OBJECTIVE

To evaluate the effect of mySugr^TM app on diabetes self-management, HbA1c level and its acceptability among app users with type 2 diabetes (T2DM).

A prospective, single-arm interventional study in 70 adult Filipino patients with T2DM and HbA1c ≥ 8.0%. Participants used the basic mySugr^TM mobile app for 12 weeks. The Modified Behavior Score Instrument and the Diabetes Self-Management Questionnaire (DSMQ) pre- and post-intervention measured its impact on diabetes self-management while the Mobile Application rating Scale (MARS) assessed the quality of the app.

There was a significant increased adherence to the diabetes self-care behaviors. DSMQ showed that only 12% of the participants had poor self-care behaviors at week 12 particularly in physical activity and diet. The baseline median HbA1c [9.55% (8.43-11.30)] and estimated HbA1c [8.9% (8.3-10.9)] declined significantly after week 12, [8.0% (8.0-8.43)] and [7.2% (6.5-8.1)] respectively with a very significant p value of (p < 0.00001). About 42% of patients achieved an HbA1c level of ≤7%. MARS confirmed the app’s good quality and acceptability.

Mobile application such as mySugr^TM mobile app can be a viable tool for improved self-care behavior and help in achieving good glycemic control among patients with poorly controlled T2DM even as early as 12 weeks. The app has good quality and acceptability.

Background: A well-informed patient with Type 2 diabetes may be more compliant with treatment. This study aims to evaluate the diabetes-related knowledge and socio demographic determinants of patients seen at University of Santo Tomas Hospital through a translated and validated Filipino-DKT questionnaire.

Methods: Standard translation procedure was used to produce the Filipino version of the DKT2. A convenience sample of 112 outpatients with Type 2 diabetes was identified for six months at the University of Santo Tomas Hospital, Philippines. All data were collected using the Filipino-DKT and a demographic questionnaire.

Results: The Filipino-DKT demonstrated an acceptable Cronbach's alpha of 0.70 and an acceptable average inter-item correlation of 0.40 (p<0.001). The test-retest reliability was excellent, with a Pearson coefficient r of 1.00 (p<0.001). Our study demonstrated that of the 112 patients with diabetes who answered the general knowledge test, the majority had average knowledge of 78.64%, while 16.07% had poor knowledge. A total of 55 participants on insulin answered the second part of Filipino-DKT that measures insulin knowledge. Surprisingly, 56% of the subjects on insulin had poor knowledge, and only 7% had good knowledge. Results showed that the majority (56%) had poor knowledge. Participants who reported poor control of their diabetes (HbA1c >7%) also reported lower levels of knowledge about diabetes and insulin use. There was no association between duration of diabetes, family history of diabetes, and type of diabetes with knowledge of diabetes.

Conclusion: The Filipino diabetic knowledge of diabetes is poor and not related to age, sex, and duration of diabetes. Filipino-DKT is an acceptable, reliable, and valid measure of diabetes knowledge used in our clinical practice and research.

BACKGROUND

Thyroid storm (TS) continues to be a diagnostic and therapeutic challenge. It is a life-threatening severe thyrotoxicosis characterized by organ decompensation. This study aims to determine if there are any changes in this present century about TS diagnosis and management. Furthermore, it aims to describe the clinical profile, precipitants, and outcomes of patients with TS seen at the University of Santo Tomas Hospital (USTH) and assess the association of patient characteristics with mortality.

This is a retrospective cohort analysis of patients with TS admitted at USTH from 2009 through 2018. Logistic regression analysis was used to determine the association of age, Burch Wartofsky-Point Scale (BWPS) score, clinical manifestations, and precipitating factor with mortality.

A total of 21 cases were identified. Majority of the patients were female (90.48%) with a mean age of 42.90 years old. The overall mean BWPS was 49.52 (16.35) while those who expired had higher mean score of 61.67 (5.77). TS as the first clinical presentation was seen in only one patient (4.7%) while majority were previously diagnosed with hyperthyroidism, (95.24%). Graves’ disease (90.48%) was the most common etiology of thyrotoxicosis. Cardiac manifestations were predominant and tachycardia was the most common clinical manifestation (80.95%) with thyrotoxic heart disease as a comorbidity (23.81%). The most common precipitant was infection (52.38%) followed by noncompliance with treatment. The mean hospital length of stay was four days with two patients needing intubation, and both expired afterward. There were three mortalities (14.29%) due to multiple organ dysfunction and fatal arrythmia.

TS remains a life-threatening condition. Aggressive treatment is justified once with suspicion of TS. Age, BWPS on admission, clinical manifestation and precipitants did not predict the likelihood of mortality. Since predictive features are still not thoroughly identified due to its infrequency, it remains for us to be vigilant and not delay crucial treatment to improve the morbidity and mortality associated with TS.

Background & Objective: Chronic pain impacts the quality of life of patients, with neuropathic pain causing profound negative sequelae. Assessment of pain whether nociceptive or neuropathic is important to provide appropriate treatment. The objective of this study is to translate and validate the pain-DETECT Questionnaire (PDQ) to two widely spoken regional languages in Filipino. Methods: The PDQ, a self-administered questionnaire, was translated from English into the Filipino version, painDETECT Tagalog (PDQ-Tag) and painDETECT Cebuano (PDQ-Ceb). One hundred Filipino patients suffering from pain for at least three months were recruited in the out-patient clinics of a hospital and completed the questionnaire. The investigators, blinded to the subjects PDQ-Tag and PDQ-Ceb scores, examined the subjects using the standard clinical and neurological examination. The PDQ-Tag and PDQ-Ceb, scores were validated. Both questionnaires were administered to the same patient twice, two days apart by the same investigator. Results: Seventy subjects completed the (PDQ-Tag) and thirty subjects the (PDQ-Ceb). The sensitivity and specificity of PDQ-Tag were both 80% for an upper limit cut-off value of ≥ 17. The sensitivity and specificity of PDQ-Ceb were 62.5% and 80% respectively, for an upper limit cut-off value ≥ 18.0. Both questionnaires were reliable [Cronbach’s alpha coefficient: 0.78 (PDQ-Tag) and 0.70 (PDQ-Ceb), good test-retest stability with intra-class correlation coefficient: 0.93 for PDQ-Tag and 0.99 for PDQ-Ceb]. Cohen’s kappa were 0.64 and 0.61 for PDQ-Ceb and PDQ-Tag respectively, with P value<0.001 indicating a significant agreement on the assessment of neuropathic pain. Conclusion: PDQ-Tag and PDQ-Ceb are reliable and valid self-administered screening tools to detect neuropathic pain among Filipinos.

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