\r\n\tGlobalization does not represent a pure and generous process for humanity or other species, but rather it implies social exclusion and also provokes situations of vulnerability in groups of people, forced exclusion, and apartheid: poor job opportunities, lack of access to education, worse socio-sanitary conditions. Specifically, it can be said that social segregation entails the apartheid of social groups of different ages, genders, and ethnicities; these groups live a reality manifested through the deepening of poverty, in terms of increased vulnerability of the poor and groups with little economic, social, cultural, labor and health stability.
\r\n
\r\n\tThis book aims to talk about some topics that are neglected in the discourses of academic communities and political elites. The inequality process is deeply rooted among humans and is part of many people's lives in the form of modern apartheid, gender segregation, lack of health access, and cultural gap. All those structural inequality processes are the product of the biopower perpetuated and produced in the macrosystem, exosystem, mesosystem, and microsystem. For many people from the academy, the information-consuming public, and the society in general, it is a problem to talk about these processes, since they have either lost interest or have normalized the structural and social inequity. For this reason, we see it as transcendental to explain how this situation occurs from the most internal fibers to the most evident processes, intending to make it more visible and thus expose the situation for possible solutions.
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1. Introduction
The group of plants belonging to a family of giant woody grasses is called bamboo. Among the wide spectrum of uses of bamboo are conceivable purpose, like scaffolding to boats, cooking utensils, furniture, food, fuel, landscaping, ornamental display and a thousand other uses [1]. Despite the enormous importance of bamboo to our social and economic well-being, researchers are still exploiting the potential derivable from most bamboos, in accordance to the International Network for Bamboo and Rattan (INBAR) vision 2015–2030 to carry out sustainable development goals. Furthermore, the food and agricultural organization in collaboration with INBAR (FAO/INBAR) has devised a strategic goal by promoting innovative solutions for poverty and environmental sustainability using bamboo and rattan [2]. However, there is a need to set a direction and define a road map for green development through research and expansion of research breakthroughs using bamboo as a natural fiber source. Being an example of natural fibers, bamboo is renewable, carbon neutral and biodegradable and also produces waste that is either organic or can be used to generate electricity or make ecological housing material [3]. It provides socio-economic benefits, since natural fibers not only come from the environment, but also benefit it.
2. Overview of bamboo research
In order to achieve the above goals, information about the latest empirical breakthroughs with respect to bamboo research scientific discoveries is very pertinent. It is assumed that these findings will further enhance the previous contributions of researchers on the latest scientific applications of bamboo fibers and result of research activities. These are necessary indicators that might be used to assess progress towards these and future milestones. Efforts have been focused in the past towards addressing some of the most pressing contemporary socio-economic issues that bother on the solutions for poverty and environmental sustainability using bamboo. It has been revealed that, apart from the very long species of bamboo, there exist dwarf bamboo which are distributed in areas like northern part of Japan [4]. The growth characteristics of different species of bamboo with respect to geographical locations are therefore important in order to have an idea of the distribution of this dominant forest floor bamboo species in the respective region.
A review of microfungi, i.e., bamboo ascomycetes, with brief appraisal of major morphology and phylogeny of bambusicolous ascomycetes needs to be highlighted, while various species of fungi associated with bamboo need to be enumerated. Moreover, the history, distribution and importance of bamboo ascomycetes to agricultural and economic development as well as research prospects of bamboo ascomycetes will assist in examining the physico-mechanical and thermal studies of bamboo fiber [5]. The knowledge of the fundamental characteristics of bamboo fiber to maximize bamboo utilization in the area of providing mechanical and physical properties of bamboo has been seen as panacea which affects the bamboo durability and strength.
Another area of utmost interest is the modification of bamboo for sustainable product development. Both chemical and thermal modifications of bamboo otherwise called pyrolysis of bamboo enhance the properties of bamboo by extending the bamboo fiber applications [6]. Chemical treatments assist in reinforcing bamboo by modifying the bamboo surface and improve its compatibility with polymer matrix [7]. One of the major by-products of the charcoal collected during the pyrolysis of the charcoal is bamboo vinegars. The potential usage of charcoal from bamboo pyrolysis as safe pigment for food and natural moisture-proof material is another area of paramount research interest. The end use of these modificational approaches on bamboo is for food, energy, pulp, paper, buildings, etc.
The potential of bamboo as a new renewable energy is another breakthrough in the development and scientific cultivation of bamboo. This has been reported to greatly influence people’s sociocultural lifestyle and emergence of natural fibre-based composites from various types of bamboo. The influence of type and form of bamboo fibers as fillers and reinforcements has further promoted the performance of bamboo composites. Bamboo production for traditional and modern applications as the country develops and emergence of new economic activities with bamboo resources utilization is very prominent specifically in forest-depleted region like China [8]. Furthermore, the application of bamboo in friction material and as reinforcement materials in concrete structure has been reported as safe and comfortable and could provide simple house for poor families. Recently bamboo is being used as reinforcement in thermoplastic polymers [9], since natural fiber such as bamboo exhibits comparable reinforcement effects to that of conventional glass fibers [10]. The changes in engineering properties of the thermoplastic matrices after the incorporation of untreated and treated bamboo are few of the uses of bamboo in polymer composite. The recent report of the suitability of the alkaline sulphite anthraquinone and methanol pulping on bamboo culms, i.e., G. scortechiniibamboo species, has been attracting the attention of polymer scientists [11]. Its use in industrial production of pulp and paper packaging was buttressed by the biometric characterization of the bamboo culms together with the optimum pulping parameters.
