Objectives: The objective of this paper was to present the results of replantation and revascularization surgery of the hand or digit and to describe the factors associated with survival of the replanted and revascularized digit. Methods: From January 1, 2005 to July 31, 2010, a retrospective review of the Microsurgery Unit Database was done to determine the number of patients referred to the Unit for amputations of the upper extremity. The injuries were classified by mechanism of injury (guillotine, crush, avulsion, and gunshot/blast), level of injury, and whether or not a vein graft was used. A total of 8 patients with 8 hand parts had replantation surgery and seven patients with 10 revascularized parts were reviewed. Functional Outcome: Functional outcome was measured using the range of motion of the involved digit or body part using a finger or standard goniometer. Sensory recovery of the replanted or revascularized part was measured using the static 2-point discrimination test. Results: A total of 86 patients from January 2005 to July 2010 suffered amputation or near amputation injuries that were referred to the Microsurgery Unit. Of these patients, 8 patients with 8 hand parts had replantation surgeries while 7 patients with 10 hand parts had revascularization surgeries. In total, there were 15 patients (14 males and 1 female) with an average age of 26.2 years old (range, 4-68 years old). The overall viability rate was 72.2% (62.5% for replantation surgery and 80% for revascularization surgery). The average follow-up of the patients who had a successful replantation procedure was 19 months (range, 3-48 months). Those who had successful revascularization procedures after partial or near amputation of the hand or fingers had an average of 7.3 months follow-up (range, 3-14 months). Functional Outcome: Four of the 12 patients had no functional results because of no recovery yet was expected on recent follow-up. In all digital replantations, stiffness was present even after 6 months post replantation. Of the 5 patients who had successful replantation surgery, only 4 had functional results. The best results were from the through wrist and through-palm amputations. Protective sensation was achieved in all tested patients. Conclusion: Successful replantation and revascularization surgery mainly depend on the mechanism of injury. Crush injuries tend to have poorer prognosis compared to guillotine type injuries. Replantation and revascularization surgeries require intensive post-operative rehabilitation to maximize the functional outcome. Key words: replantation, revascularization
Human ; REPLANTATION

We report an innovative approach to reconstructing the defect after excision of giant tumor cell (GCT) involving the entire first metacarpal. Reconstruction was performed using non-vascularized fibular autograft fused at the metacarpo-phalangeal (MP) joint and soft tissue arthroplasty using ligament reconstruction and tendon interposition (LRTI) at the carpo-metacarpal (CMC) joint of the thumb.

Two years after the procedure, the CMC joint had functional pain-free motion and radiographs showed fusion of the MP joint. The patient did not present with any major complication and was satisfied with the outcome of the procedure.

Human ; Female ; Young Adult ; Thumb ; Metacarpal Bones ; Autografts ; Metacarpophalangeal Joint ; Arthroplasty ; Tendons ; Finger Phalanges ; Ligaments ; Pain

INTRODUCTION: Trigger finger is one of the most common causes of hand pain and disability. Surgical treatment consists of release of the A-1 pulley by open or percutaneous techniques. Many authors have noted that percutaneous release is convenient and cost-effective with a low complication rate. Only few studies have published results on combination of percutaneous release and steroid injection. OBJECTIVE: To compare the differences of outcomes in adults with trigger finger treated with combination of percutaneous release and corticosteroid injection to those treated with percutaneous release alone METHODS: We included all patients older than 18 years old in the UP-PGH Department of Orthopedics with a diagnosis of trigger finger who have consented to participate in this study. They were randomized into two treatment groups. One group was treated with percutaneous release only and the other group was treated with combined percutaneous release and corticosteroid injection. Outcomes measured were total active motion (TAM), postoperative pain, time to return-to-work, patient satisfaction, and complications. RESULTS: Post-procedure, both groups showed significant improvement in motion of the fingers (p = 0.034) and pain relief (p = 0.001). TAM scores of the combination group were better compared to the control at all time intervals (p = 0.03, 0.008, 0.004, 0.019) and better pain VAS scores in the 1st week (p = 0.009). Patients who received the combination treatment showed a trend toward better patient satisfaction, shorter duration of post-release pain and earlier return-to-work. CONCLUSION: significantly improves TAM and pain VAS scores.
Trigger Finger Disorder ; Tendon Entrapment ; Steroids

