Clinic ; upper case pea ; upper case aitch ; upper case gee ; Corneal Diseases

A five-year review of anorectal complications seen following radiotherapy for cervical carcinoma was done with the following objectives: 1) to present the profile of patients presenting with anorectal complications following radiation treatment for cervical cancer; 2) to describe the manifestations of these complications and findings on proctosigmoidoscopy with biopsy; and 3) to present the approaches in their management. A total of 116 patients, all with confirmed diagnosis of cervical cancer, were seen over this period. Mean age was 49.5 years. All received external beam cobalt and intracavitary radium. Complications were observed from 10 days to 20 months after treatment. Anal bleeding was the most common complaint (62%), followed by rectovaginal fistula (14%). Residual/recurrent malignancy was noted in seven patients (6%). Treatment modalities varied considerably, ranging from conservative and symptomatic treatment for bleeding, pain, constipation, and diarrhea, to major abdominal procedures for rectovaginal fistula

Human ; Rectovaginal Fistula ; Constipation ; Sigmoidoscopy ; Uterine Cervical Neoplasms ; Cobalt ; Pain ; Biopsy ; Diarrhea ; Anus Diseases

The Community Mental Health Program (CMHP) of the Center for Health Development Calabarzon is an initiative that aims to integrate mental health into primary care to facilitate person-centered and holistic services. At the core of CMHP is a referral pathway between health centers and tertiary-level mental health services for the diagnosis and continuing management of persons with mental health conditions, as well as the use of an innovative medication (specifically for schizophrenia). This commentary presents lessons learned from a one-year implementation of CMHP in four pilot sites in the provinces of Rizal and Laguna, which stakeholders in mental health may consider in the design of community-based mental health programs to further the mandate of the Mental Health Act.
Schizophrenia ; Mental Health Services ; Program Evaluation ; Paliperidone Palmitate

Background: Due to the Coronavirus disease 2019 (COVID-19) pandemic, non-emergency services like botulinum toxin A (BoNT) injections were temporarily discontinued. Objective: We aimed to create standard practices that optimize the management of patients needing BoNT injections while ensuring both patients' and healthcare professionals' safety. Methods: We evaluated published guidelines and best practices to determine their applicability for BoNT injection during this pandemic. We then devised a decision tree algorithm for use in our hospital. Results: A decision tree algorithm has been formulated based on patient evaluation and risk stratification, triaging, the urgency of the procedure, and proper precautions on personal protective wear as appropriate for the procedure’s risk stratification. Conclusion The algorithm is in place to ensure the safety of both the patient and healthcare professional. It can be adopted and revised by other centers to suit their clinic needs.
Movement Disorders ; COVID-19 ; Botulinum Toxins ; Therapeutics ; Pandemics

Parkinson’s disease (PD) is a chronic, neurodegenerative condition resulting in various motor impairments, including speech disorders. However, at the height of the coronavirus disease 2019 pandemic, a patient with PD could not access traditional in-person neurorehabilitation care. This case report highlights the feasibility of telerehabilitation to deliver speech therapy over a distance using available resources in a developing country. We describe a Filipino elderly woman, public speaker, and marriage counselor, seeking teleconsultation for her voice problems (slow and soft) attributed to PD. At that time, most center-based outpatient rehabilitation centers in Manila were closed due to the pandemic, and the patient preferred to stay at home for safety reasons. Hence, she was evaluated and managed remotely by an interdisciplinary team (neurologist, physiatrist, speech-language pathologist) through video calls. Since the ideal rehabilitation set up (in-person evaluation and therapy; use of Lee Silverman Voice Therapy) could not be done, the clinicians had to find practical alternatives, such as remotely administering subjective perceptual voice assessments, objective speech analysis using the Praat™ computer application, and speech teletherapy through synchronous (videocalls, phone calls) and asynchronous (e-mails, text messages, pre-recorded exercise videos) techniques. Notable speech improvements were observed by the clinicians, patient, and patient’s frequent communicative partners after at least four teletherapy sessions. However, the carry-over of the improvements was affected by the patient’s lack of compliance with the prescribed home exercise program. Telerehabilitation using synchronous and asynchronous techniques for speech disorders due to PD was found feasible, beneficial, safe, and practical amid social distancing and low resources in a developing country
Speech Therapy ; Telerehabilitation ; Parkinson Disease ; Voice Disorders ; COVID-19

INTRODUCTION: Noise-induced hearing loss (NIHL) attributed to occupational noise exposure is one of the most common causes of permanent hearing impairment. In the Philippines, road traffic remains the biggest source of noise. The authors aimed to determine the prevalence of NIHL among traffic enforcers in Quezon City and quantify their occupational noise exposure levels. METHODS: Traffic enforcers were recruited via convenience sampling and screened using a questionnaire and otoscopic examination. Participants underwent pure tone audiometry and those found to have hearing loss were classified as “indicative” or “suspected” NIHL. Audiometric measurements of noise levels in areas where the traffic enforcers were assigned were taken using a calibrated smartphone application. RESULTS: “Indicative of NIHL” was highest in the 41 to 50-year age group and “suspected NIHL” was highest in the 31 to 40-year age group. “Indicative of NIHL” was highest among those working for 1 to 5 and 11 to 15 years in the right ear (25%) and 11 to 15 years in the left ear (30%). “Suspected NIHL” was highest among those working for 6 to 10 years. The average noise levels from the different areas measured at different times ranged from 79.0 to 82.5 dB. CONCLUSION “Indicative of NIHL” is more prevalent in the older age group while “suspected NIHL” is more prevalent in the middle age group. The prevalence of “indicative of NIHL” is highest among those in service for 1 to 5 and 11 to 15 years while “suspected NIHL” is highest among those in the service for 6 to 10 years. The average noise level measurements were within the safe values suggested by WHO.
Audiometry, Pure-Tone ; Hearing Loss, Noise-Induced ; Noise, Occupational