Background: There are currently no data on the prevalence and incidence of chronic pain in the Philippines. Objective: This study was undertaken to determine the incidence and prevalence of chronic pain in the general adult population of the Philippines. It also aimed to establish the demographic profile of chronic pain sufferers, identify the causes and intensity of chronic pain, and understand the impact of chronic pain on daily living and quality of life. This study also explored current treatment practices for patients with chronic pain, their levels of satisfaction with treatment, and barriers to obtaining appropriate treatment. Methodology: The study was conducted in the Philippines via a quantitative sample survey that involved face-to-face interviews using a two-phase structured questionnaire. Results: The survey showed an overall prevalence of moderate-to-severe chronic pain (chronic pain M+S) of 10.4% of the general adult population, with an annual incidence rate of 3.4%. Chronic pain M+S was more commonly reported by women and the elderly. The most common locations of pain were the knees, back and lower back. Daily routine was affected in about half of the sufferers, but they had rational attitudes to pain and positive views of medical treatment. High consultation fees discouraged nearly two-thirds of sufferers from seeking medical advice for their pain. Despite the availability of effective pain treatments, a large proportion of patients taking prescription painkillers reported that the medication was less than effective, indicating a large gap between achievable pain relief targets and patients’ expectations of pain medications. Conclusion: The Philippines has a relatively high prevalence of chronic pain M+S. There is a need for improved pain management to ensure that patients with chronic pain receive appropriate and effective treatment.

Objective: To facilitate the recognition of intracellular yeasts of Histoplasma capsulatum and differentiate it from Leishmania amastigotes and other parasites, using the combination of then Giemsa) to previously fixed peripheral blood smears. Microscopy was performed with 400ístudy. Methods: The combination of both stains was applied consecutively (first Grocott and Giemsa and a rapid modification of Grocott stains to peripheral blood smears in a hematological and 1000í, the latter using immersion oil. Results: The yeasts of Histoplasma capsulatum were observed into the cytoplasm of leukocytes as brownish oval elements, with 3-4 μm in diameter. Conclusions: The combination of both techniques is a simple and fast method to facilitate recognition of intracellular yeasts and it is different from intracellular parasitic elements. Moreover, it allows distinguishing the cell elements that are in the microscopic preparations. It may be very helpful in those cases in which the presumptive diagnosis of histoplasmosis has not been established yet and where other more sophisticated methods are not available.

Pregnancy with placental mesenchymal dysplasia (PMD), with concomitant cytomegalovirus (CMV) infection, and with coexistent normal viable fetus is very rare. An 18 year old, Gravida 2 Para 0 (0-0-1-0), was referred to our institution at 24 weeks age of gestation, with impression of molar pregnancy with a live twin fetus. Subsequent ultrasound revealed placentomegaly with placental features similar to hydatidiform mole. Her pregnancy was complicated with intrauterine growth restriction (IUGR) and oligohydramnios. TORCH panel at 25 weeks age of gestation revealed positive for CMV IgG. She had normal serum ?-HCG, with elevated maternal serum alpha feto protein (msAFP). A caesarean section was done at 37 weeks age of gestation for placenta previa marginalis in haemorrhage. She delivered a live baby girl, APGAR score of 9,9, maturity testing of 37 weeks, small for gestational age. The baby was also positive for CMV IgG. Gross examination of the placenta revealed tortuous vessels and multiple cystic spaces. Histopatho-logically, there were hydropic stem villi with no trophoblastic proliferation. Immunohistochemically, placental mesenchymal dysplasia was confirmed.

Human ; Female ; Adolescent ; Cytomegalovirus

Family is the basic unit of our society where in, there is a trade of different emotions such as love, happiness, even ideas and experiences. A home where families dwell and lived together harmoniously with children, parents and older adults is an important shelter that gives everyone a sense of security most especially to our elders. Living away from your own family is considered complex. This is a common scenario for older adults facing life away from their real home and lives inside a nursing home.

This study aims to describe and understand the lived experiences of older adults living in nursing homes - who they are, their characters, feelings, beliefs and principles in life.

