Sapporo Medical Journal

Abstract : The Citarum River is the longest river in West Java stretching from Bandung City to the Jakarta bay. This river has been utilized as a vital object to provide power generation, irrigation, drinking water, and household utilities. The existence of heavy metals such as mercury (hg), cadmium (Cd), & Lead (Pb) in the river has become a serious concern. This research was aimed to analyze human health risk exposed by heavy metals from the consumption of the water, fish, and vegetables around the upper Citarum River. River water, well water, fish, & vegetables were collected around The Citarum River to analyze heavy metals content (Hg, Cd, and Pb). In this research, the concentration of Cd in all samples were below the standard limit. The concentration of Hg in fish & vegetables samples ranged from 0.17 – 0.78 mg/kg and <0.02 – 0.042 mg/kg, respectively. Meanwhile, Hg concentration was below the limit of detection for river and well water. Pb concentration in river, well water and vegetables were below 0.005 mg/l & below 0.1 mg/kg, respectively. Pb concentration in fish samples ranged from < 0.1 – 0.28 mg/kg. In this result, we found that fish sample D had the highest concentration for all heavy metals than other samples. It was estimated that fish samples around the upper Citarum River were not safe for consumption based on Hg tolerable daily intake with risk question (RQ) value was over than 1. However, it was still tolerable for Cd and Pb.

Abstract : Osteoarthritis is the single most common cause of disability in older adults. A study reported that musculoskeletal disorders were much greater than previously thought and accounted for 6.8% of the factors contributing to decreased age productivity in patients worldwide. This study is a retrospective analytic observational study with a cross sectional approach to postoperative high tibial osteotomy (HTO) patients at Dr. Soetomo general hospital and Husada Utama hospital in Surabaya. It was found that the most gender data were women with 20 patients (86.9), the most age was 51-60 years with 12 patients (52.1%), the most BMI was obese with 11 patients (61.1%), and the KOOS score of the pain, symptoms, activity daily living, sports, and quality of life components are 89.29, 92.51, 93.61, 56.96, and 82.61. Based on the FTA angle, the most patients were varus 4 and valgus 6. In addition, there were a significant difference between the mean FTA angle and between VAS average before and after surgery (p=0.000) and (p=0.000). There is an improvement in terms of clinical, radiological, and satisfactory KOOS score

Abstract : Background: Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in women of reproductive age with a prevalence of up to 10%. Aim: The aim of this study was to evaluate vitamin D levels in PCOS women compared to normal fertile women and the relation between vitamin D and fasting insulin hormone levels in PCOS women. Materials and Methods: A prospective case-control study was conducted on 80 subjects who were classified into two groups: group (I) cases included 40 infertile women diagnosed with PCOS and group (II) control included 40 normal fertile women. Demographic and clinical characteristics of all the patients were recorded Results: No significant differences were noticed between groups regarding age, body mass index, sun exposure, however, cases group had lower gravidity. The results showed that LH level was significantly higher in PCOS group compared to the control one, while the opposite trend was observed in FSH levels. The fasting insulin hormone level was higher in PCOS group compared to control. PCOS group had a significantly lower 25 (OH) D level in comparison with the control group. In the PCOS group, 25 (OH) D level was negatively correlated with both fasting insulin level and body mass index. Conclusion: Women with PCOS had a significantly lower serum 25 (OH) D level compared to normal fertile women. Insulin resistance was prevalent in PCOS patients and there was a significant inverse correlation between vitamin D level and both fasting ins

Abstract : Objective: The purpose of this study is to assess the effect of trans-nasal endoscopic management of choanal adenoid in management of the adult patient with persistent nasal symptoms. Patients and methods: This study conducted on 40 patients with bilateral nasal obstruction not responding to medical treatment of the nasal symptoms. The youngest patient's age was 18 years and the oldest was 43years (mean22.9± 7.4). Diagnosis preoperative was based on a careful history, examination including nasal endoscopy to confirm the diagnosis. Phoniatrics evaluation included (APA) and, Nasometery and examination including nasal endoscopy to confirm the diagnosis. A transnasal endoscopic powered adenoidectomy using a microdebrider in all patients to remove the choanal adenoids Results: A high statically significant difference between the nasal symptoms pre and post-operative follow up. Our patients had different degrees of improvement in the three follow up post-operative as regards the degree of nasal obstruction, Nasal discharge, Snoring, Chronic cough, Degree of crustations, and Degree of intranasal adhesions, and nasal bleeding. Conclusion: Our results revealed that the microdebrider is one of the best tools in removing chonal adenoid completely and relief most of nasal symptoms.

Abstract : Background : COVID 19 pandemic result in great thread to the public health and by the measures taken to limit viral transmission , a lot of maternal healthcare services had been disrupted .Our research aimed to assess the impact of COVID-19 on access to maternal health services in Basrah city .method : This is a descriptive retrospective records based study implemented during the period from 1st of March 2019 to 31st of August 2019 (pre-COVID19 ) compared to same months of 2020 (intra-COVID 19). All pregnant women who attended to six chosen primary health care centers in Basrah were included in the study. Results: Comparing 2019 maternal health services indicators with those from 2020, there is reduction about 22% in women in first antenatal visits and 33% in antenatal visits more than one less than four ,49% in visits equal and more than four , postnatal visits by 16% and tetanus toxoid doses by 17% . The greatest reduction occurred in March 2020 then these services utilization surged in July 2020 and decreased again in August .Conclusion:Our results demonstrate negative effects of COVID-19 on maternal health access and a deficient health information system in Basrah.