BACKGROUND AND OBJECTIVE

Foreign body (FB) ingestion is a common pediatric concern in the Philippines, but local studies on flexible endoscopic management are lacking. This study aimed to describe the clinical profile and outcomes of children referred for flexible endoscopic management and identify factors associated with poor outcomes.

METHODS

This retrospective cohort study included 145 patients agedRESULTS

Most FB ingestions (96.55%) were accidental, with coins as the most common FB (56.55%). Patients were admitted an average of 40.42 hours post-ingestion and referred for endoscopy within 9.28 hours. Flexible endoscopy was performed in 44.83% of cases, with a 98.46% success rate and an average procedure time of 32.25 minutes. Spontaneous passage occurred in 50.34% of cases. Poor outcomes were linked to age 48 hours; OR: 15.43, p = 0.0181), and prolonged procedures (>30 minutes; OR: 12, p = 0.0318). Good outcomes were associated with unremarkable physical exams (OR: 0.078; p = 0.0018), early admission (CONCLUSION

Flexible endoscopy is effective and safe for FB extraction in children. Early admission and timely intervention significantly improve outcomes, while delays and prolonged procedures increase the risk of complications.

Human ; Adolescent: 13-18 Yrs Old ; Child: 6-12 Yrs Old ; Foreign Bodies ; Endoscopy ; Child ; Retrospective Studies

BACKGROUND

Maternal malnutrition is a major cause of low birth weight (LBW) newborn outcome especially among adolescent mothers. It is one of the key drivers of child stunting and initiates the vicious cycle of intergenerational malnutrition. The body mass index prior to pregnancy or at the initial trimester is currently being used to establish the desired weight gain throughout pregnancy. However, Filipino adolescents often delay their first antenatal visit at a later stage of pregnancy. Without a baseline weight, the establishment of appropriate weight gain and nutritional status is often challenging. Mid-upper arm circumference (MUAC) was proven to be a good proxy measure of acute malnutrition, however, there was no global consensus on what MUAC cut-off point to use to identify pregnant adolescents at risk for delivering LBW babies. Finding the optimal cut-off could facilitate early identification and intervention of pregnant adolescents who are nutritionally at risk and could eventually break the cycle of intergenerational malnutrition.

OBJECTIVES

The study aims to determine the association of maternal MUAC and the birth weight outcomes among newborn deliveries of adolescents in a tertiary hospital for a period of six months and to identify the optimal maternal MUAC cut-off point that can be used to predict low birth weight outcome among newborn deliveries of adolescents in a tertiary hospital.

METHODS

A cross-sectional study was conducted among adolescents ages 10 to 19 years who delivered babies in a tertiary hospital in the Philippines for a period of six months. Maternal MUAC and LBW outcome were documented, and their association was determined using a logistic regression analysis. To measure diagnostic accuracy, the sensitivity, specificity, and the area under the curve were taken for each MUAC point. A receiver operating characteristic (ROC) curve was used to aid the MUAC cut-off determination.

RESULTS

Out of 237 newborn deliveries, 35% were noted with low birth weight while 65% had normal birth weight. Most of the mothers were in their late adolescence at 78%. The crude association for the MUAC cut-offs ≤23.00 cm, ≤23.50 cm, and ≤24.00 cm and LBW showed a significant value of 2.19, 2.25, and 2.39 at 95% CI, respectively. However, it is only the cut-off ≤24.00 cm that showed significant results for adjusted association by the logistic regression analysis. The MUAC cut-off ≤24.00 cm also showed a better trade-off value between the sensitivity and specificity. Furthermore, the optimal maternal MUAC measurement that predicts LBW newborn outcome points to ≤24.00 cm cut-off based on the ROC curve.

CONCLUSION

This study shows that the maternal MUAC is predictive of LBW outcome among adolescent deliveries.A MUAC cut-off of ≤24.00 cm was superior to lower cut-offs studied. The pregnant adolescents might need a higher MUAC cut-off than adults to allow timely intervention and prevention of poor neonatal outcomes. By doing this simple screening test, suspected pregnant adolescents can be easily identified and referred for further confirmatory testing.

