The Relationship Between Husband Support and Behavior of Pregnant Teenagers to Face Pregnancy During the Covid-19 Pandemic in Gombong, Kebumen, Indonesia

Background: Age influences pregnancy and childbirth. Pregnant women aged less than 20 years old or pregnant adolescents are not physically and mentally ready to cope with pregnancy or childbirth. The husband's support highly determines the health status of the mother. This research aimed to determine the relationship between husband support and the behavior of pregnant adolescents to face pregnancy during the COVID-19 pandemic in the Gombong District, Kebumen Regency. Methods: This study used a cross-sectional approach. The population was all pregnant women aged less than 20 years in the Gombong District, Kebumen Regency. It used a saturated sampling technique involving 256 people. Data were analyzed using univariate and bivariate analysis to answer the percentage and the Chi-Square test to answer the research hypothesis. Results: The study showed that 130 (50.8%) husbands did not support the mothers, and 126 (49.2%) husbands supported the mothers. The result also showed that 116 (45.3%) of the pregnant women showed positive behavior, while140 (54.7%) pregnant women showed negative behavior. The chi-square test found a p-value of 0.005, which proved a significant relationship between the husband's support and the behavior of pregnant adolescents to overcome pregnancy during the covid-19 pandemic. Conclusion: Pregnant teenagers with husband support will prepare for pregnancy and childbirth programs more maturely to ensure the safety of both mother and fetus

Advanced abdominal pregnancy with dead foetus: a case report

Abdominal pregnancy is a rare form of ectopic pregnancy in which the zygote implanted within the peritoneal cavity exception at ovaries, fallopian tubes and intra ligament spaces. The diagnosis is challenging and can be missed especially when the imaging facilities are not available in remote areas.A 35 years old, G3P2+0 was admitted to the hospital at 38+2 weeks of pregnancy with the chief complaint of reduced foetal movement for three days. She was taking regular antenatal care with the midwife at the rural health centre and uneventful until 37 weeks of pregnancy. On physical examination, the abdomen was distended, the foetal parts were easily palpable, no visible foetal movement and the foetal heart sound was not audible. Abdominal ultrasound scan identified the term foetus of abdominal pregnancy without foetal cardiac activity. The patient underwent laparotomy and dead, male foetus was extracted uneventfully. The placenta was attached to intestines and mesentery so that which was removed with great caution and secured haemostasis. The mother’s condition was stable throughout the operation and did not need to give the blood transfusion. The sutures were removed after 7 days and the healthy patient discharged from the hospital.Abdominal pregnancy is a rare condition and the diagnosis can be missed during the antenatal period and hence it is crucial to raise the awareness of health care personals especially in remote areas. The suspicious case of abdominal pregnancy should be referred to the experienced clinicians in the centres with diagnosis facilities

Magnesium for treating sickle cell disease

Sickle cell disease is an autosomal recessive inherited haemoglobinopathy which causes painful vaso-occlusive crises due to sickle red blood cell dehydration. Vaso-occlusive crises are common painful events responsible for a variety of clinical complications; overall mortality is increased and life expectancy decreased compared to the general population. Experimental studies suggest that intravenous magnesium has proven to be well-tolerated in individuals hospitalised for the immediate relief of acute (sudden onset) painful crisis and has the potential to decrease the length of hospital stay. Some in vitro studies and open studies of long-term oral magnesium showed promising effect on pain relief but failed to show its efficacy. The studies show that oral magnesium therapy may prevent sickle red blood cell dehydration and prevent recurrent painful episodes. There is a need to access evidence for the impact of oral and intravenous magnesium effect on frequency of pain, length of hospital stay and quality of life

Investigation of Japanese Encephalitis Virus Infection in Bogalay Township, Myanmar in 1999

