Oral cavity malignancy reconstructive surgery has advanced from pedicle fl aps to microvascular free tissue transfer. Previously, reconstruction of these defects were done using radial forearm free fl ap in this centre. We report our experience using anterolateral thigh free fl ap in a 49 year old lady with squamous cell carcinoma of the tongue. Excision of tumour left a defect which was later reconstructed using microvascular free tissue transfer using the right anterolateral thigh free fl ap. The fl ap was well taken up at the recepient site and no evidence of fl ap failure noted post operatively and on completion of radiotherapy. She was able to maintain comprehensible speech and swallowing ability.

Mental illness has always brought distress to the patients as well as their families and/or care providers. Fadden tried to describe the phenomenon of burden among families as "one or more in the household is doing more than their fair share, has activities restricted outside the relationship and experiences a greater or lesser degree of distress". Tronco, et al., in their study in Bulacan found that the concerns were financial burden, inaccessibility health resources, stigma, distress during exacerbations, shame, and isolation. This study was done to describe the psychosocial effects of care giving on primary of persons with Schizophrenia seen at the Psychiatry Out Patient Clinic of UP-PGH. This descriptive cross sectional survey. Those included were adult caregivers of schizophrenic patients. Instruments used were the translated versions of General Health Questionnaire -28 and the Burden Assessment Schedule. A total of 102 respondents were included in the study. Out of these, 76.4% were between the ages 41-65 years, married, mothers of the patients. About 62.4% had been taking care of their patients for more than five years. Using the GHQ, 11.8% were identified to have significant psychiatric symptoms. There was impact on material relationship and the illness was perceived to be was severe to some extent. In all, almost half of the respondents, 52 (50.9%), perceived care giving to be burdensome to some extent. Given the results of the study, one can see that some caregivers develop psychopathology, hence, the need for intervention. This can be done through debriefing sessions, psycho education, and individual therapy, if needed.
Human ; Female ; Aged ; Middle Aged ; Adult ; CAREGIVERS ; SCHIZOPHRENIA

Methods: A prospective, randomized, controlled trial was performed involving patients requiring laser iridotomy who were randomized either to Nd:YAG laser or sequential argon-Nd:YAG laser iridotomy. Iris-perforation success rate, the average number of laser shots and amount of laser energy used, the intraocular pressure (IOP) after laser treatment, and the rate of complications were compared. The prelaser pupil size was correlated with the iris perforation success rate. Results: Forty-one eyes underwent laser iridotomy (23 Nd:YAG and 18 sequential). All eyes had patent iridotomies. There was no difference between the two groups in terms of the number of Nd:YAG laser shots delivered (p=0.97) and amount of Nd:YAG energy used (p=0.64). The total amount of laser energy used was higher in the sequential group (p=0.003). There was no significant difference in the IOP and complication rates after treatment. A positive correlation was seen between prelaser pupil size and number of Nd:YAG shots needed to enlarge (r=0.38, P=0.01). Conclusion: Nd:YAG laser alone and sequential argon-Nd:YAG have comparable success in attaining patency of laser iridotomy, IOP control, and rate of complications in dark irides of Filipinos.
Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; GLAUCOMA ; LASERS, SOLID-STATE ; NEODYMIUM ;

Background: Niacinamide is known for its anti-inflammatory effect and skin penetration capability. Currently, limited studies are available on its efficacy on psoriasis. Objective: This study aimed to determine the efficacy and safety of 4% niacinamide cream on mild to moderate psoriasis. Methods: 40 patients were randomly allocated to 4% niacinamide cream (N), or 0.1% triamcinolone acetonide cream (TAC) or 4% niacinamide cream and 0.1% triamcinolone acetonide cream (N-TAC) for 10 weeks treatment. A 50% improvement in psoriasis area severity index (PASI50) was considered as the primary endpoint of the study. Secondary outcome measures were physician global assessment (PGA), dermatology life quality index (DLQI), and adverse events. PASI and PGA were assessed biweekly. DLQI was assessed at the start and at the end of the study period. Results: PASI50 was achieved in 85% of patients in N-TAC, 75% of patients in TAC and 15% of patients in N. There was no statistical significant difference between groups TAC and N-TAC (p=0.645, Fisher’s exact test). A higher number of patients in N-TAC (31%) achieved PGA1 score or “almost clear” and reached PASI50 earlier (60% at week 4). A higher improvement in DLQI score was seen in N-TAC; however, mean DLQI improvement did not vary by treatment group (p=0.0770). No adverse event was reported for groups TAC and N-TAC while pruritus and erythema were noted in N. Conclusion: Monotherapy of 4% niacinamide cream was not effective in the treatment of mild to moderate psoriasis. The combination N-TAC showed a continuous and sustained improvement of lesions compared to monotherapy TAC.
triamcinolone acetonide ; niacinamide ; psoriasis

