GANGGUAN HASRAT SEKSUAL PADA WANITA PASCASALIN DAN HUBUNGANNYA DENGAN CARA PERSALINAN

1Yusnia Irchami F, 1Irfan H, 1Isanawidya H.P, 1Avie A.B, 2Edi Patmini, 3Agung Nugroho, 2Muhammad Nurhadi Rahman ABSTRACTBackground: Sexual dysfunction in postpartum woman is closely related to the period of pregnancy and childbirth. One of the diagnostic criteria for sexual dysfunction is a sexual desire. Sexual desire disorder can be influenced by psychological factors and marriage relationship. However, there has been no consensus stating with certainty the effect of the method of delivery against sexual desire disorder in postpartum woman.Objective: To assess association between delivery method and sexual desire disorder among postpartum woman in RSUD Panembahan Senopati Bantul Yogyakarta.Method: A cross sectional study was conducted involving 53 subjects in spontaneous vaginal group and 49 subjects in sectio caesarea group. The Female Sexual Function Index (FSFI) questionnaire was administered to measure sexual desire disorder in 2-6 months postpartum woman. Data was analyzed using chi-square analysis. Result & Discussion: In spontaneous vaginal group, 62.3% of the subjects experienced sexual desire disorder while in sectio caesarea group showed 55.1% (p=0.463). Spontaneous vaginal delivery increases the risk of sexual desire disorder, but not significant statistically (Prevalence ratio 1.130 convidence interval (CI) 0.814 to 1.569).Conclusion: There was no significant relationship between the method of delivery and the prevalence of sexual desire disorder among postpartum woman in RSUD Panembahan Senopati Bantul, Yogyakarta.Keywords: Sexual desire disorders, spontaneous vaginal delivery, sectio caesarea delivery, postpartum womanABSTRAK Latar Belakang: Disfungsi seksual yang terjadi pada wanita pascasalin erat kaitannya dengan masa kehamilan dan persalinan. Salah satu kriteria diagnostik disfungsi seksual adalah hasrat seksual. Gangguan hasrat seksual dapat dipengaruhi oleh faktor psikologis wanita dan hubungan pernikahan. Namun, belum terdapat konsensus yang menyatakan dengan pasti pengaruh metode persalinan terhadap gangguan hasrat seksual pada wanita pascasalin. Tujuan: Mengetahui hubungan antara metode persalinan terhadap prevalensi gangguan hasrat seksual pada wanita pascasalin di RSUD Panembahan Senopati Bantul Yogyakarta.Metode: Desain penelitian ini adalah studi potong lintang (cross sectional) dengan melibatkan 53 subjek pada kelompok persalinan vaginal dan 49 subjek pada kelompok sectio caesarea. Kuesioner Female Sexual Function Index (FSFI) digunakan untuk mengukur gangguan hasrat seksual pada subjek yang berada pada bulan ke 2-6 periode pascasalin. Data dianalisis dengan analis chi-square.Hasil & Pembahasan: Pada kelompok vaginal spontan, sebesar 62,3% subjek mengalami gangguan hasrat seksual sedangkan pada kelompok sectio caesarea didapatkan hasil sebesar 55,1% (p=0,463). Persalinan vaginal spontan meningkatkan risiko terjadinya gangguan hasrat seksual secara tidak bermakna (Rasio prevalensi 1,130 convidence interval (CI) 0,814-1,569). Kesimpulan: Tidak terdapat hubungan yang bermakna antara metode persalinan dengan prevalensi gangguan hasrat seksual pada wanita pascasalin di RSUD Panembahan Senopati Bantul Yogyakarta.Kata kunci: Gangguan hasrat seksual, persalinan vaginal spontan, persalinan sectio caesarea, wanita pascasalin 1Mahasiswa S1 Pendidikan Dokter Fakultas Kedokteran UGM2Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM / RSUP Dr. Sardjito3Bagian Kesehatan Ibu dan Anak, Ilmu Kesehatan Masyarakat, Fakultas   Kedokteran UGM 

Contribution of Color Information in Visual Saliency Model for Videos

International audienceMuch research has been concerned with the contribution of the low level features of a visual scene to the deployment of visual attention. Bottom-up saliency models have been developed to predict the location of gaze according to these features. So far, color besides to brightness, contrast and motion is considered as one of the primary features in computing bottom-up saliency. However, its contribution in guiding eye movements when viewing natural scenes has been debated. We investigated the contribution of color information in a bottom-up visual saliency model. The model efficiency was tested using the experimental data obtained on 45 observers who were eye tracked while freely exploring a large data set of color and grayscale videos. The two datasets of recorded eye positions, for grayscale and color videos, were compared with a luminance-based saliency model. We incorporated chrominance information to the model. Results show that color information improves the performance of the saliency model in predicting eye positions

