Sapporo Medical Journal

Abstract : Vulnerable groups, such as pregnant women, are a group that is at risk of health problems during a disaster. Weak physical condition due to the impact of the disaster and high anxiety can cause contractions that can lead to miscarriage, premature birth, and labor that is earlier than it should be. Family involvement as community empowerment, so that the family as the smallest unit can recognize as early as possible the risks, disastrous impacts of pregnant women. This research consists of three stages. Stage 1 is an exploratory study. The second stage is model development. A Disaster Response Pregnant Mother Family Empowerment Model was developed and used to increase the ability to face disasters in the context of reducing the risk of pregnant women in disaster conditions. Family mentoring uses the empowerment model for disaster response families twice with a span of one week. The third stage of the research was a quasi-experiment with pre-post test two group designs. Samples per group are 20 people. The sampling technique was the purposive sampling technique. The pre-post test was conducted to determine knowledge and attitudes, using a questionnaire, while the skills used observation. In the control group, only modules were given. The research concludes that the family empowerment model for pregnant women who respond to disasters affects increasing the ability to reduce the impact of disasters.

Abstract : Background:Vitamin D is an essential factor for body healthy especially in pregnant, deficiency of this vitamin is worldwide distributed health careincluding Middle East. The aim of the study is a determine the relationships between vitamin D concentration and some social and hematological parameters in pregnant women in Thi-Qar province/South of Iraq. Method:A comparative analytical study design was used with in Bint Al-Huda public hospital- and Al-Rahman gynecology and obstetrics private hospital /Thi-Qar-Southern of Iraq. In a period from September to November/2020, list of questionnaire includings: age, occupation, residence, miscarriage and trimester. specific investigation involving complete blood count and vitamin D level assay were done by coulter counter and immune fluorescence technique.. Results: the result showed high prevalence of vitamin D insufficiency among the women under study with no significant differences among the group (p value = 0.887), and there are no significant relation between the age, occupation and residence with the vitamin D levels under (p value ≤ 0.05), while the results reveals significant differences in Hb, PCV and MCHC between groups under (p value = 0.014, 0.003, 0.045), respectively. Also, high level of correlation was seen between vitamin D concentration and hematologic parameters (Hb, PCV,MCHC) with significance correlation (p-value < 0.001). Conclusion:the high percent of women including pregnant in Iraq suffer from vitamin D deficiency and insufficiency and the socio-economic factor play a role in this status with the high correlation between vit. D level and Hb, PCV and MCHC levels of blood, diagnosis and treatment of vit. D deficiency with adequate 25(OH)D concentrations are critical to maintain a good health care for pregnant women. More studies are required to detects others factors related to this deficiency in Iraqi populations

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.