Nine (9) older adult participants were purposively selected from two different nursing homes in Metro Manila in this phenomenological inquiry. Semi-structure interview guide was used in gathering narrative testimonies of the participants. Face to face interview was conducted, fields notes, transcribed verbatim, and then data of testimonies were analyzed using phenomenological approach. Themes were identified based on participant's narrative accounts. Identified themes were as follows: enhancing and deepening of spiritual wellness; acknowledging and easing the feeling of loneliness; gaining joy from children's support; maintaining optimum wellness; finding security and self fulfillment.

Human ; Male ; Female ; Aged ; Loneliness ; Happiness ; Love ; Emotions ; Nursing Homes ; Personal Satisfaction ; Comprehension ; Parents

INTRODUCTION: GUARD (vildaGliptin clinical Use in reAl woRlD) was  a  multinational,  prospective,  observational  study that assessed the effectiveness,safety  and  tolerability of vildagliptin and vildagliptin+metformin in patients with type 2 diabetes mellitus (T2DM) under real-world conditions across four  geographical  regions  (Asia,  the  Middle  East,  Central  America and Africa). The current paper discusses the results of patients with T2DM enrolled in the Philippines.
METHODS: Patients  with  T2DM  who  were  prescribed vildagliptin or vildagliptin+metformin combination therapy were enrolled and followed as per routine clinical practice for 24 ± six weeks. Primary endpoint was the change in HbA1c from  baseline  to  study  end  (week  24±6).  Key  secondary endpoints included proportion of patients reaching target HbA1c ?7.0%, incidence of hypoglycemic events, adverse events (AEs) and serious AEs (SAEs).
RESULTS: A total of 1,117 patients were included in the final analysis, 280 on vildagliptin (of these, eight patients received additional oral antidiabetes medications) and 837 on vildagliptin+metformin. At baseline, the mean (±SD) age of the enrolled population was 54.1±11.5 years, BMI 26.3±4.7 kg/m2, HbA1c 8.0±1.2% and T2DM duration 2.3±4.0 years.At  study  end,  significant  mean  (±SE)  reductions  in  HbA1c of -1.2±0.1% (p<0.0001) and -1.5±0.1% (p<0.0001) from a baseline of 7.6±1.1% and 8.1±1.2% were observed for the vildagliptin and vildagliptin+metformin group, respectively.A similar proportion of patients achieved HbA1c ?7.0% in the vildagliptin (66.1%) and vildagliptin+metformin group(62.7%). Changes in body weight and BMI from baseline to week 24±6 were statistically significant (p<0.0001) in both the vildagliptin (-1.5±0.3 kg; -0.6±0.1 kg/m2) and the vildagliptin+metformin group (-1.4±0.2 kg; -0.5±0.1 kg/m2).The incidence of hypoglycemia was low--six patients reported hypoglycemia in the vildaglipti metformin group and  none  in  the  vildagliptin  group.  Incidence  of  adverse events was also low in both the groups (vildagliptin, 8.6% and vildagliptin+metformin, 5.3%).
CONCLUSION: Vildagliptin  and  vildagliptin+metformin significantly  reduced  HbA1c  with  good  weight  control and low incidence of hypoglycemia in patients with T2DM under real-world conditions in Philippines

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Metformin ; Vildagliptin ; Diabetes Mellitus, Type 2 ; Adamantane ; Pyrrolidines ; Hypoglycemic Agents ; Nitriles ; Hypoglycemia ; Body Weight ; Asia ; Africa ; Central America

Sofosbuvir is one of the new direct-acting antiviral drugs against hepatitis C virus (HCV) infection. This drug has recently been launched into the market, and generic versions of the medication are expected to be produced by local drug producers in some countries. Therefore, new methods are required to control sofosbuvir in pharmaceuticals. In the present study, a new method based on reversed phase (RP)-ultra-high performance liquid chromatography (UHPLC) coupled to diode array detection (DAD) and mass spectrometry (MS) was developed to facilitate the qualitative and quantitative analysis of sofosbuvir in film coated tablets. A wavelength of 260 nm was selected to perform a cost-effective quantification and the method showed adequate linearity, with an R2 value of 0.9998, and acceptable values of accuracy (75%–102%) and precision (residual standard deviation < 5%). The detection and quantification limits were 0.07 μg/mL and 0.36 μg/mL, respectively. Furthermore, the use of high-resolution MS enabled us to ensure the specificity, check impurities and better sensitivity. Therefore, this methodology promises to be suitable not only for the routine analysis of sofosbuvir in pharmaceutical dosage forms, but also for potential degradants.

