Sapporo Medical Journal

Abstract : Background: The most common mechanism of renal injury is blunt trauma. Conservative management of such trauma is widely practiced all over the world. However, in our social-cultural environment, this approach leads sometimes to discussions with patients and families as it often is perceived as inactivity on the side of the surgeons. Therefore, we attempted to assess patients and patients families concerns and the acceptance of a conservative treatment approach in a group of patients with severe blunt renal trauma. Patients & method: From February 2000 to December 2018, 72 patients presented with blunt renal trauma. Mean age was 30 (range 10- 55) years. Sixty three (87.5%) were male. The study was approved by the ethical committee of Basrah College of Medicine under the approval number 0304092-2020. The initial management of all patients was adequate resuscitation in the emergency room. The patients and their families were given questionnaires at their discharge to assess their satisfaction and/ or worries about the conservative approach in managing renal trauma, and subsequently they were categorized into 3 groups according to their satisfaction: totally satisfied, partially satisfied, and not accepting the conservative approach of management. Results: Fifty five patients (76%) had blunt renal trauma following a road traffic accident, 17 (24%) had a fall from height. Sixty-six patients (92%) were hemodynamically stable while 6 patients (8%) were unstable and needed immediate surgical intervention. According to AAST grading (table 1), of those 22 had grade I injuries, 19 grades II, 15 grades III, and 10 IV, respectively. The stable patients were initially monitored with a conservative treatment approach by nil by mouth, administration of IV-fluids, broad- spectrum antibiotics (ceftriaxone), absolute bed rest, use of painkillers as paracetamol vials, and blood transfusions if required. Close observation of all patients was carried out by monitoring of vital signs and abdominal examination with two hourly chart for first 24 hour then 4 hourly chart thereafter, and daily measurement of hematocrit. However, 5 patients (8%) and their family members were so much worried about this approach that they insisted on surgical exploration despite having been made aware of the risk of nephrectomy but none of them ended with nephrectomy, 12 (18%) further patients and their family members underwent the same worries and discussions, but finally accepted the conservative approach after understanding its rationale. Two thirds of patients (n=49/ 74%) accepted the conservative approach from the start. Conclusion: Conservative treatment is the standard treatment for hemodynamically stable blunt renal traumata. However, for lay people such as patients and their family members it may be difficult to comprehend that the traumatized organ should not be explored and repaired. There is an expectation for surgical repair in one third of our patient population which has the potential to cause undue stress to the attending surgeon and may impair the impartiality of surgical decisions. Making the patients and relatives understand and be part of an informed decision making is crucial to act in the best interest of the patient.

Abstract : The purpose of this article is to guide researchers to understand the basic concept of ICC and example ICC analysis will provide for easier understanding of the ways the process analysis in SPSS software. Selection of the correct ICC reliability should include software information, “model” and “type,” selections. For model selection focusing on one-way random, two-way random, and two-way mixed model. Besides that, type selection only focusing on “absolute agreement” and “consistency”. Interpretation of the result from ICC must follow the guideline because currently a lack of a standard for reporting ICC in the clinical research community. It is important for researchers to report detailed information about their ICC estimates by inserting software information, “Model”, “Type,” selections, and 95% confidence intervals.

Abstract : Thalassemia is one of the greatest human monogenic diseases, These inherited disorders of hemoglobin synthesis are considered as a reduced production of globin chains of hemoglobin. Aim of study : To study the incidence and determinants of viral infection with hepatitis B and C in patients with thalassemia post blood transfusion. Patient and method: This cross sectional study was performed at thalassemia center from November 2019- April 2020. . All ages were included in this study. Two hundred (200) patients were included, . Age range from (3 months - 46 years. .we send the patients for all investigations including Hb, Hb electrophoresis, liver function test, viral markers, renal function test, weight, length measure. SPSS version 23 was used for analysis. Results: of 200 thalassemic patient, all of them on blood transfusion, 3 of them infected with hepatitis B (1.5%) and 26(98.5 %) patient infected with hepatitis C and the total number was 29 (14.5 %). Recommendation: All patient must checked several times before transfusion and the blood must be tested (2-3) times before transfusion and should use new instruments before transfusion

Abstract : Background: The pandemic of COVID­19 has been causing millions of cases of severe pneumonia and respiratory distress in more than 200 countries and territories of the world. The causative agent, SARS­CoV­2, is a novel coronavirus, with well­ recognized lung complications. However, the evidences are mounting about both central and peripheral nervous system complications. Objectives: This is a case series study aimed to show the incidence of GBS among recently cured post COVID-19 infection cases and to describe their clinical and investigational characteristics. Methods: This study is a descriptive study, in which we have included fifteen patients diagnosed as COVID-19 cases in the last 2-4 weeks before the onset of their weakness. All of them have been admitted to Basrah hospitals in the period between 15/7/2020 and 1/9/2020 complained from rapidly progressive ascending weakness fulfill the clinical criteria of GBS. Results: The incidence rate of GBS in post COVID-19 cases during the period of study was about (0.375%). This result is much higher than the commonly known incidence rate of GBS in the community (0.017)

Abstract : Background: Chronic suppurative otitis media (CSOM) is a common public health problem worldwide. The global burden of illness from CSOM is estimated to involve about 65 to 330 million individuals with draining ears. There is an association between CSOM and poor educational performance. A portion of the variability observed may be related to differences in sampling and processing methods. The Causative microorganisms may be same or different in both ears, so this study was done to determine the prevalence of same micro organism versus different types in bilateral chronic suppurative otitis media Tooke place in Alhabobi teaching hospital. Method: a hospital-based cross-sectional descriptive study carried out at the ENT outpatient clinic and the Microbiology Department ofAlhabobi teaching hospital and private laboratory .The sample comprised 46 patients with bilateral active CSOM. All patients were evaluated through a detailed history and clinical examination. Pus samples from draining ears were collected by aspiration with a sterile pipette. The specimens were immediately sent for microbiological analysis. Data were analyzed using SPSS.version 20. Results: The most of the patients were female (29) 63%, infection was common among age group below 30 years. Housewife 35% followed by students24% were the commonest occupational distribution. Most of the results of cultures were same type of bacteria in both ears (69.5%) while (30.5%) were different.No significant different between type of bacteria in relation to age of patients and sex distribution ,while there was significant relationship between type of occupation and type of bacterial isolation whether same or different , while didn’t shown in regard to kind of residence. In our study the significant statistically difference between type of bacteria in term of same or different was clear in income distribution. Conclusions: Our study was shown that 30.5% of cases were different types of bacteria and it was important to do swabbing from both ear because its statistically significant characters.