Teikyo Medical Journal

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Teikyo Medical Journal

Journal ID : TMJ-17-03-2022-11200

Total View : 430

Title : Association between bacterial pathogens and some biomarkers of urinary tract infection

Abstract :

Even though its gold standard status, culture method is time consuming and expensive to use when diagnosing UTI. For this reason, rapid and accurate biomarkers are needed to diagnose UTIs and their causative more quickly. The prediction of UTI and finding specific pathogens requires the identification of a biomarker which is more precise as they have extended their list. One hundred patients were selected from the Ramadi Teaching Hospital by urologists in expert urologist clinics according to inclusion criteria for UTI cases. Fifty apparently healthy subjects with the same ages and sexes were included in the study as control group, Human Interleukin- 6 and Interleukin-8 evaluated in blood samples, Elastase Procalcitonin and CRP were evaluated in urine samples, by using ELISA technique. The females were 68% and males were 32%, the mean age of patients was 35.95±12.3, and for control was 33.0±10.33, Escherichia coli isolated from 21%, followed by 13% and 12% for Staphylococcus epidermidis and Staphylococcus aureus while 4% for Klebseilla pneumonia, all included markers were significantly higher in patients than controls. The AUC for CRP was 0.998, sensitivity and specificity of the test were 98% and 97%, respectively and the highest levels of IL- 6, CRP, PCT and Elastase were recorded with K. pneumonia. All markers used in this study have a significant differences between patients and control, CRP was imperative markers in urinary tract infection followed by IL-8 and procalcitonin.

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Journal ID : TMJ-16-03-2022-11199

Total View : 458

Title : Toxic Retinopathy Associated with Etanercept Treatment (Enbrel) Case Report

Abstract :

This work aims to emphasize the importance of the ophthalmological examination in monitoring patients on anti-TNF alpha. In addition to common complications, such as anterior uveitis and retrobulbar optic neuritis, the patient may potentially develop non reversible toxic retinopathy. This ophthalmological impairment, which is more common in patients on synthetic antimalarial drugs, is characterized by the absence of initial symptoms, which makes it a major screening issue. We report the case of a patient, followed in the internal medicine consultation, for ankylosing spondylitis. The diagnosis was retained according to the ASAS EULAR 2010 criteria in 2008. Treatment with anti-TNF alpha was recommended as a second line treatment after the failure of non steroidal anti-inflammatory drugs and Salazopyrine. After 18 months of treatment with Etanercept, systematic annual ophthalmological examination revealed, through macular OCT, a suggestive involvement of early toxic retinopathy, confirmed by multifocal ERG. Etanercept was then discontinued. Therefore, close monitoring should be carried out systematically in all patients on anti-TNF alpha to detect retinal toxicity, which remains an unusual complication as it is unmentioned in recent studies.

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Journal ID : TMJ-15-03-2022-11198

Total View : 480

Title : Electrocardiograph Alteration Correlated to Epicardial Fat Tissue Thickness: A Systematic Review

Abstract :

Epicardial adipose tissue (EAT) or epicardial fat tissue (EFT) affect cardiac electrical impulse through chemical secretion. Change of electrical cardiac impulse may lead into cardiac arrhythmia. Measurement of EAT correlates to the prognosis of cardiac arrhythmia cases caused by inflammatory and fibrotic properties which facilitate arrhythmogenesis. The aim of this study is to review the change of cardiac impulses and arrythmias correlation to EAT. Epicardial Adipose Tissue, Epicardial Fat, Electrocardiography, and Arrhythmia were used as keywords. Studies that we include were published between 2015 and 2021. We use inclusion and exclusion criteria to select included studies. We included five observational studies. This review includes 644 patients with predominant male younger than 65 years old. Epicardial fat tissue thickness more than 5,35 mm and 9 mm correlates to increased P-wave dispersion and increased T peak-end (Tp-e)/QT ratio, and Tp-e/QTc duration. Thicker EAT also correlates to the presence of fragmented QRS (fQRS). We found no cut-off point to determine- increased EAT. Epicardial fat tissue thickness correlates to P-wave dispersion, Tp-e/QT, Tp-e/QTc ratio, and fQRS. Evaluation of these parameters in echocardiography examination might have beneficial value to predict arrythmia in patients, especially those with overweight or obesity.