The Case for Visual Analytics of Arsenic Concentrations in Foods

Arsenic is a naturally occurring toxic metal and its presence in food could be a potential risk to the health of both humans and animals. Prolonged ingestion of arsenic contaminated water may result in manifestations of toxicity in all systems of the body. Visual Analytics is a multidisciplinary field that is defined as the science of analytical reasoning facilitated by interactive visual interfaces. The concentrations of arsenic vary in foods making it impractical and impossible to provide regulatory limit for each food. This review article presents a case for the use of visual analytics approaches to provide comparative assessment of arsenic in various foods. The topics covered include (i) metabolism of arsenic in the human body; (ii) arsenic concentrations in various foods; (ii) factors affecting arsenic uptake in plants; (ii) introduction to visual analytics; and (iv) benefits of visual analytics for comparative assessment of arsenic concentration in foods. Visual analytics can provide an information superstructure of arsenic in various foods to permit insightful comparative risk assessment of the diverse and continually expanding data on arsenic in food groups in the context of country of study or origin, year of study, method of analysis and arsenic species

Small volume plasma exchange for Guillain-Barré syndrome in resource poor settings: A safety and feasibility study

Background: In Bangladesh, most patients with Guillain-Barré syndrome (GBS) cannot afford standard treatment with intravenous immunoglobulin (IVIG) or a standard plasma exchange (PE) course, which partly explains the high rate of mortality and residual disability associated with GBS in this country. Small volume plasma exchange (SVPE) is an affordable and potentially effective alternative form of plasma exchange. SVPE is the repeated removal of small volumes of supernatant plasma over several days via sedimentation of patient whole blood. The aim of this study is to define the clinical feasibility and safety of SVPE in patients with GBS in resource poor settings. Methods: A total of 20 adult patients with GBS will be enrolled for SVPE at a single center in Bangladesh. Six daily sessions of whole blood sedimentation and plasma removal will be performed in all patients with GBS with a target to remove an overall volume of at least 8 liters (L) of plasma over a total of 8 days. Serious adverse events (SAE) are defined as the number of patients developing severe sepsis associated with the central venous catheter or deep venous thrombosis in the limb where the catheter is placed for SVPE. Based upon a predictive success rate of 75%

Small volume plasma exchange for Guillain-Barré syndrome in resource poor settings: A safety and feasibility study

Background: In Bangladesh, most patients with Guillain-Barré syndrome (GBS) cannot afford standard treatment with intravenous immunoglobulin (IVIG) or a standard plasma exchange (PE) course, which partly explains the high rate of mortality and residual disability associated with GBS in this country. Small volume plasma exchange (SVPE) is an affordable and potentially effective alternative form of plasma exchange. SVPE is the repeated removal of small volumes of supernatant plasma over several days via sedimentation of patient whole blood. The aim of this study is to define the clinical feasibility and safety of SVPE in patients with GBS in resource poor settings. Methods: A total of 20 adult patients with GBS will be enrolled for SVPE at a single center in Bangladesh. Six daily sessions of whole blood sedimentation and plasma removal will be performed in all patients with GBS with a target to remove an overall volume of at least 8 liters (L) of plasma over a total of 8 days. Serious adverse events (SAE) are defined as the number of patients developing severe sepsis associated with the central venous catheter or deep venous thrombosis in the limb where the catheter is placed for SVPE. Based upon a predictive success rate of 75%, the SVPE procedure will be considered safe if less than 5 of 20 SVPE-treated GBS patients have a SAE. The procedure will be considered feasible if 8 L of plasma can be removed in at le

Tracking the emergence of azithromycin resistance in multiple genotypes of typhoidal salmonella

The rising prevalence of antimicrobial resistance in Salmonella enterica serovars Typhi and Paratyphi A, causative agents of typhoid and paratyphoid, have led to fears of untreatable infections. Of specific concern is the emerging resistance against azithromycin, the only remaining oral drug to treat extensively drug resistant (XDR) typhoid. Since the first report of azithromycin resistance from Bangladesh in 2019, cases have been reported from Nepal, India, and Pakistan. The genetic basis of this resistance is a single point mutation in the efflux pump AcrB (R717Q/L). Here, we report 38 additional cases of azithromycin-resistant (AzmR) Salmonella Typhi and Paratyphi A isolated in Bangladesh between 2016 and 2018. Using genomic analysis of 56 AzmR isolates from South Asia with AcrB-R717Q/L, we confirm that this mutation has spontaneously emerged in different Salmonella Typhi and Paratyphi A geno-types. The largest cluster of AzmR Typhi belonged to genotype 4.3.1.1; Bayesian analysis predicts the mutation to have emerged sometime in 2010. A travel-related Typhi isolate with AcrB-R717Q belonging to 4.3.1.1 was isolated in the United Kingdom, increasing fears of global spread. For real-time detection of AcrB-R717Q/L, we developed an extraction-free, rapid, and low-cost mismatch amplification mutation assay (MAMA). Validation of MAMA using 113 AzmR and non-AzmR isolates yielded >98% specificity and sensitivity versus phenotypic and whole-genome sequencing assays currently used for azithromycin resistance detection

