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The underlying hypothesis of this PhD is that the negative impact of adjuvant endocrine therapy on genitourinary symptoms in postmenopausal women with early breast cancer has been underestimated in clinical trials and that there are a myriad of genitourinary symptoms related to or exacerbated by endocrine therapies that are commonly not reported by women to their oncologists. These symptoms can be troublesome and may lead to noncompliance with treatment, especially if associated with other side effects. This issue has not been comprehensively addressed, resulting in uncertainty regarding the frequency and severity of genitourinary adverse effects associated with antiestrogens and their potential impact on quality of life (QoL). Furthermore, no studies have comprehensively and prospectively evaluated the full range of genitourinary symptoms from before therapy begins and over time. These symptoms include urinary frequency, urgency, incontinence, dysuria, prolapse among others. This study fills an important gap in the current literature and is clinically important as interventions could be used to better manage and treat many of these symptoms.A number of data collection methods and instruments were used in this project, selected on their ability to address the proposed research questions. Using a qualitative approach, with semi-structured interviews, Study I sought an in-depth insight of the genitourinary symptoms experienced by women with early breast cancer on antiestrogen therapy and an understanding on how symptoms impact on daily life and sexual function. Study II employed a prospective design, using carefully selected validated instruments, to measure the prevalence and severity of genitourinary symptoms in postmenopausal women with breast cancer (prior to adjuvant endocrine therapy) and documented the trajectory of symptoms over time. The impact of genitourinary symptoms on sexual function and QoL was also investigated. The study attempted to identify predicto

As part of our continuous effort to elucidate the biochemical and immunological nature of human sperm surface antigens, monoclonal antibodies to human spermatozoa were generated by improved hybridoma techniques. Following immunizations with the membrane fraction of human spermatozoa and cell fusions, hybrid cells were cultured in a semi-solid HAT-selection medium to maximize the number of monoclones recovered. Subcultures were made in liquid phase 7 to 10 days after cell fusions by removing colonies from the initial medium. Based on the results of screening by microplate enzyme-linked immunoassay, 143 of 552 initial clones were found to secrete antibodies to human sperm antigens. More than one-hundred independently derived hybrid cell lines were established. Using indirect immunofluorescent procedures, 62 cell lines were shown to produce antibodies to surface antigens of human spermatozoa. Unique sperm antigens that react with monoclonal antibodies were identified by the SDS gel/protein blot radioimmunobinding method. Sperm agglutinating and immobilizing antibodies were exhibited by 4 and 15 hybrid cell lines, respectively. Fourteen of the monoclonal antibodies also exhibited cross-reactivity with methanol-fixed sperm cells of the rabbit or mouse or both whereas a reaction was not seen with viable sperm of these species. Generation of monoclonal antibodies against a wide spectrum of human sperm antigens should facilitate future investigations regarding immunologic-associated human infertility and fertility control.

The rising caesarean section rate is becoming a cause for concern among many obstetricians all over the world more so in developing countries where there is strong aversion to caesarean section. A five year study was conducted between 1998 to 2002 to evaluate incidence of caesarean section in the University of Calabar Teaching Hospital and factors that influence the rising trend in caesarean section rate in our environment and also to find out the case fatality rate associated with this surgical operation. Caesarean section accounted for 19.8% of the total deliveries while spontaneous vaginal delivery accounted for 75.6%. Other modes of deliveries included assisted breech delivery (2.8%), vacuum (1.5%), forceps – (0.5%), destructive operations (0.14%). The caesarean section rate increased progressively from 17.9% in 1998 to 21.9% in 2002. Emergency caesarean sections (80.0%) were more frequently performed than elective cases (20.0%). Majority of the patients (82.9%) were booked while only 17.1% were unbooked. The commonest indication for emergency caesarean section was obstructed labour due to cephalopelvic disproportion (25%), followed closely by fetal distress (13.9%). The case fatality from caesarean section was calculated as 1.29%. It is obvious that there is increase in the caesarean section rate in our environment, which is in line with what is happening in the developed countries where the operation is more liberally used. In consonance with finding in other Teaching Hospitals, caesarean section appears to be on the increase in Nigeria. Although it has been suggested that increased rates of caesarean section would reduce the unusually high perinatal mortality in this area, this has not been subjected to objective scientific analysis. Keywords: caesarean section, cephalopelvic disproportion, obstructed labour Mary Slessor Journal of Medicine Vol. 5(1), 2005: 41-45

