Background: Cholesterol is an important biomolecule for cells. However, because of certain lifestyle, the amount of cholesterol can increase beyond what our bodies can consume. Increased intake may result in the accumulation of cholesterol in the blood leading to atherosclerosis that can lead to congestive heart failure. With the use of statins, cholesterol levels are reduced therefore lowering the risk for this disease. It does so by inhibiting the hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase, the first committed enzyme in cholesterol biosynthesis. In light of the increasing cases of hypercholesterolemia, there is a need to discover novel classes of HMG-CoA inhibitors. Objective: The primary objective of this study was to screen extracts of leaf-associated fungi for their capacity to inhibit hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase, the first committed enzyme in cholesterol biosynthesis. Methods: Eight (8) plants were sampled for the fungal epiphytes and endophytes on their leaves. The fungal isolates were identified by sequencing the internal transcribed region (ITS) of the 18S rDNA. All fungal isolates were cultured in 20 flasks containing 300 mL potato dextrose broth at 30°C for 14 days. The culture broths were then subjected to reduction in volume using a rotary evaporator. HMG-CoA reductase inhibition assay was carried out using the ethyl acetate extracts from the culture broths. Reagent grade pravastatin was used as the positive control. Results: There were a total of sixty-six (66) fungal taxa that were tested for their capacity to inhibit the enzyme HMG-CoA reductase. Of the 50 that tested positive, there were 25 families represented and 5 isolates were of uncertain status taxonomically (incertae sedis). There were also nine classes that were represented and the class with the most number of isolates was Sordariomycetes. The highest percentage inhibition was observed in Pestalotiopsis lespedezae with 65.01 % inhibition. The other fungi with notable inhibitory activities were Colletotrichum cymbidiicola (64.16%) and Schizophyllum commune (57.85%). Conclusions This study may be the first report of production of HMG-CoA reductase inhibitors in the genus Colletotrichum and in the other leaf-associated fungal taxa that tested positive for HMG-CoA reductase inhibition. It is therefore very promising that a novel statin compound, or even a new class of substances with antihypercholesterolemic bioactivity may be discovered from these leaf-associated fungal isolates. The crude extracts of these fungi are prime candidates for downstream fractionation for the subsequent isolation and structure elucidation of the bioactive compound.
Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Endophytes ; Cholesterol

With the onset of a metabolic syndrome epidemic and the increasing life expectancy, erectile dysfunction (ED) has become a more common condition. As incidence and prevalence increase, the medical field is focused on providing more appropriate therapies. It is common knowledge that ED is a chronic condition that is also associated with a myriad of other disorders. Conditions such as aging, diabetes mellitus, hypertension, obesity, prostatic hypertrophy, and prostate cancer, among others, have a direct implication on the onset and progression of ED. Characterization and recognition of risk factors may help clinicians recognize and properly treat patients suffering from ED. One of the most reliable treatments for ED is penile prosthetic surgery. Since the introduction of the penile prosthesis (PP) in the early seventies, this surgical procedure has improved the lives of thousands of men, with reliable and satisfactory results. The aim of this review article is to characterize the epidemiology of men undergoing penile prosthetic surgery, with a discussion about the most common conditions involved in the development of ED, and that ultimately drive patients into electing to undergo PP placement.
Diabetes Complications/surgery* ; Diabetes Mellitus/epidemiology* ; Erectile Dysfunction/surgery* ; Humans ; Hypertension ; Impotence, Vasculogenic/surgery* ; Male ; Pelvic Bones/injuries* ; Penile Implantation/statistics & numerical data* ; Penile Induration/surgery* ; Penile Prosthesis ; Penis/injuries* ; Prostatectomy/adverse effects* ; Prostatic Neoplasms/surgery* ; Radiation Injuries/surgery* ; Radiotherapy/adverse effects* ; Reoperation ; Spinal Cord Injuries/epidemiology* ; Vascular Diseases/epidemiology* ; Wounds and Injuries/epidemiology*