Human ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Pregnancy In Adolescence ; Infant, Low Birth Weight ; Adolescent Mothers

BACKGROUND AND OBJECTIVE

Mindfulness-based interventions (MBI), a novel treatment, and cognitive behavioral therapy (CBT), the standard treatment, are both effective in treating anxiety in adolescents. This study determined the effectiveness of mindfulness-based interventions versus cognitive behavioral therapy in reducing symptoms of anxiety among adolescents experiencing social anxiety through a systematic review and meta-analysis.

METHODS

A systematic approach was used to identify eligible studies. Electronic databases, reference lists of relevant articles, and gray literature were searched. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and subgroups. Heterogeneity was measured using visual assessment, the I2 statistic, and chi-square test.

RESULTS

Randomized controlled trials comparing MBI to CBT for adolescents diagnosed with social anxiety or social phobia disorder were analyzed, with non-randomized studies being excluded. Structured searches in electronic databases, reference lists, and gray literature were conducted by four independent reviewers who initially identified potential articles through title and abstract screening. After a comprehensive review of full-text articles and a consensus-building process, the selection of included articles was finalized. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and to examine subgroups, with heterogeneity being assessed through visual evaluation, the I² statistic, and chi-square tests. Total number of participants was 255; 101 were male and 158 were women. Mean age was 27.5 years old, and diagnosed with Social Anxiety Disorder, Social Phobia, or DSM-IV-Defined-Anxiety-Disorder. They were divided into two groups: 125 participated in 8- to 12-week MBI sessions lasting 2 hours each, while 130 underwent 2-hour CBT sessions spanning 8, 12, or 14 weeks. There is moderate quality of evidence reporting non-significant difference on MBI vs CBT's effectiveness in alleviating symptoms of social anxiety [mean (95% CI) = -0.04 (-0.58, 0.51)].

CONCLUSION

Study found that there were no significant differences between Mindfulness-Based Interventions and Cognitive Behavioral Therapy in reducing social anxiety in adolescents. Mindfulness interventions have advantages in terms of cost-effectiveness for reducing symptoms of anxiety. Future research should include larger sample sizes and longer follow-up periods to further assess long-term effects of these interventions.

Human ; Adolescent ; Mindfulness ; Anxiety ; Cognitive Behavioral Therapy ; Occupational Therapy

BACKGROUND

Cervical cancer, caused by human papillomavirus (HPV), is the second most common cancer among Filipino women. Despite vaccine availability, the Philippines has a low 60% immunization rate, driven by hesitancy and poor public awareness.

AIMS AND OBJECTIVES

This study assessed how 100 women (ages 18–45) in Quezon City understood HPV and their willingness to vaccinate.

MATERIALS AND METHODS

Researchers used a pre–post interventional study and purposive sampling and Cochran’s formula for size calculation. Participants completed a pretest, a Department of Health/World Health Organization/Centers for Disease Control and Prevention-based digital educational intervention, a posttest, and a satisfaction survey. Data were gathered confidentially under informed consent.

RESULTS

Results showed significant improvement in knowledge and willingness to vaccinate (P < 0.001), with almost all respondents expressing willingness. The intervention received high satisfaction ratings, proving the digital tool was effective and well-received.

CONCLUSION AND RECOMMENDATION

In conclusion, this study demonstrated that a structured digital educational tool effectively bridges knowledge gaps and addresses vaccine hesitancy in a community setting. Findings emphasize the importance of targeted, community-level initiatives to reduce cervical cancer risk. Future research should include teens and males and use a larger randomized sample for definitive evidence.

Human ; Female ; Adolescent: 13-18 Yrs Old ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Uterine Cervical Neoplasms ; Human Papillomavirus Viruses ; Vaccination ; Women

Human ; Female ; Adolescent: 13-18 Yrs Old ; Nerve Sheath Neoplasms ; Peripheral Nerves ; Neoplasms

Objective: This study described clinicodemographic profiles of children with prolonged length of stay admitted at the regular service ward of Philippine Children’s Medical Center (January 2023 – December 2023).

