BACKGROUND:In the postpartum period, fertility and sexual activity can return rapidly, placing women at risk of unintended pregnancy within the first 12 months following delivery. Unintended pregnancies during this period, particularly with short interpregnancy intervals, are associated with adverse maternal and neonatal outcomes. Postnatal contraception (PNC) counselling is often inconsistent, and gaps exist in both patient and provider knowledge and practices. OBJECTIVE:The objective of this study is to assess knowledge, attitudes, and practices of healthcare professionals and postnatal women regarding PNC and to evaluate the termination of pregnancy (TOP) clinic to review women seeking termination within 12 months of delivery in a UK district general hospital. METHODS:A cross-sectional, questionnaire-based survey of healthcare professionals and postnatal women was conducted between September 2024 and December 2024. In parallel, a retrospective study of women undergoing TOP between December 2023 and November 2024 was performed using electronic medical records. Quantitative survey data were analysed descriptively, and free-text responses were thematically analysed. RESULTS:Fifty-seven healthcare professionals (73.7% midwives (n= 42/57), 26.3% (n= 15/57) doctors) and 60 postnatal women participated. All staff acknowledged the importance of PNC counselling, but midwives were more likely than doctors to view it as part of their role (83.3% (n= 35/42) vs 40% (n= 6/15)). Knowledge of early return of fertility was limited (26.6% (n= 4/15) of doctors; 7.1% (n= 3/42) of midwives). Common barriers included time constraints and workload, and most staff expressed interest in further training (92.8% (n= 39/42) of midwives; 80% (n= 12/15) of doctors), preferring online modules 58% (n= 33/57) or face-to-face sessions 28% (n= 16/57). Among women, 53.4% (n= 32/60) were multiparous, 43.3% (n= 26/60) reported the recent pregnancy as unplanned, only 26.6% discussed PNC postnatally, mostly verbally, and awareness of fertility returning as early as three weeks postpartum was low (13.3%; n= 8/60). The audit showed that 15.4% (n= 29 of 188) women underwent TOP within 12 months of delivery, indicating that approximately one in five women experienced unintended pregnancies shortly after childbirth. CONCLUSION:Significant gaps exist in knowledge and counselling practices regarding PNC among both healthcare professionals and women. The findings underscore the need for systematic staff training and structured counselling pathways to improve timely uptake of contraception, reduce short interpregnancy intervals, and prevent unintended postpartum pregnancies.
Background Martial arts involve cutting, jumping and landing movements known to increase injury risk. Martial artists frequently sustain injuries. Recreational martial arts have yet to implement an evidence-informed prehabilitation programme to prevent these injuries. Here, we evaluate the Martial Arts Striking Sports prehabilitation programme (MASS-12) in a recreational setting. Methods Three traditional martial arts warm-ups and two MASS-12 warm-ups were delivered over 2 weeks as a recreational Jiu Jitsu club hall. A coach and seven athletes (five male, two female), ranging in experience from white belt to brown belt, participated. Main Outcome Measures were the Frontal plane projection angle (FPPA), a measure of dynamic knee valgus and Single leg vertical hops (SLVH), a measure of performance. Results Over half of recreational athletes reported previous, serious lower limb injuries. Athlete FFPA and SLVH significantly improved (−11.9° to −1.93°, 25.2 vs 27.5 cm, respectively) after the MASS-12. Athletes appreciated the increased feedback and sense of preparedness. The coach found it easy to teach and perceived improvements in performance. Conclusions The MASS-12 is easy for coaches to implement; improves lower limb alignment; and is accepted by athletes. A significant improvement on current practices, the MASS-12 should be widely implemented in recreational martial arts.
Superior mesenteric artery syndrome (SMAS) is a rare cause of upper gastrointestinal obstruction caused by compression of the third portion of the duodenum between the abdominal aorta and the superior mesenteric artery, usually due to rapid weight loss or an anatomical predisposition that reduces the retroperitoneal fat pad between these vessels. Its symptoms often mimic more common gastrointestinal disorders, which can delay diagnosis, making cross-sectional imaging, particularly computed tomography (CT), essential for identifying a reduced aortomesenteric angle and distance with proximal duodenal dilatation. We report the case of a 17-year-old female patient who presented with persistent nausea, vomiting, and inability to tolerate oral intake despite extensive gastroenterological evaluation; upper gastrointestinal endoscopy and magnetic resonance cholangiopancreatography were unremarkable, but CT subsequently demonstrated an aortomesenteric angle of approximately 17° and a distance of approximately 7 mm with proximal duodenal dilatation, consistent with SMAS. She was managed conservatively with nutritional optimisation and supportive therapy. This case highlights the diagnostic challenge of SMAS and underscores the importance of considering it in patients with unexplained persistent vomiting, as early recognition and appropriate imaging are crucial to prevent prolonged morbidity and unnecessary investigations.
Congenital pulmonary airway malformation (CPAM) is a rare developmental lung malformation that is usually diagnosed antenatally or during early childhood. Adult presentation is uncommon and may present a significant diagnostic challenge because of overlapping radiological features with other cystic lung diseases and malignancy. We report the case of a 49-year-old man with an incidentally detected large multiseptated cystic lesion occupying almost the entire right upper lobe. CT and PET-CT suggested a congenital cystic lung lesion without evidence of metabolically active malignancy. Following multidisciplinary discussion, the patient underwent video-assisted thoracoscopic wedge resection. Histopathological examination demonstrated benign cystic pulmonary changes without evidence of malignancy. The patient made an excellent postoperative recovery, with complete radiological resolution and objective improvement in pulmonary function. This case highlights the importance of considering CPAM in the differential diagnosis of large cystic pulmonary lesions in adults. Multidisciplinary assessment and surgical resection remain essential for establishing a definitive diagnosis and achieving favorable clinical outcomes.