Pregnancies associated with fetal macrosomia in the University of Calabar Teaching Hospital, Calabar, over a seven years period were studied. The aims were to establish the incidence of fetal macrosomia and possible risk factors associated with macrosomic births. The incidence of macrosomic births was 4.0% or 1 in 25 deliveries. Mean maternal age was 27.2 years. About 58% of women were para 5 and above. Sex ratio of babies showed a male predominance of 2.1 to 1. History of previous macrosomic birth was obtained in 28.0% of cases. Maternal weight greater than 90kg was observed in 31.4%, gestational diabetes in 2.6% and post-term pregnancies in 9.6% of cases. Main disorder of labour were obstructed labour (14.4%) and prolonged second stage of labour (5.2%). The use of instrumental vaginal delivery was significantly higher in macrosomic than in non-macrosomic births (x2 = 14.34 p=0.0001). However the use of abdominal delivery in macrosomic birth was not significantly higher than in non-macrosomic births (x2=0.22 p=0.6415). Fetal macrosomia is a cause of peri-natal morbidity and mortality in Calabar. There is a call for a high index of suspicion whatever the identified risk factors are present. Key Words: Fetal macrosomia, incidence, and associated risks. Mary Slessor Journal of Medicine Vol.4(1) 2004: 32-36

Objective: To assess the indications for and outcomes of primary caesarean section (PCS) perfomed in nulliparous and grandmultiparous women in the Abha region of Saudi Arabia. Methods: A retrospective cohort study. Materials: 393 nulliparous women (para 0) (NPG) and 432 grandmultiparous women (parity>5) (GMPG) who had PCS at the Abha Maternity Hospital (AMH) over a 3-year period, (1997-1999) formed the basis of the study. Results: The PCS rates in NPG and GMPG were 19.4% and 18.3% respectively with no statistically significant difference. (p>0.05). There were statistically significant differences between the two groups regarding the mean age, blood loss during surgery, post operative haemoglobin, and birth weight were compared, p 0.05. The most common indication for surgery in the two groups of patients was fetal distress (NPG =28%, GMPG = 25%: p=NS), followed by failure of progress in labour. (NPG = 22.7%, GMPG = 21.6%, p = NS). Antepartum haemorrhage (APH) was the indication for PCS in 6.8% of the NPG and 13.9% of the GMPG, (p <0.05). Multivariate linear regression analysis indicated that maternal age and booking status significantly affected birth weight (p=0.004,p=0.022 respectively). However, neither birth weight nor low Apgar score was affected by the indications for CS or parity. While there were no perinatal deaths in the series, no statistically significant difference was found between the two groups with regards to low Apgar score (0.05. Conclusion: The major indications for PCS were the same in the NPG and GMPG in our study while the CS rates were similar in both groups. However, APH and its inherent complications occured more commonly in the GMPG. Neonatal morbidity was similar in both groups of women, but the mean birth weight was significantly higher in the GMPG. However, in order to reduce the high CS rate in these groups of patients, and in our obstetric population in general, it is suggested that CTG be used appropriately in high risk women and tha