Materials and Methods: A descriptive and retrospective clinical profiling of patients with prolonged length of stay at PCMC was done (January 2023 to December 2023). Included were patients aged 1-18 years old admitted at the regular service ward and discussed during the overstaying audit. Excluded were those admitted at Neonatal Intensive Care Unit and Newborn Service Ward. Patients with prolonged length of stay admitted under the Hematology and Oncology Service ward and those with incomplete chart information were also excluded. Data collected were age, sex, area of residence, presence of comorbidities, diagnosis, reason for prolonged length of stay, and clinical outcomes.

Results: 153 patients were included in this study. Majority of the patients with prolonged length of stay were adolescents (43.79%). Most of the patients identified in this study were female (78%). Those who overstayed were predominantly from Quezon City (27.45%). Comorbidities were present in 93.46% of patients. Neurologic conditions accounted for majority of the admissions (35.29%). Most common reason for overstaying of patients was due to a medical reason (91.5%). Furthermore, 93.46% of patients were discharged while 6.54% died.

Conclusion: This retrospective study presented the clinical profile of patients with prolonged length of stay who were mostly adolescents, with female predominance. Neurologic disease was the most common diagnosis identified among patients. Those patients who have prolonged length of stay were generally because of medical problems mostly due to the complexity and chronicity of their disease. Strengthening of ongoing service delivery network and prompt subspecialty referrals and involvement may be recommended to address discharge delays and maximize hospital resources.

Human ; Male ; Female ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Length Of Stay ; Critical Care ; Chart

OBJECTIVE: This study aims to assess the effectiveness of unilateral ST 36 stimulation using Japanese acupuncture technique in the early return of bowel function after intrabdominal surgery compared with placebo in children between 3-18 years of age undergoing general anesthesia.

METHODOLOGY: This is a single-center, prospective, randomized controlled trial (RCT) among American Society of Anesthesiologists (ASA) I-III children aged 3-18 admitted for elective intraabdominal surgery under general anesthesia. Thirty-eight subjects were randomly assigned to non-acupuncture or acupuncture group. Press tack needle was placed on the right ST 36 point of the subject and stimulated on five occasions. Bowel motility, time to first flatus, first sips of water, start of solid food, first defecate, and length of hospital stay were the outcomes recorded.

RESULTS: The acupuncture group had earlier normal bowel sounds appreciated, and faster time to first flatus and defecate. Time to start sips of water, initiate feeding, and discharged from the hospital were earlier in the non-acupuncture group. Nonetheless, these were all statistically insignificant (p=0.188, 0.270, 0.307, 0.472, 0.085, and 1.0). Return of bowel sounds per minute was found to be prompter in the acupuncture group compared to non-acupuncture, which was statistically significant on the first day postoperatively with a p value of=0.045.

CONCLUSION: Unilateral ST 36 stimulation using Japanese acupuncture can help with early recovery of normoactive bowel sounds on the first day after intraabdominal surgery. However, this was ineffectual in enhancing overall bowel function following intraabdominal operation. Larger, homogeneous abdominal surgery is advised for future investigations.

Human ; Male ; Female ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Acupuncture ; Anesthesia, General ; Randomized Controlled Trial ; General Surgery

BACKGROUND: Adolescence was associated with suboptimal diabetes control. Studies supporting the use of mobile technology to improve glycemic control and adherence to treatment had mixed results.

OBJECTIVES: This study aimed to evaluate the effect of SMS reminders on improving glycemic control in adolescents with Type 1 Diabetes Mellitus (T1DM)

METHODOLOGY: A randomized control study among adolescents with poorly controlled type 1 diabetes mellitus was done. Data were processed from 56 out of 64 subjects who were randomized into control (N=29) who received standard of care and SMS group (N=27), who received standard of care and a daily SMS reminder regarding diabetes self-care for 12 weeks. An adherence form was answered by all participants and glycosylated hemoglobin (HbA1c) before and after intervention was compared.

RESULTS: HbA1c did not significantly differ between SMS and control groups after 12 weeks of intervention (SMS 9.98+2.12 vs control 10.54+2.13, p value of 0.305). Post intervention, there was no significant difference between SMS and control group in terms of adherence to insulin injection (no p value), blood glucose (BG) monitoring (p value 0.106), and diabetic diet (p value 0.803). However, adherence on exercise was significantly higher among control group than SMS group (p value 0.003).