BACKGROUND: The relative importance of body composition, lifestyle factors, bone turnover and hormonal factors in determining bone mineral density (BMD) is unknown. We studied younger postmenopausal women to determine whether modifiable or nonmodifiable risk factors for osteoporosis have stronger associations with BMD. METHODS: In multivariable linear regression models, we tested associations between non-bone body composition measures, self-reported measures of physical activity and dietary intake, urinary N-telopeptide (NTx), sex hormone concentrations, and BMD in 109 postmenopausal women aged 50 to 64 years, adjusting for current hormone therapy use and clinical risk factors for low BMD. Lean mass, fat mass and areal BMD (aBMD) at the lumbar spine, femoral neck, total hip and distal radius were measured using dual energy X-ray absorptiometry. RESULTS: Higher body weight and self-reported nonwhite race were independently associated with higher aBMD at the lumbar spine, femoral neck, total hip and distal radius. Lean and fat mass were not independently associated with aBMD. Older age and higher urinary NTx were independently associated with lower aBMD at the distal radius but not at weight-bearing sites. Sensitivity analyses demonstrated lack of an independent association between total daily protein or calorie intake and BMD. CONCLUSIONS: BMD, weight and race were the most important determinants of aBMD at all sites. Older age and higher bone turnover were independently associated with lower aBMD at the distal radius. In a limited analysis, self-reported physical activity, dietary protein and calorie intake were not associated with aBMD after adjustment for the other variables.
Absorptiometry, Photon ; Body Composition* ; Body Weight ; Bone Density ; Continental Population Groups ; Dietary Proteins ; Female ; Femur Neck ; Hip ; Humans ; Life Style* ; Linear Models ; Menopause ; Motor Activity ; Osteoporosis ; Radius ; Risk Factors ; Spine ; Weight-Bearing

A small set of gastric adenocarcinomas (9%) harbor Epstein-Barr virus (EBV) DNA within malignant cells, and the virus is not an innocent bystander but rather is intimately linked to pathogenesis and tumor maintenance. Evidence comes from unique genomic features of host DNA, mRNA, microRNA and CpG methylation profiles as revealed by recent comprehensive genomic analysis by The Cancer Genome Atlas Network. Their data show that gastric cancer is not one disease but rather comprises four major classes: EBV-positive, microsatellite instability (MSI), genomically stable and chromosome instability. The EBV-positive class has even more marked CpG methylation than does the MSI class, and viral cancers have a unique pattern of methylation linked to the downregulation of CDKN2A (p16) but not MLH1. EBV-positive cancers often have mutated PIK3CA and ARID1A and an amplified 9p24.1 locus linked to overexpression of JAK2, CD274 (PD-L1) and PDCD1LG2 (PD-L2). Multiple noncoding viral RNAs are highly expressed. Patients who fail standard therapy may qualify for enrollment in clinical trials targeting cancer-related human gene pathways or promoting destruction of infected cells through lytic induction of EBV genes. Genomic tests such as the GastroGenus Gastric Cancer Classifier are available to identify actionable variants in formalin-fixed cancer tissue of affected patients.
Adenocarcinoma/*diagnosis/*etiology/therapy ; DNA Methylation ; Epstein-Barr Virus Infections/*complications ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Gene Expression Regulation, Viral ; *Genomics/methods ; Herpesvirus 4, Human/*physiology ; Host-Pathogen Interactions/genetics ; Humans ; MicroRNAs/genetics ; Mutation ; RNA, Messenger/genetics ; Signal Transduction ; Stomach Neoplasms/*diagnosis/*etiology/therapy ; Virus Integration