Spiritual-church based health clinics identified by public health coordinators were visited, between May 2002 and September 2002. Practitioners were interviewed regarding their obstetric practices and facilities available to them. The 47 spiritual church based birth places were located in urban and sub-urban area, with majority of labour rooms attached to the churches. Fifteen (36.9%) of each birthing places had concrete floor, running (tap) water and electricity. Thirty-three (70.2%) had vono beds while 15(31.9%) had babies' cots, and orthodox delivery instruments in 10 (21.3%). For conducting delivery, 33 (70.2%) used delivery couch or wooden tables, 9(11.1%) had native earthen bed while 5(10.6%) conducted delivery on mats spread on the floor. The attendants were women aged between 25 and 65 years with 20 (20.6%) married to Pastors in charge of the church, and 54 (55.7%) had no formal education. Twenty-one (44.7%) of the centers kept delivery records with no records of deaths or complicated cases. Twenty-eight (59.6%) centers performed vaginal examination during pregnancy and out of these 17 (60.7%) used their bare hands lubricated with olive oil. All attendants prescribed prayers and fasting at least monthly to pregnant women with administration of “holy water” and olive oil. Their predictions of complicated cases were based on God's revelation in 21 (44.7%). During delivery, attendants in 14 (29.8%) centers used gloves while 33 (70.2%) used bare hands with or without olive oil. Regarding what each center does when confronted with complications, majority 26 (55.3%) offer prayers and invite prayer band, while 14 (29.8%) refer patients to orthodox health facilities. Suggestions are made on how to improve their quality of obstetric care with the aim of reducing maternal mortality in our environment. Mary Slessor Journal of Medicine Vol.3(2) 2003: 51-56

A qualitative comparative study of the bacterial flora of the vagina and cervix of 90 non-pregnant women of childbearing age (18-35 years) in Calabar was undertaken. The study revealed that both aerobic and microaerophilic organisms as well as the strictly anaerobic bacteria constituted the microflora of the lower genital of this group of women. Of the 90 women sampled, Lactobacilli were the most frequently isolated organism in both the cervix and vagina, occurring in 62.2% and 75.6% and the samples respectively. Proteus species were the least in incidence, occurring in only 4% of either the cervical or vaginal specimens. The following pathogenic organisms were isolated in both the vagina and cervix: Escherichia coli, Staphylococcus aureus, Candida albicans, Clostridium species and Beta-haemolytic Streptococci. In general, the same types of organisms were isolated in both the cervical and vaginal samples, although the incidence in the two sources varied. Mary Slessor Journal of Medicine Vol.3(2) 2003: 1-4

A ten-year review of the socio-demographic determinants of eclampsia was conducted at the University of Calabar Teaching Hospital (UCTH) Calabar from January 1988 to December, 1997. There were 12.749 deliveries during the study period, with 38 documented cases of eclampsia, giving an incidence of 3.0 per 1000 births. The mean age of the eclamptics was 21.3 years and mean parity was 1.3 children. The incidence of twin gestation among exclamptics was 158 per 1000 births. Five (13.2%) patients had past histories of eclampsia, while in 7 (18.4%) cases history of change of spouse was obtained in the index pregnancy. Thirty three (86.8%) patients were unbooked for antenatal care and eclamptic fits occurred more often in the antenatal period (55.3%). Majority of patients (39.5%) had no formal education and 34.25% were subsistence farmers living in the suburbs of Calabar. More cases of eclampia presented in the rainy season (May to October) than in the dry season (November to April) – 63.2% versus 36.8%. Knowledge of the socio-demographic determinants of eclampsia can be used in planning measures to reduce the incidence of this preventable obstetric emergency. Mary Slessor Journal of Medicine Vol.3(2) 2003:72-74

