Sapporo Medical Journal

Abstract : Percutaneous nephrolithotomy (PCNL) is frequently performed by Urologist as a main way of management of renal stones of large size. Fluoroscopy is used commonly to guide Percutaneous nephrolithotomy (PCNL) with the hazards of radiation to the patients and the operating team, that is why Ultrasound represents a good lower cost alternative to guide this procedure as it gives a better needle access, ensures urinary tract dilatation and localization of small residual radiolucent stones.Also; it has lesser risk of adjacent organs’ injuries. Patients and methods: In this prospective interventional study, one hundred ninety-three patients, aged 12 years and morewith staghorn renal stones of 70 millimeters diameter and less involved for the period of January 2012 till March 2019. All patients underwent necessary basic blood,urine and imaging studies for preoperative assessment. Patients divided into two groups based on the image guiding the operation, those who underwent Ultrasound guided Percutaneous nephrolithotomy (PCNL) were 115, and the rest 78 underwent Fluoroscopy guided Percutaneous nephrolithotomy (PCNL). Then, under general anesthesia; stone extraction performed with intraoperative assessment of operative time, total time of access, exposure time to radiation. And post-operative follow up of patients for complications and outcomes including stone free rate, any residual stone, need for ESWL or for second PCNL, failure of needle access, hospital stay, bleeding or hematuria, need for blood transfusion or embolization, fluid extravasation, fever or sepsis, Colonic or inferior vena cava injury, Pneumothorax or hemothorax. Results: The two groups were homogenous regarding gender and age, serum creatinine and hemoglobin concentration were not different between them pre-operatively. There was a higher stone free rate by using Ultrasonic guided percutaneous nephrolithotomy, and there was no statistical difference between the two procedures regarding the risk of injury to internal organs and bleeding, and both procedures did not cause colonic, hepatic or splenic injuries. Operative time, post-operative hospital stay and post-operative extravasation, fever, and sepsis were not significantly different between the two groups. Conclusion: Apart from stone free rate and radiation exposure, both ultrasonic- guided, and Fluoroscopy guided Percutaneous nephrolithotomy have the same value as surgical procedures for treatment of renal stones, and there was no significant difference between them.

Abstract : Background: Microalbuminuria is associated with an increased risk of cardiovascular events and death and chronic kidney disease in patients with diabetes mellitus and hypertension. epidemiologic studies have found that microalbuminuria is predictive, independently of other risk factors, for all-cause and cardiovascular mortality and CVD events within groups of patients with diabetes or hypertension, and in the general population Aim of study This study was designed to determine Correlation of microalbuminuria and Multiple Risk Factors in Acute Coronary Syndrome. Patients and methods The present study was carried out during period Oct 2019 to Jan 2020 on patients presenting to AL-Nassiriya Heart center and AL-Hussein Teaching hospital . It was an observational comparison study in which comparison of two groups according to the presence and absence of microalbuminuria in patient diagnosed to have acute coronary syndrome after proper history, thorough clinical examination and investigations and find their correlation with multiple risk factors for acute coronary syndrome Results and Discussion Microalbuminuria in cases population was found to be in total 34 patients out of 55(61.81%);whereas in control population, 3 patients comprising of 14.81 On comparison of these two populations, the difference between occurrence of microalbuminuria was found to be stastically significant(x2 =11.7 and p value 1 In MA+ve cases ,there were 4 cases with DM,3 cases of hypertension ,6 smokers and 13 with multiple risk factors. In MA-ve cases there were 2 cases of DM ,1 case with hypertension and 6 smokers and only 2 with multiple risk factors. The difference between occurrence of microalbuminuria was significant in cases with multiple risk factors ). In the present study the difference in occurrence of microalbuminuria were significant (p < 0.05)in acute coronary syndrome with multiple risk factors than isolated factor which is similar to DIABHYCAR and HOPE study Conclusions: This observation implies that microalbuminuria is significantly more commonly seen in patients with acute coronary syndrome as compared to healthy adults of same biological characteristics. The difference between occurrence of microalbuminuria was significant in cases with multiple risk factors than any isolated single risk factor

