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Teikyo Medical Journal


Journal ID : TMJ-14-06-2022-11317
Total View : 393

Title : The relationship between pregnancy and serum vitamin B9 and B12.

Abstract :

Folate (vitamin B9) is a necessary ingredient for DNA replication. Also used as a substrate in a variety of enzymatic processes involved in amino acid synthesis and vitamin metabolism. Vitamin B12, commonly known as cobalamin, is a water-soluble vitamin. It comes in cyano-, methyl-, deoxyadenosyl-, and hydroxy-cobalamin forms. From December to June 2019, 50 pregnant women were registered in Al-Karkh Materuity Hospital. After obtaining informed consent, fasting blood (n=25) was taken by a single puncture from patients (either demonstrated vitamin B9 or B12 deficiency) and healthy volunteers (n=25). The weight of the baby at birth, the type of delivery, and the length of the pregnancy were all documented. After gaining oral agreement from the participants, fasting blood (2ml) was taken from the vein in plain vacutainers. Commercially available tests were used to determine the levels of vitamin B9 (folate) and vitamin B12 in the blood (Sigma, USA). GraphPad Instat was used to calculate the statistical significance of the unpaired t-test (3.0, Trial Version). Women with low vitamin B9 levels had a significantly lower fetal weight (p0.0001) than healthy controls. Similarly, as compared to healthy controls, B12 deficient women had lower infant birth weights. Vitamin B9 levels in healthy controls were 174.3821385.17 pmol/l, while they were 119.878525.81 pmol/l in B9 deficient subjects. The vitamin B12 concentration in the B12 deficient group was substantially lower (211.64931.71pg/ml) than in the healthy control group (401.47258.94 pg/ml). We may conclude from this research that vitamins B9 and B12 are critical for the growth and development of the fetus. The supplementing should begin before the pregnancy is planned. Folate (Vitamin B9) and vitamin B12 are linked to pregnancy difficulties in a negative way.

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Journal ID : TMJ-14-06-2022-11316
Total View : 369

Title : Effects of crunch abdominal exercise in the closure of recti abdominis muscles separation in multigravidas: A quasi-experimental study

Abstract :

Diastasis Recti Abdominis (DRA) is a common postpartum condition with predominance women who have undergone multiple pregnancies and births. It is characterized by an abnormal gap between adjacent recti abdominis muscles and weakness of the abdominal segment with impairment of effective trunk function, among other complications. Structured physical exercises have great potentials of resolving DRA with improved muscular strength outcomes. This study evaluated the effects of structured abdominal exercise on the closure of Inter Recti Distance (IRD) among multiparous women. Thirty (30) multiparous women presenting with varying degrees of DRA participated in this quasi-experimental study and were randomly assigned into two groups (experimental – 23 and control – 7). Participants in the experimental group performed isometric abdominal exercises over a four-week period while those in the control group practiced only low-impact jogging exercises. Using the analysis of variance (ANOVA), the exercise group recorded significantly decreased mean IRD at p< 0.05, and also were able to carry out more sustained crunch exercises, when compared to the control group. Within the exercise group, there was also comparative significant increase in mean abdominal muscle strength. The outcome of the study shows that exercises may enhance abdominal muscle strength and potentiate closure of IRD, as well as improve functional activities of daily living in postpartum women.

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Journal ID : TMJ-14-06-2022-11313
Total View : 391

Title : The Prevalence and Clinical Predictors of Esophageal Varices in Liver Cirrhosis Patients at Dr. Cipto Mangunkusumo National Referral Hospital in Indonesia

Abstract :

Liver cirrhosis is a terminal condition which can cause a complication in the form of esophageal varices (EV). Early detection and management of EV had become an important factor to prevent the occurrence of bleeding. This study is aimed to explore the prevalence and clinical predictors of EV. A cross-sectional study on liver cirrhosis patients undergoing EV screening using endoscopy in the Hepatobiliary Integrated Procedure Room of Dr. Cipto Mangunkusumo Hospital (RSCM) was conducted from January 2016 to December 2017. From a total of 148 patients, the prevalence of EV in patients with liver cirrhosis was 57.4%, which was categorized into small degree (23.6%) and large degree (33.8%). This study also found a significant mean difference in clinical parameters between the EV and non-EV groups. These parameters include albumin and bilirubin levels, INR, and platelet count, as well as CTP, MELD, and APRI scores (p<0.001). The clinical parameter with the highest discrimination and sensitivity in predicting EV was CTP score (AUROC: 0.734, 77.65% sensitivity, 61.90% specificity, p<0.001) while the APRI score was found to have the highest specificity (AUROC: 0.691, 60.00% sensitivity, 71.43% specificity, p<0.001). Patients with CTP-C score were found to be the highest proportion of cirrhosis patients experiencing EV. Parameters such as platelet count and CTP scores could act as clinical predictors of EV in cirrhosis patients.

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Journal ID : TMJ-12-06-2022-11312
Total View : 474

Title : Sporadic hypokalemic periodic paralysis: A case report and literature review

Abstract :

The hypokalemic periodic paralysis is a rare (1:100000) inherited channelopathy of skeletal muscles characterized by muscle weakness coinciding with low potassium levels, many classifications exist. However sporadic, familial, and thyrotoxic is the commonest, we presented a thirty-eight-year-old Filipino Female with sporadic periodic paralysis with quadriparesis. The literature of the published case reports, the genetic background, investigation, and treatment was reviewed.

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Journal ID : TMJ-11-06-2022-11310
Total View : 362

Title : Ethical issues related to shortage of personal protective equipment for healthcare workers amidst the COVID-19 pandemic

Abstract :

In areas with inadequate supply and/or increasing demand for such equipment, many ethical considerations have been taken into account regarding the adequate availability of PPE for clinicians who are in contact with COVID-19 patients. This survey study aimed to investigate the impact of PPE shortage in Saudi Arabia on some ethical considerations regarding HCWs and patient communication. The study was conducted as an online cross-sectional survey from July 2020 to December 2020, with eligible HCWs from different academic, governmental, and private sectors in Saudi Arabia. A total of 453 valid responses were included in the final analysis. The mean age of the participants was 37.5±8.5 years, and 62.0% of them identified as male. Most participants (62.3%) reported having faced a shortage/lack of PPE, with 78.8% of them having experienced difficulties in procuring PPE at the time of need; only 15.7% did not have any previous experience in using PPE. While training courses regarding the proper use of PPE were offered to most participants (88.1%), about one-third of the participants (36.0%) reported that their hospitals did not have a clear protocol on who should have priority in using PPE. Noteworthy, 47.9% of the participants believed the refusal to treat patients in the absence of PPE to be an ethical act, regardless of the kind of illness the patient was suffering from, while 32.9% of them considered it to be ethical only if the patient was a suspected/confirmed COVID-19 case. A greater number of participants (43.3%) reported that the admitted patients were aware of the importance of the doctors wearing PPE. This study indicated a huge shortage of PPE supplies among Saudi healthcare facilities. Further approaches need to be adopted to ensure adequate availability of PPE, so HCWs could maintain the best quality of care.

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