3. Conclusion
Since bamboo has high potential socio-economic value, more efforts should be geared towards unraveling possible application of the various forms of bamboo. With the aim of maintaining a good balance between the fundamental and practicability of bamboo utilization, critical approach to meeting new challenges of technology and innovations is a task the researchers should prepare to surmount.
Acknowledgments
The author is thankful to the School of Industrial Technology, Universiti Sains Malaysia (USM), for contributing effectively towards the success of this book.
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School of Industrial Technology, Universiti Sains Malaysia, Penang, Malaysia
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1. Introduction
Episiotomy is a surgical cut in the tissue between the vagina and the anus (called the perineum) made just before delivery. It is one of the most commonly practiced obstetric procedures done to enlarge the diameter of the vulval outlet to facilitate the passage for the fetal head and prevent an uncontrolled tear of the perineal tissues in the second stage of labor [1, 2, 3]. The procedure was introduced into obstetric practice without any sound scientific evidence corroborating any possible benefits [4]. It was promoted in the twentieth century by renowned interventionists, obstetricians such as Gabe and De Lee [5]. Their perception was that the female body was essentially defective and dependent on medical interventions to enable childbirth [5]. In 1970s, there was disagreement in the practice especially because of pressure from the women’s movements demanding changes in the obstetric model [4].
In 1983, Thacker and Banta gave a full account of the lack of scientific data supporting the use of episiotomy and the potential danger associated with the procedure [3]. Historical indications such as a prolonged second stage, macrosomia, non-reassuring fetal heart rate, instrumental delivery, occiput posterior position, and shoulder dystocia have been questioned [6].
Routine episiotomy is now considered to be obstetrics violence when a woman is automatically transformed into a patient and when routine medical procedures are carried out without giving the woman the right to make her own decisions concerning her own body [7].
1.1 Types of episiotomy
The most commonly practiced and accepted type of episiotomy is the mediolateral, owing to its protective roles in preventing obstetric anal sphincter injury (OASI) [8]. Median/midline episiotomy, although has a bigger risk of causing OASI, is praised for causing less pain/bleeding, ease in repair, and healing more easily [9]. A clear illustration and description of the type of episiotomy can be seen in Figure 1 and Table 1. Other reported episiotomy types in literature are lateral episiotomy, which was condemned, and also a J-shaped episiotomy incision that is not commonly practiced.
Figure 1.
Illustration of episiotomy types.
Type of episiotomy
Definition
Way of execution
Median
The incision starts at the posterior fourchette and runs along the midline through the center of the perineal body. The incision should run for approximately half of the length of the perineum (2–3 cm) without affecting the anal muscle
Mediolateral
An incision is performed downward and outward from the midpoint of the fourchette, either to the right or left toward the ischial tuberosity with 3–4 cm length, beginning in the midline and directed laterally, and downward away from the rectum. It affects the skin, subcutaneous tissue, bulbospongiosus muscle, superficial transverse perineal muscle, and the levator
Lateral
The incision starts from about 1 cm (0.4 in) away from the center of the fourchette and extends laterally. Possible complications comprise injury to the Bartholin’s duct, which is why lateral incisions are deemed inadvisable by most specialists and rarely mentioned in the obstetric literature
J-shaped episiotomy
It entails a midline incision, curved laterally away from the anus. Curved scissors are used starting in the midline of the vagina until the incision is 2·5° cm from the anus, then directing the incision toward the ischial tuberosity away from the anal sphincter
Radical lateral (Schuchardt incision)
Generally considered a non-obstetrical incision, it is a fully extended episiotomy, deep into one vaginal sulcus and is curved downward and laterally partway around the rectum. It may be carried out at the beginning of radical vaginal hysterectomy or trachelectomy to allow easy access to the parametrium, to enable extraction of a neglected vaginal pessary, or quite rarely, to facilitate childbirth if complications arise (fetal macrosomia, difficult breech, or shoulder dystocia)
Episiotomy incision is generally repaired after delivery of placenta to achieve hemostasis and approximate lacerated tissues. The aseptic procedure is carried out in a well-lit room with adequate exposure and appropriate instruments and anesthesia. Since most if not all repairs are done in laboring wards, adequate local or regional analgesia is used. Extension to a third- or fourth-degree perineal tear may necessitate examination under anesthesia and requires regional or general anesthesia that is done in an operating theater.
A suture is placed approximately a centimeter proximal to the apex of the incision within the vagina and secured with a knot, vaginal mucosa, and sub-mucosa are sutured up to the hymeneal ring, perineal muscles are then approximated followed by the closure of perineal skin using a continuous subcutaneous suturing technique [11]. Continuous stitching technique is preferred to interrupted as it is associated with less pain, easily performed by the inexperienced operator, and economical [12].
1.3 Current trend in episiotomy practice
Episiotomy is practiced in varied ways with differing prevalence ranging from as low as less than 1/3 to as high as 86% [13] depending on whether it is used routinely or in a restricted way.
World Health Organization (WHO) Guideline Developing Groups emphasized the need for health systems to adopt a policy of restrictive rate of not more than 10% rather than routine use of episiotomy to reduce its potential complications and the use of additional resources for its treatment [14] as restrictive episiotomy has shown benefits [15]. Restrictive other than routine episiotomy protocol has been supported by FIGO [16], a mediolateral episiotomy type is the one recommended, and this should be performed under adequate analgesia, whether anesthesia is already in place for labor, such as epidural, or by administering a local infiltration [16].
