Sapporo Medical Journal

Abstract : Background: Hepatic encephalopathy HE is a neuropsychological disorder in patient with advanced liver disease. The ammonia has a critical role in HE pathogenesis. The aim: to evaluate efficacy and safety of sodium benzoate (SB) as a cheap adjunctive agent that can be used in addition to rifaximin or lactulose for the treatment of HE. Methods: This study included 90 patients of overt HE in 3 groups: Group A (30 patients received oral sodium benzoate capsule and lactulose), group B (30 patients received oral sodium benzoate capsules and rifaximin, and group C (30 patients (control group) received lactulose and rifaximin). Each group was subjected to clinical examination, and laboratory investigations. The three groups evaluated before and after treatment for clinical response using West Haven Criteria classification of HE, Clinical Hepatic Encephalopathy Staging Scale (CHESS) score and psychometric tests. Results: There was statistically significant difference in WHC grades of HE, CHESS score of HE, and psychometric tests before and after treatment in each group (P < 0.05). There was no statistically significant difference in the overall improvement between the three studied groups after the treatment regarding WHC grades, CHESS score and psychometric tests. No reported significant adverse events. Conclusion: Adding SB to either lactulose or rifaximin in the treatment of HE is clinically equivalent to lactulose and rifaximin combination. This finding highlights the therapeutic

Abstract : Aim of the work: to clinically describe patients with COVID-19 who presented to El-Minia university hospital screening triage and to Clarify the simplest way to predict the severity of COVID-19. Patients and methods: the current study is a retrospective study on the clinical criteria and laboratory results including inflammatory and coagulation markera (NLR, LMR, CRP, ferritin and D-dimer) of 76 patients of COVID-19. The patients classified based on the severity into severe and non-severe group. Results: the median age of studied patient was 47 years old of them 43 male and 33 female. The risk of severity increased with hypertension and chronic kidney disease. As regards laboratory results in WBCs, neutrophil percentage and count, NLR, ALT, AST, urea and creatinine Significantly increased also there was an increase in inflammatory markers as CRP, ferritin and D-dimer with decrease in Hb, lymphocytes percentage, monocytes percentage level in severe group comparing to non-severe group. By applying binary logistic regression analysis it was found that increase in WBCs, Neutrophil count, NLR, ALT, Urea, Creatinine, CRP, Ferritin and D-dimer increasing the progression and severity of COVID-19. Conclusion: lymphopenia and NLR especially CRP, ferritin also, inflammatory markers, is an effective and reliable indicator of the severity and indication of hospitalization in COVID-19 patients.

Abstract : Adipose-derived stem cells (ADSCs) are promising stem cell for autologous regenerative therapy. However, culturing process of ADSCs manipulated the size of cells into senescence formed. The aim of this study was to investigate the effect of concentration variation of ascorbic acid towards proliferation of human ADSCs. Human ADSCs were isolated by enzymatic digestion and cultured in presence serum. To evaluate trilineage ability of ADSCs, multipotency assay into adipocyte, chondrocyte and osteocyte were conducted. The prepared cells then cultured into 8 groups involved cells cultured in Dulbecco’s Modified Eagle’s Medium (DMEM) only, DMEM with 10% foetal bovine serum (FBS) (DMFA), DMFA with 25, 50, 75, 100, 125, and 150 µg/ml of ascorbic acid, respectively. Morphology observation including spread size of cells, population doubling time, viability and proliferation curve were performed. Analysis of type 1 and type 2 collagen and vascular endothelial growth factor (VEGF) as well were conducted in mRNA level using quantitative-real time PCR. The results showed that the cells had plastic adherence capacity and could be differentiated into adipocyte, chondrocytes, and osteocyte. After 120 hours of observation, the cells which cultured with FBS without ascorbic acid supplementation has the highest spread cells in size, lowest in cell yield and lowest in doubling time while the lowest spread size cells with the highest of cell yield and fastest in doubling time was in group with 75 µ

Abstract : The recent COVID-19 pandemic has imposed a great global challenge. Patients with chronic illnesses may have drug adherence difficulties during the curfew. The aim of this study is to evaluate medication adherence among chronic patients during the pandemic era, and to report this section of the population’s knowledge and perception of the health services within the same period. A cross sectional questionnaire-based survey was performed. It was electronically distributed to people from Gulf Cooperation Council nations with a special emphasis on Saudi Arabia. Included in this study, were those who suffered of chronic diseases, respondents who did not suffer any chronic illness were excluded. Our study results have shown that 1066 of the participants suffered of chronic diseases. Among them; 78 different chronic disorders were encountered. Those who were not regularly adherent to their medications during the pandemic era, constituted 29.2% of the study population, 68.3% expressed hesitancy to visit healthcare centers during that time. This was attributed to their fear of contracting the viral infection. In conclusion, Chronic patients during the COVID-19 pandemic may have a higher morbidity and mortality risks. This may be explained by their reluctancy to visit the health care facilities. They should be targeted by further educational programs to encourage them for a regular health facility visits to keep adherent to their medications. The social media may have a great role.

Abstract : Cleft lip and palate incidence is influenced by various factors. Many studies about maternal risk factors have been investigated, but it results variedly. This study wants to give a glimpse about maternal profile of cleft’s patient in Indonesia. The data was collected from 2014 to 2018, from social service held by Hayandra Peduli Foundation. The data collected primarily, and 604 subjects obtained. The most common age group was 30-39 (41.5%) with 27.2% of all subjects were under 20 or over 35 years old of age. Most of the subjects (94.21%) have education level below diploma, still presumably related to low socioeconomic status of the family. Most of the patient (99.8%) already had routine antenatal care during pregnancy period to health officers and most of them went to midwife’s office (58.6%). Events related to pregnancy which related to cleft incidence and were recorded in this study: preterm birth (5%), history of miscarriage (13.4%), and serious illness and/or complication during child birth (5.6%). In this study most of the subjects (96.2%) consume fruits and vegetable at least once a week, while seven subjects (1.2%) were active smokers, and 70.2% of subjects were passive smokers. 18% of subjects had had an exposure to x-ray during their pregnancy period. Several maternal risk factors in Indonesia, including socioeconomic, events during pregnancy, history of previous miscarriage, dietary and smoking habits, and environment factors, possibly held accountable for cleft in