1.Impact of the COVID-19 Pandemic on children diagnosed with diabetic ketoacidosis admitted in a tertiary pediatric hospital
Camille S. Cantalejo S. Cantalejo ; Lorna R. Abad
The Philippine Children’s Medical Center Journal 2024;20(1):22-31
Objectives:
This study aims to determine the effect of the COVID-19 pandemic on the
incidence, severity, and outcome of children diagnosed with diabetic ketoacidosis admitted in a
tertiary pediatric hospital.
Materials and Methods:
Two groups were identified as the basis for classification:
pre-pandemic (2017 to 2019) and COVID-19 pandemic (2020 to 2022). The Mann‐Whitney U test
was utilized to test for the differences in continuous variables, while Pearson’s chi‐squared test was
used to test for differences in categorical variables.
Results:
The study involved 136 participants, 63 of whom were recorded in the pre-pandemic
period and 73 during the COVID-19 pandemic period. Data revealed no conclusive relationship
between sex (p=0.578), age (p=0.225), or height (p=0.876) across the two time frames. However,
data showed significant difference between the weight (p=0.007) and BMI (p=0.003) of children
with DKA pre-pandemic and during pandemic. This implies that marked changes in weight and
BMI reflect possible changes in health behaviors, healthcare access, or other variables that may
have altered during the COVID-19 pandemic. Furthermore, there was no discernible difference
between pre-pandemic and COVID-19 in terms of severity, incidence, or the amount of time
between the onset of symptoms and consultation.
Conclusion
The demographic and clinical characteristics of patients with DKA across
the two study periods indicate a degree of stability in patient profiles. Despite the unique
circumstances of the pandemic, patient outcomes in terms of glycemic control and mortality were
like those observed pre-pandemic. The significant difference in weight and BMI emphasizes how
crucial it is to monitor and respond to modifications in the nutritional status and metabolic health of
DKA patients during times of crisis, like the COVID-19 pandemic. Comprehending these changes
can provide focused treatments aimed at promoting the best possible health outcomes for
susceptible patient groups.
Diabetic Ketoacidosis
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Diabetes Mellitus
;
COVID-19
2.Ring chromosome 10 in Filipino child: A case report and review of literature
Dion-Berboso April Grace ; Abad Lorna R. ; Esquejo Amelito L ; Chiong Mary Anne D.
Acta Medica Philippina 2011;45(4):66-69
We report a 12-day-old infant who presented with ambiguous genitalia, short stature, low-set ears, stubby nose, patent ductus arteriosus and ventricular septal defect. He was confirmed to have a ring chromosome 10 by cytogenetic analysis. Review of the literature showed that our patient shared common clinical manifestations with previously described cases.
Infant Newborn
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DISORDERS OF SEX DEVELOPMENT
;
UROGENITAL ABNORMALITIES
;
CYTOGENETIC ANALYSIS
;
DIAGNOSIS
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DIAGNOSTIC TECHNIQUES AND PROCEDURES
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CLINICAL LABORATORY TECHNIQUES
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CYTOLOGICAL TECHNIQUES
4.Incidence and risk factors of falls and fall-related injuries at the medical and surgical wards of the Philippine General Hospital.
Javier Juanito S. ; Ang-Muñoz Cynthia D. ; Abad Lorna R. ; Campo Mildred B. ; Caro Ruzanne M. ; Rafael Evangeline E.
Acta Medica Philippina 2016;50(4):313-317
OBJECTIVE: There is no published local data available on falls and fall-related injuries among hospitalized patients. This study aims to determine the incidence of falls, fall-related injuries and related risk factors at the surgical and medical wards of a tertiary government hospital in the Philippines.
METHODS: This is a cross-sectional study using consecutive sampling of patients admitted to the medical and surgical wards of a tertiary government hospital from May 2014 to April 2015. Data collection included the patients' demographic data, diagnosis, medications, details on the fall, consequence of the fall, and risk factors for the fall.