Despite the controversy regarding the validity of episiotomy’s routine use in obstetrics and the fact that liberal use of the procedure has been discouraged, this is still one of the most commonly performed obstetric procedures worldwide [17, 18]. Although this restrictive episiotomy practice has shown many benefits, especially regarding the reduction of injuries to the posterior perineum, the strictest definition of restrictive use was to avoid episiotomy unless indicated for fetal well-being. Other definitions of restrictive episiotomy are to “avoid the procedure,” use only when “medically necessary,” or not perform an episiotomy to avoid a laceration [19]. The balance between risk and benefit for episiotomy is therefore not entirely straightforward. An episiotomy may be unavoidable if the baby needs to be delivered quickly.
The lack of evidence supporting episiotomy benefits has caused a significant decline in the practice in most countries. In France, a decline from 15.5% in 2013 to 9.3% in 2017 has been realized [20], and for operative vaginal births, there had been a varied decrease in episiotomy rates from as low as 25% to as high as 75% in some geographical location in France [21].
1.4 Indications
Historical indications for episiotomy included: abnormal progress of labor, non-reassuring fetal status, prematurity, assisted vaginal delivery, shoulder dystocia. It was also believed to hasten the second stage of labor, decrease pelvic floor disorder and sexual dysfunction, reduce urinary and fecal incontinence [15]. Several guidelines recommend the use of mediolateral episiotomy for the prevention of obstetric anal sphincter injuries (OASI) [8]. Episiotomy plays the main role during assisted vaginal birth as this is related to the increased incidence of OASI. The procedure can be indicated when there is a high likelihood of third-degree or fourth-degree perineal tear, soft tissue dystocia, a requirement to accelerate delivery of a compromised fetus, and need to facilitate operative vaginal delivery or a history of female genital mutilation [22].
1.5 Factors associated with episiotomy
Varied risk and protective factors are influencing the practice of episiotomy in obstetrics. The risk factors include primiparity [23, 24], absence of prior vaginal birth, assisted vaginal delivery are among the predictive factors influencing episiotomy practice. In some settings, episiotomy operations were being performed to allow midwifery and medical students the opportunity to learn and practice the procedure [24]. Being an adolescent and having other medical conditions while pregnant is associated with the procedure [25].
Factors that are protective against episiotomy include perineal massage. This procedure can be done especially in the second stage of labor [26, 27, 28]. The procedure is an effective approach to increasing the chance of delivery with intact perineum especially for women with a first vaginal birth [29]. In other literature, massage can be started as early as 34 weeks of gestation, and it is done with oil for 5–10 min every day to increase flexibility and elasticity [30]. In addition to massage, perineal support and warm compresses during the second stage are protective for episiotomy and anal sphincter injury [30].
Another important innovative tool to reduce the risk of episiotomy is an Epi-No device, developed in early 2000, to facilitate a natural birth and reduce the risk of perineal injury including needs for episiotomy. The Epi-No device is promising, with potentially positive effects on a natural birth without major complications [31].
1.6 Obstetric anal sphincter injuries (OASI)
OASI are injuries that involve the anal sphincter. It is dreaded complication after a vaginal delivery that has significant maternal morbidity such as perineal pain, dyspareunia, flatulence, and anal incontinence [33].
OASI either involves third or fourth-degree perineal tears. A third-degree perineal tear is defined as a partial or complete disruption of the anal sphincter muscles, a fourth-degree involves the rectal mucosa [34] as seen in Table 2 and Figure 2.
Third-degree tear
Injury to the perineum involving the anal sphincter complex
3A
Less than 50% of EAS thickness torn
3B
More than 50% of EAS thickness torn
3C
Both EAS and IAS torn
Fourth-degree tear
Injury to perineum involving the anal sphincter complex (both EAS and IAS) and anal epithelium
Buttonhole tear
External anal sphincter intact but anal or rectal mucosa with or without internal anal sphincter tear
The risk of getting OASI can be done by relieving pressure on the central posterior perineum by an episiotomy and/or controlled delivery of the head. An episiotomy aimed at 60° from the midline has been seen to be protective for OASI [36]; hence, the introduction of episiotomy scissors specially designed to achieve a cutting angle of 60°, EPISCISSORS-60® [37]. Vacuum-assisted delivery and bigger babies were seen to be an important independent factor in one cohort study [38].
1.6.1 OASI repair—sphincteroplasty
A repair can be done primarily if OASI is diagnosed following vaginal delivery, and this represents the mainstay of treatment. A delay of up to 12 h is allowable if resources for repair are not available. A secondary repair can be done later when tissue edema has subsided for cases diagnosed later or if injuries have been unrepaired for more than 12 h, and this is referred to as secondary repair [39].
The aim of sphincter repair (either primary or secondary) is to restore a functioning anal canal by reconstruction of a muscular cylinder that is at least 2 cm thick and 3 cm long [39].
Meticulous hemostasis and anatomic approximation with a multilayer closure of all disrupted tissue layers are the key principles for preventing complications and restoring fecal continence and two recognized methods for the repair of OASI: end-to-end (approximation) and overlap repair [39] are important depending on the extent of the injuries as illustrated in Figure 3.
Figure 3.
Episiotomy repair technique. Adopted from [39].
An overlap is more superior to an end-to-end method in terms of reduction in perineal pain, dyspareunia, flatus incontinence, and fecal incontinence [39, 40].
