Opinion of Young People on the Crises of Emerging Adulthood: Premarital Sex, Ex-nuptial Pregnancy and Infant Abandonment

Premarital sex, ex-nuptial pregnancy and infant abandonment are increasing problems. This study aimed to explore the opinion of youngsters on the contributing factors of this triad. A focus group discussion was conducted among 59 consented youngsters who were clustered into six groups. Standard prompts were given, discussions were audiotaped, transcribed and thematically analysed. Main themes emerged as the contributing factors include adjustment with the transition in life, conflict in relationships and lacking internal defences. Understanding these factors within the social development of youngsters is essential to equip them in making an informed decision on their sexuality and crises in life. Keywords: ex-nuptial pregnancy, infant abandonment, premarital sex, youngsters eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI:https://doi.org/10.21834/ebpj.v6iSI4.289

Postnatal confinement among Malay women: Comparing practices between two different generations

This study aimed to determine the difference in postnatal confinement practice between two different generations. It was an unmatched cross-sectional study involving 200 women. Women aged less than 50, and 50 years old or more, were grouped as younger and older generation, respectively. This study showed there were significant differences in postnatal confinement practice including the pattern of food restriction and some traditional postnatal care practices (less sexual abstinence, hot compression, herbal bath and avoiding social outing among women from younger generations). Clinically proven intervention should be recommended, and harmful practices should be discouraged to ensure a safe confinement practice.Keywords:  post-partum; puerperium; traditional; era eISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i12.191

Prevalence of urinary incontinence, its risk factors and effect on the quality of life in women after their first delivery / Bahiyah Abdullah … [et al.]

Although urinary incontinence is commonly associated with increasing parity, there is however a lack of published data on urinary incontinence among primiparous women. This study aims to determine its prevalence among primiparous women at 6-8 weeks postpartum, its risk factors and effects to their quality of life. Methods: This is a crosssectional study involving primiparous women at 6-8 weeks postpartum. Women in their third trimester were recruited using convenience sampling. Data were obtained using a study proforma, and International Consultation on Incontinence Questionnaire – Short Form (ICIQSF) over a face-to-face interview. The same questionnaire with additional enquiries on delivery was completed over a telephone interview at 6-8 week postpartum. Data were analysed using chi-square and simple logistic regression tests contained in the Statistical Package for Social Science version 20.0. Results: Three hundred and six women participated in this study. The prevalence of urinary incontinence in the third trimester of pregnancy was 34.3% (95%CI: 29.0, 39.7) and dropped to 5.2% (95% CI: 2.7, 7.7) at 6-8 weeks postpartum. Childhood enuresis and postpartum body mass index were the two factors that showed significant association with postpartum urinary incontinence. Urinary incontinence in 95 (31%) women had resolved by 6-8 weeks postpartum, whereas 10 (3.3%) women still had persistent symptom. A small proportion of women (2.0%) developed urinary incontinence in the postpartum period. Majority of women with urinary incontinence did not feel it significantly affected their quality of life. The ICIQ- SF mean score was 6.13 (range 2- 12). Conclusions: Postpartum urinary incontinence is rather uncommon among primiparous women and does not seem to affect their quality of life. Childhood enuresis and postpartum BMI were risk factors associated with postpartum urinary incontinence

The challenge in diagnosing and managing heterotopic interstitial pregnancy in natural conception / Noor Azura Noor Mohamad … [et al.]

