OBJECTIVE: The potential of a low-cost, novel Kinect?-based markerless motion analysis system as a tool to measure temporospatial parameters, joint and muscle kinematics, and hand trajectory patterns during the propulsion and recovery phase of wheelchair propulsion (WCP) was determined.

METHODS:Twenty (20) adult male track and field paralympians,(mean age = 36 ± 8.47) propelled themselves on a wheelchair ergometer system while their upper extremity motion was recorded by two Kinect? cameras and processed.

RESULTS: The temporospatial parameters, joint kinematics, and hand trajectory patterns during the propulsion and recovery phase of each participant's WCP cycle were determined and averaged. Average cycle time was 1.45s ± 0.19, average cadence was 0.70 cycles/s ± 0.09, and average speed was 0.76m/s ± 0.32. Average shoulder flexion was 30.99° ± 28.38, average elbow flexion was 24.23° ± 12.25, and average wrist flexion was 12.82° ± 26.78. Eighty five percent (85%) of the participants used a semicircular hand trajectory pattern.

CONCLUSION: The low-cost, novel Kinect?-based markerless motion analysis system had the potential to obtain measurable values during independent wheelchair propu
Biomechanical Phenomena ; Ergometry ; Track and Field ; Para-Athletes

Patients with multiple strokes are often excluded from studies due to poor outcomes. This case report described change in mobility and balance in a 54-year-old male with four strokes following intensive physical therapy (PT) based on the Task oriented Approach. Outcome assessment demonstrated clinically meaningful change in balance and mobility, and no adverse events. Intensive task-oriented PT is safe and feasible, and may contribute toward positive outcomes in severe disability related to multiple strokes.

Human ; Male ; Middle Aged ; Physical Therapy Modalities ; Stroke ; Outcome Assessment (health Care) ; Cerebral Infarction

OBJECTIVE: To determine the prevalence, demographic, clinical profile, diagnostic and treatment outcomes of adult patients diagnosed with disseminated tuberculosis

METHODS: This is a cross sectional study of patients referred to the UP-PGH TB DOTS clinic with a diagnosis of disseminated TB from January 2011 to December 2015.

RESULTS: The prevalence of disseminated tuberculosis was 1.7 %.Mean age at diagnosis was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. The most common comorbidity was HIV (5.8%). The mean duration of symptoms before initial consult was 281 days (SD 510.7). The most common presenting symptoms were abdominal pain (19%), back pain (13%), and abdominal enlargement (11%). The lungs (86%) are still the most commonly involved site, followed by the gastrointestinal tract (22%) and the vertebra (27%). Majority were started with Category I treatment regimen (54%, 37 patients). Of the 68 patients, only 16% (11 patients) continued follow-up at PGH; all had documented treatment completion.

CONCLUSION: Patients with disseminated tuberculosis are young and majority had no comorbid illness. They have long latency of symptoms prior to diagnosis, and usually present with nonpulmonary symptoms despite high evidence of pulmonary involvement. To date, this is the largest local study on disseminated TB known to the authors.

Human ; Male ; Female ; Middle Aged ; Adult ; Comorbidity ; Abdomen ; Treatment Outcome ; Abdominal Pain ; Gastrointestinal Tract ; Tuberculosis ; Back Pain ; Hiv Infections

BACKGROUND: Non-adherence to treatment in epilepsy is considered as a worldwide problem ranging from 30-50% of patients. Despite its striking magnitude, only a few studies tried to explain the factors affecting it. Moreover, a standard method to measure adherence to treatment among patients is still lacking. An in-depth analysis on adherence to treatment of patients with epilepsy, taking into factor their values, beliefs, and culture, is deemed necessary.

OBJECTIVES: The purpose of this qualitative study is to investigate the contributory factors and issues on treatment adherence faced by Filipino patients with epilepsy and their caregivers. This study also aimed to serve as a catalyst to further stimulate local researches on treatment adherence in epilepsy.

METHODS:?Four focus group discussions were conducted with patients and caregivers who voluntarily agreed to participate and share their experiences on dealing with epilepsy. A total of 39 participants were included. The focus group discussions, facilitated by skilled moderators, were composed of an ice breaker and a discussion on the experiences and issues faced by the participants. The discussions were transcribed and analyzed using thematic coding.

RESULTS: Three main content categories were identified from the focus group discussions, namely, 1) accepting a life with epilepsy, 2) dealing with the disease, and 3) ensuring freedom from seizure attacks, which were further sub-categorized. From these, a number of factors affecting treatment adherence were identified and a conceptual framework was developed by the investigators.

CONCLUSION: This study was able to demonstrate that conducting a focus group discussion was an effective means of eliciting the experiences and issues in patients and their caregivers. Several factors affecting treatment adherence such as patient-doctor relationship, financial resources, government support, adverse medication effects, religious belief, trigger avoidance, frequent reminders, and safety precautions were elucidated in this study.

Epilepsy ; Treatment Adherence and Compliance

BACKGROUND: Dysphagia is common among post-stroke patients,causing disability due to malnutrition and pneumonia. Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment modality to address this complication.

