AimTo compare the mean of anteroposterior (AP) measurements of the uterus in longitudinal and oblique transverse planes, and the pulsatility index (PI) and resistive index (RI) of the uterine artery and superficial skin wound artery between patients taking Channa striatus and placebo.Background Channa striatus, also known as haruan, is a fresh water snakehead fish consumed in many parts of Southeast Asia. Channa striatus is also normally consumed by women postpartum to promote wound healing as well as to reduce post-operative pain.MethodologyThis study is a randomised, double blind, placebo-controlled study conducted in women after Lower Segment Caesarean Section (LSCS). Subjects were randomised to either a Channa striatus or a placebo group and were given a daily dosage of 500 mg of Channa striatus extract or 500 mg maltodextrin, respectively, for six weeks post LSCS. The anteroposterior measurements of the uterus in the longitudinal and oblique transverse planes, and the pulsatility index (PI) and resistive index (RI) of the uterine and superficial skin wound arteries were assessed using pelvic Gray-scale ultrasound and Doppler ultrasound at baseline (Day 3) and at two weeks, four weeks and six weeks post-operatively.ResultsSixty-six subjects were randomised into the study with 33 in the Channa striatus group and 33 in the placebo group. No significant differences were detected in terms of the pulsatility index (PI) and the resistive index (RI) of the uterine and superficial skin wound arteries between the Channa striatus and placebo groups. However, in the Channa striatus group, the AP measurements of the uterus on the longitudinal and oblique transverse planes were significantly lower compared to the placebo group (p<0.05 and p<0.001, respectively).ConclusionDaily intake of Channa striatus extract results in marked differences compared to placebo in terms of uterine involution and recovery in women post LSCS.Trial Registration www.isrctn.com 11960786

Maternal morbidity is a concept of increasing interest in maternal health. This review aims to assess the contributory factors for severe maternal morbidity over the past one decade worldwide. A comprehensive electronic search was conducted. The search was restricted to articles written in the English language published from 2004 to 2013. Qualitative studies were excluded. A total of 24 full articles were retrieved of which 9 cohort, 7 case-control, 3 cross-sectional studies, and 5 unmentioned designs were included. The contributory factors were divided into 3 components: (a) sociodemographic characteristics, (b) medical and gynecological history, and (c) past and present obstetric performance. This review informs emerging knowledge regarding contributory factors for severe maternal morbidity and has implications for education, clinical practice and intervention. It enables a better understanding of the problem and serves as a foundation for the development of an effective preventive strategy for maternal morbidity and mortality.

Malay-Muslim identity is the regular norm among Malays in Malaysia; however, this identity has been challenged with the emergence of sexual-and-gender minority (SGM). Even though Malay cultural values and Islamic teachings prohibit same-sex orientation and cross-gender, a SGM group has evolved among Malay-Muslim natal females. This meta-synthesis was conducted to explore the psychosocial factors involved in the construction of SGM and its consequences among Malay natal females in Malaysia using the Sandelowski-Barroso approach. A systematic search of articles was done in the selected databases by using identified keywords between October to December 2020. Twelve full articles were included after proper screening and in-depth reviews. The quality of these articles was assessed independently by two researchers. The articles were then analysed using ATLAS.ti 8 software to group the data into subthemes and themes. Lastly, the effect sizes of each subtheme were calculated. Three main themes were identified: affection seeking, hurtful experience and nurturing influences. Malay natal females also shared consequences following construction of SGM identity which include acceptance from community, continuous conflicts in life and mental health consequences. This meta-synthesis revealed the influences that shape the construction of Malay SGM women. Thus, interventions shall be planned to aid them according to cultural and psychosocial factors.