OBJECTIVE: This study describes the utilization pattern of psychiatric consultation services at the UP-PGH from 1999 - 2008 by reviewing the demographic data of patients referred, describing the Axis I (Clinical Disorders and Other Disorders That May Be a Focus of Clinical Attention) and Axis III (General Medical Conditions) diagnoses of referred patients, and by identifying the sources of, and reasons for the different referrals.
METHODS: Relevant data from the annual census of the Consultation - Liaison (CL) Psychiatry Section from 1999 - 2008 was reviewed according to age, sex, civil status, reasons for referral, DSM-IV TR Multi-axial diagnoses and sources of referrals.
RESULTS: The percentage of referrals to consultation psychiatry has increased from 1.03% in 1999 to 1.77% in 2008. There is equal distribution between males and females. Majority of the consultation referrals were married and belonged to the 21-40 age group. The top five referring services were general medicine, surgery and trauma, obstetrics-gynecology, otorhinolaryngology and orthopaedic departments. The top three reasons for referring patients were mood problems, agitation and restlessness, and suicide attempts/behaviour. Majority of the axis I diagnoses were adjustment disorder, depressive disorders, and psychological reactions to illness. According to Axis III diagnoses, majority of the referrals were associated with poisoning and injury, neoplasms, and endocrine, nutritional, metabolic and immunity disorders.
CONCLUSION: The referral rate to the CL-Psychiatry Section at the UP-PGH has increased throughout the period studied. This may be attributed to programs and activities that improve efficiency in the delivery of psychiatric knowledge and skills, and better personnel supervision. The referral rate of 1.03% to 1.82% was consistent with those in other countries.

Human ; Male ; Female ; Adjustment Disorders ; Attention ; Censuses ; Depressive Disorder ; Diagnostic And Statistical Manual Of Mental Disorders ; Gynecology ; Neoplasms ; Obstetrics ; Orthopedics ; Otolaryngology ; Psychiatry ; Psychomotor Agitation ; Referral And Consultation ; Suicide, Attempted

Fluphenazine (FP) treatment (50 mg/kg bw, ip in saline) 30 min before or 6 or 10 h after CCl4 administration (1 ml/kg ip in olive oil) significantly prevented the liver necrosis produced by the hepatotoxin at 24 h. FP had enhancing effects on the covalent binding of CCl4 reactive metabolites to cellular constituents and on CCl4 induced lipid peroxidation. FP lowered body temperature of the CCl4-poisoned animals during the 24 h observation period. The obtained results are compatible but do not prove the hypothesis that calmodulin (CaM) had participation in late occurring events preceding necrosis. FP lowering action on body temperature, however, might also play a role in the effects of this drug on the onset of CCl4 induced liver necrosis. FP levels in liver tissue as determined by gas chromatography-mass spectrometry evidenced the presence of the drug in amounts sufficient to inhibit CaM and that suggests that not all preventive effects of FP are due to its indirect actions on the central nervous system via decreased body temperature.
Animals ; Body Temperature Regulation ; drug effects ; Calmodulin ; antagonists & inhibitors ; Carbon Tetrachloride ; toxicity ; Chemical and Drug Induced Liver Injury ; Fluphenazine ; analysis ; pharmacology ; therapeutic use ; Gas Chromatography-Mass Spectrometry ; Lipid Peroxidation ; Liver Diseases ; drug therapy ; pathology ; prevention & control ; Male ; Microsomes, Liver ; metabolism ; Necrosis ; Rats ; Rats, Sprague-Dawley

The expression of both constitutive and inducible forms of nitric oxide synthase (NOS) was investigated by immunohistochemical staining of formalin-fixed paraffin-embedded sections in normal and Listeria monocytogenes-infected brains of goats. In normal control goats, a small number of neurons showed immunoreactivity of both iNOS and nNOS, and the number of iNOS-positive neurons was higher than the number of nNOS-positive neurons. In natural listeriosis, listeria antigens were easily immunostained in the inflammatory cells of microabscesses. In this lesion, the immunoreactivity of iNOS in neurons was more intense than the control, but nNOS was not. In microabscesses, nNOS was weakly visualized in macrophages and neutrophils, while iNOS was expressed in macrophages, but not in neutrophils. These findings suggest that normal caprine brain cells, including neurons, constitutively express iNOS and nNOS, and the expressions of these molecules is increased in Listeria monocytogenes infections. Furthermore, inflammatory cells, including macrophages, expressing both nNOS and iNOS may play important roles in the pathogenesis of bacterial meningoencephalitis in goat.
Animals ; Brain/cytology/*enzymology ; Glial Fibrillary Acidic Protein/analysis ; Goat Diseases/*enzymology ; Goats ; Immunohistochemistry ; Listeria Infections/enzymology/*veterinary ; Neurons/*enzymology ; Nitric Oxide Synthase/*analysis ; Nitric Oxide Synthase Type I ; Nitric Oxide Synthase Type II

