: In rare cases with no clinical practice guidelines available, the approach heavily relies on small studies, reports, and professional experience based on sound clinical judgement from available data. : We present a case of a 52-year-old male radiation technologist with a 5-year history of pancytopenia diagnosed with radiation-induced marrow aplasia after presenting with bilateral lower extremity weakness and numbness. MRI revealed spinal EMH along T3 to T12. He was given steroids and radiation therapy (RT) of 18Gy in 10 fractions with improvement in sensory status at 4th session of RT and was discharged with steroid on tapering and maintenance of eltrombopag. BM aplasia following chronic low-level radiation exposure results from the accumulation of cytogenetic abnormalities over time. EMH is a compensatory mechanism for BM aplasia, the diagnosis of which is established by MRI. In spinal EMH, transverse myelopathy occurs from spinal cord compression (SCC). As of writing and with our literature-search, spinal EMH has never been reported in patients with aplastic anemia or radiation-related BM aplasia. With the paucity of available data, there is currently no specific guidelines in managing BM aplasia from radiation and consequent SCC. However, as with most cases of SCC, radiotherapy, steroids, and surgical decompression are viable options. This case report will add to the very small pool of information on EMH from radiation-induced BM aplasia and its approach to management especially in this rare, never-before-reported presentation.
Human ; radiation

BACKGROUND: HIV patients suffer from anxiety and depression but a formal assessment infrequently happens.

ObJECTIVES: The study aimed to measure the prevalence of anxiety and depression among HIV patients in UPPhilippine General Hospital.

METHODS: This study involving 417 HIV-positive patients used the Hospital Anxiety and Depression Scale - Pilipino version to identify cases, with stepwise regression analysis for correlation.

RESULTS: The prevalence of anxiety, depression, and mixed diagnosis was 10.1% (0.072-0.130), 3.1% (0.014-0.048), and 10.8% (0.078-0.138), respectively. Anxiety was correlated with female sex (OR = 7.82, CI 1.03-59.49), unemployment (OR = 1.76, CI 0.90-3.42), smoking (OR = 1.84, CI 0.89-3.79), homosexuality (OR = 7.64, CI 1.36-42.74), and non-use of protective methods during intercourse (OR = 1.81, CI 0.84-3.93). Depression was correlated with unemployment (OR = 2.79, CI 0.91-8.54) and non-disclosure of status (OR = 3.04, CI 0.79-11.67). Mixed diagnosis was correlated to unemployment (OR = 2.09, CI 1.10-3.96), smoking (OR = 2.14, CI 1.08-4.25), homosexuality (OR = 3.14, CI 0.92- 10.65), and non-use of protective methods during intercourse (OR = 1.65, CI 0.77-3.53).

CONCLUSIONS: Lower prevalence of anxiety and depression among HIV patients was found in this study compared with other countries. There is, however, a need to allocate resources for screening mental health problems in HIV patients.

Human ; Male ; Female ; Middle Aged (a Person 45-64 Years Of Age) ; Adult (a Person 19-44 Years Of Age) ; Anxiety ; Depression ; Mental Health ; Human Immunodeficiency Virus

Background and Objective: Convalescent plasma therapy (CPT) may reduce the risk of disease progression among patients with COVID-19. This study was undertaken to evaluate the efficacy and safety of CPT in preventing ICU admission among hospitalized COVID-19 patients. Methods: In this open-label randomized controlled trial, we randomly assigned hospitalized adult patients with COVID-19 in a 1:1 ratio to receive convalescent plasma as an adjunct to standard of care or standard of care alone. The primary endpoint was ICU admission within first 28 days of enrolment. Primary safety endpoints include rapid deterioration of respiratory or clinical status within four hours of convalescent plasma transfusion and cumulative incidence of serious adverse events during the study period including transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), severe allergic reactions, and transfusion-related infections. Results: A total of 22 patients were assigned to receive convalescent plasma as an adjunct to standard of care and 22 to receive standard of care alone. The median time from onset of COVID-19 symptoms to study enrolment was eight days (IQR, 4 to 10). Two patients (9.1%) in the CPT group and one patient (4.5%) in the control group were admitted to the ICU. The primary outcome measure, ICU admission, was not different between the two groups (q-value >0.9). No patient who received convalescent plasma had rapid deterioration of respiratory/clinical status within four hours of transfusion and none developed TRALI, TACO, anaphylaxis, severe allergic reactions, or transfusion-related infections. There was also no significant difference in the secondary outcomes of 28-day mortality (two patients in the CPT group and none in the control group, q-value >0.90), dialysis-free days, vasopressor-free days, and ICU-free days. Conclusions Among hospitalized COVID-19 patients, no significant differences were observed in the need for ICU admission between patients given CPT as adjunct to standard of care and those who received standard of care alone. Interpretation is limited by early termination of the trial which may have been underpowered to detect a clinically important difference.
COVID-19 ; COVID-19 Serotherapy