Although the repair techniques have been well documented, the confidence in detecting OASI and competence in the repair of OASI does not correlate with knowledge of anatomy and risk factors of OASI in a survey among obstetricians [41].
1.7 Complications
The suitability of routine use of episiotomy has been questioned by specialists and scientific societies, and several professional medical associations and patient and women’s rights advocates have been associating it with obstetric violence [9]. Episiotomy has been associated with the risk of repeat episiotomy in the subsequent birth due to tighter perineum and weaker scar [42]. Post episiotomy pain is common after delivery, and this may end up in pain at first intercourse especially if it occurs in the first 3 months after delivery [43]. The risk is higher if intercourse occurs within the first 6 weeks after delivery and in some cases, women present with gaping episiotomy wounds following intercourse [44]. The incision substantially increases maternal blood loss, the average depth of posterior perineal injury, risk of anal sphincter damage, improper wound healing, increased amount of pain in the first several postpartum days, and infection [45]. Episiotomy at the first vaginal birth significantly and independently increases the risk of repeated episiotomy and spontaneous tears in subsequent delivery [42, 46].
Episiotomy-related morbidity can be measured using the Redness, Ecchymosis, Edema, Discharge, and Apposition scale (REEDA scale) [47]. Higher REEDA scores denote poor healing process or severe trauma to the perineal tissue as shown in one of our studies in Mulago Hospital in Uganda [48]. The rate of the gaping wound is particularly higher among those done episiotomy compared with spontaneous perineal tear [48], and this can be attributed to the fact that spontaneous perineal tear occurs normally along the natural tissue planes, and it’s easier to repair compared with episiotomy. A similar study in Mulago relates episiotomy to increased risk of infection and the need for secondary re-suturing [49].
Episiotomy-related pain has been shown to persist for more than 14 days after delivery [48] supporting claims that cutting across tissue planes is associated with more pain compared with spontaneous tear that normally follows the natural tissue planes as reported by [3, 50, 51] and that episiotomy is a painful policy [2]. A meta-analysis done by [52] found out that episiotomy is associated with increased incidence and severity of postpartum perineal pain.
2. Conclusion
An episiotomy is, therefore, a traumatic procedure that should be practiced restrictively. World Health Organization (WHO) Guideline Developing Groups and FIGO emphasized the need for health systems to adopt a policy of restrictive rate of not more than 10%, and mediolateral episiotomy type is the one recommended, and this should be performed under adequate analgesia, whether anesthesia is already in place for labor, such as epidural, or by administering a local infiltration.
Conflict of interest
The authors declare no conflict of interest.
\n',keywords:"episiotomy, obstetric anal sphincter injuries (OASIs), redness, ecchymosis, edema, discharge and apposition (REEDA), scale restrictive episiotomy, and mediolateral episiotomy",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/80687.pdf",chapterXML:"https://mts.intechopen.com/source/xml/80687.xml",downloadPdfUrl:"/chapter/pdf-download/80687",previewPdfUrl:"/chapter/pdf-preview/80687",totalDownloads:34,totalViews:0,totalCrossrefCites:0,dateSubmitted:"December 26th 2021",dateReviewed:"February 1st 2022",datePrePublished:"April 19th 2022",datePublished:null,dateFinished:"March 2nd 2022",readingETA:"0",abstract:"Episiotomy is one of the most commonly practiced obstetric procedures done to enlarge the diameter of the vulval outlet to facilitate the passage for the fetal head and prevent an uncontrolled tear of the perineal tissues in the second stage of labor. Historically, the procedure was indicated to prevent third- or fourth-degree perineal tears as well as for prolonged second stage, macrosomia, non-reassuring fetal heart rate, instrumental delivery, occiput posterior position, and shoulder dystocia. Routine episiotomy is now considered to be obstetrics violence, rates of not exceeding 10% have been recommended by World Health Organization (WHO). Despite this recommendation, episiotomy is still practiced routinely in many settings.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/80687",risUrl:"/chapter/ris/80687",signatures:"Francis Pebolo Pebalo and Jackline Ayikoru",book:{id:"11283",type:"book",title:"Childbirth",subtitle:null,fullTitle:"Childbirth",slug:null,publishedDate:null,bookSignature:"Prof. Julio Elito Jr.",coverURL:"https://cdn.intechopen.com/books/images_new/11283.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80355-715-1",printIsbn:"978-1-80355-714-4",pdfIsbn:"978-1-80355-716-8",isAvailableForWebshopOrdering:!0,editors:[{id:"35132",title:"Prof.",name:"Julio",middleName:null,surname:"Elito Jr.",slug:"julio-elito-jr.",fullName:"Julio Elito Jr."