An investigation was in Nyi-naung-wa village, Bogalay township for Japanese encephalitis (JE) virus infection and the possibility of a JE outbreak. JE virus antibody was determined among the pigs and the people living near the pig farms in that village and at an adjacent village as a control. The known JE virus vector Culex mosquito species were also identified in both villages. Haemagglutination inhibition (HAI) methods were used for the detectioon of JE and dengue antibodies. Homotypic or monotypic JE antibodies were detected in 33% of the pigs tested. No homotypic nor monotypic JE antibodis was detected among the villagers. Although there was no JE virus infection among the people, because of the presence of JE virus infection among the pigs and the presence of Culex mosquito vector in that area, the possibility of a JE outbreak in humans in that area, if the number of pig breeding per household increase and the mosquito density become higher is discussed

Malaria Elimination in the Greater Mekong Subregion: Challenges and Prospects

Malaria is a significant public health problem and impediment to socioeconomic development in countries of the Greater Mekong Subregion (GMS), which comprises Cambodia, China’s Yunnan Province, Lao People’s Democratic Republic, Myanmar, Thailand, and Vietnam. Over the past decade, intensified malaria control has greatly reduced the regional malaria burden. Driven by increasing political commitment, motivated by recent achievements in malaria control, and urged by the imminent threat of emerging artemisinin resistance, the GMS countries have endorsed a regional malaria elimination plan with a goal of eliminating malaria by 2030. However, this ambitious, but laudable, goal faces a daunting array of challenges and requires integrated strategies tailored to the region, which should be based on a mechanistic understanding of the human, parasite, and vector factors sustaining continued malaria transmission along international borders. Malaria epidemiology in the GMS is complex and rapidly evolving. Spatial heterogeneity requires targeted use of the limited resources. Border malaria accounts for continued malaria transmission and represents sources of parasite introduction through porous borders by highly mobile human populations. Asymptomatic infections constitute huge parasite reservoir requiring interventions in time and place to pave the way for malaria elimination. Of the two most predominant malaria parasites, Plasmodium falciparum and P. vivax, the prevalence of the latter is increasing in most member GMS countries. This parasite requires the use of 8-aminoquinoline drugs to prevent relapses from liver hypnozoites, but high prevalence of glucose-6-phosphate dehydrogenase deficiency in the endemic human populations makes it difficult to adopt this treatment regimen. The recent emergence of resistance to artemisinins and partner drugs in P. falciparum has raised both regional and global concerns, and elimination efforts are invariably prioritized against this parasite to avert spread. Moreover, the effectiveness of the two core vector control interventions—insecticide-treated nets and indoor residual spraying—has been declining due to insecticide resistance and increased outdoor biting activity of mosquito vectors. These technical challenges, though varying from country to country, require integrated approaches and better understanding of the malaria epidemiology enabling targeted control of the parasites and vectors. Understanding the mechanism and distribution of drug-resistant parasites will allow effective drug treatment and prevent, or slow down, the spread of drug resistance. Coordination among the GMS countries is essential to prevent parasite reintroduction across the international borders to achieve regional malaria elimination

Bcl9の異なるエピトープを認識する二つの抗体を用いた免疫組織化学的マッピングによるミャンマー国若年性発症肝細胞がんの特徴付け

B-cell lymphoma 9 (Bcl9) is the core component of Wnt/β-catenin signaling and overexpressed in nuclei of various tumors, including hepatocellular carcinoma (HCC). However, the extent of Bcl9 expression relative to HCC differentiation stage and its functional aspects are poorly understood. In this study, we examined the expression pattern of Bcl9 immunohistochemically, using two anti-Bcl9 antibodies; one was a conventional polyclonal-antibody (anti-Bcl9ABC) against amino acid no.800?900 of human-Bcl9, while the other (anti-Bcl9BIO) was against amino acid no.50?200, covering Pygopus-binding sites of Bcl9. Immunohistochemistry using anti-Bcl9BIO demonstrated distinctive staining in the cytoplasm, while the anti-Bcl9ABC signal was detected in both cytoplasm and nuclei of HCC cells, reflecting different states of Bcl9 function because Pygopus-binding to Bcl9 is essential to exert its function together with β-catenin in nucleus. Quantitative analysis revealed a significantly higher immunohistochemical-score by anti-Bcl9BIO in normal liver comparing various differentiation grades of HCC (P < 0.004), whereas no significant difference was noted with anti-Bcl9ABC. Interestingly, immunohistochemical-score of anti-Bcl9BIO in patients aged < 40 years was significantly lower than that of ? 40 years group (P < 0.01). The results indicated that anti-Bcl9BIO detected cytoplasmic Bcl9, which does not bind to Pygopus suggesting it could be a useful indicator for development of HCC in young Myanmar patients.長崎大学学位論文 学位記番号:博(医歯薬)甲第1129号 学位授与年月日:平成31年3月20日Author: Myat Thu Soe, Yasuaki Shibata, Myo Win Htun, Kuniko Abe, Kyaw Soe, Nay Win Than, Thann Lwin, Myat Phone Kyaw and Takehiko KojiCitation: Acta Histochemica et Cytochemica, 52(1), pp.9-17; 2019Nagasaki University (長崎大学)課程博

