TEST ; Upper case ess ; Filipinos ; Screening procedure ; Tuberculosis

Current ; Tuberculosis ; Child

seconds ; Illness, NOS ; Philippines ; Attitude to Health

INTRODUCTION: Serial beta human chorionic gonadotropin (?hCG) monitoring after molar evacuation is advised for early detection of persistent trophoblastic disease. The aim of this study was to determine the percentage of patients who developed post-molar gestational trophoblastic neoplasia during a 6-month follow up period after normalization of ?hCG surveillance for patients who underwent treatment for molar pregnancy.
METHODS: Data was analyzed from the Section of Trophoblastic Diseases at the Philippine General Hospital- Department of Obstetrics and Gynecology to estimate the incidence of persistent trophoblastic disease among 258 women with molar pregnancy form 2000-2011.
RESULTS: Among the 258 registered hydatidiform mole patients, 205 patients (79.5%) attained normal ?hCG titers titer levels after evacuation of molar products. There was no occurrence of postmolar gestational trophoblastic neoplasia among patients who achieved normalization of ?hCG titers after treatment. ?hCG levels did not attain normalization following evacuation in 53 patients (20.5%). Out of the 53 patients, 50 patients (94.3%) were detected to have gestational trophoblastic neoplasia within the first six months post-treatment. Only 3 patients (5.7%) were determined to have disease progression after six months during the one-year follow-up period.
CONCLUSION: The follow-up period after a molar pregnancy may be reduced for patients whose serum ?hCG levels spontaneously decline to normal levels after evacuation. The results of this study showed that the median time to obtain normal ?hCG levels is 88 days for those who received chemoprophylaxis and 85 days for those with lower initial ?hCG values (less than 100,000 mlU/ml).

Human ; Female ; Aged ; Middle Aged ; Adult ; Gynecology ; Obstetrics ; Gestational Trophoblastic Disease ; Hydatidiform Mole ; Chorionic Gonadotropin ; Disease Progression ; Chemoprevention ; Molar

INTRODUCTION: Serial beta human chorionic gonadotropin (?hCG) monitoring after molar evacuation is advised for early detection of persistent trophoblastic disease. The aim of this study was to determine the percentage of patients who developed post-molar gestational trophoblastic neoplasia during a 6-month follow up period after normalization of ?hCG surveillance for patients who underwent treatment for molar pregnancy.
METHODS: Data was analyzed from the Section of Trophoblastic Diseases at the Philippine General Hospital- Department of Obstetrics and Gynecology to estimate the incidence of persistent trophoblastic disease among 258 women with molar pregnancy form 2000-2011.
RESULTS: Among the 258 registered hydatidiform mole patients, 205 patients (79.5%) attained normal ?hCG titers titer levels after evacuation of molar products. There was no occurrence of postmolar gestational trophoblastic neoplasia among patients who achieved normalization of ?hCG titers after treatment. ?hCG levels did not attain normalization following evacuation in 53 patients (20.5%). Out of the 53 patients, 50 patients (94.3%) were detected to have gestational trophoblastic neoplasia within the first six months post-treatment. Only 3 patients (5.7%) were determined to have disease progression after six months during the one-year follow-up period.
CONCLUSION: The follow-up period after a molar pregnancy may be reduced for patients whose serum ?hCG levels spontaneously decline to normal levels after evacuation. The results of this study showed that the median time to obtain normal ?hCG levels is 88 days for those who received chemoprophylaxis and 85 days for those with lower initial ?hCG values (less than 100,000 mlU/ml).

Human ; Female ; Aged ; Middle Aged ; Adult ; Gynecology ; Obstetrics ; Gestational Trophoblastic Disease ; Hydatidiform Mole ; Chorionic Gonadotropin ; Disease Progression ; Chemoprevention ; Molar

Background: Approximately 20%–25% of high-risk gestational trophoblastic neoplasia (GTN) patients initially treated with first-line chemotherapy regimen develop resistance to the regimen. The EP-EMA (Etoposide-cisplatin and etoposide, methotrexate and actinomycin D) regimen is the most commonly utilized second-line agent. Objective: This study aimed to identify factors leading to remission using etoposide and cisplatin-etoposide, methotrexate, and Actinomycin D (EP-EMA) as salvage chemotherapy among resistant high-risk GTN. Methods: This is a retrospective descriptive study that reviewed the medical records of patients admitted in the section of trophoblastic diseases diagnosed with high-risk GTN from January 2006 to December 2015. Results: The medical records of 20 patients were retrieved and reviewed. The complete remission rate with EP-EMA is 60% (12/20). The overall survival rate for 1 year is 70% (14/20). Only 20% of the patients went home against advice and did not complete treatment. This regimen reported toxicities ranging from Grade 2–4 myelosuppression and electrolyte imbalance. Forty-five percent had Grade 4 neutropenia and Grade 2 anemia and 20% had Grade 2 thrombocytopenia. Hypokalemia and hypomagnesemia were noted in 8 patients (40%). Although not statistically significant, a trend showed that those in the remission group mostly had Stage III diseases with metastasis only in the lungs, prognostic score of between 7 and 12, and with beta-human chorionic gonadotropin (β-hCG) levels <10,000 mIu/ml at the start of EP-EMA treatment. Conclusion There is an improved response with EP-EMA chemotherapy across the years in our institution. Factors such as stage of disease, pulmonary metastasis, and low β-hCG at the start EP-EMA chemotherapy denote a possible good response and may contribute to patients' complete remission with EP-EMA chemotherapy. However, further studies with larger patient sample size are recommended to support the latter.
Gestational Trophoblastic Disease