OBJECTIVE: The study aimed to compare real versus sham rTMS in treating post-stroke dysphagia.

METHODS: PubMed, Ovid, ClinicalKey, Herdin, and Google Scholar databases were searched from their earliest record to 31 July 2015 for randomized controlled trials that used rTMS to treat post-stroke dysphagia. The Jadad scale was used to assess the quality of the studies. The weighted mean difference (WMD) between baseline and post-treatment mean for Penetration Aspiration Scores (PAS) measured in the experimental and control groups were extracted for subsequent meta-analyses.

RESULTS: Three studies were analyzed. The WMD in PAS score between rTMS and control using liquid bolus two weeks after treatment in two good quality studies was -1.14 (95% confidence interval (CI) = -1.80 - -0.48, P = 0.001, I2 = 0.0%), and after four weeks was -1.83 (CI = -3.22 - -0.44, P = 0.010, I2 = 0.0%).

CONCLUSION: Treatment of post-stroke dysphagia with rTMS improved PAS on subgroup analyses of studies using liquid bolus after two weeks, and between real and sham treatment after four weeks.?

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Deglutition Disorders ; Transcranial Magnetic Stimulation ; Stroke ; Pubmed ; Qualitative Research ; Pneumonia ; Malnutrition

Objective. The present study aims to correlate the LGU list of PhilHealth Sponsored Members in a municipality of Batangas with the list of poor residents as identified by the Participatory Action Research (PAR) methodology. Method. Interview of key informants documented the processes utilized by the LGU in determining PhilHealth beneficiaries for the Sponsored Program and the Participatory Action Research (PAR) survey in the classification of households into poor, middle and rich in four barangays of the municipality. The list of LGU Sponsored members was then cross matched with the PAR household classification. Results. The comparison of the LGU list of Sponsored members and the household classification by the PAR survey showed a wide discrepancy: (1) 464 "Not Found" Sponsored households or 70% of the LGU's Sponsored list; (2) inclusion of the non-poor: 140 middle class families as classified by the PAR survey or 21.1% of the LGU's Sponsored list; and (3) exclusion of 413 or 87.5% of true poor families identified by the PAR Survey. Only 59 families or 8.9% of the LGU Sponsored list were classified as poor families by PAR. Conclusion. PAR offers communities, LGUs and the National Health Insurance Program a tool to validate the coverage of the Sponsored program. LGUs and the PhilHealth should consider such tool or similar tools to validate their identification, selection and enrollment of the poor, which is extremely vital in achieving universal coverage. Given the right tool, communities are in the best position to identify the poor for the Sponsored program. By way of collaboration with the underprivileged themselves, the academe has a role in assisting communities in acquiring collective awareness of their own situation and developing capacity for improving their lives. The academe also has a role in assisting LGUs in improving their health systems and national health programs in validating and improving their implementation. Further studies should be done to investigate the following: the identity of the "not found" SP members; the utilization of PhilHealth benefits by the poor; and the prospect of utilizing the PAR method by other non-academic institutions in monitoring the progress of community programs.
Human ; Male ; Female ; PUBLIC-PRIVATE SECTOR PARTNERSHIPS ; HEALTH SERVICES ; INSURANCE, HEALTH ; HEALTH CARE ECONOMICS AND ORGANIZATIONS ; ECONOMICS ; FINANCING, ORGANIZED ; INSURANCE

Introduction. Several studies have been conducted on the use of Immunoglobulin Y (IgY) technology in the fields of diagnostics and therapeutics. IgY is the avian counterpart of the mammalian immunoglobulin G (IgG) which is exclusively transferred from the hen to the yolk thus conferring passive immunization to the growing embryo. However, despite the advantages it offers over the use of mammalian immunoglobulin, IgY technology has remained underutilized. Objective. The objective of this study is to produce an IgY with activity against synthetic peptide analogs of known immunogenic epitopes of the Hepatitis B Surface Antigen (HBsAg) - a molecular marker of Hepatitis B infection. Methods. Chickens were immunized with synthetic peptide analogs of previously reported immunogenic epitopes of the S and the pre-S1 regions of the Hepatitis B surface antigen (HBsAg). IgY specific for the synthetic peptides was isolated by delipidation and salt precipitation and was further purified by affinity chromatography. Purity and molecular weights of the whole IgY molecule and its subunits were assessed and determined by SDS-PAGE. Anti-peptide activity and specificity were determined by indirect ELISA. The study was approved by the Ethical Review Board (ERB) and Technical Review Board of the Research Implementation and Development Office (RIDO), University of the Philippines Manila. Results and Conclusion. The IgY that was purified in this study had an approximate molecular weight of 165 kilodaltons. The heavy and light chains are 60 and 28 kilodaltons, respectively. The affinity purified IgY demonstrated anti-peptide antibody activity against synthetic peptide analogs of known immunogenic epitopes of the HBsAg. Specific binding against a battery of synthetic peptides also revealed that the affinity purified IgY specifically binds to the known immunogenic epitope of the HBsAg.
HEPATITIS B SURFACE ANTIGENS ; HEPATITIS B ANTIGENS ; HEPATITIS B VIRUS ; IGY