}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_1_2",title:"1.1 Types of episiotomy",level:"2"},{id:"sec_2_2",title:"1.2 Episiotomy repair",level:"2"},{id:"sec_3_2",title:"1.3 Current trend in episiotomy practice",level:"2"},{id:"sec_4_2",title:"1.4 Indications",level:"2"},{id:"sec_5_2",title:"1.5 Factors associated with episiotomy",level:"2"},{id:"sec_6_2",title:"1.6 Obstetric anal sphincter injuries (OASI)",level:"2"},{id:"sec_6_3",title:"1.6.1 OASI repair—sphincteroplasty",level:"3"},{id:"sec_8_2",title:"1.7 Complications",level:"2"},{id:"sec_10",title:"2. Conclusion",level:"1"},{id:"sec_14",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Usha DSSADV. A Clinical study of Agaruvadi Yoni Dhupana on episiotomy wound. European Journal of Biomedical and Pharmaceutical sciences. 2016;3(3):322-327'},{id:"B2",body:'Borruto FCC. Episiotomy: A too often unnecessary and harmful practice. MOJ Womens Health. 2016;2(1):00020'},{id:"B3",body:'Thacker SB, Banta HD. Benefits and risks of episiotomy: An interpretative review of the English language literature, 1860-1980. Obstetrical & Gynecological Survey. 1983;38(6):322-338'},{id:"B4",body:'Myers-Helfgott MG, Helfgott AW. Routine use of episiotomy in modern obstetrics. Should it be performed? Obstetrics and Gynecology Clinics of North America. 1999;26:305-325'},{id:"B5",body:'Gabbe SG. The prophylactic forceps operation 1920. American Journal of Obstetrics and Gynecology. 2002;187(255):254'},{id:"B6",body:'Amorim MM, Franca-Neto AH, Leal NV, Melo FO, Maia SB, Alves JN. Is it possible to never perform episiotomy during vaginal delivery? Obstetrics & Gynecology. 2014;123:38'},{id:"B7",body:'D’Gregorio P. Obstetric violence: A new legal term introduced in Venezuela. International Journal of Gynaecology and Obstetrics. 2010;111:201-202'},{id:"B8",body:'Nygaard CC et al. Appraisal of clinical practice guidelines on the management of obstetric perineal lacerations and care using the AGREE II instrument. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2020;247:66-72'},{id:"B9",body:'Zaami S et al. Does episiotomy always equate violence in obstetrics? Routine and selective episiotomy in obstetric practice and legal questions. European Review for Medical and Pharmacological Sciences. 2019;23(5):1847-1854'},{id:"B10",body:'Fodstad K, Staff AC, Laine K. Effect of different episiotomy techniques on perineal pain and sexual activity 3 months after delivery. International Urogynecology Journal. 2014;25(12):1629-1637'},{id:"B11",body:'Kilpatrick S. Normal labor and Delivery in Obstetrics, Normal and Problem Pregnancies. 5th ed. P.C.L. Elsevier: Amsterdam, Netherlands; 2007'},{id:"B12",body:'Kettle CHR, Ismail KM. Continuous versus interrupted sutures for repair of episiotomy or second degree tears. 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American Journal of Obstetrics and Gynecology. 2009, 200:573.e1-573.e7'},{id:"B19",body:'Eltorkey MM, Eltorkey MM, Al Nuaim MA, Kurdi AM, Sabagh TO, Clarke F. Episiotomy, elective or selective: A report of a random allocation trial. Journal of Obstetrics and Gynaecology. 1994;14:317-320'},{id:"B20",body:'Clesse C et al. Episiotomy practices in France: Epidemiology and risk factors in non-operative vaginal deliveries. Scientific Reports. 2020;10(1):20208'},{id:"B21",body:'Goueslard K et al. How did episiotomy rates change from 2007 to 2014? Population-based study in France. BMC Pregnancy and Childbirth. 2018;18(1):208'},{id:"B22",body:'Goh R, Goh D, Ellepola H. Perineal tears—A review. The Australian Journal of General Practice. 2018;47(1-2):35-38'},{id:"B23",body:'Chigbu BOS, Alukaa Kamanu C, Adibe E. Factors influencing the use of episiotomy in Nigeria, should their use be restricted? Nigerian Postgraduate Medical Journal. 2008;1(9):13-16'},{id:"B24",body:'Barnabas TAI, Olusyo A, Amale DA. Relative frequency and predictors of episiotomy in Ogbomoso Nigeria. Internat Journal of Medical Update. 2012;7(2):41-44'},{id:"B25",body:'Carvalho CC, Moraes FO. Pernambuco. Prevalence and factors associated with practice of episiotomy at a maternity school in Recife. Med Bras. 2010;56(3):333-339'},{id:"B26",body:'Geranmayeh M et al. Reducing perineal trauma through perineal massage with vaseline in second stage of labor. Archives of Gynecology and Obstetrics. 2012;285(1):77-81'},{id:"B27",body:'Shahoei R et al. The effect of perineal massage during the second stage of birth on nulliparous women perineal: A randomization clinical trial. Electronic Physician. 2017;9(10):5588-5595'},{id:"B28",body:'Akhlaghi F et al. Effect of perineal massage on the rate of episiotomy. Journal of Family & Reproductive Health. 2019;13(3):160-166'},{id:"B29",body:'Labrecque M et al. Randomized controlled trial of prevention of perineal trauma by perineal massage during pregnancy. American Journal of Obstetrics & Gynecology. 1999;180(3):593-600'},{id:"B30",body:'West Z, Isaacs L. In:. West Z, Isaacs L. editiors. Chapter 10—Preparation for labour, in Acupuncture in Pregnancy and Childbirth. 2nd edition. Churchill Livingstone: Edinburgh; 2008. p. 155-168.'},{id:"B31",body:'Kavvadias T, Hoesli I. The EpiNo® device: Efficacy, tolerability, and impact on pelvic floor—Implications for future research. Obstetrics and Gynecology International. 2016;2016:3818240-3818240'},{id:"B32",body:'Varma A, Gunn J, Gardiner A, Lindow SW, Duthie GS. Obstetric anal sphincter injury. Diseases of the Colon & Rectum. 1999;42(12):1537-1542'},{id:"B33",body:'Lincová M et al. Obstetric anal sphincter injuries - review of our date between 2015-2017. Ceská Gynekologie. 