution is a pretty lucrative business. If Mother Courage was only driven by profit wouldn’t she decide that maybe selling Kattrin’s body would help her business? Mother Courage looses all three of her children at the end of the play. As each dies she just seems to pick up and move on, with a brief moment of sorrow. This is a characteristic that adds to the readers contempt for her, and rightly so. Wouldn’t you think the death of a child would affect a mother to the point of agony? But it doesn’t seem to reach Mother Courage on this level. Why is it, that in spite of losing all her children, Mother Courage fails to see the lig... Free Essays on Mother Courage Mother Courage and Her Children The story of Mother Courage and Her Children is one of progressive ruin in the face of war and it’s devastating consequence. As each of Courage’s children leave or die, the burden placed upon her is augmented. By the end of Brecht’s tale, Mother Courage is forced to, quite literally, carry her burdens on her own. As a director, a proper approach to the script would take this progression into account. To exemplify the corrosion of Mother Courage’s world, and the expansion of her burden, attention must be drawn to the wagon, the primary symbol of Courage’s hope and her duty. A possible approach to the symbolism of the wagon would be to increase its size from the beginning of the play to the end. By the final scene, Courage would be pulling a far larger burden, both literally and figuratively than at the beginning of her journey. Another dramaturgical element to be accounted for is that of music. Narrative songs of both hope and despair permeate the play, and are integral to its structure and rhythm. Action on stage should not cease during the songs, but continue as normal. As they are sung, sheets should be folded, knives sharpened and other daily tasks completed, thus changing the songs from capricious acts of artistry, to a necessary expression of powerful emotion. As is exemplified in Courage’s mute and mutilated daughter, Kattrin, the fruits of war have their consequence. Though Courage subsists on the ravages of war, it is the same conflict that ultimately destroys all that she loves. It is this irony that presents an inspiring challenge both dramaturgically and directorially....

Metaphorical Criticism of American Beauty Essay

Metaphorical Criticism of American Beauty - Essay Example As the paper declares the underlying message in the film is every human being’s quest for happiness and beauty, but this message is communicated through metaphors rather than stated directly in the dialogues. One of the most significant metaphors in the film is the use of the color red, as represented in the rose and rose petals that occur periodically in the film. The red symbolizes love and lust, yet it also symbolizes violence and death. Similarly, the metaphor of a garbage bag is used to present a message that is quite the opposite – that of beauty and transience. Each one of the characters in the film is involved in the same search – the search for happiness, although in each character’s case, the object of happiness is different. For the protagonist Lester, happiness lies in sexual conquest of his daughter’s friend by becoming youthful again, which reflects his desire to pull himself out of his current family situation where he is controlled b y his wife and her perceptions of what is socially correct. According to the report findings a metaphor is an outward symbol that helps in the process of attaining knowledge about the world. It is a group of things related in a particular manner in order to discover similar relations within another group, through the agents of language, categorization, comparison and contrast. It presents visually, the message that is being transmitted mentally, through the cognitive abilities of association.

Explain the Theme of a Short Story Essay Example | Topics and Well Written Essays - 500 words

Explain the Theme of a Short Story - Essay Example Bahiyya suffers from discrimination in her own family. Born of a Muslim family, she needs to succumb to the decrees of her religion. In the Muslim tradition, men are considered powerful than women. In fact, they are vested with the power to rule over women, thus they are given the privilege to dominate the women around them, including their mother and older siblings. In the story, Bahiyya’s mother tells her, â€Å"When your father’s gone, he’ll be the man in the family and what he says goes†¦Ã¢â‚¬ (365). This makes Bahiyya feel how unfortunate it is for her to be a woman. Bahiyya also questions the absurd traditions in her society. When she was younger, she experienced female genital mutilation (FGM). According to the World Health Organization website, FGM is a procedure that intentionally causes injury to the female genitals for non-medical reasons. Bahiyya mentions this experience using a metaphor as she compares her genitals to the mulberry, thus she says that the women â€Å"cut the mulberry with a razor† (368). Rifaat did not mention the term FGM to make it sound metaphoric and to illustrate the innocence of Bahiyya but she suggests that FGM can affect a woman’s sexual fulfilment as Bahiyya confesses, â€Å"I wasn’t all that happy with him†¦perhaps the reason was what those women did to me with the razor when I was a young girl† (367). Rifaat may have used â€Å"perhaps† to suggest Bahiyya’s ignorance but readers may interpret it as a means to sound less assuming so as not to make the work too contr oversial. The story also tackles the unjust marital arrangement in the Muslim tradition. As seen in the story, Bahiyya is in love with Hamdan but is made to marry Dahshan. The inability of women to decide for marriage is still an issue among the Muslims until now. In the story, Rifaat uses the romance between Hamdan and Bahiyya to gain the