Bacterial colonization, species diversity and antimicrobial susceptibility patterns of indwelling urinary catheters from postpartum mothers attending a Tertiary Hospital in Eastern Uganda

Background Postpartum urinary Catheter-Related Infections (CRIs) are a significant cause of maternal sepsis. Several studies done have reported the presence of mixed populations of bacteria with a significant increase in Extended-Spectrum Beta-Lactamase (ESBL) Enterobacteriaceae spps, Methicillin-Resistant Staphylococcus aureus (MRSA), Multi-Drug Resistant (MDR) bacteria in urine and blood cultures of catheterized patients despite the use of prophylactic antibiotics. This study aimed at determining the bacterial species diversity and susceptibility patterns of indwelling urinary catheters from postpartum mothers attending Mbale Regional Referral Hospital (MRRH). Methods A cross-sectional study employing quantitative and qualitative was carried out in MRRH among postpartum mothers with urinary catheters and their care-takers. The purposive non-random sampling strategy was used to collect data using an interviewer-administered questionnaire for the quantitative data collection and in-depth interviews for qualitative data collection. All the data collection tools used were developed, pretested and validated. At the point of de-catheterization, Catheter tips from enrolled participants were cut about 2-3cm below the balloon aseptically into test-tube containing peptone water, sonication technique employed, and incubation done 24hours then cultured to ensure phenotypic identification. An antibiotic sensitivity test was performed using the disc diffusion method following Clinical and Laboratory Standards Institute (CLSI) guidelines. Quantitative data collected was entered in Microsoft Excel and then exported to STATA14 for statistical analysis. Thematic analysis was used to analyse and organise qualitative data by an inductive coding method using Nvivo 12 software. Results In this study, 208 postpartum mothers participated, the majority of whom were caesarean section mothers of age range 20–24 years and 17 care-takers with a median age of 32 years. The prevalence of catheter tips bacterial colonisation was 98% despite 88.5% of the participants being on broad-spectrum antibiotics. The average duration of catheterisation was 2 days. All bacteria isolates were potential uro-pathogens with a mean occurrence of 2 bacteria species in each urinary catheter tip. The rates of MDR to commonly used antibiotics were high. The urinary catheter size of greater than F14 and duration of catheterization greater than 2 days were significantly associated with the number of bacterial species isolated from each sample. The maintenance care and knowledge of care-urinary catheter care among the care-takers was found sub-optimal. Conclusion There was a high prevalence of catheter colonisation with bacterial spps diversity averaging 2 spps per sample despite use of broad spectrum antibiotics. The MDR rates were high, which calls for routine culture and sensitivity. Health workers practicing obstetric medicine need to pay attention to catheter sizes during catheterisation and its duration. Health education should be part of antenatal and postnatal care education.

“Worn-out but happy”: Postpartum Women's Mental Health and Well-Being During COVID-19 Restrictions in Australia

Background: From late 2019, COVID-19 disease has infiltrated the global population causing widespread challenges to public health. One cohort that has received less attention, but who may be more vulnerable to the mental and physical health related impacts of COVID-19 restrictions are postpartum mothers. The aim of this study was to explore the mental health, well-being, and health behaviours of mothers up to 12 months postpartum whilst living in Australia under COVID-19 level 3 and 4 restrictions.Methods: 351 women in their first year postpartum residing in Australia whilst under level 3/4 social distancing restrictions (during April 13 and June 11, 2020) were recruited to participate in an online questionnaire. The survey measured symptoms of depression, anxiety, and stress (DASS), wellness (SF-36), physical activity (Godin-Shephard score), perceived value of health outcomes, diet, and sleep. Descriptive statistics and linear regressions were performed.Results: Data was analysed for 139 eligible women. Of these women, 74% scored “normal” for depression, 84% for anxiety, and 72% for stress. Over half (58%) of women reported being worn out all, most, or a good bit of the time and 77% reported being a happy person all, most, or a good bit of the time. Analysis of the perceived values of health outcome revealed women had high value for “getting out of the house,” “achieving a better overall mood,” and “to feel better physically.” Women were considered physically active according to the Godin Leisure score, however only 41% of women met the current Australian national physical activity guidelines of 150 min.week−1.Conclusions: Overall the majority of postpartum mums that were surveyed, have normal mental health symptoms, and despite being worn out most are happy at least a good bit of the time. This study highlights the importance of health values in maintaining leisure physical activity and mental health. In addition it appears women may benefit from virtual group exercise and community programs to encourage being physically active and socialising with friends simultaneously.

