1.Effectiveness of healthy foodie nutrition game application as reinforcement intervention to previous standard nutrition education of school-aged children: A randomized controlled trial
Florence Rochelle Gan ; Elaine Cunanan ; Rebecca Castro
Journal of the ASEAN Federation of Endocrine Societies 2019;34(2):144-152
Objective:
Games promoting nutrition education are helpful tools to improve nutrition knowledge. Healthy Foodie is an interactive web-based nutrition game for Filipino children. This study aimed to determine the effectiveness of Healthy Foodie on the nutrition knowledge of children aged 7 to 10 years old.
Methodology:
This study had 2 phases. In Phase 1, we developed and validated the Healthy Foodie nutrition game application and Nutrition Knowledge Questionnaire involving 46 participants. The Nutrition Knowledge Questionnaire was divided into 2 15-item questionnaires: Part 1 pertained to Food Group Knowledge and Part 2 on Food Frequency Knowledge. Phase 2 was the implementation of the game and questionnaire. This was a randomized controlled trial conducted in two elementary schools in Manila, involving 360 participants divided equally into control and experimental groups.
Results:
For Phase 1, internal consistency of the questionnaire using the Kuder-Richardson Formula 20 was 0.75 for part 1 and 0.70 for Part 2. In Phase 2, comparing the adjusted posttest mean Food Group Knowledge scores, there was statistically higher score (F=111.84, p=0.0001) in the experimental group (11.57±0.20) compared to the control (8.51±0.20). In the adjusted posttest mean Food Frequency Knowledge scores, there was a statistically higher score (F=56.12, p=0.0001) in the experimental group (10.70±0.15) compared to the control (9.07±0.15).
Conclusion
A nutrition game-based intervention such as Healthy Foodie is effective as a reinforcement intervention to previous standard nutrition education of school-aged children
Health Education
;
Video Games
2.Treatment outcome of a β-hCG Secreting Intracranial Germ Cell Tumorin an adult Filipino using definitive Chemotherapy followed by Radiotherapy: A case report
Florence Rochelle Gan ; Maria Honolina Gomez ; Julie Ann Tapispisan
Journal of the ASEAN Federation of Endocrine Societies 2022;37(1):97-102
We report a case of a 24-year-old Filipino male who complained of general weakness, polydipsia, weight loss, bitemporal headaches, loss of libido and behavioral changes. Endocrine work-up revealed neurogenic diabetes insipidus and panhypopituitarism. Brain MRI showed multiple intracranial tumors in the left frontal lobe, pineal and suprasellar region with moderate non-communicating hydrocephalus. Intracranial mass biopsy with ventriculo-peritoneal shunting was done. Histopathology of the mass and CSF revealed a germinoma. He underwent chemoradiotherapy while on maintenance hormone replacement.
Neoplasms, Germ Cell and Embryonal
;
Germinoma
;
Hypopituitarism
;
Diabetes Insipidus
3.Validation of the Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) among Filipino patients in a Tertiary Medical Center
Hanah Go ; Florence Rochelle Gan
Journal of the ASEAN Federation of Endocrine Societies 2024;39(1):18-25
Objectives:
Gestational diabetes mellitus (GDM) is a common pregnancy complication with adverse fetal and maternal outcomes. Currently, there are only a few validated tools available that address knowledge in GDM. Recognition of the inconsistencies will provide for an effective learning program to achieve optimal results. This study aimed at validating the “Gestational Diabetes Mellitus Knowledge Questionnaire” (GDMKQ).
Methodology:
A cross-sectional validation study on GDMKQ among 51 GDM patients aged at least 18 years was conducted in the outpatient clinics of a tertiary hospital. Excluded were those with pre-existing diabetes. The questionnaire was submitted for peer review for translation to Filipino and back-translation. Concurrent validity, internal consistency and test-retest reliability of the questionnaire were undertaken as part of the validation process. Descriptive analysis was used for data elaboration by using SPSS v23.