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Journal ID : TMJ-15-03-2022-11197

Total View : 413

Title : A NON-INVASIVE TEST TO EVALUATE CHANGES IN GENE EXPRESSION IN THE O-GLCNACYLATION PATHWAY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Abstract :

Protein O-GlcNAcylation plays a major role in the development of type 2 diabetes and its complications. The objective of our current study is to analyze the differences in gene expression of enzymes involved in the hexosamine biosynthetic pathway (HBP) by the method of non-invasive assessment. We evaluated the changes of genes expression of HBP enzymes among type 2 diabetics and non-diabetics cheek swab samples. Patients from a free dental clinic consented to take part in the study. The desired variables were obtained from the patients i.e., demographic details, medical and past family history. We collected buccal epithelial cells that were processed and frozen. For assessment of expression of genes, we used real-time PCR and enzyme primers. The relative amount of gene expression was determined by Peri Primer software and normalized to beta actin mRNA. The comparison t-test was applied to assess the means of two groups, which analyzed the differences in the gene expression among the non-diabetic and diabetic patients. Out of total 82 patients, majority of patients had no any prior history of diabetes while 15 were diabetic. The results showed changes in genetic expression of O-GlcNAc transferase (p<0.05). A significant difference were observed in gene expression between two groups i.e. diabetic and non-diabetic with lower power due to small number of diabetic groups.

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Journal ID : TMJ-15-03-2022-11196

Total View : 480

Title : Cost Effectiveness Analysis of Breast Cancer Patients at Early, Locally Advanced, and Advanced Stage in Saiful Anwar Hospital Malang.

Abstract :

Breast cancer is the most common cause of cancer-related death in women. Breast cancer requires medical treatments at varying costs based on the stage and treatment given. Expensive medical treatment, however, does not necessarily affect the patients’ quality of life. Therefore, it is necessary to calculate the cost-effectiveness of the treatment based on the value of quality of life (QALY) of breast cancer patients who have undergone treatment. To determine the total cost incurred for the breast cancer patients at early-stage, locally advanced stage, and advanced stage and to analyze the cost-effectiveness of treatment at each stage based on the quality of life (QALY). Observational analysis of breast cancer patients who underwent examination and treatment at the Surgical Oncology Clinic of Saiful Anwar Regional Public Hospital, Malang. Respondents were divided into 3 study groups based on the stage when the patient first underwent the examination. From each respondent, the total costs incurred by the hospital for the patient were calculated, and each respondent filled out the EQ-5D questionnaire to determine the U-QALY value (converted using the EQ-5D Thailand conversion table). The effectiveness evaluation was done by calculating the Incremental Cost Effectiveness Ratio (ICER) and based on the Threshold (the value of Indonesia's per capita income). Of the total 87 respondents in this study, 10% were early-stage patients, 65% locally advanced stage, and 25% advanced stage. The average U-QALY scores for each group were 0.92, 0.85, and 0.6 consecutively. Cost-effectiveness in the early stage group was categorized to be positive because it did not show an increase in QALY. In the locally advanced stage group, the ICER value in the mastectomy and chemotherapy group was Rp. 24,000,000.00 / 0.3 QALY gained and Rp. 39,000,000.00 / 0.5 QALY gained in the mastectomy, chemotherapy, and radiotherapy groups. In the advanced stage group, the ICER value was Rp. 15,000,000.00 / 0.5 QALY gained in the radiotherapy group. The quality of life of breast cancer patients (measured in QALY value) was strongly influenced by the stage of the disease. The higher the stage, the lower the QALY value. The Cost-Effectiveness in the early stage, locally advanced stage, and advanced stage at Saiful Anwar Hospital was relatively positive because its value was lower than the threshold value.

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