BACKGROUND

Feasibility studies are a necessary first step in assessing the practicality of methods and procedures used in a more extensive study. Others emphasize that feasibility studies aim to test the practical aspects of a future study and use the results to inform modifications that can enhance the study design and increase the chances of success in the more extensive study. Before conducting the main study, we rigorously refined data collection procedures based on the best available evidence, informed by the scoping review, expert consultation, and pilot testing.

To evaluate the feasibility and practicality of the proposed research methodology and to identify and address potential challenges associated with data collection. The specific objective is to determine the intra-rater reliability in determining MVIC, which is part of the procedure in the sEMG protocol.

This study is composed of two phases: (Phase 1) a pragmatic pilot study using an experienced biomechanist to refine the protocol. Thorough preparation, including a dry run and expert review, preceded the pilot study. (Phase 2) a preliminary testing phase to evaluate the protocol and to assess the intra-rater reliability of the MVIC used in the sEMG protocol. A high speed treadmill, Nexus software, Vicon and Delsys sEMG systems were used to capture kinematic and muscle activity data during high-speed running, enabling a comprehensive biomechanical analysis.

The final protocol underwent a feasibility and acceptability assessment based on five pre-defined metrics: recruitment efficacy, optimization of data acquisition methodologies, data integrity and completeness, procedural tolerability, and resource allocation efficiency. Pilot testing anomalies and their respective corrective actions were systematically documented. Furthermore, the intra-rater reliability of the maximum voluntary isometric contraction (MVIC) measurement exhibited a range from moderate to excellent, as determined by statistical analysis.

This study successfully demonstrated the feasibility and practicality of our research methods. We evaluated all identified parameters and completed the assessments on schedule. The feasibility study proved valuable in identifying and addressing challenges encountered during data collection, such as equipment malfunctions and logistical hurdles. The study also demonstrated a moderate to excellent intra-rater reliability of MVIC assessment.

OBJECTIVES

Human papillomavirus (HPV) is a prevalent sexually transmitted infection linked to cervical and anal cancers. Although there are many studies worldwide on knowledge, attitudes, and practices (KAP) regarding HPV, research in the Philippines is still limited. This study assessed the knowledge, attitudes, and practices (KAP) of senior high school students in Manila regarding HPV infection and vaccination.

A descriptive cross-sectional survey was conducted among 345 senior high school students from a private tertiary school in Manila using a self-administered questionnaire. Frequencies and percentages summarized demographic characteristics and KAP responses

Most respondents demonstrated good knowledge of HPV, with 86.4% recognizing its link to cervical and anal cancer and 86% identifying it as a common sexually transmitted infection. Attitudes toward vaccination were largely positive: 73% expressed willingness to be vaccinated, and 87.8% considered the vaccine safe. However, only 2.6% had been vaccinated. Limited discussions about HPV, misconceptions about gender susceptibility, and low awareness of local vaccine availability contributed to poor uptake. The internet was the primary information source (84.9%).

Most respondents demonstrated good knowledge of HPV, with 86.4% recognizing its link to cervical and anal cancer and 86% identifying it as a common sexually transmitted infection. Attitudes toward vaccination were largely positive: 73% expressed willingness to be vaccinated, and 87.8% considered the vaccine safe. However, only 2.6% had been vaccinated. Limited discussions about HPV, misconceptions about gender susceptibility, and low awareness of local vaccine availability contributed to poor uptake. The internet was the primary information source (84.9%).

BACKGROUND

Mpox, a zoonotic disease identified in central Africa in 1958, is mainly endemic to the Congo basin and West Africa. Collecting demographic and clinical data is crucial for early recognition and differentiation of skin lesions as the Philippines addresses this public health challenge.

We describe the demographics, clinical profile, and outcomes of suspected and confirmed mpox cases in the Philippines from July to November 2022.

This case series reviewed suspected and confirmed mpox cases at the Research Institute for Tropical Medicine from July to November 2022. Clinical data, demographics, and outcomes were collected through retrospective chart reviews and summarized using descriptive statistics.

Fifteen cases were reviewed, including 2 confirmed mpox cases, with an average age of 37.8 years and 80% male. The other symptoms associated with rash at presentation included fever (20%) followed by lymphadenopathy, malaise and chills reported in 1 case each. All patients had pustules and erythematous papules, with 67% showing vesicles. Lesions mainly appeared on the extremities (93%), trunk (60%), and head/neck (47%), evolving into crusts within 1–2 days. Non-confirmed cases were often misdiagnosed as varicella (60%), arthropod bites (20%), or folliculitis (7%).

