Search

Recent trends in international travel and emigration have brought the practice of female circumcision, also known as female genital mutilation, to the awareness of an increasing number of physicians and public policy agencies in developed countries. The main reason for the continuation of this practice is deeply held tradition. The high incidence of complications attending the procedure leads to a poor quality of life and potential life-threatening problems. Female circumcision serves no biologically useful purpose and perpetuates the subjugation and social deprivation of females. Suggestions for the eradication of this custom include universal education of females and public enlightenment campaigns; legislation tends to send the practice underground. This review is aimed at providing objective background information on female circumcision to residents in obstetrics and gynecology. An effective solution to this problem requires not just knowledge but also wisdom in order to offer a compassionate approach to the management of these women. The American women’s health care specialist should be well informed on this issue because of the increasing likelihood of contact with these women. It is also hoped that health care providers will become sensitized to the point of designing and participating actively in effective schemes for the worldwide eradication of this practice.

Objectives: Retrograde cardioplegia has been widely used for the protection of adult hearts during cardiac operations. Its efficacy to protect immature myocardium is still unclear. This study was designed to assess the effects of retrograde cardioplegia on myocardial perfusion and energy metabolism in immature hearts. Methods: Piglet hearts were divided into 3 groups. Hearts in group 1 were used to assess myocardial perfusion of retrograde cardioplegia by means of magnetic resonance imaging. Hearts in groups 2 and 3 were used to assess the effects of retrograde cardioplegia on myocardial energy metabolism by use of phosphorus 31 magnetic resonance spectroscopy. Results: Magnetic resonance images showed that perfusion with retrograde cardioplegic solution was heterogeneous. A perfusion defect was noted during retrograde cardioplegia in the right ventricular wall and in a portion of the posterior wall of the left ventricle in 4 of 6 hearts. Phosphorus 31 spectra showed that at the end of 45-minute retrograde cardioplegia, myocardial intracellular pH was 6.83 ± 0.17 and phosphocreatine was 53.5% ± 27% of its prearrest value. The adenosine triphosphate level, however, remained normal throughout the retrograde cardioplegia period. Last, the hearts subjected to retrograde cardioplegia or antegrade cardioplegia showed similar and complete metabolic and functional recovery during reperfusion. Conclusions: Retrograde cardioplegia provides heterogeneous perfusion. Its ability to protect the right ventricular myocardium is poor and varies between individuals. Myocardial perfusion provided by retrograde cardioplegia is slightly less than that needed to sustain normal myocardial energy metabolism under normothermic conditions. (J Thorac Cardiovasc Surg 2000;119:1102-9)

Oocyte retrieval in a stimulated in-vitro fertilization treatment cycle was unsuccessful when inadvertently carried out 12 h after the administration of human chorionic gonadotrophin (HCG) injection. Repeat follicular aspiration at 36 h post-HCG injection recovered 20 oocytes, out of which 16 metaphase-II eggs were subjected to intracytoplasmic sperm injection and eight became fertilized. Uterine transfer of three cleaving embryos resulted in a singleton pregnancy which went to term and a healthy female infant was delivered. Our experience shows that in addition to issues of HCG bioavailability to the developing follicles, the temporal relationship between HCG administration (or the luteinizing hormone surge) and follicular aspiration is also an important consideration in the determination of the aetiology of the empty follicle syndrome.

A retrospective study was carried out to assess the potential of 16 hysterectomized women to achieve surrogate pregnancies. A total of 11 patients completed 16 cycles of assisted conception treatment incorporating in-vitro fertilization and gestational surrogacy. Three other women failed to respond to ovulation induction while two more patients produced few oocytes which also failed to fertilize. Six host mothers became pregnant thereby giving a pregnancy rate of 37.5% (6/16) per patient and embryo transfer and 27.3% (6/22) per cycle of treatment commenced. Two women later miscarried, three have given birth to twins and the remaining host has delivered a male infant. The commissioning mother's age was closely related to occurrence and continuation of pregnancy in the host. Hysterectomized women demonstrate varying patterns of response to assisted conception treatment but gestational surrogacy generally appears to be a feasible option especially in younger patients.

After mapping the current notions of African agency discourse, the article suggests a more dialogical approach to the discourse, the partnership notion of African agency discourse. This suggestion is based on the view that African leaders and academics are apparently not yet ready to walk unaided. Therefore, the article proposes a broadened African agency that involves other races. Specifically, it stresses the need for a discourse that goes beyond a black identity as a category for an African agency discourse to be African proper. The essay further suggests that the contribution of the “other” in the discourse should be cherished by black and white discussants.

Liberation, it is often argued, is no longer the most helpful metaphor for the present situation in (South) Africa, which needs to capture the complex social and theological challenges ahead. There is a popular view that the new social and political changes brought with them new challenges and responsibilities for theologians in Africa, in general, but South Africa and Nigeria in particular. This essay attempts to examine the South African and Nigerian social and political challenges of the past 10 years. It argues that such challenges should shape, redirect the tasks, contents and methods of theology of African theologians toward “developmental” issues such as poverty, HIV/Aids, wars, public life and public morality, as they seek to address the social and political challenges of the new millennium.

This essay explores the role of the “ordinary reader” in Gerald O West’s hermeneutics. Firstly, it offers a brief overview of the background context of liberation from which West developed his hermeneutics. Secondly, West’s hermeneutics of liberation in its South African context is explored. Thirdly, the role of the so-called “ordinary reader”, especially in the interpretive process, in West’s hermeneutics of liberation, is examined. The essay argues that the voices of the “ordinary readers” in the collaborative reading need to be clearly evident, so that it does not seem as though the socially engaged biblical scholar is simply reading through the “ordinary readers”.

Pseudomyxoma peritonei is an intra-abdominal neoplasm with obscure origin and an indolent but relentless course. The cause of death is usually malignant cachexia and/or metastasis following repeated laparotomy to evacuate the intraperitoneal mucinous material. Different combinations of treatment modalities including surgery, chemotherapy and radiotherapy have failed to effect a cure or proper control of the disease. We have evaluated the feasibility of laser therapy in two cases. The disease is well under control and the patients are well. Our recommendation is that repeated laparoscopic laser ablation should have a role in the treatment of pseudomyxoma peritonei.