Background Few data exist regarding the effect of hormonal contraception (HC) on incidence and progression of cervical disease (e.g., cervical dysplasia, squamous intraepithelial lesions, cervical intraepithelial neoplasia) in HIV-infected African women. Study Design We conducted an observational study of HIV-seropositive women in Johannesburg, South Africa. The effect of individual HC types on the incidence and progression of cervical disease was determined using Poisson regression to obtain adjusted incidence rate ratios (IRR). Results We evaluated 594 HIV-infected women, with median follow-up time of 445 days; 75 of these women were receiving some form of hormonal contraception (largely DMPA, NET-EN, or COCs) at baseline. Risks of incidence and progression of cervical disease were similar comparing women not receiving HCs to women receiving DMPA, NET-EN, or COCs both individually by HC-type and considering all HC together. Conclusions There was no statistically significant effect of particular HC methods or of HC use in general on rates of incidence or progression of cervical disease in this study. These results should reassure us that use of HC is unlikely to substantially increase risks of cervical disease among HIV-positive women.

Aim: To apply the Robson Ten Group Classification System (TGCS) in major South Asian hospitals to begin making recommendations to optimize cesarean section (CS) rates. Materials and methods: This cross-sectional study was conducted from September 2018 to February 2019 at public sector hospitals in five South Asian countries. We analyzed the pooled data for all five hospitals. The data were then stratified by the study hospitals. We utilized a Pearson χ 2 test to assess differences in CS by group. And p values <0.05 were considered statistically significant. Statistical analysis was performed using STATA 16. Results: A total of 37,251 women delivered in the five participating hospitals during the 6-month study period. Of these, 13,592 women were delivered by CS with a composite CS rate of 36% (range, 22-53%). Women in groups 1, 2, and 5 were the largest contributors to the overall CS rate in the participating hospitals. Statistically significant differences in CS rates between the hospitals were found in all groups except group 9. Conclusion: TGCS is useful as a starting point with which to identify patient groups warranting interventions to optimize CS. However, data collection alone is not sufficient. Analysis and interpretation should also include assessing maternal and neonatal outcomes. Clinical significance: Preliminary findings indicate that strategies to optimize the use of CS should include avoidance of medically unnecessary primary CS and increasing vaginal birth after cesarean.

No abstract

No abstract

The water quality problem has begun to receive significant attention from society in Malaysia as the water pollution issue has arisen over the years. Thus, determining the status of raw water quality is crucial to ensure the level of raw water quality has met the usable standard. This study aimed to identify the land activities near the Sungai Masai, Johor. Then, determine the water quality parameter of Sungai Masai, Johor and classify it according to the Water Quality Index (WQI) Malaysia. Complete characterization and classification of the water quality were compared with the standard from the Department of Environment (DOE) for Sungai Masai and were determined by conducting an experiment. Results show that water quality under three different types of land activities around Sungai Masai can be classified as Slightly Polluted or Class III, with WQI values ranging from 59.34 to 74.47. It can be concluded that the surrounding area around Sungai Masai has led this river to be highly contaminated. However, water from Sungai Masai can be used as drinking water, but it requires further treatment before consumption. The water was suitable only for fishery activities and agricultural irrigation if untreated. To improve the quality of research, the parameter for heavy metals should be conducted in the Industrial area to determine whether industrial waste may end up accumulating in the soil and sediment of water bodies or not.