Sapporo Medical Journal

Abstract : Aim: to evaluate the feasibility and safety of primary closure sutures for the common bile duct compared to T-tube usage, post laparoscopic, common bile duct (CBD) exploration for treating choledocholithiasis associated with cholecystolithiasis.   Methods: Patients with choledocholithiasis accompanying cholecystolithiasis who underwent a failed ERCP procedure were included in this four-year- retrospective study in the period from January 2015 until December 2018. They were divided into two groups; group I: included those who had primary suturing closure of CBD, while group II were those who underwent a T tube insertion technique. Patients’ data including the pre, intra, and post-operative outcome were evaluated. Results:  Forty-three patients were included; they were 26 females and 17 males with the ratio of (1.5 to 1).  G I (n= 28) were those with primary closure suturing technique. While G II (n= 15) had a T tube inserted. During the first postoperative day, total drainage was not high among G I patients compared to those of G II. No significant statistical difference existed between the two groups as regards the total bilirubin level (TBL) post-surgery.  This facilitates the short time of removing the T tube among G I patients. Conclusion: Primary closure sutures of the common bile duct is a safe and feasible post choledochotomy procedure.

Abstract : Burns are a global public health problem. Problems that are often found in burn patients are wound problems, infections, sepsis, and others. Infections can be caused by bacteria, virus and fungi. Infection in burn patients may trigger an increase in morbidity rates that lead to longer hospitalization and require greater costs. Objective: The aim of this study was to explore the correlation of the types of bacteria that infect burn patients and the length of stay of bacteria-infected burn patients. Methods: This study was a descriptive study by collecting data retrospectively of burn patients in period between January – December 2015 from patient medical record in burn center of RSUD Dr. Soetomo Surabaya.The data was analyzed using excel. Results: The number of patients collected was 61 patients, of whom 41 patients were infected with bacteria. Gram-negative bacteria is the most common infectant in burn patients among them are Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanni, Enterobacter spp., Proteus spp. and Escherichia coli. The length of stay of burn patients who infected with bacteria was twice longer that of uninfected burn patients. the average duration of treatment for uninfected burn patients was 0-10 days whereas the length of treatment period for infected burn patients averaged 11-20 days.

Abstract : Juvenile xanthogranuloma (JXG) is a rare histiocytic disorder that typically affects children. The clinical presentation of this disease is characterized by single or, rarely, multiple yellow and brown skin nodules, most often found on the face and neck. Internal organ involvement has been sporadically observed in JXG and is associated with an increased risk of serious complications. We report a case with a giant form of JXG.

Abstract : Based on the data from "World Kidney Day", there are at least 1 out of 10 people around the world with a certain level of morbidity that leads to Chronic Kidney Disease (CKD). Many studies have shown that oxidative stress contributes to the progression of CKD. This study aims to compare malondialdehyde (MDA) and 8-dihydro-2-deoxyguanosine (8-OHdG) as oxidative stress markers in CKD patients who were treated with angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) and who were not treated with both therapies. In this study, fifty-four hospitalized CKD patients were recruited randomly from three different hospitals in Surabaya, Indonesia. This study’s subjects were grouped based on their consumption of ACEi/ARB. Oxidative stress markers, MDA and 8-OHdG, were calculated using the Mann-Whitney test with a p-value<0.05. Urinary MDA in the patients receiving ACEi/ARB was lower than those who did not receive (3.75 (2.24-9.92) vs 5.16 (2.61-19.41); p=0.002). Urinary 8-OHdG in the patients receiving ACEi/ARB was lower than those who did not receive any (4.11 (0.36-20.26) vs 6.61 (1.76-31.35); p=0.028). There were positive correlations between urinary MDA and urinary creatinine (R=0,547; p=0,000) and between urinary 8-OHdG and urinary creatinine (R=0,630; p=0,000). These results implicate that ACEi/ARB administration in CKD patients is beneficial for reducing urinary oxidative stress markers.

Abstract : Counseling on the selection of contraceptive methods is a strategic intervention to improve the continuity of contraceptive use. Midwives as the largest source of contraceptive services in Indonesia have a major role in the implementation of contraceptive counseling, for the reason this article examines description of the implementation contraceptive counseling among midwives and the characteristics of acceptors receiving counseling. This study used data from Indonesia Demographic and Health Survey (IDHS) in 2017. The sample was married women who received contraceptive pill, injection, IUD, and implant services by midwives within 5 years prior to the survey, with a sample size of 9163 women. The implementation of contraceptive counseling among midwives in Indonesia is only 30%. Very few adolescence merried women received contraceptive counseling. Countraceptive counseling increased with education, socioeconomic level and living in urban areas. Increasing the age of marriage, access to the education right and a socio-economic level that is evenly distributed throughout the region was important points as input for policy makers in Indonesia.