RESUMO
Background: As one of Indonesia's major social media platforms, Instagram provides abundant information, including fertility topics. However, fertility information in Bahasa (Indonesian language) had never been mapped before. This study aims to determine the prevalence, authorship, and types of fertility-related information in Bahasa shared on Instagram using hashtag and content analysis. Additional outcomes included a comparison of post content stratified by author type (healthcare providers vs. non-healthcare providers). Materials and methods: Five hashtags comprising fertility terms in Bahasa (Indonesian language) were derived. Content analysis was performed on the top 100 posts for each hashtag to determine the authorship and content type. The contents posted by healthcare providers were analyzed and compared to those published by non-healthcare providers. Results: Our search yielded 3 883 000 posts for the five most popular hashtags. The three most popular hashtags were 'promil', 'program hamil' and 'bayitabung'. Authorship of the top posts for each hashtag was predominantly by for-profit healthcare institutions (27.6%), followed by commercial alternative/herbal medicine (20.2%), patients (20%), physicians (11.8%), allied health professionals (3.2%), professional societies (0.8%), and others (16.4%). Of these posts, 35.4% were advertisements, 28% were related to patient experience, and 18% were educational. Healthcare provider groups were more likely to author educational posts than advertisements, while non-healthcare providers were more likely to post content for commercial purposes (P < 0.001). Conclusion: Fertility-related posts were dominated by for-profit healthcare institutions and alternative/herbal medicines for commercial purposes. The physician group authored more of the educational content. There is plenty of room for optimal utilization of social platforms as educational media.
RESUMO
Introduction and importance: International Federation of Gynecology and Obstetrics (FIGO) and WHO report the incidence of postpartum haemorrhage (PPH) reaches 1-10% and contributes to an increase in postpartum maternal mortality with uterine atony as the most common cause. B-Lynch method is a suturing technique to overcome PPH. Although this method has proven useful as an emergency life-saving measure, the post-procedure complications are still able to occur. Presentation of case: The patient was not menstruating for 14 months after giving birth through caesarean section with B-Lynch due to PPH. Before pregnancy, she had regular menstruation cycle and normal menstrual duration. Her general and gynaecological status were normal. Ultrasound showed the impression of uterine hypoplasia and endometrium that were difficult to assess while both ovaries were normal. Diagnostic hysteroscopy showed a severe degree of Asherman's syndrome. The results of FSH, LH and estradiol were normal. Discussion: B-lynch suture is performed as a method to stop PPH in uterine atony. Secondary amenorrhoea occurs as a complication of B-lynch. Compression action of B-lynch can cause progressive myometrium necrosis resulting in synechiae and blockade of uterine blood flow. This will interfere with the development of the uterus. Intrauterine adhesions and amenorrhoea with normal levels of FSH, LH, and estradiol support the diagnosis of Asherman's syndrome. Conclusion: This case shows that the B-Lynch procedure, which is the worldwide recommended method for treating postpartum haemorrhage due to its high success rate, can cause complications of Asherman's syndrome and cause secondary amenorrhoea.
RESUMO
Recombinant tissue plasminogen activator (r-tPA) is the first-line drug for the treatment of acute ischemic stroke, despite it may lead to a variety of complications in some cases. In patients with extensive stroke, infarction of the brain can cause suppression of the respiratory center in the brain leading to neurogenic pulmonary edema that potentially causes respiratory failure. Its etiology is either due to a neurogenic or non-neurogenic process. Nevertheless, the definite pathophysiology of these circumstances remains unclear. In this study, we reported four cases of post-thrombolytic ischemic stroke patients who suffer from pulmonary edema with different symptoms and onset times as well as we discuss the possible explanation behind these different outcomes.