Risk-stratification is an essential step in planning of the treatment of patients with endometrial carcinoma, as it allows the omission of lymphadenectomy and/or adjuvant treatments in patients who are at low risk for extrauterine spread and have a good prognosis. This thesis consists of three cohort studies and one meta-analysis that were conducted to evaluate the reliability of methods that are currently available for the risk-stratification of endometrial carcinoma, and to develop new methods that might be clinically applicable. Cohort studies were based on a sample of 1166 women who were surgically treated for endometrial carcinoma at the Department of Obstetrics and Gynecology, Helsinki University Hospital, between January 2007 and December 2013. In the first study, previously recognized risk factors for an advanced stage and poor outcome were used to create a calculatory score to predict lymph node and distant metastasis in endometrial carcinoma. The score combining weighted risk factors was: (2 x leukocytosis) + (3 x thrombocytosis) + (7 x elevated CA125) + (4 x preoperative high-risk histology, defined as grade 3 endometrioid or nonendometrioid carcinoma). Depending on the number of risk factors of an individual patient, the score ranged from 0 to 16 points. Using six as the cut-point for positive and negative test results, the area under curve for this total score was 0.823, with 71.6% sensitivity, 75.2% specificity, 25.9% positive predictive value, and 95.7% negative predictive value. In the second study, the reliability of macroscopic pelvic lymph node findings at surgery in predicting para-aortic metastasis was evaluated. Lymph nodes were considered grossly positive based on size and morphology. In patients who underwent comprehensive lymphadenectomy (n = 117), grossly positive pelvic nodes predicted para-aortic metastasis with a sensitivity of 52.4% and specificity of 93.8%. The positive and negative likelihood ratios were 8.4 and 0.51, respectively. Th, Kohdunrunkosyöpä on länsimaissa yleisin gynekologinen syöpä, sen ilmaantuvuus on lisääntymässä. Suomessa uusia kohdunrunkosyöpätapauksia todetaan lähes 900 vuodessa. Kohtuun rajoittuneessa taudissa ennuste on hyvä, jopa 90% potilaista on elossa viiden vuoden kuluttua diagnoosista. Jos leviämistä todetaan, ennuste huononee selvästi. Tyypillinen ensioire on postmenopausaalinen tai nuoremmalla poikkeava verinen emätinvuoto. Tavallisesti diagnoosiin päästään kohdun sisälimakalvolta otetusta kudosnäytteestä. Vaginaalinen ultraäänitutkimus on osa perusselvittelyjä. Muita kuvantamistutkimuksia, kuten magneettikuvausta ja tietokonetomografiaa, käytetään todetun kasvaimen piirteiden tarkempaan selvittelyyn ja imusolmuke- ja muiden etäpesäkkeiden etsimiseen. Kasvaimen ominaispiirteiden perusteella voidaan kohdunrunkosyöpäpotilaalle ennen hoitojen aloittamista määritellä riskiluokka taudin leviämisen riskin suhteen. Kohdunrunkosyövän hoidon perusta on leikkaus, jonka laajuuden määrittää leikkausta edeltävän riskiluokituksen tulos. Matalassa riskiluokassa pelkkä kohdun, munasarjojen ja munajohtimien poisto on riittävä hoito. Kohtalaisen ja suuren riskin luokissa poistetaan kohdun ja sen sivuelinten lisäksi paikalliset imusolmukkeet lantiosta ja para-aortaalisesti (vatsa-aortan ympäriltä). Leikkauksen jälkeisten liitännäishoitojen (sädehoito ja/tai solunsalpaajahoito) käyttö päätetään usein sen perustella, löytyykö lopullisessa patologin tutkimuksessa imusolmukkeista etäpesäkkeitä vai ei. Nykyisin käytössä olevat riskiluokitusmenetelmät toimivat puutteellisesti. Riski tulee usein ali- tai yliarvioiduksi, mikä altistaa potilaan ali- tai ylihoidolle. Väitöskirjatutkimuksen tavoitteena oli kehittää uusia menetelmiä kohdunrunkosyövän imusolmuke-etäpesäkkeiden riskin arvioimiseen, ja arvioida olemassa olevien menetelmien toimivuutta. Aineistona oli 1/2007 ja 12/2013 välisenä aikana HYKS Naistentautien ja synnytysten yksikössä leikatut kohdunrunkosyöpäpotilaat. Sairauskertomuksista et

