Comparison of two self-sampling methods for human papillomavirus (HPV) DNA testing among women with high prevalence rates

One major advantage of molecular assays for human papillomavirus (HPV) DNA detection is that these assays can be performed on self-collected samples unlike cytology or visual inspection with acetic acid (VIA). This cross-sectional study was carried out between March 2017 and April 2019 to compare the diagnostic performance in self-collected urine and vaginal samples for HPV DNA detection. Viral DNA was extracted from processed samples using a Qiagen viral DNA extraction Kit (QIAamp DNA Mini Kit). To detect four common high-risk HPV types (16, 18, 31, 45), multiplex real-time polymerase chain reaction (PCR) targeting the LCR/E6/E7 region of the HPV genome was performed in ABI 7500 cycler (Applied Biosystems). The negative samples were screened by conventional PCR targeting the L1 capsid region to exclude other HPV types. The overall agreement between the two self-collecting sampling methods was 64.04% with a κ value of 0.29 pointing towards a fair agreement (P < .01). The sensitivity of HPV DNA detection in urine samples was 57.95% (47.52%, 67.72), and specificity was 84.6% (66.47%, 93.85%) when compared with vaginal samples. The study concludes that self-collected vaginal HPV DNA testing is more sensitive than unpreserved-urine samples for HPV DNA detection in a hospital-based setting.     

Effect of Maternal Cardiac Disease on Perinatal Outcome

Perinatal outcome of 223 pregnancies complicated by maternal cardiac disease, over a 5-year period has been studied. Mean birth-weights of these babies were compared to the Institute's reference neonatal weight curves at different periods of gestation and found lower than the reference. The mean difference of 150 g was statistically significant. The incidence of prematurity, small for gestational age and perinatal mortality was analyzed according to the risk factors i.e. type, duration and severity of symptoms. The perinatal outcome was directly proportional to the severity of symptoms, irrespective of the type and duration of heart disease.     

Comparison of Low Molecular Weight Heparin (Fragmin) With Sodium Heparin for Prophylaxis Against Postoperative Thrombosis in Women Undergoing Major Gynaecological Surgery

Summary: A randomized controlled trial was undertaken comparing the efficacy and safety of low molecular weight (LMW) heparin (Fragmin) with sodium heparin for prophylaxis against postoperative thromboembolic disease after major gynaecological surgery. Women were randomized to receive subcutaneous injections of 5,000 U of either once daily LMW heparin or twice daily sodium heparin. A total of 566 women were recruited, of whom 552 completed the study. Most women (461) had malignant disease and 430 of these underwent radical surgery. The remainder underwent major, but not radical surgery. There were 5 thromboembolic events in the LMW heparin group and 2 in the sodium heparin group, with no significant difference between these groups. No significant difference was found in the incidence of intraoperative or postoperative transfusion in the 2 groups. The decision of which heparin to use in routine practice cannot be made on clinical grounds.     

In vitro iron attachment to the intestinal brush border

Iron attachment to brush border membrane of guinea pig small intestine was measured by an in vitro technic. Both inorganic and hemoglobin iron uptake was assessed under various conditions. Electron microscopic and biochemical studies showed that iron was adsorbed to the glycocalyx of the brush border membranes. Iron attachment was selective depending on the iron stores of the animal. Several iron-binding compounds reduced the uptake of inorganic iron when they were added at the beginning of the incubation period and did not affect attachment of hemoglobin iron. Gastric juice markedly increased attachment of heme iron to the pellet. This effect appeared to be related to the effect of acid on the hemoglobin molecule.Supported in part by a Roche research grant.     

Leiomyoma of the Vagina

Summary: Approximately 250 cases of leiomyoma of the vagina have been reported. A case of a 46-year-old female with leiomyoma of the anterior vaginal wall, not associated with uterine leiomyomas is presented. The practical approach to such a vaginal mass entails immediate careful excision.     

Failure of Chloroquine Malaria Prophylaxis in Pregnancy

EDITORIAL COMMENT: Failure of chloroquine for malaria prophylaxis is important, if not alarming, for residents and visitors, especially pregnant women, in these areas.
Summary: Women in a hyperendemic malarious area of Papua New Guinea are supplied with weekly chloroquine chemoprophylaxis at antenatal clinics. A study of 180 women in late pregnancy failed to show any difference in Plasmodium falciparum parasite rates between regular and irregular clinic attenders. Nor was anaemia in late pregnancy associated with parasitaemia; however, grandmultiparas exhibited significantly more prevalent parasitaemia and anaemia in late pregnancy. This study reveals a need for a more detailed investigation of the effects and usefulness of chemoprophylaxis with chloroquine in areas where P. falciparum chloroquine resistance is present.     

Bilirubin helps to overcome the two-cell block in mouse oocyte cultures

Purpose In vitrofertilization and culture of mouse oocytes, under normal atmospheric oxygen tension, subjects them to severe oxidative stress. Oocytes from some strains of mice lack the natural protective mechanism that guards them against this oxidative stress and fail to develop beyond the two-cell stage.Methods We could overcome the toxic effects of oxygen metabolites by adding 0.2–0.4 mg/dl bilirubin in a lactate-pyruvate culture medium defined by Whitten (1971). Six-to 8-week-old ICR (Institute of Cancer Research) female mice were super ovulated by intra peritoneal injection of 5 IU PMSG (pregnant mare serum gonadotropin) followed by 10 IU hCG 48 h later. The oocytes were collected from the distended fallopian tubes and inseminated with 1–2 million sperm from 3–4-month-old ICR male mice. The eggs were scored at 24, 48, and 72 h after the hCG injection.Conclusions With 0.4 mg/dl bilirubin supplement, by the end of 72 h, 82% of the eggs progressed from the two-cell stage to the four-cell stage. Routine inclusion of bilirubin can improve embryo development in vitro.