Heterotopic interstitial pregnancy in natural conception is very rare. Definitive diagnosis is made by systematic pelvic ultrasound. Simultaneous viable conception observed in both intraand extra-uterine is pathognomonic of heterotopic interstitial pregnancy. We report a 34-yearold woman primigravida at 10 weeks’ amenorrhoea who underwent evacuation of retained product of conception for missed miscarriage. Intraoperatively, minimal product of conception was retrieved. Bedside pelvic ultrasound showed cystic mass at right superolateral part of uterine fundus suspicious of interstitial pregnancy. Cornual resection was performed via laparotomy. Histopathological examination showed presence of product of conception and interstitial pregnancy. Serum β-human chorionic gonadotropin dropped from 10,027 IU/l on day one post-ERPC to 210 IU/l at day three post-cornual resection. This case report highlighted the challenge in diagnosing heterotopic interstitial pregnancy conceived naturally. Timely diagnosis may avert dire consequences of massive haemorrhage from ruptured uterine cornua

Delayed presentation of a huge abdominopelvic mass during the COVID-19 pandemic

Background: Giant ovarian cysts are rare in developed countries due to advanced achievements in medical diagnostics. However, in the midst of the coronavirus disease 2019 (COVID-19) pandemic, patients with non-COVID-19-related illnesses tend to delay their health-seeking attention; thus, they had presented late. Case presentation: A 25-year-old single lady complained of a 3-month worsening abdominal pain and distention. She was initially well but neglected the symptoms due to the COVID-19 situation, yet came to our attention after she developed obstructive symptoms. A computed tomography (CT) scan of the abdomen revealed a huge cystic lesion from the pelvic area, which later was found to be from the right ovary upon urgent laparotomy exploration. The histopathological examination was consistent with mucinous cystadenoma of the ovary. Discussion: Acute non-COVID-19-related emergencies have decreased, as evidenced by reduced visits to the Emergency Department, and the number of abdominal CT scans. An emergency case like a huge abdominopelvic mass deserves an extensive radiologic examination as clinical assessment alone may not be adequate. Preoperative CT is superior to ultrasonography in getting the extent of the lesion, local infiltration, staging purpose, and surgical intervention. Pathology with a variety of spectrums such as mucinous neoplasm deserves to be investigated, evaluated, and resected even during the COVID-19 pandemic. Conclusion: A giant abdominopelvic cystic mass can present emergency havoc during the COVID-19 pandemic. Urgent surgical intervention is mandatory by using full protection and exercising extreme precaution, regardless of the preoperative screening to avoid unnecessary viral transmissions

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Comparison between direct plunging and vitrification techniques on development of mouse embryos at various preimplantation stages

This study evaluated the efficiency of direct plunging and vitrification techniques in preserving mouse embryos at various preimplantation stages. Embryos were from superovulated ICR female mice. In direct plunging, embryos were equilibrated in EG (4.0 M), sucrose (0.25 M), BSA (4%), loaded into straw and plunged into LN(2). The straw was thawed in water bath (37 degrees C) and embryos were equilibrated in sucrose (0.5 M), BSA (4%). In vitrification, embryos were equilibrated with EG (7.5%), DMSO (7.5%) with EG (15%), DMSO (15%) and loaded onto cryoleaf. The cryoleaf was plunged into LN(2). Embryos were warned in sucrose (1.0 M), sucrose (0.5 M), washing solution and in modified WM medium. Frozen-thawed/vitrified-warmed embryos were cultured in modified WM medium in 5% CO(2) incubator (37 degrees C). Some embryos were transferred into pseudopregnant CBA/ca females for in vivo viability assessment. Vitrification gave higher survival rates than direct plunging technique at all developmental stages studied. No significant differences in the percentage of live-birth from direct plunging (22.40 +/- 4.40%), vitrification (29.80 +/- 9.00%) and control embryos (28.83 +/- 3.25%)

Optimal design of water networks involving multiple contaminants for global water operations

This work presents the development of a systematic technique to target the minimum fresh water consumption and wastewater generation to achieve maximum water recovery (MWR) for systems involving multiple contaminants. A generic linear programing (LP) model has been developed based on water network superstructure to simultaneously set the targets and design the MWR network, for both mass transfer‐based (MTB) and non‐mass transfer‐based (NMTB) problems (i.e. global water‐using operations). This work also includes cases where fresh water concentrations for all contaminants are assumed to be either zero or non‐zero. The proposed method is superior since it can guarantee a global optimal solution. Application of the methodology on three case studies shows significant water savings, illustrating the effectiveness of the proposed approach