Objective: To compare Nimesulide alone with Nimesulide and Green Tea (Camellia sinensis) as adjunct therapy in the management of osteoarthritis. Design: Single-blind controlled therapeutic trial. Setting: Out Patient Department of Quezon City General Hospital. Study Subjects: Patients aged 40 years old and above who satisfied the clinical criteria for osteoarthritis. Interventions: A total of 30 out of 39 patients aged 42-82 from the QCGH Out Patient Department were included in the study. Patients were randomly assigned to receive either the Control Group - Nimesulide only taken on as needed basis for four weeks or the Treatment Group - Nimesulide and Green Tea (Camellia sinensis), the former taken on an as needed basis, while the latter taken three times a day for four weeks upon enrollment in the study. Both groups contained 15 patients each. Using the Epi-Info, Epistal and SPSS softwares, the sociodemographic characteristics and the efficacy of Green Tea as an adjunct therapy were analyzed and compared, as well as the occurrence of adverse events observed between the two treatment groups. Cost-effectiveness of Green Tea as adjunct treatment was measured using the mean treatment cost as compared to Nimesulide only treatment. Results: Thirty patients completed the study. The mean age of the Control Group is 62 and 58 for Treatment Group. There were more females than males in both groups at 67 percent and 80 percent, respectively. A big part of the study subjects for the Control Group were laborers 7 (46.7 percent) and housewives 5 (33.3 percent) for the Treatment Group. As to body mass index, most of the patients belonged to Obese Class I, 53.3 percent and 40 percent, respectively. The most commonly involved joint for both groups was the knee (33.3 percent, 46.7 percent, respectively). Pain control improved in both groups as shown by a decreasing trend in Visual Analog Scale scores but difference between the two was not statistically significant. Improvement in functionality was observed in both groups as evidenced by decreasing scores in Functional Capacity Scoring System but the difference between the two groups became statistically significant after the 3rd and 4th weeks of treatment. There was also an improvement in the degree of pain control in both groups as seen by a decreasing amount of Nimesulide used and the difference between the two was statistically significant. Three patients from the Control Group had untoward symptoms during the course of treatment compared to only one from the Treatment Group. Three from the Control Group presented with gastrointestinal symptoms most probably due to the Nimesulide being taken, while the patient from the Treatment Group experienced insomnia on the 4"1 week of treatment. However, difference between the two groups was not significant. As to the total cost of the entire treatment (4 weeks), the Treatment Group had Php2.37 more than the Control Group. Conclusion: This study showed that Green Tea (Camellia sinensis) is an effective, safe and cost-effective adjunct therapy in the treatment of osteoarthritis.
Human ; Male ; Female ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; OSTEOARTHRITIS ; PLANTS, MEDICINAL ; NIMESULIDE

Background: The healthcare system began transitioning from a traditional clinic-based consult to telemedicine due to the COVID-19 pandemic. This change makes telemedicine a promising tool for managing diseases from the comfort of one’s home. Objective: This study aimed to determine the effectiveness of telemedicine in blood pressure (BP) control and the most effective mode of telemedicine in BP control among hypertensive patients. Methods: This meta-analysis was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search for articles was done using electronic databases (PubMed, MESH, and Clinical key). Identified articles were reviewed independently by two researchers and were statistically analyzed. Results: Eight studies were included in the final analysis. A statistically significant difference between intervention and control groups was observed for both SBP and DBP (estimated SMD of SBP at 0.19 mmHg (p-value 0.003, chi2 =30.52, df =11, CI = -0.31 to -0.06) with substantial heterogeneity at 71%; DBP at −0.15 mm Hg (p<.004; x2=14.19, df =9 95% CI −0.25 to − 0.02) with low heterogeneity at 37%). Conclusion Telemedicine is an effective means of reducing blood pressure among adult hypertensives. It enables access to individualized continuing care in hard-to-reach areas where patients with comorbidities are the high-risk groups. Future research can be done using the same output measurement and statistical analysis to determine the most effective mode of telemedicine in controlling blood pressure.
Telemedicine ; Hypertension ; Blood Pressure

OBJECTIVE: To determine the effectiveness and safety of Aloe vera as an adjunct treatment to Metformin in lowering Fasting Blood Glucose levels in Diabetic patients.

DESIGN: Therapeutic Clinical Trial

STUDY SUBJECTS: Patients aged 40-65 years old taking Metformin 500mg twice a day with FBS of 126mg/dL to 250mg/dL with no other co-morbidities seen at Family Medicine - Quezon City General Hospital, Out Patient Department.

METHOD: Sixty (60) out of 93 study subjects were included after baseline determination of FBS and was assigned to either of the two groups after systematic random sampling method. Both groups had 30 subjects each and were given Aloe vera and placebo on the assigned group. Repeat FBS was determined after 2 weeks. Data gathered were analyzed using Epi info 6 SPSS ver 20 and STATA 11.0 Software.

RESULTS: Sixty (60) patients completed the study. The mean height in Group A (OHA+Aloe vera) was 161.53(+/- 7.651) and Group B 159.83 (+/- 8.465). The mean height in Group A was 60.70 (+/-11.996) and Group B 59.95 (+/-10.528). The mean BMI in Group was 23.21 (+/- 4.027) and in Group B 23.557 (+/-4.481). The mean age in Group A was 52.97 (+/-­5.720) and in Group B 57.63 (+/-4.287). The Gender had a p value of 0.796; occupation p value 0.067; and education p value 0.796. The comparison of mean change in FBS within groups had a p value of 0.001. The comparison of mean change in FBS between groups in pre-treatment, p value of 0.933; post treatment p value of 0.0104. The FBS % change in both groups had a p value of 0.001. The comparison of age-adjusted percent change in the FBS between the 2 groups had a p value of 0.001. There was one patient who experienced bloatedness on the third day of treatment in Group A.

