How B-Lynch suture and bilateral internal iliac artery ligation saved the uterus of a young patient with severe postpartum haemorrhage.

Obstetric haemorrhage is the leading cause of maternal death worldwide (27.1%) and more than 66% of its deaths were classified as postpartum haemorrhage (PPH). The most common cause of PPH is uterine atony. Obstetrician should be skillful in managing obstetric emergencies; especially pertaining to PPH. Application of the B-Lynch suture on an atonic uterus is one of the surgical options in PPH patients who wish to conserve the uterus and it has a very high success rate.We present a primigravida patient who developed massive primary PPH followed by disseminated intravascular coagulation, which was successfully managed with B-Lynch suture and bilateral internal iliac artery ligation. We described in detail regarding the management of massive PPH and application of these surgical procedures on the atonic uterus with an attempt to preserve the uterus and future fertility in this young patient.

Occupational lung disease: A narrative review of lung conditions from the workplace.

Occupational lung diseases are lung conditions caused or made worse by materials when a person is exposed to a workplace. The diagnosis of an occupational disease is important for workers' decision to continue work and for their eligibility under compensation programmes. We revisit the existing lung diseases that are closely associated with the occupation at the workplace namely occupational asthma, silicosis, black lung disease, farmers' lung disease, asbestos-linked disease, and hypersensitivity pneumonitis. Occupational lung diseases contribute toward global health and economic impacts. Prevention and control of occupational lung diseases require a collaborative effort among employers, workers, occupational physicians, pulmonary physicians, industrial hygienists, and members from other disciplines.

No Evidence of Coronaviruses or Other Potentially Zoonotic Viruses in Sunda pangolins (Manis javanica) Entering the Wildlife Trade via Malaysia.

The legal and illegal trade in wildlife for food, medicine and other products is a globally significant threat to biodiversity that is also responsible for the emergence of pathogens that threaten human and livestock health and our global economy. Trade in wildlife likely played a role in the origin of COVID-19, and viruses closely related to SARS-CoV-2 have been identified in bats and pangolins, both traded widely. To investigate the possible role of pangolins as a source of potential zoonoses, we collected throat and rectal swabs from 334 Sunda pangolins (Manis javanica) confiscated in Peninsular Malaysia and Sabah between August 2009 and March 2019. Total nucleic acid was extracted for viral molecular screening using conventional PCR protocols used to routinely identify known and novel viruses in extensive prior sampling (> 50,000 mammals). No sample yielded a positive PCR result for any of the targeted viral families-Coronaviridae, Filoviridae, Flaviviridae, Orthomyxoviridae and Paramyxoviridae. In the light of recent reports of coronaviruses including a SARS-CoV-2-related virus in Sunda pangolins in China, the lack of any coronavirus detection in our 'upstream' market chain samples suggests that these detections in 'downstream' animals more plausibly reflect exposure to infected humans, wildlife or other animals within the wildlife trade network. While confirmatory serologic studies are needed, it is likely that Sunda pangolins are incidental hosts of coronaviruses. Our findings further support the importance of ending the trade in wildlife globally.

DIFFERENTIALS IN SEXUAL AND REPRODUCTIVE HEALTH KNOWLEDGE AMONG EAST MALAYSIAN ADOLESCENTS.

The aim of this study was to assess the knowledge of East Malaysian adolescents on sexual and reproductive health issues. Data were collected in March-July 2015 from 2858 adolescents aged 13-18 years from selected East Malaysian secondary schools using a self-administered questionnaire. Twelve items relating to sexual and reproductive health were used to measure respondents' knowledge based on their responses 'True', 'False' or 'Don't know', with the proportion of correct answers being the variable of interest. Cronbach's alpha for the twelve items was 0.761 and the mean knowledge score was 6.8. While the majority of the respondents knew that a woman can get pregnant if she has sex with a man and that HIV and AIDS can be transmitted through sexual intercourse, knowledge about Malaysia's abortion laws, that a woman can get pregnant if she has sex only once and that people with sexually transmitted infections may look healthy was poor. Older respondents and those from urban schools reported significantly higher knowledge than younger respondents and those from rural schools, respectively. More emphasis should be given in schools to the specific topics for which low levels of sexual and reproductive health knowledge were found, with greater attention being given to younger adolescents and those in rural areas.

Private troubles to public issue: empowering communities to reduce alcohol-related harm in Sabah, Malaysia.

Summary: Alcohol is the number three contributor to the burden of disease worldwide so must remain a priority health promotion issue internationally. Malaysia is a Muslim country and alcohol-related harm was not seen as a priority until recently, because it only affects a minority of the population. Sabah has more than 30 different ethnic groups, and alcohol has a traditional role in the cultural practices of many of these groups. In 2009, the Intervention Group for Alcohol Misuse (IGAM) was formed, under the umbrella of Mercy Malaysia by a group of healthcare workers, academics, members of the Clergy and people who were previously alcohol-dependent concerned about the harmful effects of excessive alcohol consumption. IGAM in collaboration with other bodies have organized public seminars, visited villages and schools, encouraged the formation of a support group and trained healthcare professionals in health promotion intervention. The focus later changed to empowering communities to find solutions to alcohol-related harm in their community in a way which is sensitive to their culture. A standard tool-kit was developed using WHO materials as a guide. Village committees were formed and adapted the toolkit according to their needs. This strategy has been shown to be effective, in that 90% of the 20 committees formed are actively and successfully involved in health promotion to reduce alcohol-related harm in their communities.

Microenvironmental factors involved in human amnion mesenchymal stem cells fate decisions.

Human amnion mesenchymal stem cells (HAMCs) show great differentiation and proliferation potential and also other remarkable features that could serve as an outstanding alternative source of stem cells in regenerative medicine. Recent reports have demonstrated various kinds of effective artificial niche that mimic the microenvironment of different types of stem cell to maintain and control their fate and function. The components of the stem cell microenvironment consist mainly of soluble and insoluble factors responsible for regulating stem cell differentiation and self-renewal. Extensive studies have been made on regulating HAMCs differentiation into specific phenotypes; however, the understanding of relevant factors in directing stem cell fate decisions in HAMCs remain underexplored. In this review, we have therefore identified soluble and insoluble factors, including mechanical stimuli and cues from the other supporting cells that are involved in directing HAMCs fate decisions. In order to strengthen the significance of understanding on the relevant factors involved in stem cell fate decisions, recent technologies developed to specifically mimic the microenvironments of specific cell lineages are also reviewed. Copyright © 2015 John Wiley & Sons, Ltd.

Migrant workers in Sabah, East Malaysia: The importance of legislation and policy to uphold equity on sexual and reproductive health and rights.

Sabah, located in Southeast Asia, hosts the highest number of non-Malaysian citizens (27.7%), predominantly the Indonesian and Filipino migrants in comparison to other states in Malaysia. Sabah has inadequate data on migrants' sexual and reproductive health and rights (SRHRs). Various migrant-related policies and laws are present, but they do not offer full protection and rights to legal migrants in terms of their SRHRs. The aim of the laws and policies appears to be controlling the migrants from having any negative impact on the locals, rather than protecting migrants' health and rights. This affected their rights to marriage, having children, increase their vulnerabilities to labour trafficking and sexual abuse and access to health-care services. Female migrant workers and undocumented migrants form the most vulnerable subgroups of migrants. This narrative review highlights the status of SRHRs of migrants in Sabah and the migrant-related Malaysian laws and policies affecting their SRHRs.