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

Influence of Surcharge Loading, Retained Soil and Restrained Soil on Design of Diaphragm Wall

Many different types of embedded retaining wall are constructed due to the increasing demands. In Yangon, Myanmar is encountered deep excavation problem. Many buildings are damaged due to excavation of adjacent building. Therefore, embedded retaining wall as excavation support system is necessary to be sustainable buildings. There are important that influence of surcharge loading, retained soil and restrained soil on design of embedded retaining wall.  In this paper, diaphragm Wall is emphasized and solved using soil structure interaction analysis. Behaviour of diaphragm Wall wall is based on various factors. Consider with natural and increasing of shear strength parameter of retained and restrained soils to get the level of the dredge line is stiff soil and various distances from wall to surcharge. Sites are located in urban setting, there are near building and separately from main structure. This project involves the construction of 5 m depth retaining wall. In case study (A) retained soils is soft, medium (low) clay, restrained soil is mostly cohesive soil. There are medium (low), stiff, medium, hard soil layers.  In case studies (B to H) are increasing shear strength parameter of retained soil and restrained soil. All cases are considered with various distances from wall to surcharge. According to the soil conditions and distance from wall to surcharge, Wall depth, horizontal and vertical movement of ground and wall deflection are described. When retained and restrained soil reach stiff condition, then ground movement and wall deflection reach acceptable limit and wall depth become more safe and economical condition

Clinical Profile of Intermediate Syndrome in Organophosphate Poisoning

Organophosphate (OP) poisoning is a major global health problem, causing over 200,000 deaths annually especially in developing countries. In Poison Treatment Center, New Yangon General Hospital, Myanmar, OP poisoning accounts for 14% of total poison admission in 2013, 17% in 2014 and 10.3% in 2015 respectively

Island health review, progress and the way forward in the Western Pacific Region

Island health differs from other health care systems, particularly in that there are limited resources and referral faculties available. With globalisation and climate change, island populations have become increasingly vulnerable to natural disasters and global pandemics. This study will identify, explore, compare and report on island health issues facing in the western Pacific, before making appropriate recommendations. A review of selected health indicators in Pacific islands was collected from the World Health Organization (WHO) and other publicly available resources. In the Pacific region, 15 islands saw lower health expenditure (<US $500), one physician and two to six nurses per 1,000 people (fall below WHO recommendation), lower life expectancy (60-70 years), higher fertility rates (2.5 to 6.4 children per women, excepting Palau), and higher adolescent fertility rates (23 to 88 children per 1,000 girls, excepting Tonga). Island populations also suffer a higher disease burden per 100,000 people, with TB, malaria, and non-communicable diseases contributing to elevated mortality rates throughout much of the region. This article highlights four areas: the sustainable development of the health workforce, improved maternal and antenatal health care provisioning, and selective communicable and non-communicable disease control. However, there are some limitations especially under reporting of maternal health data and generalization effect of reported data

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

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

High rate of virological failure and low rate of switching to second-line treatment among adolescents and adults living with HIV on first-line ART in Myanmar, 2005-2015.

BACKGROUND: The number of people living with HIV on antiretroviral treatment (ART) in Myanmar has been increasing rapidly in recent years. This study aimed to estimate rates of virological failure on first-line ART and switching to second-line ART due to treatment failure at the Integrated HIV Care program (IHC). METHODS: Routinely collected data of all adolescent and adult patients living with HIV who were initiated on first-line ART at IHC between 2005 and 2015 were retrospectively analyzed. The cumulative hazard of virological failure on first-line ART and switching to second-line ART were estimated. Crude and adjusted hazard ratios were calculated using the Cox regression model to identify risk factors associated with the two outcomes. RESULTS: Of 23,248 adults and adolescents, 7,888 (34%) were tested for HIV viral load. The incidence rate of virological failure among those tested was 3.2 per 100 person-years follow-up and the rate of switching to second-line ART among all patients was 1.4 per 100 person-years follow-up. Factors associated with virological failure included: being adolescent; being lost to follow-up at least once; having WHO stage 3 and 4 at ART initiation; and having taken first-line ART elsewhere before coming to IHC. Of the 1032 patients who met virological failure criteria, 762 (74%) switched to second-line ART. CONCLUSIONS: We found high rates of virological failure among one third of patients in the cohort who were tested for viral load. Of those failing virologically on first-line ART, about one quarter were not switched to second-line ART. Routine viral load monitoring, especially for those identified as having a higher risk of treatment failure, should be considered in this setting to detect all patients failing on first-line ART. Strategies also need to be put in place to prevent treatment failure and to treat more of those patients who are actually failing

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