High coverage amongst those at risk and a high attendance rate are essential in achieving a good impact in a cervical cancer screening programme. In Finland, attendance in the programme is approximately 70% with a slight decreasing trend. There is wide variation in the current invitation practice between municipalities. The introduction of human papillomavirus (HPV) testing in cervical cancer screening has brought about a new possible means of improving attendance rates, as HPV-testing can be performed on self-collected samples. This offers the opportunity to supply sampling devices directly to the homes of the women (self-sampling). The aim of this study was to investigate the effects and feasibility of using self-taken samples for HPV-testing to conduct cervical cancer screening of non-attendees to the Finnish cervical screening programme. The effect on attendance to the screening programme, on overall screening test coverage (including also testing outside the screening programme), on the yield of precancerous lesions detected by screening and on the costs of a screening programme were assessed, as were women s views on this new screening modality. The effects of self-sampling were first studied as a first reminder (i.e. among non-attendees after the primary invitation) in a randomized setting in comparison to a reminder letter, and then in a non-randomized setting as a second reminder after two invitation letters. As a first reminder to non-attendees after the primary invitation, a self-sampling test resulted in somewhat higher attendance than a reminder letter. The difference was small, and in terms of resulting costs (price per extra screened woman and price per detected CIN2+ lesion), a reminder letter with a pre-assigned appointment time is a more feasible choice than a self-sampling test. However, self-sampling can be used to increase screening attendance as a second reminder after two invitation letters. Overall attendance rates increased by 4-8%, and the, Kohdunkaulan syövän seulontaohjelman tehokkuuteen vaikuttaa ohjelman peittävyyden sekä diagnostiikan ja hoidon laadun lisäksi ennen kaikkea osallistumisaktiivisuus. Suomessa joukkotarkastuksiin osallistuu nykyisin alle 70 % kutsutuista. Kuntien kutsukäytännöissä on varsin suuria eroja. Uusi mahdollisuus parantaa seulonnan osallistuvuutta ovat naisten itse kotona ottamat näytteet, joista laboratoriossa tehdään papilloomavirus (HPV) -testi. Tässä väitöskirjatutkimuksessa selvitettiin mahdollisuutta käyttää kotona tapahtuvaa näytteenottoa ensimmäistä kertaa Suomen seulontaohjelmassa. Seulontaan osallistumattomille naisille lähetettiin kotiin näytteenottoväline, ja seurattiin menetelmän vaikutuksia seulontaohjelman osallistuvuuteen, seulontatestien peittävyyteen (sisältäen myös ohjelman ulkopuoliset näytteet) ja seulonnassa todettujen syövän esiasteiden määrään. Lisäksi selvitettiin vaikutuksia kustannuksiin ja naisten kokemuksia tästä uudesta seulontatavasta. Tutkimuksen ensimmäisessä osassa näytteenottoväline lähetettiin ensimmäisen kutsun jälkeen osallistumattomille naisille ja menetelmää verrattiin satunnaistetussa asetelmassa kirjalliseen uusintakutsuun. Kotinäytteenotolla saavutettiin hieman korkeampi osallistuvuus kuin kirjallisella uusintakutsulla osallistuvuus nousi uusintakutsulla 6-14 % ja kotinäytteenotolla 17 %. Ero kokonaisosallistuvuudessa jäi kuitenkin niin pieneksi, että kotinäytteenoton korkeammat kustannukset eivät tasoittuneet. Kotinäytteenottoa voidaan kuitenkin suositella käytettäväksi kolmantena kutsuna niille, jotka eivät ole osallistuneet kahden kirjallisen kutsun jälkeen. Näin käytettynä osallistuvuus nousi kotitestillä 4 8 %, ja uusintakutsulla ja kotitestillä yhteensä 12 23 %. Samalla seulonnassa todettujen esiasteiden määrä lisääntyi 25 33 %. Valtaosa kotinäytteellä seulontaan osallistuneista oli kuitenkin käynyt lähiaikoina seulontaohjelman ulkopuolella Papa-kokeessa, joten vaikutukset testien kokonaispeittävyyteen jäivät pienemmiksi kuin o