Small volume plasma exchange for Guillain-Barré syndrome in resource-limited settings: A phase II safety and feasibility study

Objective To assess the safety and feasibility of small volume plasma exchange (SVPE) for patients with Guillain-Barré syndrome (GBS). Design Non-randomised, single-arm, interventional trial. Setting National Institute of Neurosciences and Hospital, Dhaka, Bangladesh. Participants Twenty adult (>18 years) patients with GBS presented within 2 weeks of onset of weakness who were unable to walk unaided for more than 10 m. Interventions SVPE involves blood cell sedimentation in a blood bag and removal of supernatant plasma after blood cells are retransfused. This procedure was repeated three to six times a day, for eight consecutive days. Fresh frozen plasma (FFP) and normal saline were used as replacement fluid. Outcome measures Serious adverse events (SAEs) were defined as severe sepsis and deep venous thrombosis related to the central venous catheter (CVC) used during SVPE. SVPE was considered safe if less than 5/20 patients experienced an SAE, and feasible if 8 L plasma could be removed within 8 days in at least 15/20 patients. Results Median patient age 33 years (IQR 23-46; range 18-55); 13 (65%) were male. Median Medical Research Council (MRC) sum score was 20 (IQR 0-29; range 0-36); three (15%) patients required mechanical ventilation. One patient developed SAE (severe sepsis, possibly related to CVC). The median plasma volume exchanged was 140 mL/kg (range 110-175) and removal of 8 L plasma was possible in 15 (75%) patients. Patients received a median 1 g/kg IgG via FFP although a substantial proportion of IgG was probably removed again by the SVPE sessions. GBS disability score improved by at least one grade in 14 (70%) patients 4 weeks after SVPE started. No patients died. Conclusion SVPE seems a safe and feasible alternative treatment to standard plasma exchange (PE) or intravenous immunoglobulin (IVIg) for GBS; further studies of clinical efficacy in low-income and middle-income countries are warranted. Trial registration number NCT02780570

A multi-targeted approach to suppress tumor-promoting inflammation

Cancers harbor significant genetic heterogeneity and patterns of relapse following many therapies are due to evolved resistance to treatment. While efforts have been made to combine targeted therapies, significant levels of toxicity have stymied efforts to effectively treat cancer with multi-drug combinations using currently approved therapeutics. We discuss the relationship between tumor-promoting inflammation and cancer as part of a larger effort to develop a broad-spectrum therapeutic approach aimed at a wide range of targets to address this heterogeneity. Specifically, macrophage migration inhibitory factor, cyclooxygenase-2, transcription factor nuclear factor-κB, tumor necrosis factor alpha, inducible nitric oxide synthase, protein kinase B, and CXC chemokines are reviewed as important antiinflammatory targets while curcumin, resveratrol, epigallocatechin gallate, genistein, lycopene, and anthocyanins are reviewed as low-cost, low toxicity means by which these targets might all be reached simultaneously. Future translational work will need to assess the resulting synergies of rationally designed antiinflammatory mixtures (employing low-toxicity constituents), and then combine this with similar approaches targeting the most important pathways across the range of cancer hallmark phenotypes

Outpatient treatment of decompensated heart failure: a systematic review and study level meta-analysis

Patients with acutely decompensated heart failure (ADHF) are usually admitted to hospital for management. There is growing interest in delivering intravenous (IV) diuretic therapy at home, in the community or at hospital day-care units; the safety and effectiveness of outpatient-based management (OPM) for ADHF has not been established. We conducted a systematic literature review and meta-analysis to investigate the short-term safety and effectiveness of OPM compared with inpatient management (IPM) of ADHF. Pre-specified endpoints were 30 day mortality and 30 day hospitalization. The meta-analysis was conducted using RevMan 5.4 software. Twenty-nine studies of OPM were identified, including 7683 patients. Only five studies directly compared OPM (n = 1303) with IPM (n = 2047), including three observational studies, and two randomized controlled trials (RCTs). The other 24 studies only stated OPM outcomes. For the five studies comparing IPM versus OPM, patients were generally aged >75 years and of similar age for each strategy, with a similar proportion of men (56%). In a study-level, aggregate analysis, 30 day all-cause mortality was 9.3% (121/1303) for OPM, compared with 15.6% (320/2047) for IPM [OR 0.29 (95% CI 0.09, 0.93) P = 0.04]. Four studies reported 30 day all-cause hospitalization; 22.0% for IPM versus 16.8% for OPM [OR 0.73 (95% CI 0.61, 0.89), P = 0.001]. In the two RCTs, we found no difference in 30 day mortality or hospitalization. In observational studies, OPM of ADHF is associated with lower 30 day hospitalization and lower 30 day mortality; such differences were not observed in two small, single-centre RCTs. A substantial, multicentre RCT is required to confirm the safety and effectiveness of OPM for ADHF