Purpose: To compare the efficacy and safety of Proparacaine 0.35%- Fentanyl 0.0015% solution and Lidocaine 2.8% - Fentanyl 0.0015% solution as topical anesthesia for pharmacoemulfification with intraocular lens implantation. Methods: A prospective randomized, triple- masked clinical study. Ninety six patients with senile cataract were divided into two treatment groups Proparacaine - fentanyl group (PF group) and the Lidocaine Fentanyl group (LF group). Volume of anesthetic required latency and duration of anesthesia were compared. Visual analog pain scale was used to assess intraoperative patient's pain. Preoperative patient anxiety; surgeons and anesthesiologists assessment of the operative condition were also determined. Slit-lamp biomicroscopy was done on the first day postoperatively. Unpaired students T- test and descriptive statistics were employed with level of significance at p<0.05. Results: Similar volume of the anesthetics was used in both groups. Mean latency period for the PF solution was 0.51 minutes +/-0.18 (SD) which was significantly shorter than the LF solution at 3.14 minutes +/- 1.09 (p<0.05). Mean duration of anesthetic effect of the PF group was significantly shorter at 33. 47 minutes +/-4.57 while the LF group lasted 69.09 minutes +/- 16.20 9p<0.05). Majority of the patients in both groups [44 (905) PF group; 40 (85%) LF group] denied any pain or discomfort during surgery. Mean pain score was 0.16 PF group and 0.23 for the LF group. The surgeon noted optimal operative conditions while the anesthesiologist reported significant difference in patients response during surgery with hand squeezing noted in 7 (15%) patients in the LF group 9p<0.05%). There was no significant difference in biomicroscopic findings on day 1 postoperatively. Conclusion: Proparacaine 0.035% - fentanyl 0.0015% solution is as effective and as safe as lidocaine 2.8% - fentanyl 0.0015% solution for topical anesthesia in phacoemulsification with intraocular lens implantation.
Human ; PROXYMETACAINE ; FENTANYL ; LIDOCAINE ; PHACOEMULSIFICATION ; MICROSCOPY, ACOUSTIC ; ANESTHESIA

Background: Diabetes mellitus is a chronic disease which has been increasing both in incidence and global impact. In the Philippines, cases of diabetes mellitus increase at an alarming rate. Previous study in Nigeria among Type 2 Diabetic patients with non-alcoholic fatty liver disease (NAFLD) has observed an increased prevalence of 69%. However, there is no definite association between severity of NAFLD and glycemic control (HbA1c). Objectives: To investigate the prevalence of NAFLD and its association with glycemic control of Type 2 Diabetes Mellitus (T2DM) patients at Batangas Medical Center (BatMC) – Out Patient Department (OPD). Methods: A single center, cross sectional study was performed on 80 T2DM patients, who underwent OPD consultation between November 2020 to October 2021. Clinicodemographic profile, duration of T2DM, diagnostic tests including HbA1c and ultrasound of the liver were taken. Chi-Square test of homogeneity and Fisher’s Exact test/Fisher-Freeman-Halton test were utilized for comparison of categorical variables from a single population to determine whether there is a significant association between the severity of NAFLD and patients characteristics and glycemic control. Results: 80 T2DM patients were included in the analysis, there was an equal number of male (50%) and female (50%). Majority of the patients were in the age of 50 – 59 years old (33%), with a BMI of 25 and above (81%), had been diagnosed with T2DM for > 5 years (72%) and maintained with oral hypoglycemic agents (68%). The prevalence of NAFLD by ultrasonography among T2DM patients was 81%. 80% of these patients had mild NAFLD and 20% had moderate NAFLD; but none had severe NAFLD. The average HbA1c level of 8.9% had a mild NAFLD compared to patients with moderate NAFLD with an average HbA1c level of 10.1%. With a p=0.053, NAFLD severity and glycemic control do not show any statistically significant association. Subgroup analysis was not performed in the study due to limited sample size. In addition, results of association are not sufficient evidence for any conclusion; hence, there appear to be no group of interest. Conclusion The result of this study confirmed that the prevalence of NAFLD in T2DM was high at 81% but there is no sufficient evidence to conclude a statistically significant association between the level of glycemic control and the severity of NAFLD.
Diabetes Mellitus, Type 2 ; Non-alcoholic Fatty Liver Disease ; Glycemic Control ; Dyslipidemias ; Obesity ; Metabolic Syndrome

Introduction: Coronavirus disease (COVID-19) is currently a global health crisis and is caused by a new strain of coronavirus. However, emerging literature of case reports noted possible extrapulmonary manifestations of the disease. Because COVID 19 is a relatively new disease, at present, little existing literature tackles the diagnosis and therapeutic management of COVID‐19‐related conditions outside the pulmonary system. Case: A 24-year-old male presented with sudden stiffening of all extremities but non-contrast computed tomography (CT) scan was unremarkable. Chest X-ray revealed interstitial pneumonia and SARS-CoV-2 RT-PCR (OPS/NPS) was positive. Electrocardiogram (ECG) findings showed supraventricular tachycardia and had elevated Troponin I levels. Pertinent physical findings noted were slurring of speech, dysmetria, and vertical nystagmus. The patient was initially treated as a case of Bacterial Abscess versus Viral encephalitis. Pericardial ultrasound revealed small pericardial effusion and was started on Colchicine. Repeat cranial CT scan noted unremarkable results but due to persistence of symptoms, the patient was started with Dexamethasone. On Day 16 of illness, the patient was noted to have full resolution of symptoms. Rapid antibody testing was done which revealed positive for both IgG and IgM hence the patient was discharged with the final diagnosis of Viral Myopericarditis resolved, Viral encephalitis resolved, COVID-19 pneumonia recovered. Conclusion Extrapulmonary manifestations have been reported increasingly as an atypical presentation of COVID 19 infection. Early recognition of viral myopericarditis and viral encephalitis as a manifestation of COVID 19 can lead to the initiation of proper treatment and management. More reports on these cases can aid future studies on diagnostics and therapeutic approaches during the COVID-19 pandemic.
COVID-19 ; Encephalitis, Viral ; SARS-CoV-2 ; Coronavirus Infections