2019;84(1):18-22'},{id:"B34",body:'Fernando RJ, Adams EJ. RCOG Green Top Guidelines: Management of Third and Fourth Degree Perineal Tears Following Vaginal Delivery. Green Top Guidelines; 2007'},{id:"B35",body:'Keriakos R, Gopinath D. Obstetric anal sphincter injuries. Journal of Acute Disease. 2015;4(4):259-265'},{id:"B36",body:'Kapoor DS, Thakar R, Sultan AH. Obstetric anal sphincter injuries: Review of anatomical factors and modifiable second stage interventions. International Urogynecology Journal. 2015;26(12):1725-1734'},{id:"B37",body:'van Roon YKC, Rahman N, Vinayakarao L, Melson L, Kester N, Pathak S, et al. Comparison of obstetric anal sphincter injuries in nulliparous women before and after introduction of the EPISCISSORS-60® at two hospitals in the United Kingdom. International Journal of Women\'s Health. 2015;7:949-955'},{id:"B38",body:'Jansson MH et al. Risk factors for perineal and vaginal tears in primiparous women—The prospective POPRACT-cohort study. BMC Pregnancy and Childbirth. 2020;20(1):749'},{id:"B39",body:'Spinelli A et al. Diagnosis and treatment of obstetric anal sphincter injuries: New evidence and perspectives. Journal of Clinical Medicine. 2021;10(15):3261'},{id:"B40",body:'Fernando RSA, Kettle C, Thakar R. Methods of repair for obstetric anal sphincter injury. Cochrane Database of Systematic Reviews. 2013;12:CD002866'},{id:"B41",body:'Napoé GS, Foust-Wright CE, Pulliam SJ, Melamed A, Batalden RP, Berkowitz LR. Confidence in repair of obstetric anal sphincter injuries and objective assessment in obstetricians. Practice. 2015;20(20):24-24'},{id:"B42",body:'Zilberman A et al. Once episiotomy, always episiotomy? Archives of Gynecology and Obstetrics. 2018;298(1):121-124'},{id:"B43",body:'Viswanathan M, Hartmann K, Palmieri R, Lux L, Swinson T, Lohr KN, et al. The Use of Episiotomy in Obstetrical Care: A Systematic Review: Summary. Rockville, Maryland: AHRQ Evidence Report Summaries; 2005'},{id:"B44",body:'Alum AC et al. Factors associated with early resumption of sexual intercourse among postnatal women in Uganda. Reproductive Health. 2015;12(1):107'},{id:"B45",body:'Woolley RJ. Benefits and risks of episiotomy: A review of the English-language literature since 1980, Part I. Obstetrical & Gynecological Survey. 1995;50(11):806-820'},{id:"B46",body:'El-Nagger MHA. Effect of self perineal care instructions on episiotomy pain and wound healing of postpartum women. Journal of American Science. 2012;8(6):640-650'},{id:"B47",body:'Davidson. REEDA: Evaluating postpartum healing. Journal of Nurse-Midwifery. 1974;19:6-9'},{id:"B48",body:'Pebolo PF, Judith A, Dan KK. Episiotomy related morbidities measured using redness, edema, ecchymosis, discharge and apposition scale and numerical pain scale among primiparous women in Mulago National Referral Hospital, Kampala, Uganda. The Pan African Medical Journal. 2020;36:347'},{id:"B49",body:'Odar E, Wandabwa J, Kiondo P. Sexual practices of women within six months of childbirth in Mulago hospital, Uganda. African Health Sciences. 2003;3(3):117-123'},{id:"B50",body:'Woolley RJ. Benefits and risks of episiotomy: A review of the English-language literature since 1980, Part II. Obstetrical & Gynecological Survey. 1995;50:820-835'},{id:"B51",body:'Amorim M et al. Selective episiotomy vs. implementation of a non-episiotomy protocol: A randomized clinical trial. Reproductive Health. 2017;14(1):55'},{id:"B52",body:'Gün İ, Doğan B, Özdamar Ö. Long- and short-term complications of episiotomy. Turkish Journal of Obstetrics and Gynecology. 2016;13(3):144-148'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Francis Pebolo Pebalo",address:"pebalopebolo@gmail.com",affiliation:'
Faculty of Medicine, Department of Reproductive Health, Gulu University, Gulu, Uganda
Faculty of Medicine, Department of Reproductive Health, Gulu University, Gulu, Uganda
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IntechOpen is committed to disseminating high-quality scientific research in a manner that exemplifies the best practice in scholarly publishing. IntechOpen is an official member of the Committee on Publication Ethics (COPE), which advocates the maintenance of the highest ethical standards for all parties involved in the act of publishing, including Authors, Academic Editors of the book, Peer Reviewers, the publisher and Societies, where applicable.
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Conflicts of Interest Policy
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In line with publication ethics practices recommended by COPE, ICMJE, and other similar organizations, IntechOpen's contributing Authors, Academic Editors, and Peer Reviewers are required to declare fully all possible conflicts of interest.
IntechOpen's Authorship Policy is based on ICMJE criteria for authorship. In order to be identified as an Author, the following requirements must be met:
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A substantial contribution to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work
\\n\\t
Participation in drafting or revising the work
\\n\\t
Approval of the manuscript version to be published
All scientific works are subject to Peer Review prior to publishing. IntechOpen is a member of the Committee on Publication Ethics (COPE) and all participating referees and Academic Editors are expected to review submitted scientific works in line with the COPE Ethical Guidelines for Peer Reviewers where applicable.