HUBUNGAN PENGETAHUAN DAN SIKAP IBU NIFAS TENTANG ASI KOLOSTRUM DENGAN PEMBERIAN ASI KOLOSTRUM PADA BAYI BARU LAHIR

WHO recommends mothers to exclusively breastfeed their babies in the first 6 months after birth to achieve optimal growth, development and health. This study aims to determine the relationship between knowledge and attitudes of postpartum mothers with colostrum breastfeeding for newborns in the working area of ??the Rambung Public Health Center, South Binjai District in 2017. The design of this study used an analytic survey, with a cross sectional approach. The sampling was purposive sampling with a total sample of 86 people in the working area of ??the Rambung Health Center, Rambung Dalam Village, South Binjai District, North Sumatra Province. The data used are secondary and primary. Data were analyzed by chi-square test. The results of the study, there was a significant relationship between the attitude of postpartum mothers with colostrum breastfeeding in the working area of ??the Rambung Health Center, Rambung Dalam Village, South Binjai District, North Sumatra Province with p value = 0.000 < (0.05). Giving colostrum breast milk to newborns because it can help provide comfort and strengthen baby antibodies early, so it is hoped that the Rambung Health Center, especially health workers, can improve service programs, especially counseling and socialization to postpartum mothers that the importance of colostrum breastfeeding for newborns.

Perbedaan Kadar Zink ASI pada Ibu Postpartum dengan Anemia dan Tidak Anemia

Zinc is one of the substances needed in breast milk for baby growth. Zinc deficiency is a common health problem that affects the development of children and contributes to diseases such as diarrhea, pneumonia, and malaria. The purpose of this study was to determine the difference in zinc levels in the first week postpartum mothers with anemia compared to postpartum mothers who were not anemic. The research design used observational analytic with a cross-sectional approach, with purposive sampling. Examination of zinc levels in breast milk using spectrophotometry. Data analysis used an unpaired t-test. The test results obtained that the average zinc level in the first week postpartum mothers who were not anemic was 0.40±0.350 mg/L while the average zinc level in the first week postpartum mothers with anemia was 0.42±0.439 mg/L with p-value=0.92 (p>0.05). There was no difference between zinc levels in the first week postpartum mothers with anemia and not anemia. The zinc concentration in breast milk is highest during colostrum, while the lowest value is between 7-12 months of lactation and increases during weaning.

LITERATUR REVIEW: PENGARUH PEMBERIAN ASI PADA IBU POSTPARTUM DENGAN KEJADIAN POSTPARTUM DEPRESSION

Postpartum depression is the situation of depression experienced by mothers after giving birth. Postpartum depression affects the reduction or cessation of the process of breastfeeding to mothers. The purpose of this study was to analyze the effect of breastfeeding mothers with the incidence of postpartum depression on postpartum mothers. The research method was carried out by a literature review study approach using several journal sources that were selected based on predetermined criteria. The data source is based on updated journals with limited journal publication from 2015-2021. The results were showed the differences in the level of depression in postpartum mothers are due to differences in responses or coping mechanisms possessed by each mother. The conclusion is the risks of postpartum depression were occured due to three factors, which are problems with breastfeeding, husband's support, and income.

E-Postpartum mobile application to increase postnatal knowledge care

Background: During this pandemic, maternal health services must still be considered because it is feared that there will be an increase in postpartum maternal morbidity and mortality. Postpartum care knowledge is vital for postpartum mothers to maintain their condition, so it is necessary to make an application that helps mothers through the E-Postpartum application.Objective: The study aims to develop and test the E-Postpartum mobile application to increase knowledge of postnatal care.Method: This study employed Research & Development consisting of 4 stages, namely Literature Study, Development Stage, Validity Expert, and Trial.Results: The E-Postpartum mobile application has six features, starting from education about postpartum care to consultation. The trial results showed that the application effectively increased the knowledge and action of postpartum mothers (p <0.001).Conclusion: The E-Postpartum application is beneficial for health workers in providing education, especially for postpartum mothers in carrying out care during the postpartum period. This postpartum application will make it easier for mothers to check their condition and make it easier for midwives to detect early and control the mother's condition even remotely.

EFEKTIVITAS DAUN BANGUN-BANGUN DALAM MENINGKATKAN PRODUKSI ASI PADA IBU NIFAS

Exclusive breastfeeding is breastfeeding for the first 6 months of the baby's life without the intake of other food or drinks except vitamins, drugs and ORS. Bangun-bangun plant (Coleus Amboinus Lour) is one of the types of plants consumed by new mothers in North Sumatra, especially by the Batak tribe. The purpose of this study was to determine the effectiveness of the leaves of Bangun-bangun in increasing milk production in the Independent Practice of Midwife Rismayani Harahap, S.Tr.Keb. The research method uses the Quasi Experiment Design method using the Non-Equevalent Control group approach. The study used the Independent T-Test test, namely P = 0.000, which means that there is an Effectiveness of Giving Bangun-bangun Leaves to Increase Breast Milk Production in Postpartum Mothers