A 44-year old phenotypic female, married with primary amenorrhea presented with recurrent urinary tract infection and an incidental finding of a pelvo-abdomlnal mass.Ultrasonogram with doppler studies showed a huge pelvo-abdominal mass with rich intratumoral and peripheral color flow and low resistance index. No uterus or cervix was demonstrated. Tumor marker, CA-125 level, was elevated. Exploratory laparotomy confirmed the absence of the uterus and fallopian tubes. The left "ovary" was converted to a 16cm x 15cm x 12cm predominantly solid encapsulated mass. The capsule was smooth with a point of rupture measuring approximately 1 cm in diameter, exuding fresh blood. The right "ovary" was grossly normal measuring 3cm x 2cm x 2cm. Bilateral "oophorectomy", peritoneal fluid cytology, infracolic omentectomy with frozen section, were carried out. Histopathology of the left pelvic mass revealed testicular seminoma, while the right mass was consistent with an atrophic testis. Peritoneal fluid was positlve for malignant cells. Referral to a gynecologic oncologist was done for adjuvant radiation therapy. With the late realization of her being genetically male,psychological therapy and genetic counseling were advised.

Human ; Female ; Adult ; Fallopian Tubes ; Ovary ; Frozen Sections ; Seminoma ; Cervix Uteri ; Ascitic Fluid ; Amenorrhea ; Laparotomy ; Uterus ; Ovariectomy ; Urinary Tract Infections

Humans ; Kidney Transplantation ; economics ; Presumed Consent ; Reimbursement, Incentive ; Tissue Donors ; supply & distribution ; Tissue and Organ Procurement ; methods ; standards ; Transplants ; ethics

OBJECTIVES: AST and ALT often rise in dengue patients up to five-fold; they usually peak in the second week of illness. This study aims to determin the significance of elevated AST,ALT; AST:ALT ratio among pediatric patients with Dengue Shock Syndrome (DSS).

METHODS: From October 2008 to October 2009, 57 pediatric patients, who met the criteria for DSS, were admitted in the ICU. AST, ALT and AST:ALT determinations were done open admission.

RESULTS: The differences in the elevation of AST, ALT and AST:ALT in relation to age and sex of patients were not statistically significant (p-value= >0.05). A significance was noted in the ALT elevation when correlated to BMI (p-value 0.04) as opposed to only a marginal significance with AST. The more obese the patient the higher the increase in the level of serum transaminases. There was only marginally significant difference in the elevation AST:ALT ratio according to BMI (p-values 0.06 and 0.09 respectivelty). A 4-fold increase in both AST and ALT were not significantly associated with the presence or absence of hepatomegaly (p-value = > 0.05). However, there was a significant difference noted in the AST:ALT ratio according to outcome -- those who died had an elevated mean ratio than those who survived (p value= 0.01). On the other hand, there was a marginally significant difference in the AST elevation according to outcome (p value = 0.08). A four-fold increase in both AST and ALT were significantly associated with mortality (p- values 0.004 and 0.03 respectively).

CONCLUSION: AST and ALT elevation of >4-fold may prognosticate the outcome of patients with DSS. Further investigation is required.

Human ; Male ; Female ; Young Adult ; Adolescent ; Child ; Child Preschool ; Infant ; Infant Newborn ; Severe Dengue ; Virus Diseases ; dengue ; Alanine Transaminase ; Tertiary Care Centers ; Aspartic Acid

Spirituality is a multifaceted concept with varied definitions. In the nursing literature, it is commonly described based on its significance in the lives of individuals. Exploring the perspectives of nurses, nursing students, and patients regarding spirituality and spiritual care is crucial to gain a sound understanding of how these concepts impact the nursing profession. This literature review explored the perspectives on spirituality and spiritual care of four population groups: nurse educators, nursing students, clinical nurses, and patients. A literature search was done using worldwide databases. The 84 articles included dealt with the perceptions of nurse educators, nursing students, clinical nurses, and patients regarding spirituality and spiritual care.

The four main categories of perspectives from the nurse educators, nursing students, nurse clinicians, and patients yielded ten sub-categories: (a) meaning of spirituality and spiritual care, (b) role of spirituality and spiritual care in nursing practice, (c) role of nursing education in developing spirituality and spiritual care competence of nursing students, (d) manner of integrating spirituality and spiritual care in nursing curriculum, (e) methods of teaching spirituality and spiritual care, (f) manner of spiritual care delivery, (g) barriers and challenges to the teaching and learning of spirituality and spiritual care, (h) barriers and challenges to spiritual care delivery, (i) ways of enhancing nurse educators' competence in curricular integration and teaching spirituality and spiritual care, and (j) ways of enhancing nurses' competence in spiritual care delivery.