A pilot study was undertaken using data from a population based screening program.The study aimed to determine the reliability of the frequency doubling technology using the Octopus 101 as the gold standard. 38 test eyes underwent frequency of doubling and octopus perimetry.Frequency doubling perimetry results were then correlated with Octopus perimetry results.Twenty-one out of the thirty-eight test results had a positive correlation.Test results showed a high sensitivity (76%) as compared with a lower (48%) specificity of the frequency-doubling perimeter for detecting visual field abnormalities
Human ; PERIMETRY

A finite element model of the temporomandibular joint (TMJ) and the human mandible was fabricated to study the effect of abnormal loading, such as awake and asleep bruxism, on the articular disc. A quasilinear viscoelastic model was used to simulate the behaviour of the disc. The viscoelastic nature of this tissue is shown to be an important factor when sustained (awake bruxism) or cyclic loading (sleep bruxism) is simulated. From the comparison of the two types of bruxism, it was seen that sustained clenching is the most detrimental activity for the TMJ disc, producing an overload that could lead to severe damage of this tissue.
Bruxism ; physiopathology ; Elasticity ; Finite Element Analysis ; Humans ; Temporomandibular Joint ; physiopathology ; Viscosity

Many different materials are available for grafting during surgery for Peyronie's disease (PD). To study the outcomes associated with the use of a lyophilized bovine pericardium graft (Peri-Guard®) to repair tunical defects in patients with PD, descriptive study of 43 patients with disabling penile curvature was performed. Curvature was measured before and after the intervention using a standardized procedure. Surgical technique was plaque excision and grafting of the tunical defect carried out by a single surgeon. A lyophilized bovine pericardium patch was used for grafting. We measured the change in penile curvature and length, the ability to perform successful sexual intercourse without further pharmacological or surgical treatment, and the satisfaction with treatment. Follow-up data were available for a total of 41 patients. Median age was 50 years (IQR 48-52); mean follow-up time was 14 ± 6 months. Complete penile straightening was achieved in 33 patients (80.5%) and five patients (12.2%) had curvature under 20°. Three months after surgery and stretching therapy, mean (s.d.) flaccid penile length increased from 11.2 ± 2.8 cm to 12.1 ± 2.9 cm (P = 0.062). Seventy-five percentage of patients reported being able to achieve successful intercourse without further treatment. Eighty-five percentage of patients reported to be satisfied with the treatment. There was no evidence of tissue rejection or infection, and only four patients suffered an adverse event. Plaque excision and grafting of the tunical defect with lyophilized bovine pericardium seems to be a safe and effective treatment for patients with PD.

Most widespread three-component penile prosthesis models are 700CX™ and Titan ®. Our purpose is to assess patient and partner satisfaction after the first implant. This is a multicenter, retrospective, nonrandomized study in which all patients who met the inclusion criteria between 2009 and 2013 were included. In total, 248 patients agreed to participate. To evaluate patient satisfaction, a validated but modified 11-question questionnaire was completed (EDiTS); and a nonvalidated two-item questionnaire was given to the partner. Statistical analysis used an ordinal logistic regression model. Two hundred and forty-eight patients (194 with 700CX™ vs 54 with Titan®) and 207 couples completed the questionnaire (165 with 700CX™ vs 42 with Titan®). Overall satisfaction was high. Both showed great reliability for sexual intercourse and high compliance with prior expectations. Most patients were able to manage the penile prosthesis correctly within 6 months. Postoperative penile shortening led to some dissatisfaction in 42% and 46% of cases (700CX™ /Titan®). Significant differences were found in three questions of patients' questionnaire. There were more patients satisfied with the 700CX™ (P = 0.0001). No patient with Titan® implant took longer than 6 months to optimal management. Only 4% of patients with 700CX™ implant were dissatisfied with the deflation, in contrast to 24% with the Titan® (P = 0.0031). Of the two partners' questions, one showed a statistically significant difference (P = 0.0026). It seems that group 700CX™ would recommend to re-implant the prosthesis with a greater tendency. The overall satisfaction was very high for both prostheses. The final aspect of the erected and flaccid penis was satisfactory, but both groups showed significant discontent with its final size. Partners' overall satisfaction was high.