Sapporo Medical Journal

Abstract : Background: Renal failure is one of the most common diseases and might develop to the end-stage level in which need to have hemodialysis to survive. Generally, Arteriovenous Fistula (AVF) created for hemodialysis access and its maturity depends on several factors, including hand exercise. This study aims to evaluate the implications of hand exercises in the process of AVF maturation in patients with chronic kidney failure. Methods: Performing literature search using Pubmed, The Cochrane, and Google Scholar databases were done from 2015 to 2019. All case series, cohort studies, and clinical trials were considered if they met inclusion criteria. Result: From 603 studies, five studies were met inclusion criteria. Four studies showed hand exercises with different protocols from each study. The outcome parameter was varied throughout all the studies. Hand exercise has believed to have a potential effect on AVF maturation. Through ultrasonographic value, diverse findings in the outcome such as arterial and vein diameter and increasing of blood flow measured. One study had assessed clinical maturation in AVF as one of the outcomes of the study. Nevertheless, one study showed no significant effect of hand exercise in ultrasonographic maturation. Conclusion: Hand exercises with different types of exercises can make changes in AVF maturation parameters. However, it needs further accessible evidence study with the same exercise protocol and evaluation so that the effect of t

Abstract : Purpose: To identify various perioperative factors that could affect early mortality in Tetralogy of Fallot (TF) patients after the total correction procedure. Method: This retrospective cohort study used a cross-sectional design using secondary data from medical records of TF patients who underwent total correction procedures at Dr. Soetomo Academic General Hospital, Surabaya, Indonesia from August to September 2019. The study outcomes were a single risk factor or concomitant risk factor that affected the mortality rate during post-total correction treatment of TF patients. Results: Forty-two patients undergoing total repair surgery during the study period, this study had a mortality rate of 33.3% (14 patients). Univariate analysis reveals factors influencing mortality namely age <24 months (OR=15.0, p=0.02), weight <10 kgs (OR=6.25, p=0.025), SaO2 <75% (OR=12.833, p=0.013), HCT >65% (OR=4.5, p=0.049), ventilator time >48 hours (OR=4.5, p=0.031), Fever (OR=50, p=<0.001), residual PS (OR=14, p=0.021), residual VSD (OR=16.1, p=0.003), VIS (OR=59.8, p=<0.001). Conclusion: In our study, we found variables that influenced mortality rate in univariate analysis. A cardiac surgeon can take this into contemplation while choosing the best option for the patient by seeing these perioperative factors to reduce the mortality rate in TF cases after total repair. Keywords: Mortality rate, Perioperative Factors, Tetralogy of Fallot, Total Correction

Abstract : Background: Candida the most mutual source of urinary tract infection (UTI) as an opportunistic pathogen. Risk factors like: diabetes mellitus, pregnancy, steroids and hospitalization can promote candiduria. This study aimed to evaluates candiduria in pregnant women and their relation to social and physiological parameters. Method: Across sectional analytical study extended all over 2019 (January till December) to recruit 510 ladies, done in Bint Al-Huda public hospital- and Al-Rahman gynecology and obstetrics private hospitals Thi-Qar-Southern of Iraq, where specific age criteria that extended from 14 years till 55 years with mean age of 29±7.56 years. Results: The results showed significant differences (p <0.05) in the presence of bacterial and fungal infections in a female under this study. While, there is no relations between both groups of female in pH value of urine. The presence of fungal infections was not correlated with the types of blood groups and jobs of infected women under (P > 0.05). Conclusion: It was noted through the study that the rate of urinary tract infections with Candiduria in Iraqi women is one of the relatively low rates in the world and is mainly affected by the state of immune debility during pregnancy and related to bacterial infections with no relationship to the urine pH, types of blood groups and the type of work with the rates of occurrence of this type of infections.

Abstract : Background: The primary goal of central precocious puberty treatment is to preserve final adult height. Safe and effective treatment of central precocious puberty in the form of long-acting GnRH analogs has been available for many years. Aim of study: To study the clinical characters of patients with central precocious puberty and their response to GnRh agonist therapy. Patients and Method: A randomized clinical trial study that conducted at Pediatric Endocrinology Outpatient Clinic in Children Welfare Teaching Hospital / Medical City from 1st of November 2018 to 30th of October 2019. It included 83 patients presented to the hospital because of early pubertal development and diagnosed with central precocious puberty. Subcutaneous injections of GnRH agonist (goserelin acetate [Zoladex]) were administered to all patients. Patients were observed for weight, height and sex maturation rate in addition to laboratory data were taken after at least 12 months. Results: In this study, there were significant decrease in height, suppression of the significant increase in bone age, and a significant increase in BMI level after treatment compared to that before treatment. Basal LH, FSH estradiol & testosterone values after treatment decline to significant levels. Conclusion: GnRHa treatment for CPP is safe and can be curative by improving the predicted height and delaying the growth rate.

Abstract : Introduction, Ureterolithiasis is the most common type of all urolithiasis. The management characteristics and efficacy of ureterolithiasis management using URS, ESWL, and ureterolithotomy in Dr. Soetomo General Hospital Surabaya are evaluated in this study. Material and Method This study used a descriptive study with a retrospective design. All medical record data of patients with reteral stone who were treated at Dr. Soetomo General Hospital Surabaya from 2014-2019. Result There were 801 patients included in the study. The highest incidence of ureteral stones was in the 51-60 years old age group (31.08%), predominantly among male patients (67.79%). URS was the most commonly performed procedure (61%). There were 270 patients with stone size < 1 cm. The procedures performed were URS and ESWL. The URS group showed significantly higher postoperative treatment (3.4 ± 2.1 days) compared to the ESWL group (p<0.05). There were 531 patients with stone size > 1 cm. The procedures performed in this group were URS, ESWL, ureterolithotomy. The shortest mean operation duration was in the ESWL group (61.56 minutes, p<0.05). Conclusion, The highest stone-free-rate (SFR) was discovered in the ureterolithotomy group (97.1%, p<0.05). ESWL had the shortest postoperative treatment duration (1 day, p<0.05). Ureterolithotomy generated the highest SFR. However, the patients had a greater hb change compared to URS. Keywords— Ureteral stone, URS, ESWL, Ureterolithotomy, Stone-free rate