The Internet has changed the dynamics of scholarly communication and publishing which is why we find it necessary to clearly indicate our stance on what we consider to be a published scientific work. A significant number of working papers, early drafts, and similar works in progress are shared openly online between members of the scientific community. It has become common practice for researchers to announce their work on a personal website or a blog in order to gather comments and suggestions from other researchers. Such works and online postings are ‘published’ in the sense that they are made publicly available, but this does not mean that if submitted for publication by IntechOpen they are not original works. We differentiate between reviewed and non-reviewed works when determining whether a work is original and has been published in a scholarly sense or not.
To identify instances of fraud and misconduct during the publishing process, IntechOpen implements a robust policy governing such occurrences. In line with our general commitment to openness, and in order to maintain the highest scientific standards, we are committed to transparency about our editorial policy regarding retractions and corrections.
When faced with potential misconduct, IntechOpen accepts its responsibility to maintain the integrity of the academic record. For particularly complex cases, IntechOpen might ask for the assistance of formal industry bodies or seek advice from an appropriate team of advisors.
\\n\\n
IntechOpen's advisors are professionals and scholars with broad knowledge and understanding of different aspects of the scientific publishing process: editorial, authorship, and reviewing roles; publication ethics, copyright, and general legal issues; as well as bibliographic and technical standards.
\\n\\n
In order to provide us with unbiased insights, without compromising the privacy of third parties, IntechOpen presents problematic cases to its advisors in an anonymized format.
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Translation Policy
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IntechOpen publishes books in the English language. If you are interested in the translation of Book Chapters, please check IntechOpen's Translation Policy.
In line with the Principles of Transparency and Best Practice in Scholarly Publishing, you can access a more detailed description of IntechOpen's Advertising Policy.
At IntechOpen we realize that exceptional circumstances can occur, resulting in a request for a refund. We will honor all justified requests in the specific instances outlined in our Refund Policy.
All chapters will be published via IntechOpen's 'Online First' service meaning chapters will be published individually, immediately after review and before the entire book is ready for publication, allowing content to be shared, searched and cited straightaway, thereby generating early stage interest and momentum for your research
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Online First Chapters are considered published on the day they are posted and are citable from that date.
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Chapters will remain listed as Online First until the final versions of the books are published online. Following publication of the full monograph, Chapters will be redirected from the Online First version and will be available only through the final link of the official published page.
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You are invited to download, use, reproduce, make derivative works of, display, distribute and cite the Online First works. You can find "How to Cite and Reference" by following the link at the end of each online book chapter. Please be aware that it is possible that further editing and changes might be made before the final release of the book.
\\n\\n
If there are supplemental materials to the chapter, these will be published at the time the final book is published online.
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Readers and Authors can notify us if they find any errors in the works published under Online First. All major errors will be accompanied by a separate correction notice, erratum or corrigendum (Retraction and Correction Policy.)
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Access policy
\\n\\n
IntechOpen books are available online by accessing all published content on a chapter level.
All published Book Chapters are licensed under a Creative Commons Attribution 3.0 Unported License. Monographs are licensed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license granted to all others. Our Copyright Policy aims to guarantee that original material is published while at the same time giving significant freedom to our Authors. IntechOpen upholds a flexible Copyright Policy meaning that there is no copyright transfer to the publisher and Authors hold exclusive copyright to their work.
With the purpose of protecting our Authors' copyright and the transparent reuse of Open Access content, IntechOpen has developed an Attribution Policy for works published under Creative Commons licenses.
IntechOpen is committed to disseminating high-quality scientific research in a manner that exemplifies the best practice in scholarly publishing. IntechOpen is an official member of the Committee on Publication Ethics (COPE), which advocates the maintenance of the highest ethical standards for all parties involved in the act of publishing, including Authors, Academic Editors of the book, Peer Reviewers, the publisher and Societies, where applicable.
\n\n
Conflicts of Interest Policy
\n\n
In line with publication ethics practices recommended by COPE, ICMJE, and other similar organizations, IntechOpen's contributing Authors, Academic Editors, and Peer Reviewers are required to declare fully all possible conflicts of interest.
IntechOpen's Authorship Policy is based on ICMJE criteria for authorship. In order to be identified as an Author, the following requirements must be met:
\n\n
\n\t
A substantial contribution to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work
\n\t
Participation in drafting or revising the work
\n\t
Approval of the manuscript version to be published
All scientific works are subject to Peer Review prior to publishing. IntechOpen is a member of the Committee on Publication Ethics (COPE) and all participating referees and Academic Editors are expected to review submitted scientific works in line with the COPE Ethical Guidelines for Peer Reviewers where applicable.
The Internet has changed the dynamics of scholarly communication and publishing which is why we find it necessary to clearly indicate our stance on what we consider to be a published scientific work. A significant number of working papers, early drafts, and similar works in progress are shared openly online between members of the scientific community. It has become common practice for researchers to announce their work on a personal website or a blog in order to gather comments and suggestions from other researchers. Such works and online postings are ‘published’ in the sense that they are made publicly available, but this does not mean that if submitted for publication by IntechOpen they are not original works. We differentiate between reviewed and non-reviewed works when determining whether a work is original and has been published in a scholarly sense or not.
To identify instances of fraud and misconduct during the publishing process, IntechOpen implements a robust policy governing such occurrences. In line with our general commitment to openness, and in order to maintain the highest scientific standards, we are committed to transparency about our editorial policy regarding retractions and corrections.