Background. Emergence of multidrug-resistant tuberculosis (MDR-TB) poses a major challenge to prevailing disease management. MDR-TB arises from mutations in several genes comprising the resistance determining regions, including rpoB, katG and gyrA. Objective. To detect and characterize mutations in rpoB, katG and gyrA. Methods. Thirty selected Mycobacterium tuberculosis isolates from the IDS-PGH were subjected to PCR amplification and sequencing. Sequences were compared to the wild type strain H37Rv. Results. Mutations were detected in codons 512, 513, 516, 522, 526, 531 and 533 of rpoB, codons 280, 281, 315 and 333 of katG, and codons 90 and 94 of gyrA sequences. The most frequently mutating codons for rpoB, katG and gyrA were 531, 315 and 94, respectively. A clustering analysis of the sequences showed occurrence of seven, four and three clusters for the genes rpoB, katG and gyrA, respectively. The eight clusters obtained from the concatenated sequences of the three genes represent the eight potential genotypes of local strains. One cluster represents the wild type strain genotype, another cluster represents the XDR strain genotype, and six clusters represent the MDR strain genotypes. Conclusion. These findings indicate the utility of multiple RDR sequence analysis in both identifying specific drug resistance mutation and genotyping of various M. tuberculosis isolates.
TUBERCULOSIS ; THERAPEUTICS ; THERAPY

Objective. This study was conducted to determine the dietary diversity score and its relation to nutritional adequacy among 16-19 year-old adolescents. Methods. Secondary data analyses were undertaken with a representative sample of 16-19 year-old adolescents (n=521) in a university campus in Manila in 2008. Dietary diversity scores (DDS) were calculated. Nutrient adequacy ratio (NAR) is the ratio of subject's nutrient intake to the 2002 Recommended Energy and Nutrient Intakes (RENI) for Filipinos. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a ratio (range from 0-1). MAR was used as a measure of adequacy of overall diet. Pearson correlation coefficients between DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. Results. The adolescents had a mean DDS of 3.94 (1.21) and a mean MAR of 0.67 (0.18). There was a strong correlation between MAR and DDS (r=0.543; P < 0.0001). A DDS of 4 was shown to be the best indicators for both MAR equivalent to 0.5 and 0.7 since they provided the best sensitivity and specificity. Conclusion. DDS can be used as a simple and quick indicator of the nutritional adequacy of the diets among these group of adolescents. Further investigation of this tool is needed for other population groups i.e., adults and elderly.
Human ; Male ; Female ; Adult ; Young Adult ; Adolescent ; DIET ; ADOLESCENT NUTRITIONAL PHYSIOLOGICAL PHENOMENA ; PHYSIOLOGICAL PHENOMENA ; NUTRITIONAL PHYSIOLOGICAL PHENOMENA ; DIET THERAPY

Objectives. As part of the global initiative to eradicate poliovirus infections this study aims to: (1) estimate the prevalence of vaccine-derived poliovirus excretion among persons diagnosed with primary immune (B-cell or combined B/T-cell) deficiency disorders (PIDD) in the Philippines; (2) describe clinical features of these PIDD patients excreting poliovirus; (3) genetically characterize vaccine-derived polioviruses isolated from persons with PIDDs; and (4) determine the duration of poliovirus excretion among subjects who tested positive for vaccine-derived poliovirus excretion. Methods. Seventy-one (71) Filipino patients (ages 0-35 years of age) with PIDD were recruited retrospectively and prospectively over a period of 16 months. The study participants, after informed consent and administration of a questionnaire for baseline data, underwent further testing of quantitative immunoglobulin levels (IgG, IgA, and IgM) and stool poliovirus isolation using two stool samples. Stool specimens which tested positive for the poliovirus were sent to the Regional Reference Laboratory in Australia for further characterization by Intratypic Differentiation (ITD) and Vaccine-derived polioviruses (VDPV) real-time PCR. These participants were then monitored on a monthly basis until laboratory tests identified two sequential months of negative poliovirus stool specimens. Results. Seventy-one (71) patients underwent interview and quantitative serum immunoglobulin testing. However, one patient expired prior to stool isolate collection. This study, then, documented that none of the remaining 70 Filipino individuals (0-35 years old) with confirmed or suspected PIDDs chronically excreted immunodeficiency-associated vaccine-derived poliovirus (IVDPV). One patient who was a recent OPV-recipient excreted poliovirus Sabin-like 1 transiently (less than 1 month) and two patients excreted non polio-enteroviruses. Conclusions. Chronic and prolonged poliovirus excretion appears to be uncommon among Filipino patients with diagnosed Primary Immunodeficiency Disease Disorders. However, as part of the continuing global initiative for poliovirus eradication, vigilance is still necessary in patients with primary immunodeficiency diseases. Adequate identification of these patients followed by monitoring their capacity for viral excretion and environmental contamination may be necessary to achieve this goal.
Human ; Male ; Female ; POLIOVIRUS VACCINE, ORAL