Objective: To fabricate an inexpensive, reproducible and portable ringlight with flexible, quick-release mount for use with point-and-shoot consumer digital cameras in intraoral photodocumentation. Methods: Design: Instrumentation Setting: Tertiary Care Hospital Procedure: A commercially-available battery-powered mountaineer’s LED (Light Emitting Diode) headlight was converted into a portable ringlight with a flexible, quick-releasemount for intraoral photodocumentation. Results: The Flexmount Ringlight delivered an even and white illumination of the oral cavity and oropharynx at a working distance of more than 5cm from the subject in focus. It resulted in sharper pictures due to its constant illumination that assisted the camera’s autofocus system in getting accurate focusing intraorally. It also allowed the camera to use smaller apertures that have put more elements in focus and faster shutter speeds that have markedly reduced motion blur. Conclusion: The Flexmount Ringlight is an inexpensive, easy-to-assemble and portable ringlight that can be used in point-and-shoot consumer digital cameras. Its constant and even illumination resulted in reproducible, sharp, shadowless photographs of the oral cavity and oropharynx.

Objective: To describe the clinical and demographic profile of patients who underwent pediatric Endoscopic Sinus Surgery (ESS) and the indications for which the procedure was performed. Methods: Design: Cross-sectional Study Setting: Tertiary Government Hospital Subjects: Using the medical record registry, all patients below 18 years of age who underwent ESS under the Department of Otorhinolaryngology – Head and Neck Surgery of a tertiary government hospital in Metro Manila between December 31, 1999 and January 1, 2008 were reviewed. The age, sex, clinical presentation indications for doing ESS and extent of surgery done were described. The Lund MacKay Grading for nasal polyposis and Scoring for sinusitis were also applied and cross-referenced. Results: Twenty-seven children aged 7 to 17 years underwent ESS. The mean age was 12.9 years with most (15 patients) belonging to the adolescent age group (13-17 years). Male to female ratio was 1.45:1. The mean interval from onset of symptoms to the first outpatient consultation was 1.5 years; the most common presenting symptoms were nasal obstruction (85.2%) and discharge (59.3%). All of the patients who underwent pediatric ESS had chronic rhinosinusitis: either with nasal polyposis (85.2%), an antrochoanal polyp (11.1%) or both (3.7%). The Lund Mackay Grading for nasal polyps and sinusitis scores were cross-referenced: patients with larger, grade III nasal polyps tended to have more extensive sinus disease than those with grade II polyps. On their first consultation, the patients tended to present with extensive nasal polyp and sinus disease indicating the need for surgery. All patients with CRS and nasal polyposis underwent polypectomy with ethmoidectomy, uncinectomy and maxillary antrostomy, with additional frontal sinusotomy for a 17-year-old male and a 17-year-old female, both with grade 3 polyposis. The three patients who had antrochoanal polyps underwent polypectomy with uncinectomy and maxillary antrostomy. There were no operative complications such as cerebrospinal fluid leak and orbital injury reported.

In the last two decades gastroesophageal reflux disease (GERD), initially thought to be a disease only common  in the West, is described  increasingly in Asia, including the Philippines. A recent local report indicated that the prevalence of erosive esophagitis (EE), a common complication of GERD, has more than doubled, i.e., 2.9% to  6.3%,  between the two time periods of 1994-1997 and 2000-2003, respectively. GERD causes recurrent annoying symptoms which are common  reasons  for  clinic  visits  and consultations thus, it is the objective of these guidelines to provide both primary care physicians  (PCPs) and specialists a current, evidence-based, country-specific recommendations for the optimal management  of  GERD.  These  guidelines  are  intended   to   empower   PCPs   to   make   a   clinic-based diagnosis of GERD, to start an empiric acid-suppressive therapy in the appropriate patient,and direct them to select which GERD patient may need to undergo investigations to ascertain further the diagnosis of GERD or to assess outcomes of therapy. We acknowledge that studies published in the future may influence the impact on our confidence on the recommendations enumerated in  these guidelines thus, we commit to update this document when it is deemed appropriate.

Physicians, Primary Care ; Prevalence ; Specialization ; Gastroesophageal Reflux ; Ambulatory Care ; Esophagitis ;

INTRODUCTION: Okra is reported to have anti-diabetic effects, but the literature shows conflicting results. The experiment aimed to determine the efficacy of three doses of okra seed powder suspension as a glucose lowering agent on streptozotocin-induced diabetic rats and its cellular effects on the liver and pancreas. METHODS: Twenty-five Sprague Dawley rats that were given streptozotocin 60 mg/kg intraperitoneally were randomly allocated to one of five treatment groups: okra seed powder at 100 mg/kg, 150 mg/kg and 200 mg/kg, acarbose (positive control) and vehicle only (negative control). The treatments were given as a 1.5 mL oral gavage daily for 21 days. Significant differences in blood glucose were determined between treatment groups in terms of relative change from baseline, using One-Way ANOVA with Dunnett’s method with acarbose as the referent group. Repeated measures ANOVA was used to analyze the blood glucose levels across the time point collections (baseline, T1 and T2). Histopathologic changes on the liver and pancreas were described using counts and proportions. RESULTS: Mean blood glucose values increased from baseline to T2 in all treatment groups. Increasing trend was observed only up to T1 in the 150 mg/kg and the 200 mg/kg okra seed treatment groups. Comparing okra treatment groups to acarbose, the percentage increase of mean blood glucose from baseline to T2 was lowest in the 200 mg/kg okra group (p = 0.040). The okra-treated rats had no fatty change and a dose-dependent decrease in cellular degeneration in the liver and none for the 200 mg/ kg treatment group. CONCLUSION The 200 mg/kg okra suspension has a potential lowering effect on blood glucose and a hepatoprotective effect. A longer period of observation with higher doses of okra suspension is recommended to study these effects further.