select *
    from t1 f
       , t2 pmap
       , t3 emap
       , t4 up
    where pmap.pat = f.pat
      and emap.enc = f.enc
      and pmap.pat_s = :pat_s
      and emap.enc_s = :enc_s
      and pmap.pa_s = 'A'
      and emap.en_s = 'A'
      and up.id = :u

select *
from t1 f
    join  t2 pmap
        on pmap.pat = f.pat
    join t3 emap
        on emap.enc = f.enc
where
     pmap.pat_s = :pat_s
  and emap.enc_s = :enc_s
  and pmap.pa_s = 'A'
  and emap.en_s = 'A'
  and up.id = :u