Optimization of the Dengue-2 Antigen ELISA Titer for the Positive Case Detection of Dengue Virus Infection by IgM ELISA

We have determined the dengue-2 antigen ELISA titer for the positive case detection of dengue virus infection by IgM ELISA using 33 paired serum samples of dengue patients admitted to the North Okkalapa General Hospital, Yangon, Union of Myanmar, in June and July, 1994. The antigen ELISA titer was found to be over 32 units in order to find out sufficient number of positive cases. This finding can be used as a reference for further experiments and the development of tetravalent dengue antigen for routine serodiagnosis of dengue virus infection

Application of IgM-capture ELISA on Myanmar Dengue Patients\u27 Serum Samples Collected in 1994

Seventy serum samples from clinically diagnosed dengue patients admitted to the North Okkalapa General Hospital, Yangon, Union of Myanmar, in 1994, were used to obtain the confirmed virological diagnosis by IgM-capture ELISA using all four types of dengue antigens raised by cell culture method. Sixty-two out of 70 specimens (88.6%) showed positive IgM ELISA titer against one or more assay antigen. Single application of dengue 2 antigen could detect 59 out of 62 positive sera (95.1% of total positives), whereas three more samples could be detected by using other serotypic antigens (either single antigen or double antigens in combination). Ten samples showing positive by single dengue antigen but negative results by the rest could possibly be due to the primary infection which showed serotype specific immune response

The potential of task shifting selected maternal interventions to auxiliary midwives in Myanmar: a mixed-method study

Background: An estimated 282 women die for every 100,000 live births in Myanmar, most due to preventable causes. Auxiliary Midwives (AMWs) in Myanmar are responsible for providing a package of care during pregnancy and childbirth to women in rural hard to reach areas where skilled birth attendants (Midwives) are not accessible. This study aims to examine the role of AMWs in Myanmar and to assess the current practices of three proposed essential maternal interventions (oral supplement distribution to pregnant women; administration of misoprostol to prevent postpartum haemorrhage; management of puerperal sepsis with oral antibiotics) in order to facilitate a formal integration of these tasks to AMWs in Myanmar. Methods: A mixed methods study was conducted in Magwe Region, Myanmar involving a survey of 262 AMWs, complemented by 15 focus group discussions with midwives (MWs), AMWs, mothers and community members, and 10 key informant interviews with health care providers at different levels within the health care system. Results: According to current government policy, AMWs are responsible for identifying pregnant women, screening for danger signs and facilitating early referral, provision of counselling on nutrition and birth preparedness for women in hard-to-reach areas. AMWs also assist at normal deliveries and help MWs provide immunization services. In practice, they also provide oral supplements to pregnant women (84%), provide antibiotics to mothers during the puerperium (43%), and provide misoprostol to prevent postpartum haemorrhage (41%). The current practices of AMWs demonstrate the potential for task shifting on selected essential maternal interventions. However, to integrate these interventions into formal practice they must be complemented with appropriate training, clear guidelines on drug use, systematic recording and reporting, supportive monitoring and supervision and a clear political commitment towards task shifting. Conclusion: With the current national government’s commitment towards one AMW in one village, this study highlights the potential for shifting specific maternal lifesaving tasks to AMWs