Young to middle-aged males with travel histories were common in suspected and confirmed mpox cases. Lesions typically included papules and pustules on the extremities, evolving into crusts and erosions within 1–2 days. Confirmed cases had umbilicated papules and fever, while PCR-negative cases were diagnosed with local skin conditions. Testing is vital for timely detection and management, especially since mpox resembles other conditions.

Objective: Our study aims to establish interrater reliability in performing the step-by-step procedure of selected pain provocation tests for hamstrings and special tests for lower extremity musculoskeletal injuries. Study Design: An interrater reliability study Setting: University of Santo Tomas - Sports Science Laboratory Participants: Ten healthy adults (five females, five males; age = 22.2 ± 0.42) from the university community. Main outcome measures: Interrater reliability of performing step-by-step procedures for selected pain provocation tests for hamstrings (painful resisted knee flexion 90°, painful resisted knee flexion 30°, active slump test, Puranen-Orava Test, bent knee stretch) and special tests for lower extremity musculoskeletal injuries (Lachman’s test, McMurray’s test, posterior drawer test, valgus, and varus stress test). Results: Fleiss kappa showed perfect agreement (κ = 1.00) for all test procedures except for Lachman’s test procedure 1 (κ= -0.11 [95% CI, -0.36 to 0.14]), active slump test procedure 4 (κ= -0.03 [95% CI, -0.28 to 0.23]), active slump test procedure 5 (κ= -0.11 [95% CI, -0.28 to 0.23]), and active slump test procedure 6 (κ= -0.05 [95% CI, -0.31 to 0.20]), which resulted in negative agreements. Conclusions The researcher developed protocols for each special and provocative test were consistent in measuring the intended procedures, and the raters were generally consistent with their ability to measure these tests.

Netherton syndrome (NS) is an autosomal recessive genodermatosis characterized by cutaneous and systemic complications (recurrent infections, dehydration, and sepsis). This highlights the urgency of making an accurate diagnosis, especially in infants and children. However, it is important to note that the recognition of NS is usually delayed due to its rarity and similarity to cutaneous disorders with atopiform, erythrodermic, and ichthyosiform presentations. We report a case of a 1-year-old female who was previously diagnosed with a case of infantile psoriasis and was subsequently treated with topical emollients. However, after months of surveillance, the patient developed feeding problems, failure to thrive, recurrent diarrhea, upper respiratory tract, and gastrointestinal infection, leading to repeated hospitalizations. The patient then underwent further clinical examinations and laboratory analysis, which revealed abnormal hair shaft findings, elevated immunoglobulin (Ig) E levels, and normal chromosomal analysis. Multispecialty referrals with other services were done to address the current problems and ensure holistic care for the patient. On her last admission, the patient was given three doses of intravenous Ig therapy with noted improvement in lesion presentation without any systemic symptoms.
Netherton Syndrome

INTRODUCTION: Cutaneous involvement is relatively uncommon representing a small fraction (1-2%) of the localizations of extrapulmonary tuberculosis. Cutaneous TB presents with several clinical forms, wherein one of the most common is scrofuloderma resulting from the direct extension of a tuberculous focus from a deeper structure such as the lymph node into the overlying skin. Tuberculous gumma is a rare form which occurs due to hematogenous spread of the TB bacilli. Although presenting with a wide clinical spectrum, it is believed that the association of different morphologies as well as numerous lesions and sites of cutaneous TB in a same patient is very rare.

CASE REPORT: This is a case of a 20-year-old Filipino male presented with a fi ve-month history of several progressive cutaneous lesions initially presenting as subcutaneous nodules evolving into well-demarcated suppurative painless ulcers which were unresponsive to topical antibiotic. Skin punch biopsy from the medial malleolar area of the right foot revealed dilated blood vessels with a diffuse inflammatory infiltrate of lymphocytes, histiocytes, and few multinucleated giant cells. Clinical and laboratory findings were consistent with cutaneous tuberculosis. Patient was started on anti-Koch's treatment regimen and presented an excellent response to treatment showing resolution of the skin lesions on the neck and forearms and notable regression of the lesions on the right foot within four (4) months.

CONCLUSION: This case serves as a reminder that cutaneous tuberculosis can manifest with a wide spectrum of clinical presentation which can mimic diverse dermatological conditions and may present with high rates of negative or equivocal diagnostic testing results. This report highlights the importance of a high index of suspicion in the timely diagnosis and management of tuberculosis in countries wherein tuberculosis remains a significant health burden such as the Philippines.