Objective: To determine the prevalence and describe the clinical characteristics of high risk HPV mong patients with oropharyngeal squamous cell carcinomas in our institution utilizing p16 and HPV DNA in-situ hybridization testing and to determine the factors associated with high risk HPV positivity. Methods: Design: Retrospective Cohort Review Setting: Tertiary Private Training Hospital Participants: 29 Results: A total of 29 primary oropharyngeal squamous cell carcinomas were diagnosed during the 11-year study period (January 2010 to December 2021). Based on the HPV in-situ hybridization status, the prevalence of high risk HPV oropharyngeal squamous cell carcinoma in our institution was 52%. Majority of these cases were males (87.5%) with a median age of ≤55 years old (60%) who are non-smokers (88.2%) and non-drinkers of alcoholic beverages (80%). There was no statistically significant association between age group, sex, smoking status, alcohol intake, lymph node status and high risk HPV infection. The most common tumor site involved in HPV-positive oropharyngeal squamous cell carcinoma was the tonsil (87%). Majority demonstrated a nonkeratinizing histology (73%) with positive lymph node status (67%) upon clinical presentation. Fifteen (83%) of the 18 p16 positive squamous cell carcinomas were positive for high risk HPVDNA. Of note, 3 (17%) out of the 18 p16 positive squamous cell carcinomas turned out to have negative HPV DNA-ISH status. Conclusion Although no statistically significant correlation between any clinical characteristic with viral status was established, HPV-mediated oropharyngeal squamous cell carcinoma in this institution was commonly seen among males aged 54 years old and below who are nonsmokers and non-drinkers of alcoholic beverages with the palatine tonsil as the most common site presenting with a non-keratinizing histology. In terms of testing, p16 staining correlates well with high risk HPV status. Future studies utilizing a larger patient population may aid in elucidating statistically significant clinical associations in our local population
human papillomavirus ; oropharyngeal cancer ; p16

Zika en Embarazadas y Niños (ZEN) is a prospective cohort study designed to identify risk factors and modifiers for Zika virus (ZIKV) infection in pregnant women, partners, and infants, as well as to assess the risk for adverse maternal, fetal, infant, and childhood outcomes of ZIKV and other congenital infections. ZIKV infection during pregnancy may be associated with longterm sequelae. In the ZEN cohort, 1,519 pregnant women and 287 partners were enrolled from 3 departments within Colombia between February 2017 and January 2018, as well as 1,108 infants born to the pregnant women who were followed to 6 months. The data include baseline questionnaires at enrollment; repeated symptoms and study follow-up questionnaires; the results of lab tests to detect ZIKV and other congenital infections; medical record abstractions; infant physical, eye, and hearing exams; and developmental screening tests. Follow-up of 850 mother-child dyads occurred at 9 months, 12 months, and 18 months with developmental screenings, physical exams, and parent questionnaires. The data will be pooled with those from other prospective cohort studies for an individual participant data meta-analysis of ZIKV infection during pregnancy to characterize pregnancy outcomes and sequelae in children.

Zika en Embarazadas y Niños (ZEN) is a prospective cohort study designed to identify risk factors and modifiers for Zika virus (ZIKV) infection in pregnant women, partners, and infants, as well as to assess the risk for adverse maternal, fetal, infant, and childhood outcomes of ZIKV and other congenital infections. ZIKV infection during pregnancy may be associated with longterm sequelae. In the ZEN cohort, 1,519 pregnant women and 287 partners were enrolled from 3 departments within Colombia between February 2017 and January 2018, as well as 1,108 infants born to the pregnant women who were followed to 6 months. The data include baseline questionnaires at enrollment; repeated symptoms and study follow-up questionnaires; the results of lab tests to detect ZIKV and other congenital infections; medical record abstractions; infant physical, eye, and hearing exams; and developmental screening tests. Follow-up of 850 mother-child dyads occurred at 9 months, 12 months, and 18 months with developmental screenings, physical exams, and parent questionnaires. The data will be pooled with those from other prospective cohort studies for an individual participant data meta-analysis of ZIKV infection during pregnancy to characterize pregnancy outcomes and sequelae in children.

OBJECTIVE: This study was conducted to document the prevalence of psychiatric morbidity among chronically ill medical patients in selected hospitals in the Philippines. METHODS: This is a cross-sectional study of the chronically medically ill patients seen in selected Primary are Evaluation of Mental Disorders (PRIME-MD), 774 patients were screened for mental disorders. The prevalence of each of the psychiatric disorders were calculated using the formula for estimation of a proportion for stratified random sampling. The differences in the sample size from each of the study sites were taken into consideration in the estimation of the sitespecific prevalence of mental disorders. The 95 percent confidence intervals of the prevalence rates were computed. RESULTS: Almost half of the patients (47.8 percent) were diagnosed with at least one of the psychiatric disorders elicited from the PRIME-MD. Thirty two percent had depressive disorder, followed by anxiety disorder, somatoform disorders, alcohol-related disorder and eating disorder. According to hospital site, the overall prevalence rate of psychiatric disorder was noted to be highest at the Davao Medical Center. CONCLUSION: The overall prevalence of psychiatric disorder noted in this study was higher than that described in foreign literature, the most common of which was depression.
Human ; Male ; Female ; MENTAL DISORDERS ; CHRONIC DISEASE ;