Sapporo Medical Journal

Abstract : This study focused on the management of cardiovascular medicines (CVMs), as cardiovascular diseases (CVDs) are the great public health problem globally and in Mongolia. The ABC (Always, Better and Control) and VEN (Vital, Essential and Non-essential) analyses were emphasized in the comprehensive manual for Drug and Therapeutic Committees which has been developed by the World Health Organization (WHO). These are the analyses involve aggregate data such as annual consumption and cost as well as clinical importance of the medicines. We aimed to identify the cardiovascular medicines needing strict management control, used at the Cardiovascular Center (CVC) in Mongolia by conducting ABC, VEN and ABC-VEN matrix analyses. The Category I (AV, AE, AN, BV and CV), which requires strict management control contains the vast majority (70.97%, 81.25% and 78.8%) of the total cardiovascular medicines analyzed and constituted the biggest amount of the total expenditures at 87.3% (116890484 MNT - Mongolian tugrik – the official currency of Mongolia), 89.53% (95107593 MNT) and 87.56% (129608248 MNT) in 2016, 2017 and 2018 respectively. ABC, VEN and ABC-VEN analyses should be carried out routinely in order to manage medicines effectively and properly at the Cardiovascular Center.

Abstract : Studies have found that daily oral 5000 IU vitamin D3 is safe to avoid insufficiency, recover from insufficiency, and avoid toxicity. Thus, this study would like to support the findings that daily oral dose of vitamin D3 for 5000 IU is still safe by following up patients who take daily oral 5000 IU vitamin D3 for four years in various diseases. 14 subjects with various diseases were recruited for this study. Subjects were administered oral vitamin D3 5000 IU daily with informed consent and blood vitamin D level was tested on study entry and follow-up. Subjects were divided into 2 groups based on their blood vitamin D level test follow-up time. The first group consisted of 12 subjects who were followed up once in the range of 1-4 years. The second group consisted of 3 subjects who were followed up every year for 4 years. One subject was included in both groups. The first group who were followed up once in the range of 1-4 years did not have a significant increase in 25(OH)D serum concentration and did not reach toxicity level. The second group which was followed up every year for 4 years had their 25(OH)D serum concentration increased but the increase was also affected by the disease they had. Daily oral 5000 IU vitamin D3 dose is safe proven by 25(OH)D serum concentration not passing 100 ng/ml which is still below 150 ng/ml, where adverse effects are usually present.

Abstract : BACKGROUND: Resistant hypertension has been identified as one of the causes for hypertensive patients failing to reach their blood pressure target. OBJECTIVE: This study aims to determine the prevalence of resistant hypertension amongst elderly hypertensive patients (aged 60 years and above) and the factors associated with resistant hypertension.METHODOLOGY: A cross-sectional study incorporating a questionnaire was used in this study and was conducted between July 2018 to February 2019. Adherence to anti-hypertensive medication was assessed by using the 14-item Hill-Bone Compliance to High Blood Pressure Therapy Scale. RESULTS: A total of 594 patients aged ≥ 60 years were studied. The mean age was 70.28 ± 6.74 years with 57.8% (n=343) being female. The mean systolic blood pressure was 144.93 ± 14.12 mmHg while the mean diastolic blood pressure was 77.67 ± 8.64 mmHg. The proportion of patients with resistant hypertension was 66.3% (394/594). In univariate analysis, factors found to significantly associated with the presence of resistant hypertension were gender, educational level and age (p<0.05). In multivariate analysis, it was found that older age and those of a lower educational level were determinants of having resistant hypertension. CONCLUSION: The prevalence of resistant hypertension among elderly patients was very high. Groups found to have a higher risk of developing resistant hypertension should be targeted during health campaigns or consultations.

Abstract : Train postpartum skill directly of accompaniment carried out by midwife to empowering the mother in her new duties related to the presence of the baby. The purpose of this study was to know the effect of accompaniment through direct Guidance at real situations in postpartum to her independence on newborns care. Design research was a quasi-experimental study with early postpartum subjects in BPM Midwife S and M at Kemang, Bogor. The research subjects were 35 respondents who received the intervention and 35 respondents as control. In this study, the intervention group received mentoring and Guidance for three days in newborn care. On the 7th day, an assessment of independence in newborn care was carried out. The control group received baby care counseling; it was based on midwifery care standards without assistance. The dependent variable was the mother's independence in newborn care. The independent variable was mentoring for the postpartum. Data analysis was using the Mann-Whitney Test. The result shows that there were significant differences in mother's independence in newborns care between both groups, where the intervention group had better independence. with a mean value of 160.55 ± 75,611 and p=0,000 (<0,005). This study concluded that mentoring of postpartum mothers could increase mother's independence in newborns care. Suggestions from this study were to optimize mentoring for postpartum in newborns care to help mothers to had independent and to optimize the return o

Abstract : Background: Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by heterogeneous bleeding manifestations as well as marked-inter individual variation in response to glucocorticoid (GCs); the 1st line ITP treatment. This may be due to Pgp as steroids outside the intracellular space thus decreasing its intracellular concentration. Methods: The study investigated the relation between single nucleotide protein; the product of ATP binding cassette B1( ABCB1) gene. It is involved in effluxing drugs polymorphism (SNPs) in ABCB1gene and the variable response to oral prednisolone treatment in 100 Egyptian ITP patients. Clinical response was measured during 1st 28 days and compared with C3435T and G2677T SNPs determined by PCR REPLF technique. Results: No significant difference in C3435T between ITP patients and control. Carriers of mutant allele of G2677T were significantly higher in ITP patients compared with the control group (p value :02) suggesting possible role in disease predisposition. Conclusion: There was no significant relation between these two SNPs and age of onset of the disease , initial platelet count, response to steroid therapy .