CONCLUSION: This study has shown that the use of Aloe vera as an adjunct treatment to Metforms is effective and safe.

Human ; Aged ; Middle Aged ; Adult ; Diabetes Mellitus ; Metformin ; Aloe ; Plants, Medicinal

Background: Diabetes ranks 8th among the Top 10 causes of mortality in the Philippines. Development of complications add to the burden of the disease. The passage of the Universal Health Care Law ensures all Filipinos access to comprehensive set of quality and preventive services without causing financial hardships Objective: To determine the clinical and demographic profile associated with prevalent complications among newly diagnosed T2DM seen at the outpatient setting of a tertiary DOH hospital Methods: A retrospective/cross – sectional study of newly diagnosed Diabetes Mellitus Type 2 from May 2018 – April 2019 using their charts through random sampling was used. Data were analyzed using descriptive statistics, iIndependent Sample T-test and Fisher’s Exact/Chi-square test for the difference of mean and frequency, respectively, and odds ratio from binary logistic regression for significant predictors of complications Results: Of the 116 newly diagnosed T2DM patients. 88 had complications and 28 patients had no complications. Majority of patients were 60-69 years old (40.52%), with SBP range of 140-150 mmHg (44.83%), FBS of >7.5mmHg (43.97%). Values for BUN and Creatinine between the two groups were significantly different. Most frequent complication was hypertension (54.87%). For every 10-year increase in age, the odds of having complications among newly diagnosed increased by 48%. For every 10 mmHg increase in SBP, the odds of having complications among newly diagnosed also increases by 75%.For every 0.5 mg/dl in FBS, the odds of having complications among newly diagnosed also increased by 91%.For every μmol/L in creatinine, the odds of having complications among newly diagnosed also increased 7.51 times Conclusion The most frequent complications among newly diagnosed T2DM were hypertension, microvascular, then macrovascular complications. The association between the profile and complication seen among newly diagnosed T2DM using odds ratio revealed predictors such as age, systolic blood pressure, FBS and creatinine.
Outpatients ; Diabetes Mellitus, Type 2 ; Family Practice

Background: The treatment of chronic illnesses commonly includes the long-term use of pharmacotherapy. Almost half of patients do not enjoy the full benefits of treatment because of poor adherence. The Universal Health Care Act advocates actively improving the health literacy, of every Filipino, motivating them to strictly adhere to the recommended treatment Objective: This study aimed to determine the barriers to adherence of maintenance medication intake among hypertensive and diabetic patients in the outpatient clinic setting Methods: A cross sectional study design, using the Morisky Medication Adherence Scale (MMAS-8) consisting of 8 questions, with a Cronbach alpha of 0.83 (Highly reliable). Simple random sampling was used for sampling Results: Out of 90 patients, 54 (60.0%) patients were adherent with their medications, while 36 (40.0%) were non-adherent. Collected social demographic profiles were analyzed to determine the barriers to the medication adherence Conclusion Forgetfulness, missing medication intake because they feel worse, or because they already feel fine are the identified barriers to adherence to maintenance medication intake among hypertensive and diabetic patients in the outpatient clinic setting. In this monocentric study, the focus was mainly on patient-related factors contributing to non-adherence. Future researches should assess also the Physician and the Health system related factors
Medication Adherence ; Hypertension ; Diabetes Mellitus

BACKGROUND

Diabetes Mellitus Type 2 is a significant global health issue with a high prevalence in the Philippines. Managing this condition effectively is crucial, and digital technologies, particularly smartphone (mHealth) applications, have emerged as a potential tool in diabetes self-management.

OBJECTIVE

This study evaluated the effectiveness of smartphone (mHealth) application use in achieving glycemic control among adults with Type 2 Diabetes Mellitus, focusing on HbA1c levels and medication adherence.

METHOD

This systematic review and meta-analysis, adhering to PRISMA guidelines, analyzed randomized controlled trials from databases like PubMed and Embase, comparing interventions using mHealth applications with standard care. The primary measures were HbA1c levels and medication adherence.

RESULTS

Ten studies involving 20,984 participants were included in the meta-analysis. Using mHealth applications led to an average HbA1c reduction of 0.36%, indicating improved glycemic control. There was considerable heterogeneity (I2 = 91%) because of the clinical and methodological diversity of the included studies. Subgroup analysis showed that the younger and older age groups, shorter and longer T2DM duration, and lower and higher HbA1c baseline benefited from its use. Sensitivity analysis still showed high heterogeneity (95%-97%), reflecting clinical diversity. A narrative analysis of two studies highlighted the utility of mHealth applications in tracking diet, physical activity, and vital stats, aiding medication adherence through reminders and data sharing with healthcare providers.

CONCLUSION/RECOMMENDATIONS

This systematic review and meta-analysis showed the effectiveness of mHealth application use in achieving glycemic control among adults with Type 2 Diabetes Mellitus by improving HbA1c levels and medication adherence. Integrating mHealth applications as adjuncts in family and community medicine as part of personalized care for managing type 2 diabetes in the Philippines can help achieve glycemic control and medication adherence. Future studies should focus on longitudinal assessments, exploring cultural and linguistic factors in the Filipino context to optimize diabetes care within this specialized medical framework.

Blood Glucose Self-monitoring ; Mobile Applications ; Diabetes Mellitus