OBJECTIVES:This study aims to determine demographics, job suitability, job satisfaction and perception among the administrative staff and research, extension and professional staff (REPS) of the University of the Philippines Manila College of Medicine.
METHODS:This is a descriptive study. A questionnaire was developed and administered to 71 administrative employees and Research, Extension and Professional Staff (REPS) to assess job profile, actual duties and responsibilities of the official job position/title during a period of five years from January 1, 2010 to December 31, 2014.
RESULTS:There are 71 employees of the University of the Philippines College of Medicine (UPCM), 61 administrative staff and 10 REPS. A majority (62%) have been with the UPCM for more than 15 years. Sixty-two employees had complete information and among these, 45 (72.6%) were hired for jobs related to their educational backgrounds. All employees underwent some form of training as part of staff development (2.56 courses/employee/year) and the staff recognized that these courses enhanced their ability to do their jobs (95.3%). However, the staff also feel that they attend many other courses (66.4% of courses attended) that are not directly related to their jobs, with only 33.6% of these courses having any bearing on the performance of their specific jobs. Survey results showed that job satisfaction and perception of the value of their work is generally high. However, sources of dissatisfaction include being assigned tasks by people other than their immediate supervisor, not enough time to do their jobs and duties assigned that are not within their job description.
CONCLUSION:Most employees of the UPCM have a high level of satisfaction with their jobs. Cited factors for this include job is essential to the organization as a whole. Some areas are seen to be sources of dissatisfaction. These include mismatch between training and actual duties, work assigned by people other than their supervisors, too little time allotted for the work assigned, and tasks expected of them that are not within their job descriptions.

Objective: The study aimed to determine if Blumea balsamifera inhibits calcium oxalate stone formation in the kidneys through determination of the number of calcium oxalate stones in the renal cortex and the percent mass of calcium oxalate. Methods: Post-test only control group design was used using five treatment groups with placebo as the negative control, potassium citrate as the positive control, and 50%, 100%, and 200% sambong treatment. Urolithiasis was induced through ethylene glycol and ammonium chloride. Each treatment group was administered its corresponding treatment solution once daily for twenty-one days. Histopathologic examination and kidney homogenate analysis were done to determine the degree of deposition of calcium oxalate stones in renal tissues and the oxalate content, respectively. Statistical analyses were performed using one-way ANOVA and post hoc Gabriel's Pairwise Comparisons Test. Results: The 100% sambong treatment group showed the least mean number of stones while the positive control and 50% sambong treatment group exhibited the highest anti-urolithiatic activity in terms of oxalate content of the kidney homogenate. Conclusion It can be concluded from the study that Blumea balsamifera inhibits calcium oxalate stone formation in the kidneys with the 100% and 50% sambong treatment most effective in decreasing number of stones and oxalate content of the kidney homogenate, respectively.
Urolithiasis ; Kidney

Objective: To determine the Disability Adjusted Life Year (DALY) weights of road traffic injuries and use the DALY weights in determining the total DALYs lost in Metro Manila using available data.

Methods: Consensus on DALY weights for each of the 31 International Classification of Diseases (ICD)10 codes related to road traffic injuries was done using Delphi Process. Experts from different fields were invited to participate in 2 rounds of discussion-and-scoring were done to obtain consensus were obtained for each DALY weight. Philippine Health Insurance Corporation (PHIC) data on the counts of the 31 ICD 10 coded claims for the years 2011, 2012, and 2013 were obtained and used to calculate the total DALY lost due to vehicular injuries for Metro-Manila.

Results: Road traffic related injuries affected mostly young people (mean 34 yo + 15) and affected mostly men (81%). There were a total of 3,199 injuries seen in 2,573 patients. 98.1% of the patients had a < 1 year type of injury with an average disability weight of 0.34154 and a total DALYs lost of 300.4. 0.5% of the patients had a ? 1 year type of injury with an average disability weight of 0.2726 and a total DALYs lost of 218.08.1.4% of the patients most likely died from their injuries earning a total DALYs lost of 1,440.The sum of DALYs lost is equivalent to a total of 1,958.12.

Conclusion: The Metro Manila loses roughly Php 76.6 Million per year due to road traffic injuries and accidents. These events are highly preventable. Without proper interventions, road traffic injuries may lead to impoverishment of the young families who pick up the pieces, or are left behind.

Human ; Quality Of Life