Hypertension is a common medical problem encountered during pregnancy. New-onset hypertension, pregnancy-induced hypertension (PIH) with (pre-eclampsia) or without proteinuria develops in previously normotensive women. PIH has been found to be a state of insulin resistance and sympathetic over-activity. Angiopoietin-like protein 6 (Angptl6) and adipocyte fatty acid-binding protein 4 (FABP4) seem to be insulin-sensitivity regulators and they could serve as insulin sensitivity biomarkers before and during complicated pregnancy. This study consists of five sub-studies with four different study populations. In the first and second prospective observational studies there were 72 relatively overweight (BMI more or as much as 24 kg/m2) nulliparous women. In the study we assessed at 24 and/or 32 weeks of gestation predictive parameters associated with subsequent pre-eclampsia. Insulin sensitivity was assessed via the Matsuda insulin sensitivity index (ISI) and by way of homeostatic model assessment of insulin resistance (HOMA-IR). Maternal serum levels of FABP4, high sensitivity C-reactive protein (hs-CRP), androgens, and plasma noradrenaline levels were determined. In a subgroup of 47 women, serum concentrations of Angptl6 were quantified. In the third study blood pressure was measured in different body positions and sympathetic activity was assessed by way of noradrenaline and adrenaline levels for 36 women. In the fourth study diurnal blood glucose profiles were assessed in 178 women with gestational diabetes mellitus (GDM). In the fifth study, 37 women with a history of pre-eclamptic or with prior normotensive first pregnancies were studied 23 24 years after delivery. Insulin sensitivity was assessed via the Matsuda whole-body ISI and serum concentrations of androgens were assessed. Relatively overweight women who subsequently developed PIH had no evidence of insulin resistance, hyperandrogenism or inflammation at 24 or 32 weeks of gestation compared with those who rema, Koholla oleva verenpaine on yleinen raskautta komplisoiva tila. Raskaus voi indusoida aiemmin terveellä naisella verenpaineen nousun, johon liittyy virtsan valkuaista (pre-eklampsia) tai verenpaineen nousun ilman virtsaan erittyvää valkuaista. Raskauden indusoiman verenpainetaudin taustalla on havaittu olevan metabolisia tekijöitä, kuten lisääntynyt insuliiniresistenssi (IR), ja merkkejä sympaattisen hermoston yliaktiivisuudesta. Angiopoietiinin kaltainen proteiini 6 (Angptl6) ja rasvasolujen rasvahappojen sitojaproteiini 4 (FABP4) ovat uusia insuliiniherkkyyteen vaikuttavia proteiineja, jotka voivat toimia insuliiniherkkyyden biomarkkereina ennen komplisoitunutta raskautta tai sen aikana. Väitöskirjatyö koostui viidestä osatyöstä. Ensimmäisessä prospektiivisessa seurantatutkimuk-sessa oli 72 suhteellisen ylipainoista (BMI enemmän tai yhtä paljon kuin 24 kg/m2) ensisynnyttäjää, joilla oli lisääntynyt riski sairastua raskauden indusoimaan verenpainehäiriöön. Heidän insuliiniherkkyytensä määritettiin 24. raskausviikolla. Raskausviikoilla 24. ja 32. määritettiin seerumin FABP4-tasot, tutkittiin onko naisilla merkkejä sympaattisen hermoston yliaktiivisuudesta tai inflammaatiosta. Toisessa osatyössä määritettiin 47 naisen alaryhmässä seerumin Angptl6-tasot 24. ja 32. raskausviikoilla. Kolmannessa osatyössä tutkittiin 36 naisella asennonmuutoksen vaikutusta sympaattisen hermoston aktiivisuuteen pre-eklamptisessa raskaudessa. Neljännessä osatyössä tutkittiin verenpainehäiriön vaikutusta 178 raskausdiabeetikon verensokerin vuorokausikäyrään. Viidennessä tapaus-verrokki -tutkimuksessa oli 37 premenopausaalista naista, jotka tutkittiin 23 - 24 vuotta joko pre-eklamptisen tai normotensiivisen ensimmäisen raskauden jälkeen. Heidän androgeeni-pitoisuutensa analysoitiin, insuliiniherkkyytensä mitattiin ja tutkittiin metabolisen ja polykystisten munasarjojen oireyhtymän esiintyvyys. Suhteellisen ylipainoisilla raskauden aikaiseen verenpainehäiriöön sairastuneilla naisilla ei ole m