Results:
The Filipino version of GDMKQ demonstrated sensible content and face validity. As measured, respondents obtained higher total and domain scores with better knowledge levels of GDM compared to its English version. An overall adequate knowledge was observed among those married and college subgroup as compared to single women and those with secondary level of education. The reliability of the questionnaire was calculated at 0.632 using the Kuder-Richardson 20. The test-retest scores using the Filipino-translated questionnaire has a Pearson correlation coefficient of 0.853 with moderate to good level of agreement with each other, and Cohen’s kappa of 0.564 with an intra-class correlation coefficient of 0.828.
Conclusion
The Filipino-translated version of GDMKQ is a valid screening tool that assesses a patient’s knowledge of gestational diabetes. Identifying the level of their understanding will enable clinicians to develop an individualized, effective learning program to improve pregnancy outcomes.
Diabetes, Gestational
;
Knowledge
;
Surveys and Questionnaires
4.Enhancing gestational diabetes management in Filipino patients: Evaluating the impact of education on knowledge, attitude, and pregnancy outcomes at a Tertiary Medical Center
Hanah R. Go ; Florence Rochelle C. Gan
Philippine Journal of Internal Medicine 2024;62(1):300-307
Introduction:
Patient education is integral in the management of gestational diabetes mellitus (GDM), a common
pregnancy complication that may cause adverse perinatal outcomes. This study evaluated the effect of diabetes education on the knowledge and attitude among patients with GDM, comparing pre- vs post-diabetes session scores and determining pregnancy outcomes.
Methodology:
A one-group pre-test and post-test experimental design study was conducted on 75 patients after one-
session diabetes counseling using the Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) and the third version of the Diabetes Attitude Scale (DAS-3).
Results:
Of the 75 subjects, 84% exhibited adequate knowledge of diabetes. Post-education, a significant increase in the total scores was seen among those less than 35 years of age (p-value: 0.003), both employed and unemployed (p-value: 0.0.026, 0.047, respectively), with a secondary level of education (p-value: 0.014) and multigravid (p-value: 0.015). An overall median positive attitude score of 3.6 was documented. For neonatal outcomes, no adverse events existed. For maternal outcomes, 17.9% had elevated fasting blood glucose while 7.1% had elevated 2-hour post-glucose tolerance test.
Conclusion
Diabetes education improves patient’s knowledge but not their attitude. Hence, improvement in attitude
interventions should be incorporated into the current diabetes education program.
Diabetes, Gestational
;
Knowledge
;
Attitude
5.Value of systemic hormonal unloading in pheochromocytoma
Florence Rochelle C GAN ; Ma. Felisse S GOMEZ ; Leilani B MERCADO-ASIS
Journal of Medicine University of Santo Tomas 2019;3(2):336-341
Systemic unloading of adrenaline improves blood
pressure (BP), but the effect on quality of life is not
emphasized. This report aims to examine the outcome of systemic hormonal unloading through unilateral adrenalectomy in three pheochromocytoma
cases.
Pheochromocytoma
;
Adrenalectomy
;
Quality of life
6.Systemic hormonal unloading in unilateral adrenalectomy in a patient with bilateral adrenal hyperplasia: A case report
Ma. Felisse Carmen GOMEZ ; Florence Rochelle GAN ; Erick MENDOZA ; Leilani B MERCADO-ASIS
Journal of Medicine University of Santo Tomas 2019;3(1):303-308
Background :
Unilateral adrenalectomy has not
been recommended in the guidelines as a treatment
for primary hyperaldosteronism secondary to bilateral adrenal hyperplasia (BAH). Interestingly, recent
studies have shown that increased circulation of
aldosterone increased oxidative stress, cardiovascular (CV) complications such as atrial fi brillation,
myocardial infarction and heart failure; and that unilateral adrenalectomy led to improved CV function.
Therefore, recognizing the role of unilateral adrenalectomy in BAH, specifi cally for improved quality of
life is important.