CONCLUSION: A 12-week SMS intervention reminder in adolescents with type 1 diabetes mellitus did not significantly improve glycemic control and adherence to standard of care (insulin injection, blood glucose monitoring, diet and exercise).

RECOMMENDATION: Future researches could include a bigger study population and longer duration of intervention. Other forms of mobile technology could also be used as a form of reminder.

Human ; Male ; Female ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Text Messaging ; Glycated Hemoglobin ; Therapeutics ; Technology ; Standard Of Care ; Self Care

Aims: We evaluated the efficacy of active video games as weight reduction intervention among obese children and adolescents by synthesizing available published evidence.

Materials and methods: A meta-analysis was performed using nine RCTs based on the PRISMA guidelines. Children less than 18 years of age who are Obese I and Obese II and underwent active video games intervention or standard weight management programs were included. A search was performed in PubMed/MEDLINE, EMBASE, Scopus, Cochrane, and HERDIN databases from inception to September 2024 databases using the MeSH and key words: (“video games” or “digital games” or “console games” or “electronic games”) AND (“weight loss” or BMI or obesity) AND (children OR pediatric OR adolescents) AND (RCT OR trials OR “randomized controlled trial). Pooled mean difference was used to determine effectiveness on reducing weight and BMI.

Results: The pooled mean difference showed significantly lower post-intervention weight (in kg) (MD=-2.97, 95%CI=-5.15 to -0.78, p=0.008) and significantly lower post-intervention BMI z-score (MD=-0.12, 95%CI=-0.13 to -0.10, p<0.000001) on children with AVG intervention. There was also lower post-intervention BMI on children with AVG intervention (MD=-1.27, 95%CI=-2.93 to 0.38). However, the difference was not statistically significant (p=0.13).

Conclusion:Active video games showed a significant benefit in weight reduction among obese children. Usual lifestyle modification interventions may be challenging due to lack of motivation and poor adherence among younger demographics. AVGs present a novel approach by integrating entertainment with physical activity, thereby addressing these barriers.

Human ; Male ; Female ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Randomized Controlled Trial ; Adolescent ; Meta-analysis ; Video Games ; Life Style ; Exercise ; Electronics

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by extreme immune activation, resulting in pathologic inflammation that may be life-threatening. Early recognition is crucial since survival largely depends on early initiation of treatment which utilizes a combination of chemotherapy, immunotherapy and in some cases even bone marrow transplantation.

OBJECTIVES: This study aims to describe the clinical characteristics, treatment received and outcome of patients diagnosed with HLH at the Philippine Children’s Medical Center from 2004 to 2017.

METHODS: A retrospective analysis of records of children 0 -18 years of age diagnosed with HLH from January 2004 to December 2017 was done.

RESULTS: A total of 39 patients were included in the study which gave an incidence of 1.22 per 3000 patients admitted under 18 years of age. There were 29 males (74.4%) and 10 females (25.6%) with a male to female ratio of 2.9:1 Mean age was 6.12 ± 3.89 years. The average time from initial presentation to diagnosis was 6 weeks and 2 days. The most commonly seen clinical and laboratory features observed in these patients were fever (100%), splenomegaly (71.8%), anemia (87.17%), thrombocytopenia (79.48%) and hypertriglyceridemia (69.23%). Only 5 patients were confirmed to be familial HLH with 3 having XLP gene mutation, and one each having syntaxin and perforin gene mutations. Majority of patients received a combination of treatment based on the HLH 2004 regimen while almost one third only received antibiotics. Only 23% of patients survived during the study period and all but one of these patients received drug combinations based on the HLH 2004 protocol.

CONCLUSION: HLH is a rare but important condition that must be recognized early and treated appropriately to optimize survival. The mortality rate of 39 patients seen in this institution is high. There is a need to better utilize the diagnostic criteria of the disease and to employ a more uniform treatment strategy. Increasing awareness among health care personnel can also improve case finding, characterization and treatment.

Human ; Male ; Female ; Adolescent: 13-18 Yrs Old ; Lymphohistiocytosis, Hemophagocytic ; Philippines