When faced with potential misconduct, IntechOpen accepts its responsibility to maintain the integrity of the academic record. For particularly complex cases, IntechOpen might ask for the assistance of formal industry bodies or seek advice from an appropriate team of advisors.
\n\n
IntechOpen's advisors are professionals and scholars with broad knowledge and understanding of different aspects of the scientific publishing process: editorial, authorship, and reviewing roles; publication ethics, copyright, and general legal issues; as well as bibliographic and technical standards.
\n\n
In order to provide us with unbiased insights, without compromising the privacy of third parties, IntechOpen presents problematic cases to its advisors in an anonymized format.
\n\n
Translation Policy
\n\n
IntechOpen publishes books in the English language. If you are interested in the translation of Book Chapters, please check IntechOpen's Translation Policy.
In line with the Principles of Transparency and Best Practice in Scholarly Publishing, you can access a more detailed description of IntechOpen's Advertising Policy.
At IntechOpen we realize that exceptional circumstances can occur, resulting in a request for a refund. We will honor all justified requests in the specific instances outlined in our Refund Policy.
All chapters will be published via IntechOpen's 'Online First' service meaning chapters will be published individually, immediately after review and before the entire book is ready for publication, allowing content to be shared, searched and cited straightaway, thereby generating early stage interest and momentum for your research
\n\n
Online First Chapters are considered published on the day they are posted and are citable from that date.
\n\n
Chapters will remain listed as Online First until the final versions of the books are published online. Following publication of the full monograph, Chapters will be redirected from the Online First version and will be available only through the final link of the official published page.
\n\n
You are invited to download, use, reproduce, make derivative works of, display, distribute and cite the Online First works. You can find "How to Cite and Reference" by following the link at the end of each online book chapter. Please be aware that it is possible that further editing and changes might be made before the final release of the book.
\n\n
If there are supplemental materials to the chapter, these will be published at the time the final book is published online.
\n\n
Readers and Authors can notify us if they find any errors in the works published under Online First. All major errors will be accompanied by a separate correction notice, erratum or corrigendum (Retraction and Correction Policy.)
\n\n
Access policy
\n\n
IntechOpen books are available online by accessing all published content on a chapter level.
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Lentil crops are vulnerable to a number of diseases caused by fungi, viruses, nematodes, insect pests, parasitic plants and abiotic stresses. Among them, the most significant and serious soil-borne disease is Fusarium wilt (Fusarium oxysporum f.sp. lentis: Fol). Fusarium wilt causes yield loss up to 50% in farmers’ fields. The pathogen showed high levels of phenotypic and genotypic diversity in India, Algeria, Syria and Iran. The disease thrives at 22–25°C temperature and affect lentil either at seedling and vegetative or the reproductive stages of the crop. To minimize yield losses, an integrated management strategy comprising resistant/partial resistant cultivars, adjusting sowing time, bio-control and chemical seed treatments is the best approach to reduce the incidence of the Fusarium wilt of lentil. 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The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"25",title:"Environmental Sciences",doi:"10.5772/intechopen.100362",issn:"2754-6713",scope:"
\r\n\tScientists have long researched to understand the environment and man’s place in it. The search for this knowledge grows in importance as rapid increases in population and economic development intensify humans’ stresses on ecosystems. Fortunately, rapid increases in multiple scientific areas are advancing our understanding of environmental sciences. Breakthroughs in computing, molecular biology, ecology, and sustainability science are enhancing our ability to utilize environmental sciences to address real-world problems. \r\n\tThe four topics of this book series - Pollution; Environmental Resilience and Management; Ecosystems and Biodiversity; and Water Science - will address important areas of advancement in the environmental sciences. They will represent an excellent initial grouping of published works on these critical topics.
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He also has an honorary appointment to serve as a Collaborative Professor at Kanazawa University, Japan, from Mar 2015 to the present. \nFormerly, Dr. Rahman was a faculty member of the University of Chittagong, Bangladesh, affiliated with the Department of Chemistry (Oct 2002 to Mar 2012) and the Department of Applied Chemistry and Chemical Engineering (Mar 2012 to Sep 2015). Dr. Rahman was also adjunctly attached with Kanazawa University, Japan (Visiting Research Professor, Dec 2014 to Mar 2015; JSPS Postdoctoral Research Fellow, Apr 2012 to Mar 2014), and Tokyo Institute of Technology, Japan (TokyoTech-UNESCO Research Fellow, Oct 2004–Sep 2005). \nHe received his Ph.D. degree in Environmental Analytical Chemistry from Kanazawa University, Japan (2011). He also achieved a Diploma in Environment from the Tokyo Institute of Technology, Japan (2005). Besides, he has an M.Sc. degree in Applied Chemistry and a B.Sc. degree in Chemistry, all from the University of Chittagong, Bangladesh. \nDr. Rahman’s research interest includes the study of the fate and behavior of environmental pollutants in the biosphere; design of low energy and low burden environmental improvement (remediation) technology; implementation of sustainable waste management practices for treatment, handling, reuse, and ultimate residual disposition of solid wastes; nature and type of interactions in organic liquid mixtures for process engineering design applications.",institutionString:null,institution:{name:"Fukushima University",institutionURL:null,country:{name:"Japan"}}},editorTwo:{id:"201020",title:"Dr.",name:"Zinnat Ara",middleName:null,surname:"Begum",slug:"zinnat-ara-begum",fullName:"Zinnat Ara Begum",profilePictureURL:"https://mts.intechopen.com/storage/users/201020/images/system/201020.jpeg",biography:"Zinnat A. 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