RESULTS: During the one-year period, 25,849 patients were admitted to the medical and surgical wards and only six patients, representing 0.02%, were reported to have sustained a fall. No major injury occurred. The patients had varied neurologic and/or musculoskeletal disorders. Two patients fell from a wheelchair, while one fell from a bedside chair. One patient fell from the bed and one slipped on the floor. All patients had watchers/witnesses at the time of the fall.
CONCLUSION: The incidence of falls and fall-related injuries is low in a local tertiary government hospital. No serious injury resulted from the falls. Prevailing practices, local cultural expectations and under reporting may have affected the relatively low incidence rates of patient falls reported in this study.
Human ; Male ; Female ; Accidental Falls ; Risk Factors ; Wheelchairs ; Hospitalization ; Data Collection ; Tertiary Care Centers ; Musculoskeletal Diseases
5.Validation of the Filipino translated questionnaire on parent attitudes about childhood vaccines.
Vincent Albert G. FLORES ; Kristine Zillah O. ARROYO ; Ma. Cecilia D. ALINEA ; Lorna R. ABAD
Pediatric Infectious Disease Society of the Philippines Journal 2020;21(1):26-36
OBJECTIVE: To determine the content validity and test-retest reliability of the Filipino Translated Questionnaire on Parent Attitudes About Childhood Vaccines.
METHODOLOGY: Eligible parents of patients seen at the Pediatric Outpatient Department, Pediatric Emergency Room and Pediatric Wards of the Philippine General Hospital were recruited into the study. The original survey tool was translated to Filipino by the Sentro ng Wikang Filipino. A focus group of four experts in the field of vaccination rated the content of each item on the questionnaire based on its relevance. Ten Filipino speaking participants were then recruited to check its face validity. This was then implemented to 67 Filipino speaking participants to check its test-retest reliability.
RESULTS: The overall item content validity index of the questionnaire was computed to be 0.95. All items had a 100% rating in terms of clarity and simplicity. The high intraclass correlation coefficient of 0.970 supports the tool's test-retest reliability. However, the test had a low Cronbach's ? coefficient of 0.687 which could be increased to 0.711 with the removal of one item from the question pool.
CONCLUSION: The Filipino Translated Questionnaire on Parent Attitudes About Childhood Vaccines has face and content validity with an acceptable internal consistency. This can serve as a framework for future researches on vaccine hesitancy.
Human ; Immunization ; Vaccination
6.university of the Philippines Manila position statement on proposed house Bill no. 292, “An act imposing excise tax on sugar-sweetened beverages by inserting a new section 150-A in the national internal revenue Code of 1997, as amended”
Red Thaddeus DP. MIGUEL ; Vicente O. MEDINA III ; Hilton Y. LAM ; Lorna R. ABAD ; Peter James B. ABAD ; Carmencita D. PADILLA
Acta Medica Philippina 2018;52(4):302-304
The Philippines, with a maximum personal income tax rate at 32%1 and a corporate income tax of 35%,1 has one of the highest income tax rates among the Association of South East Asian(ASEAN) member states.2 The new administration is now campaigning to lower the ceilings on capital and personal income tax, through a proposal originally passed in September 2016, and amended in January 2017, following public and private sector opposition for its immediate imposition.3 In its Explanatory Note, House Bill No. 292, "An Act Imposing Excise Tax on Sugar-Sweetened Beverages by Inserting a New Section 150-A in the National Internal Revenue Code of 1997, as Amended," cites this as the reason for imposing an, "excise tax of ten pesos (Php 10.00) on sugar-sweetened beverages, the rate of which shall be increased by four percent (4%) every year thereafter effective on January 1, 2017."4 According to the proposed bill, "this measure is proposed to provide additional revenue collections for our country," further claiming that, "this house bill is timely in its submission as one of the new administration's policies to pursue reforms in income tax rates.
7.Parent-child communication about congenital adrenal hyperplasia: Filipino mothers' experience.
