Sapporo Medical Journal

Abstract : The appearance isolates of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant S. aureus (VRSA), as well as vancomycin-intermediate S. aureus (VISA), in the community, becomes a big concern in worldwide public health in both developed as well as developing countries. Hence, the purpose of the current research aimed to examine phenotypic and genotypic detection of virulence factors in MRSA and VRSA and the frequency of VRSA and VISA isolates among conjunctivitis infections. The results showed that 6 (9.37%) of isolates were capsulated S. aureus by India ink staining, hence 67% of isolates showed the protease enzyme production. The results revealed that 57.8% of S. aureus isolates changed the color of DNase agar from blue to pink or rose, indicating that they were positive result. The results showed that 76.5% of S. aureus isolates produced gelatinase enzyme. The molecular results showed that all of S. aureus isolates do not contain the cap5 gene, while cap8 gene detected in 35% of S. aureus isolates. Also, result pointed out that 50% S. aureus of investigate isolates contained the hla gene. The findings of the molecular revelation of the nuc gene showed that 70% of S. aureus isolate gave positive for nuc gene.

Abstract : COVID-19 pandemic has brought challenges to healthcare service providers, including the pharmaceutical-logistics sector. This study aims to determine the evaluation of the impact of covid-19 on the resilience of inventory management at the Metropolitan Medical Center Hospital. This study uses a qualitative method of a case study with descriptive analysis of several secondary data in the form of reports or documents related to inventory data, patient visit data, as well as hospital income and expenditure data during the Covid-19 pandemic from 2020 to 2021. The research population is management who are involved in the inventory management process at the hospital. This study shows that hospital inventory conditions are not ideal in terms of inventory fulfillment to inventory turnover due to the influence of the pandemic situation which began in 2020 and will continue until 2021. The number of inventory fulfillment for unit requests to warehouses has decreased, especially at the beginning of the pandemic, the inventory turnover rate also decreased, indicating that there were supplies that were not being used because the majority of the supplies needed were centered on the Covid-19 disease with a fairly high number of visits during pandemic. Hospitals need to make various efforts, such as improving forecasting and planning mechanisms, arranging scheduled purchasing, determining drug priorities, and formulating policies according to certain conditions experienced by hospitals.

Abstract : Introduction: End-stage kidney disease (ESKD) is a global health challenge that contribute to substantial patients’ morbidity and mortality. Optimizing the management of ESKD complications is a critical role of the dialysis care-team. In this study, we aim to explore the state of anemia and electrolytes control among our hemodialysis patients in order to facilitate initiatives aiming to optimize the management and outcomes of this population. Methods: in this observational study, we examined the characteristics and laboratory profiles of hemodialysis patients at a large tertiary hospital in Saudi Arabia. Data were analyzed and described using Microsoft excel analytic functions. Results: A total of 258 HD patients were included in this study. The mean age was 53.5±16.6, and 62% were male. Diabetes was the leading cause of ESKD (52%), followed by hypertension (21%). Half of the patients were using catheters as hemodialysis access. Forty-one percent of the patients had a hemoglobin level within the guidelines target (10 – 12 g/dL), while 44% had lower levels. For phosphate, only 34% of patient had a normal (target) phosphate level, with majority having hyperphosphatemia (58%). Conclusion: Anemia and hyperphosphatemia managements are suboptimal among our HD population, with unacceptable high rate of catheter use as a dialysis access. More efforts are needed to optimize the management of hemodialysis patients, ideally through a multidisciplinary contentious quality improvement.

Abstract : Analyzing the variations of nucleotide sequences in D-loop regions mtDNA can determine the identity of specific individuals or populations and maternal kinship. The Madurese population is an ethnic group that maintains its traditional customs in harmony with the religions they adhere to and endogamous marriage as their marriage pattern. This study applied PCR amplification and sequencing strategies on HVS-1 143 bp (nt 16268-16410) and HVS 2 126 bp (nt 34-159) of mtDNA D-loop regions. This study used buccal swab samples collected from 50 pure Madurese families consisting of a mother and two children. The homology analyses of female-female, male-female, and male-male siblings showed 11 variants or morphs in 126bp HVS-2 D-Loop mtDNA (nt 34-159). The highest variant were: female-female siblings (129GC: 15%), male sibling (120C  A: 11.5%) -female sibling (120C: A: 11.5%), and male-male siblings (131TC: 11.5). The homological analysis of female-female and male-female siblings showed 11 variants on 143bp HVS-1 mtDNA D-Loop (nt 16259-16410). The highest variants in female-female siblings were: 16387AG, 16387AC: 15%; male sibling-female sibling: 16393CT, 16393CA: 11.5%; while the homological analysis of male-male siblings showed 13 variants with the highest percentage: 16367AG, 16367AC: 11%.

Abstract : Background: The oculomotor or the third cranial nerve gives innervation to the four of the six extraocular muscles, namely the medial rectus, superior rectus, inferior rectus, inferior oblique. This cranial nerve is responsible for the upward and downward as well as adduction movement of the eyeball. It also retract the upper eyelid by innervating the levator palpebrae superioris muscle. Oculomotor nerve regulates the pupillary constriction via the parasympathetic nervous system. Oculomotor nerve palsy may affect any of these roles depending from its aetiology. Case presentation: We are reporting a case of complete right sided oculomotor nerve palsy secondary to carotid cavernous fistula in a poorly controlled diabetic patient. This patient had a complete right sided ptosis with the eyeball deviated to the ‘down and out’ position in keeping with dilated pupil. A magnetic resonance angiography had confirmed the diagnosis of carotid cavernous fistula of which an urgent embolization procedure was performed. Conclusions: Diagnosing an oculomotor cranial nerve palsy correctly and to determine its exact etiology is vital. A complete, pupil-involving oculomotor nerve palsy warrants an urgent radiological imaging as to accurately localized the lesion that give rise to the presenting symptoms.