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Bariatric procedures are on the rise as a surgical treatment for morbid obesity. In reproductive age of women, bariatric surgeries will improve factors related to anovulation and lead to spontaneous fertility. Spontaneous pregnancy can happen within a year after bariatric surgery due to higher level of sex hormone binding globulin and follicular stimulating hormone and reduction in androgens level. Reduction of length of follicular phase of menstrual cycle was reported and contribute to improved ovulatory status. The major impact to pregnant women is development of small for gestational age babies due to persistent weight loss but this can be minimized by avoiding pregnancies too soon after bariatric surgery and good nutrition supplement. Risk of developing gestational diabetes mellitus and preeclampsia reduced among post bariatric surgery compared to no surgery. Another benefit observed are reduction in the risk of caesarean section and admission to neonatal intensive care unit. There are no significant changes in composition of breast milk in postpartum women without bariatric surgery and with women whom undergone surgery although more study needed to evaluate this effect. Good prenatal care, micronutrient supplement during antenatal follow up and close supervision from expert managing this pregnancy are essential component to ensure good outcome to mothers and their newborn.

The severe acute respiratory coronavirus 2 (COVID-19) pandemic impacts the health of women at reproductive age in different ways, starting from pregnancy planning to post-delivery. This narrative review summarises the challenges to obstetric practice posed by the severe acute respiratory coronavirus 2 (COVID-19) pandemic. In this paper, we highlight the impacts of COVID-19 to obstetric practice globally and the efforts taken to address these challenges. Further study is critical to investigate the effects of COVID-19 on pregnancy, the outcome of COVID-19 positive pregnant women, and the safety of vaccination during pregnancy and breastfeeding.

Dysmenorrhea is one of the leading causes of pelvic pain and menstrual disorder among women during childbearing age. The burden of dysmenorrhea is greater than any other gynaecological complaint. Some women have severe dysmenorrhea which renders them incapacitated for days each menstrual cycle requiring absence from study or duty, frequently requiring pain killer, restriction of daily performance, poor sleep, negative moods such as anxiety and depression. A 31-year-old female presented with severe dysmenorrhea and heavy menstrual bleeding (HMB) as a cause of multiple uterine fibroids, underwent surgeries to remove 100 fibroids from her uterus which has improved her quality of life, eliminating her dysmenorrhea and menstrual abnormalities.

This study aimed to investigate the relationships between parental effort to control the child’s food intake among primary school children with parents’ ‘control’, ‘restriction’ and ‘reward’ on limiting children to eat unhealthy foods. Methods: Data were collected among 485 primary school children and their parents. Questionnaire for Obesity survey among primary school children was used to document on the child’s daily food intake for one week. Results: All predictor variables are significant at the p<0.05 level. The regression parameter for parents’ effort to restrict the next meal if child eats more than usual, is associated with 0.68631 increase in the parents’ effort to control the child’s food. Similarly, the regression parameter for parents’ effort to restrict the next meal if child eats more than usual is associated with 1.11653 increase in the parents’ effort to control the child’s food intake. Likewise, healthy food as a reward for bad behaviour is associated with 0.37709 increase in the parents’ effort to control the child’s food intake. Conclusion: This research showed that parental effort to control the child’s food intake with the purpose of limiting unhealthy food when the level of parents’ education varies is explained by three predictors (con¬trol, restriction, reward) that are interpreted as the effects in long term. Clinicians, nutritionists and researchers should pay attention to improve parental practices in the communities.

Health workforce education and training is a complex investment, which align education, finance, labour market and policies. Most medical universities have limited residency programs to satisfy the postgraduate career preference and lack of supervision career and social orientations to medical students which lead to misunder¬standings of personal learning plans and preferences in medical profession. Therefore, this study aimed to examine medical students’ career choices and altitudes towards medical instruction in preparing the medical students to work in rural and remote areas of Sabah. Methods: 98 First and 95 fifth year medical students were obtained consent to answer UMS Career Study Questionnaire consisting 29 questions on (1) medical schools - school career orientation; (2) students- study year; (3) student values- academic performance, and attitudes; (4) satisfaction- salary, secure, workload. (5) Perception on specialty (6) perception of potential benefits. Results: The first three selected specialties of choices for postgraduate training. Obstetrics and Gynaecology 26 (15.2%), surgery 23 (13.5%), paediatrics and child health 18 (10.5%) of the medical students, respectively. The main reasons for specialty preferences were oppor¬tunity to learn community health problems (35%), adequate time to study in rural health facilities (28%) and privilege for specialty training (24%), family live in rural area (20%). Conclusions: Medical students’ inclination towards few clinical specialties might raise a concern in shortage in various clinical speciality areas.

Role of nurses is very important in raising awareness, motivation level and increasing rate of organ donation subsequently. There are many studies on critical care nurses’ roles and education affect organ donation. Methods: A narrative literature review article of published research. Twelve published articles from ten different countries were found using different renowned online search engines. Results: Knowledge about organ donation among nursing students almost all over the world is inadequate than expectation and requirement in respective country. Marlene R et al showed that scores on the knowledge, attitudes, and beliefs subscales were positively cor¬related with the number of requests for tissue and organs and consents obtained (0.76); and consents obtained for tissues and consents obtained for organs (0.72). Professional education was indicated in 43% of nurses surpassing family beliefs, religion and mass media. The cognitive part (knowledge) is directly depends on non-cognitive (Aware-ness and Attitude). Findings from almost all articles suggest the need of adding organ donation topic in the nursing and medical curriculum to prepare competent nurses and health care providers for future. Conclusion: This study suggests that there is a need to integrate organ donation aspects into the educational program to prepare nurses for their roles in organ and tissue procurement as well as awareness among policy makers in this regard for the well-be¬ing of our patients.