Abstract : Hypercholesterolemia is usually known as the presence of high levels of cholesterol in the blood, it closely related with the hazard of coronary heart disease and a possible indicator for early development of atherosclerosis. Octacosanol is one of policasanol components , policasanol is a mixture of higher aliphatic alcohols produces from isolation and purification of sugar cane wax (Saccharum officinarum)is one of the cholesterol-lowering drugs. Statins are the inhibitors of hydroxymethyl glutaryl coenzyme A (HMG CoA) reductase. They are mostly used to treat hyperlipidaemia. Thirty sixhealthy adult female rats. Weights and age of animals were (200-250 gm) and (10-12) weeks respectively they are Inducted to be hypercholesterolemicof 200 mg/dl .octacosanol extracted from Sugar cane plant (Saccharum officinarum)and determined by using gas chromatography – mass spectrometry (GC/MS).Animals were divided into 6 groups ( 6 rats per group) : all animals were treated orally for 8 weeks as the following: The first group (Control): animals were given Dimethyl Sulphoxide (DMSO) orally only 0.2 ml/ animal per day. The second group were only hypercholesteroled and given 0.2 ml/ animal per day of Dimethyl Sulphoxide (DMSO). The third group were hypercholesteroled and given Atorvastatin at dose (0.02 mg/ animal per day. The fourth group were not hypercholesteroled and given only Atorvastatin at dose (0.02 mg/ animal per day). The fifth group were hypercholesteroled and given Standard octacosanol at dose (0.02 mg/ animal per day). The sixth group animals were hypercholesteroled and given Extracted octacosanol at dose (0.02 mg/ animal per day). Serum levels of aldosterone , cortisol, T3 and T4 were determined by radio immunoassay. Results showed significant decrease of aldosterone and cortisol in hyperlipidemic group than control group , Also aldosterone levels in hyperlipidemic group that treated with atorvastatin were significantly decreased than those of control group. Results of T3 and T4 in groups treated with octacosanol –both the extracted and standard - were significantly decrease than those in animals of control group, while in groups treated with atorvastatin the levels of these hormones were modulated than those in control group.In conclusion both octacosanol and atorvastatine modulate aldosterone, cortisol, T3 and T4 hormones in female rats.

Abstract : Background: Maternal mortality rate was still high around 359 deaths per 100,000 live births in 2012 in Indonesia. The cause of death was associated with early fertility. Aim: This study aimed to identify the determinants of early fertility in Indonesia. Methods: The data used was derived from the 2012 Indonesia Demographic and Health Survey (IDHS). The analysis of this study used bivariate analysis with Chi-square test and multivariate analysis with logistic regressions. Results: The study showed that 36.7% of respondents who lived in rural gave birth at less than 20 years of age compared to those who lived in urban (25%). About 47.7% women were no education and primary education. About 39.6% women with lower wealth index were more likely to be young mother. Logistic regression analysis found that the early fertility associated with residence (OR=0.81; 95% CI=0.74-0.88), secondary education (OR=0.04; 95% CI=0.03-0.06), higher education (OR=0.10; 95% CI=0.08-0.14), middle wealth index (OR=0.81; 95% CI=0.73-0.90), upper wealth index (OR=0.86; 95% CI=0.77-0.97), and contraceptive use (OR=1.21; 95% CI=1.11-1.33). Recommendation: The early fertility case could be reduced by providing family planning program in Indonesia. Married women need more information on risks of early childbirth and contraceptive methods. Increasing women’s education was an important effort for a better life.

Abstract : Nowadays the influence of polymorphism of the ET-1 gene on the plasma levels of this peptide in patients with essential hypertension and congestive heart failure is poorly understood. 191 men were examined: 79 from the control group, 62 with uncomplicated essential hypertension and left ventricular hypertrophy, and 50 men with essential hypertension and congestive heart failure IInd-IIIrd classes. All patients were between the age of 40-60 years, and were residents of the Podillya region in Ukraine. Lys198Lys genotype and the Lys allele of the ET-1 gene dominate among residents of Podillia region in Ukraine. In patients with essential hypertension the level of ET-1 was significantly higher than that of the control group, with the highest concentration of peptide in individuals with congestive heart failure IInd-IIIrd classes. In men carriers of Lys198Lys genotype, the plasma concentration of ET-1 was significantly lower than in carriers of the Asn allele. In carriers of genotype Lys198Lys the highest level of peptide in plasma was determined in patients with congestive heart failure IInd-IIIrd classes. Men with uncomplicated essential hypertension with left ventricular hypertrophy, carriers of Lys198Lys genotype were more likely to encounter 2nd degree hypertension and carriers of Asn allele – 3rd degree hypertension respectively. In patients with congestive heart failure IInd-IIIrd classes, carrier of the Asn allele was seen to be associated with 3rd degree hypertension.