KEYWORDS: Cutaneous tuberculosis, Scrofuloderma, Tuberculous gumma, Metastatic tuberculous abscess

INTRODUCTION: Excessive screen time has been found to be detrimental to a child’s development. Despite its prevalence, there is a dearth of studies relating family dynamics and screen time. This study aimed to determine the association between family dynamics and the length of screen time among preschool children. METHODS: Participants were selected through convenience sampling and interviewed using the Family APGAR questionnaire. Families were classified as functional or dysfunctional. The adult respondents estimated the total screen time and this was classified as low-level or excessive. The association between screen time and APGAR classification was determined using prevalence rate ratio. RESULTS: Majority of 115 families had an APGAR classification of highly functional, with the children having an average screen time of five hours. Children from dysfunctional families were 1.23 times more likely to have an excessive amount of screen time than those with highly functional families and the difference was significant (p = 0.041). CONCLUSION Majority of the families in this study were highly functional and the average screen time of the children included in the study was five hours. Children from dysfunctional families were 1.23 times more likely to have an excessive amount of screen time than those with highly functional families.
child, preschool ; child ; Child development ; screen time ; family relations ;

BACKGROUND: Several trials on relapse rates on duration of multibacillary regimens have varying results. OBJECTIVE: To compare the relapse rate among smear-positive Leprosy patients receiving 12 blister packs of multibacillary drug therapy and 24 blister packs of multibacillary drug therapy. METHOD: A review of records of smear positive Leprosy patients seen from 2002 to 2006 was done. Demographic, clinical and therapeutic data were collected. Bacteriologic index was determined from Leprosy Laboratory records. RESULT: A total of 391 patients were found to have complete records for review and analysis. Relapse rate was 11.9%(28) for patients who received 12 blister packs and 1.91%(3) for patients who received 24 blister packs and the difference was found to be statistically significant (p<0.01). Distribution of relapse was statistically significant according to age (p<0.01), bacteriologic index (p<0.01) and clinical spectrum (p<0.01). CONCLUSION: Relapse rates shown among smear positive leprosy patients receiving 12 blister packs vs. those receiving 24 blister packs was statistically higher which differs from previously published studies. Significant predictors were clinical spectrum, bacteriologic index of >3.5, and >4 and number of blister packs.
Leprostatic Agents ; Drug Therapy, Combination ; Leprosy ; Recurrence ; Chronic Disease

Introduction: Lipoid proteinosis is a rare autosomal recessive genodermatosis with only approximately 300 cases reported worldwide. This condition is due to the loss of function mutation of the ECM1 gene which encodes for extracellular matrix protein 1 (ECM1), a secretory protein that promotes angiogenesis and is a negative regulator of endochondral bone formation. Case summary: We report a case of a 23-year-old male who presented with chronic recurrent verrucous and waxy lesions on the face and body, diffuse alopecia of the scalp, and hoarseness of voice. Lesions heal leaving scars. Dermoscopy of the eyelid margins show white to yellowish clods with accentuated brownish halo. Lesions on the nape show multiple follicular symmetric whitish-yellow clods with brownish halo and well-defined borders. Lesions on the elbows show a reticular pattern with white clods and diffusely distributed brown dots. Histopathology shows basket-woven stratum corneum, spongiosis of the epidermis with vacuolar alteration, and formation of clefts in the basal cell layer. The papillary dermis shows hyaline material which also surrounds the blood vessel and the adnexal structures. There is mild superficial and mid dermal perivascular inflammatory infiltrate of lymphocytes. PAS highlights eosinophilic material in the papillary dermis which also surrounds the blood vessels and the adnexal structures. Alcian blue staining reveals positive staining for hyaline deposits. Conclusion This report highlights the importance to recognize the clinical, dermoscopic and histopathological findings of lipoid proteinosis.
Lipoid Proteinosis of Urbach and Wiethe ; Dermoscopy

Introduction: Cryptococcosis is an opportunistic fungal infection caused by Cryptococcus neoformans. This systemic fungal infection affects 6 to 13% of patients with acquired immunodeficiency syndrome (AIDS). Only 10% of patients with this condition develop cutaneous manifestations. Case Summary: A 20-year-old male, newly diagnosed case of HIV (Human Immunodeficiency Virus), presented with multiple skin-colored molluscum contagiosum-like umbilicated papules on the face, neck and both arms. Lesions increased in number rapidly and were associated with respiratory distress. Histopathologic examination revealed findings of opportunistic fungal infection suggestive of cryptococcosis. Serum Cryptococcal Antigen Latex Agglutination System (CALAS) test was also positive. Patient was then diagnosed as a case of cryptococcosis and was a candidate for intravenous amphotericin B. However, before the planned medication was given, the patient experienced severe respiratory distress and expired several hours later. Conclusion Molluscum-like skin lesions may be a telltale sign of a disseminated opportunistic fungal infection, including Cryptococcosis. Early diagnosis followed by prompt and aggresive treatment would improve outcome and survival of the patient.
Cryptococcosis ; Acquired Immunodeficiency Syndrome ; HIV