Surrogacy in modern obstetric practice.

Surrogacy is rising in profile and prevalence, which means that perinatal care providers face an increasing likelihood of encountering a case in their clinical practice. Rapidly expanding scientific knowledge (for example, fetal programming) and technological advances (for example, prenatal screening and diagnosis) pose challenges in the management of the surrogate mother; in particular, they could exacerbate conflict between the interests of the baby, the surrogate mother, and the intending parent(s). Navigating these often-tranquil-but-sometimes-stormy waters is facilitated if perinatal care providers are aware of the relevant ethical, legal, and service delivery issues. This paper describes the ethical and legal context of surrogacy, and outlines key clinical practice issues in management of the surrogate mother.

Effect of cassava (Manihot excuelenta) on diabetes mellitus in Jamaican patients

Cassava contains linamarin, a cyanogenic glucoside thought to be a causative agent in the development of diabetes mellitus especially in the tropics. A study was done on a cohort of thirty-eight (38) diabetics, 18 cassava eating and 20 non-cassava eating attending the Diabetic Clinic at the University Hospital. The form of cassava eaten was the cake properly referred to as "bammy". Although extensive extraction was done in the preparation of bammy, linamarin was still present in all bammy extracts in concentrations varying from 0.137 to 6.11 ug/ul extract. TMCS - (Trimethyl chloro silyl) derivatization and gas liquid chromatography analysis was done on bammy extracts, and sera of cassava eaters and non-cassava eaters. Linamarin was used as standard reference. Linamarin was found in the serum of 5 (37 percent) of the diabetics consuming cassava, concentrations varying from 0.0158 - 0.180 ug linamarin/ul serum. No linamarin was found in the serum of the non-cassava consuming diabetic group. Detailed investigation of the group of five diabetics consuming cassava and showing linamarin in their serum showed that this group had relatively lower C peptide and higher glycosylated haemoglobin values than the other diabetics. These findings, though preliminary could suggest an aggravating role for linamarin in the control of diabetes in our Jamaican patients. (AU)