Routine intimate hygiene care has a major contribution in maintaining overall urogenital and perineal health in women. However, Filipino women continue to experience a major surge in vulvar and vaginal symptoms across all age groups, in a context of major changes in lifestyles and risk factors impacting their genital health. Personal beliefs, preferences, apprehensions to discuss intimate topics with health care practitioners (HCPs), availability of cleansing products in the market, and their affordability prevent many women from discussing the role of intimate hygiene care with their HCPs. Communication difficulties and lack of robust evidence, supporting optimal hygiene recommendations are some of the challenges experienced by HCPs. Through this review, the authors discuss the following factors: (i) Differing physiological needs and pathological effects that result from changing dynamics of microflora in the vulvar, perineal, and vaginal region across all age groups of women, (ii) Importance of focusing on perianal and perineal hygiene, and bowel habits, to improve the quality of vulvar hygiene and genital health, (iii) Designing approaches for HCPs to maintain genital health in the light of intimate hygiene, (iv) Recommending improvements in HCP-patient communications to help HCPs dispel the misconceptions pertaining to intimate hygiene practices, and (v) Highlighting the antimicrobial efficacy of feminine hygiene cleansers that preserve the natural microbiome and help maintain the vaginal pH within the normal range. These strategies can fill the knowledge gaps among HCPs, women, and their caregivers’ perspectives and help achieve optimal intimate hygiene.

Human ; Female ; Microbiome ; Microbiota ; Vagina ; Vulva

BACKGROUND

Nursing, as a profession, is a facet where job satisfaction and performance matter. In the changing landscape of nursing practice in the Philippines and the aftermath of the COVID-19 pandemic, it is imperative to revisit and to perform an empirical investigation of the current state of nurses' job satisfaction and performance in the hospital setting. This study aimed to describe the job satisfaction and performance among staff nurses in private and government hospitals in Baguio City.

DESIGN

Using a quantitative descriptive cross-sectional survey design, a sample of 313 randomly selected staff nurses working in two private and two government hospitals in Baguio City were surveyed from March to April 2023, using a questionnaire. This study's protocol was approved by two ethics committees, namely the Saint Louis University Research Ethics Committee and the BGHMC REC. Nominal data was analyzed using the SPSS trial version employing frequencies, percentages, and the Chi-square test.

FINDINGS

There are more staff nurses in both private and government hospitals who reported satisfactory job satisfaction levels (276 nurses, 87.9%) and had good job performance (303 nurses, 96.5%) in all domains. However, results show that there are more nurses (209 nurses, 90.7% ) in government hospitals who are satisfied with their jobs than in private hospital nurses (67 nurses, 80.1%) in the domains Intra practice Partnership/Collegiality (p=0.010); Challenge/Autonomy (p=0.001); Professional, Social and Community Interaction (p=0.010); Professional Growth (p=0.036); Time (p=0.009); and Benefits (p=0.045). In terms of job performance, more government nurses at 97.3% (224 nurses) rated a higher self-appraisal of job performance. In comparison, only 94.8% (79 nurses) of private staff nurses appraised themselves as having good performance. No significant differences were found in the domains of job performance, namely leadership, teaching, planning, communications, and professional development, except in critical care. In "Critical care," which showed significance, the results suggest that more nurses in government hospitals perceive higher job performance, revealing a significant difference (p=0.011) in the "critical care" domain, indicating that a higher proportion of nurses in government hospitals demonstrate superior performance in this area.

CONCLUSION

Through this study, it was learned that nurses in both private and government hospitals generally experience high job satisfaction and performance, reflecting a fulfilled workforce and indicating commendable competency among the staff nurses. However, more nurses in government hospitals report high satisfaction and perceived performance in critical care compared to those in private hospitals. Thus, the findings of this study can contribute to and serve as a rationale for policy making regarding creating a positive work environment, proper management and leadership, creation of training and skill development for critical care, providing opportunities for professional growth, and conducting regular evaluation and feedback----- all geared towards a satisfied and productive workforce.

Job Satisfaction ; Job Performance ; Work Performance ; Work Environment ; Working Conditions