Sapporo Medical Journal

Abstract : Aim of the work: The aim of this study was to assess the potential efficacy of new drug therapy of HCV in treatment of HCV arthropathy and to find out if sero-conversion is related to relief of patients symptoms. Materials and methods: Patients having chronic hepatitis C infection with arthropathy underwent thorough medical history and clinical examination. The following tests performed; C - reactive protein, erythrocyte sedimentation rate, liver function tests, HCV antibody test, polymerase chain reaction for HCV and rheumatoid factor. The included patients received the treatment of HCV in the form of dual therapy (Sofobuvir, Daclatasvir) or triple therapy (Sofobuvir, Daclatasvir and Ribavirin) for 3 months as secheduled. The patients underwent repeated clinical examination and laboratory assessment after completion of the treatment course and the achievement of sustained virological response (SVR). Results: The most frequent affected joints were the proximal inter-phalangeal (PIP) and the matacarpo-phalangeal (MCP) joint. On assessment of the patients' laboratory data before antiviral therapy and after SVR, there were statistically high significant improvement in the liver function tests, ESR and the number of RF positive cases. The joint affection frequencies showed also statistically high significant improvement. Conclusion: The current study concludes the high efficacy of the new drug therapy of HCV in treatment of HCV arthropathy, with significant reduction in

Abstract : Essential hypertension and its complication, a chronic heart failure, are one of the most common pathological tandems in practical cardiology. Linked etiologically and pathogenetically, they share a common path of progression, manifested by structural, functional, and humoral disturbances in cardiovascular homeostasis. In recent years, a member of the family of natriuretic peptides, brain natriuretic peptide, has taken the place of one of the biomarkers of myocardial and vascular remodeling processes, most often used in practical medicine; it is also positioned as a humoral antagonist of the activity of renin-angiotensin-aldosterone system, which is the leading pathogenetic link in most cases of hypertensive cascade and CHF. This study aims to supplement the data on the use of BNP as a signaling indicator of changes in myocardial structure and function and calculate the screening threshold levels of peptide in uncomplicated and complicated EH in postmenopausal women with polymorphic variants of the BNP gene. It was revealed that the frequency of carrying the T381C genotype and the C allele significantly prevails among the polymorphic variants of the BNP gene in women 40-65 years of age. The highest level of plasma BNP concentration, which was 193,27 ± 2,98 pg/ml, was determined in women with EH complicated by CHF. In addition, carrying the C allele of the BNP gene is significantly associated with higher levels of peptide in the blood plasma of women in all the examined groups

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.