Objectives To evaluate the feasibility, applicability and the value of customised symphysio fundal height (SFH) charts developed for women of Indian origin in the United Kingdom (UK: CSFH – In chart) and women of African origin in the UK (CSFH – Af chart) in detecting fetal growth restriction and predicting low birth weight (LBW) of the neonate in a Lankan population, and to compare these results with the results obtained from the SFH chart currently used in Sri Lanka (FHB chart) and another SFH chart which uses a range of plus or minus 2-3 cm of the value of the gestational age in weeks as the reference range (GA ± 2 to 3 cm chart). Methods Pregnant women (n = 416) with confirmed periods of gestation (POG) of <22 weeks and having a singleton fetus and with no obstetric complications, had their age, parity, POG and Body Mass Index (BMI) documented. Their SFH were measured at four weekly, fortnightly and weekly intervals between 20 - 28, 28 - 36 and 37 - 41 weeks respectively and plotted on the CSFH – In chart, CSFH – Af chart, FHB chart and the GA ± 2 to 3 cm chart. The gestational age at delivery and the birth weight were recorded. Pre term deliveries were excluded leaving 401 participants for analysis. Results There were 164 (39.4 %) primigravidae, 76 (18.9 %) had low BMI and 71 (17.7 %) had a high BMI. Maternal BMI at booking was positively correlated to the birth weight of the baby but not the parity. In detecting LBW at term, the CSFH – In chart had the best sensitivity, specificity, positive predictive value, negative predictive value, and the likelihood ratios. Of the two non customised charts the GA ± 2 to 3 cm chart was better than the FHB chart. Conclusions Until a customised SFH chart is developed for Sri Lanka, the CSFH – In chart or the GA ± 2 to 3 cm chart should be used for antenatal monitoring of fetal growth. DOI: http://dx.doi.org/10.4038/cmj.v57i4.5084 Ceylon Medical Journal 2012; 57: 159-165

To elucidate the molecular nature of human sperm autoantigens, attempts were made to raise monoclonal antibodies against these antigens by hybridoma techniques. After successive immunizations with the particulate fractions of human sperm extract in BALB/c mice, the spleen cells were fused with P3-X63-Ag8 myeloma cells. Several clones and their subclones were obtained and shown by microplate radioimmunoassay to produce antibodies against human sperm antigens. When SDS gel/protein blot radioimmunobinding was used for further molecular analysis, three independently derived clones were shown to produce antibodies, all of which cross-reacted with the same two human sperm antigens with a molecular weight of about 10 000. Using an indirect immunofluorescence assay, antibodies produced by these clones were shown to react with antigens localized on the acrosomal regions of human spermatozoa. Monoclonal antibodies produced by other clones, however, showed no cross-reactivity with any of the blotted proteins from SDS gels of human spermatozoa. Some possible reasons for this are presented.

Induced abortion is reported to be the third leading cause of maternal mortality worldwide. Accra being a capital city with its accompanying problems of rapid population increases and issues of migration also has its own problems with abortion. Figures from the Obstetrics and Gynaecology unit of Korle Bu Teaching Hospital in Accra give abortion as the third leading cause of maternal mortality. However, data from the Pathology unit of the same hospital, show induced abortion as the leading cause of maternal mortality in Accra. This study looks into an aspect of abortion that has been little studied ─ the reasons behind induced abortions. Institute of African Studies: Research Review Vol. 20(2) 2004: 1-9

We recruited 600 pregnant women, whose ages were between 17 and 40 years in Calabar, Nigeria, out of which 300 of them who picked up folded pieces of paper marked \'Yes\' for themselves and their neonates were selected. The remaining 300 pregnant women who picked up the folded pieces of paper marked \'No\' for themselves and their neonates were excluded. Thereafter, we examined 300 blood samples each from the selected mothers, placenta, cord and neonates aged between 1 and 8 days for the presence of malaria parasites. The prevalence rate of 3.0% (9) for Plasmodium falciparum was observed in the neonates while 3.3%(10), 10.3% (31) and 17.0% (51) were observed in the cord, placenta and mothers respectively. The prevalence rates of infection of the neonates and cord were not statistically significant (P > 0.05) whereas statistically significant (P < 0.05) differences occurred between prevalence rates of infection of the mothers and the placenta. The infection of gametocytes only was 6% (18) and 1.3% (4) in mothers and placenta respectively. Both gametocytes and trophozoites infections were observed in 0.3% (1) maternal blood. No gametocytes or mixed infections were observed in the cord and neonates. No statistically significant differences (P > 0.05) occurred in the tissues infected with various stages of Plasmodium falciparum. The study has confirmed congenital malaria transmission in Calabar. Keywords: congenital malaria, prevalence, placenta, cord, neonatal blood Mary Slessor Journal of Medicine Vol. 5(1), 2005: 37-40