Nurse educators, nursing students, clinical nurses, and patients presented similar and diverse perspectives, but they all recognized the significance of spirituality and spiritual care in the profession. The information derived from this study can contribute to the existing knowledge base and spur strategies at individual and institutional levels to enhance teaching and learning of the concepts, improve practice, and promote holistic care.

Human ; Nursing ; Students, Nursing ; Patients ; Spirituality

Objectives: The aim of this study was to assess the prevalence of nomophobia in university students. Methods: A systematic search was conducted of the following databases: Web of Science/ Core Collection, Scopus, PubMed, Embase, and Ovid/ MEDLINE until March 2021. Cross-sectional studies reporting the prevalence of nomophobia in undergraduate or postgraduate university students that assessed nomophobia with the 20-item Nomophobia Questionnaire (NMP-Q) tool were included. Study selection, data extraction, and risk of bias assessment were performed in duplicate. A meta-analysis of proportions was performed using a random-effects model. Heterogeneity was assessed using sensitivity analysis according to the risk of bias, and subgrouping by country, sex, and major. Results: We included 28 cross-sectional studies with a total of 11,300 participants from eight countries, of which 23 were included in the meta-analysis. The prevalence of mild nomophobia was 24% (95% confidence interval [CI], 20%–28%; I2 = 95.3%), that of moderate nomophobia was 56% (95% CI, 53%–60%; I2 = 91.2%), and that of severe nomophobia was 17% (95% CI, 15%–20%; I2 = 91.7%). Regarding countries, Indonesia had the highest prevalence of severe nomophobia (71%) and Germany had the lowest (3%). The prevalence was similar according to sex and major. Conclusions We found a high prevalence of moderate and severe nomophobia in university students. Interventions are needed to prevent and treat this problem in educational institutions.

Background: Apart from its role in bone health, recent developments have shown that vitamin D also has anti-inflammatory properties, and therefore may have a role in inflammatory bowel disease (IBD) in children. Objectives: To determine the effect of vitamin D supplementation on the disease activity of pediatric patients with IBD. Design: Random-effects meta-analysis Data Sources: : Studies were searched at Cochrane Library, PubMed, EBSCO Host, ScienceDirect, Google Scholar, and Wiley Online. Review Methods: Experimental studies measuring the effect of vitamin D on the disease activity of pediatric patients with IBD were included. The proportion of disease activity, measured as remission rate or inactivity using Pediatric Crohn’s Disease Activity Index (PCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI), and the mean and standard deviation of mean serum vitamin D [25(OH)D] level, change in 25(OH)D, and different inflammatory markers [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)] were extracted or estimated and recorded in an abstraction form. Standardized mean difference and odds ratio were used as summary effect measures and estimated using Stata/Multiprocessor. Results: The serum 25(OH)D (SMD = 1.75, z = 2.33, p = 0.001) and change in 25(OH)D (SMD = 3.37, z = 2.34, p = 0.019) was significantly higher among those who received a high dose of vitamin D. However, a significantly high heterogeneity was estimated (I2 >50%). For the disease activity of IBD, the standard mean difference of mean ESR (SMD = –1.10, z = 5.35, p = 0.001) was significantly lower with high-dose vitamin D. The likelihood of remission rate using the Pediatric Crohn’s Disease Activity Index (PCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI), and standardized mean difference of CRP were not significantly different among those who received high-dose and low-dose vitamin D. Conclusion Cognizant of the functions of vitamin D in enhancing intestinal flora balance, regulating immunologic response, and improving intestinal mucosal barrier, vitamin D can be recommended as a supplementary treatment for IBD among the pediatric population. Nevertheless, there is still insufficient evidence for the cut-off level of adequate levels of serum 25(OH)D among pediatric patients with IBD, thus necessitating further studies.
Vitamin D Deficiency

OBJECTIVE: This study aimed to determine the accuracy of internal examination and ultrasound in early stage cervical cancer. Specific objectives were to determine the accuracy of internal examination and sonography in measuring tumor size and the accuracy of sonography in detecting vaginal involvement, stromal invasion, parametrial and lymph node involvement by comparing them with the surgicopathologic findings.
MATERIALS AND METHODS: 35 patients diagnosed with early stage cervical cancer for radical hysterectomy with bilateral salpingooophorectomy were recruited. Presence of poor prognostic factors was determined by internal examination and sonography and compared with the surgicopathologic result.
RESULTS: Ultrasound and internal examination have an accuracy of 74% and 68%, respectively. Ultrasound accuracy in detecting more than one third stromal invasion is 68%, vaginal involvement is 85%, parametrial involvement is 92% and lymph node involvement is 100%.
CONCLUSION: Ultrasound can be recommended as an adjunct to internal examination in the preoperative assessment of early stage cervical cancer.

Human ; Female ; Middle Aged ; Adult ; Uterine Cervical Neoplasms ; Prognosis ; Hysterectomy ; Ultrasonography ; Vagina ; Lymph Nodes