Objective: This study described the demographics of pediatric patients who sustained open globe injuries, determined the visual outcome of open globe injuries in pediatric patients and the factors associated with final visual acuity. Methodology: The medical charts of 195 patients aged 0-18 years seen for open globe injury in a Philippine tertiary hospital for three years were reviewed. Results: The average age of patients was 7.9 years with 41% belonging to the 5-9 years old group. Seventy-five percent (75%) of the patients were males. Ninety-five percent (95%) of the open globe injuries were accidental, mostly from play (67%). The most common agents of injury were metallic objects (42%) followed by wooden objects (24%). The cornea was injured in 80% of the cases, cornea and sclera in 10%, sclera in 7%, and globe rupture in 3%. Eighty-six percent (86%) of the patients underwent surgery. Initial visual acuity was associated with the presence of complication and the site of injury. Final visual acuity was associated with the initial visual acuity, the interval from injury to consultation, the site of injury, and the presence of complications. Conclusions The majority of the injuries were accidental and thus avoidable. The education of parents and caregivers on proper storage of potentially harmful objects at home and proper supervision of children at play are important in addition to early consultation after the injury as well as a timely intervention.
Child

Objectives: The highly polymorphic nature of the CYP2D6 gene and its central role in the metabolism of commonly used drugs make it an ideal candidate for pharmacogenetic screening. This study aims to determine the prevalence of CYP2D6 polymorphisms among Filipinos and their association to lung cancer. Method: Forty seven single nucleotide polymorphisms (SNPs) of the CYP2D6 gene were genotyped from DNA samples of 115 cases with lung cancer and age- and sex-matched 115 controls. Results: Results show that 18 out of 47 polymorphisms have significant genotypic variability (>1% for at least 2 genotypes). No variant is associated with lung cancer. However, rs1135840, rs16947 and rs28360521, were found to be highly variable among Filipinos. Conclusion This study demonstrated that CYP2D6 polymorphisms are present among Filipinos, which, although not found to be associated with lung cancer, can be useful biomarkers for future pharmacogenetic studies. The SNP rs16947 is found to be associated with cancer and timolol-induced bradycardia; the SNP rs1135840, on the other hand, is only shown to be linked with cancer. The genetic variant rs28360521 is known to be associated with low-dose aspirin-induced lower gastrointestinal bleeding.
Pharmacogenetics ; Cytochrome P-450 CYP2D6 ; Lung Neoplasms ; Biomarkers

Background: Nasopharyngeal swab/oropharyngeal swab (NPS/OPS) qRT-PCR is the gold standard for detecting SARS-CoV-2. However, it has its own limitations including cost and invasiveness. As an alternative, individual qRT-PCR testing of saliva samples was validated and shown to be comparable in sensitivity and specificity with NP-OP qRT-PCR. To further maximize its utility, the researchers wish to explore antigen and pooled testing methods. Objective: The study aimed to evaluate the diagnostic accuracy of detecting SARS-CoV-2 infection using saliva-based pooled qRT-PCR and rapid antigen test compared with individual saliva qRT-PCR. Methodology: In this retrospective cross-sectional study, saliva specimen from individuals aged 18 years old and above from the outpatient specimen collection station at the Philippine Children’s Medical Center were tested individually using qRT-PCR (Mag-bind RNA Extraction Kit/MACURA, Allsheng Extraction Machine, Sansure PCR kit, and MA-600 Sansure Biotech). Non-probability convenience sampling was utilized. Based on the individual results, pools of five (5) individual specimens, which includes one (1) positive sample were tested with qRT-PCR for sensitivity. DNK-2150-1S Dynamiker SARS-CoV-2 Ag Rapid Test (Dynamiker Biotechnology Co., Ltd., Tianjin, China) was also used to test individual saliva specimens. . Out of 196 individual saliva specimens, 73 were detected to have SARS-COV-2 by qRT-PCR, while the remaining 123 were negative. Compared with the individual saliva qRT-PCR, rapid antigen tests done showed sensitivity of 46.58% (95% CI 35.13%, 58.02%), specificity of 86.18% (95% CI 80.08%, 92.28%), positive and negative predictive value of 66.67% (95% CI 53.71%, 79.60%) and 73.10% (95% CI 65.89%, 80.32%) respectively. Based on the results of individual saliva-based qRT-PCR, 62 pools were tested and showed sensitivity of 98.39% (95% CI 91.34%, 99.96%). Conclusion and Recommendation Pooled saliva-based testing for SARS-CoV-2 is comparable with individual saliva-based rapid antigen testing. The use of rapid antigen testing is less sensitive and less specific compared with qRT-PCR consistent with prior reports. Additional studies are recommended to determine optimal conditions for testing.
SARS-CoV-2 ; COVID-19

Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.