Clinical case:
A 47‐year-old hypertensive (highest
blood pressure [BP] 150/90 mmHg) woman had a
severe headache, muscle weakness, polyuria, and polydipsia. Her serum potassium (K) was low at 3.1
mmol/L (3.5–5 mmol/L). Initial tests showed elevated plasma aldosterone, suppressed plasma renin activity and elevated aldosterone-renin ratio (6.61 ng/
dL, <0.1 ng/mL and 66, respectively). Plasma aldosterone after saline suppression test (12.70 ng/dL)
confi rmed the diagnosis of primary aldosteronism
(PA). MRI showed a well-defi ned, oval-shaped solid
nodule in the medial limb of the left adrenal gland
(1.8 x 1.2 cm). Bilateral adrenal vein sampling with
adrenocorticotropic hormone (ACTH) stimulation test
was compatible with BAH (cortisol-corrected aldosterone ratio pre-ACTH stimulation 1.29 and postACTH 1.66), with dominant aldosterone secreting
left adrenal gland (7200 vs 3760 ng/dL). She was
started on spironolactone 200 mg/day and amlodipine 10 mg/day and eventually shifted to eplerenone. Despite the optimal dose of eplerenone and
amlodipine, she still experienced severe headaches,
palpitations and breakthrough elevations of BP that
led to her recurrent admissions. Eplerenone was
shifted back to spironolactone (150-200 mg/day)
with amlodipine dose (10 mg/day) normalizing her
blood pressure and potassium level, yet with persistent headache and muscle weakness. Repeat imaging using CT scan with contrast showed consistent
results. Postoperatively, with all medications discontinued the patient was asymptomatic, normotensive (110/70 mmHg) and normokalemic (4.0 mmol/L).
One month later, her BP started to increase again at
140/80 mmHg and her K decreased to 3.4 mmol/L.
Normalization of said parameters (BP:120/70
mmHg K: 4.1 mmol/L), with stabilization following
lower doses of amlodipine (5mg/day) and spironolactone (25 mg/day). Also, all the symptomatology
of the patient resolved completely.
Conclusion
This present case exemplifi es a unilateral adrenalectomy approach in BAH, which
led to improvement in BP and K levels, despite low
medication doses. Furthermore, symptom relief and
improved quality of life, as desired outcomes, were
achieved.
Hypertension
;
Hyperaldosteronism
7.Systemic Hormonal Unloading (SHU) in secondary hypertension: Addressing the long-term adverse cardiovascular outcomes
Leilani B. B. Mercado-Asis ; Felisse Carmen Gomez-Tuazon ; Florence Rochelle Gan ; Chandy Lou Malong-Calanoc
Journal of Medicine University of Santo Tomas 2024;8(1):1390-1397
Excess hormone production from adrenal tumors caused by primary hyperaldosteronism or pheochromocytoma are common etiologies for secondary hypertension. Studies have shown that sustained long-term circulating hormones in excess affect the blood vessels and cardiac structures. Inflammation of cardiomyocytes leads to fibrosis and eventual cardiomyopathy and is clinically presented as arrhythmia, nonfatal myocardial infarction, heart failure, or even death. The tissue changes and/or impaired cardiac function are reversible if early diagnosis and removal of the adrenal tumor by unilateral adrenalectomy is done. However, the condition becomes challenging if the adrenal lesions are bilateral. This article introduces the concept of systemic hormonal unloading and will discuss the philosophy of quality of life in managing bilateral adrenal disease.
Hyperaldosteronism
;
Pheochromocytoma
;
Quality of Life
8.Severe Pericardial Effusion due to autoimmune Hypothyroidism with Levothyroxine withdrawal and systemic Lupus Erythematosus
Sylvernon Israel ; Katherine Ann Tan ; Ma. Felisse Carmen Gomez ; Florence Rochelle Gan ; Jean Uy-Ho
Journal of the ASEAN Federation of Endocrine Societies 2022;37(2):83-88
The presence of autoantibodies is a common link between autoimmune hypothyroidism (AH) and Systemic Lupus Erythematosus (SLE). The coexistence of AH (Hashimoto’s Thyroiditis) and SLE is common; however, massive pericardial effusion (PEEF) with signs of tamponade is extremely rare and only a few cases have been reported in literature. We present a case of a 54-year-old female who came in with progressive dyspnea who was found out to have massive PEEF from overt AH and concurrent SLE, which was successfully managed medically. This gave us valuable insight that massive pericardial effusion occurring in overt hypothyroidism may be secondarily caused by other co-existing disease entities such as SLE. The importance of the correct diagnosis cannot be overemphasized, as this largely contributed to the successful management of this case.
Pericardial Effusion
;
Cardiac Tamponade
;
Lupus Erythematosus, Systemic