Peter James B ABAD ; Mercy Y LAURINO ; Sandra DAACK-HIRSCH ; Lorna R ABAD ; Carmencita D PADILLA
Acta Medica Philippina 2017;51(3):175-180
BACKGROUND: Family communication facilitates coping a genetic condition by ensuring accurate understanding of the illness,its inheritance pattern,associated recurrence risk and risk perception.
OBJECTIVE: This paper explores Filipino mothers' experience in communicating information about congenital adrenal hyperplasia (CAH) to their children.
METHODS:Descriptive qualitative design was used.families affected with CAH were recruited via a CAH support group.Semi-structure interview with mothers were done on the following topics:content and understanding information communicated,reasons for communicating,and changes and adjustments in the family.Thematic analysis was used to analyze the data.
RESULTS:Five families consisting 11 individuals ,including four mothers,were interviewed.finding revealed that while mother are open to communicate with their child about CAH,this is often triggered by question from the child.Mother find it challenging to discuss about the condition and when they do discuss,this is most often done to facilitate better understanding among the siblings.There is an attempt to explain inheritance of CAH but this is also limited to the mother's understanding.
CONCLUSION:The findings of the study provide guidance to health professional on how they can support parents,particularly mothers,in discussing CAH with their children.
Human ; Adaptation, Psychological ; Communication ; Risk ; Inheritance Patterns
8.Procalcitonin-Guided Antibiotic Theraphy in pediatric patients: A systematic review
Aina B. Albano-Cabello ; Jeff Ray T. Francisco ; Anna Lisa T. Ong-Lim ; Lorna R. Abad
Pediatric Infectious Disease Society of the Philippines Journal 2016;17(1):2-16
Background:
Serum procalcitonin is a useful biomarker in establishing the presence of bacterial infections and has been used in algorithms to guide antibiotic treatment among adults. It role in pediatric infections, however, remains unclear.
Objectives:
This research aims to evaluate the impact of serum procalcitonin in guiding antibiotic therapy among pediatric patients with suspected local or systemic infections.
Methodology:
Randomized controlled trials comparing procalcitonin-guided antibiotic therapy to clinically guided therapy in pediatric patients with local or systemic infections were searched through MEDLINE, Cochrane, EMBASE, HERDIN and ClinicalTrials.gov. Hand search in various search engines was also done. Outcomes included antibiotic usage, morbidity and mortality. Two reviewers independently assessed potentially relevant studies. Statistical analysis was conducted using RevMan 5.3 using inverse variance weighting and random effects model.
Results:
Five randomized controlled trials were included. Overall, there was a reduction in antibiotic prescription rate in the procalcitonin group compared to controls for all groups (RD -0.13, 95% CI [-021,0.06]; p <0.00001), however, pooled studies were heterogenous. Subgroup analysis showed that for children with pneumonia, procalcitonin guidance significantly reduced antibiotic prescription rate (RD – 012,95% CI [-021,0.04]; p <0.005 ), and may have potential in reducing the duration of therapy (95% CI [-6.8,2,54], p <0.0001) and antibiotic-related adverse effects (RD- 0.17, 95% CI[-0.24,-0.10], p<0.00001) compared to controls. In one study on neonates with early onset sepsis, procalcitonin guidance reduced antibiotic prescription rate by 27% (p=0.0009) and duration of therapy by 22.4 hours (p=0.0009). Procalcitonin guidance has no significant impact on antibiotic prescription rate in children with fever without a source (RD -0.11, 95% CI[0.28,0.05], p=0.190).
Conclusion
Procalcitonin guidance significantly reduces antibiotic prescription rate among children with pneumonia and neonates with early onset sepsis. It has the potential in reducing the duration of antibiotic therapy and antibiotic-related side effects in these populations. ON the other hand, it had no impact among children with fever without a source. These results highlight
the need for algorithm-based approaches using procalcitonin cut-off values to guide antibiotic therapy in children.
Procalcitonin
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Neonatal Sepsis