OBJECTIVE: Endoscopic third ventriculostomy (ETV) has been shown to be a sufficient alternative in the surgical treatment of hydrocephalus. Our goal in this retrospective study is to analyze our results with the use of ETV in our first 30 cases that it may provide us with selection criteria as to who among our patients will benefit most from this procedure.
METHODOLOGY: Thirty ETVs were performed in 30 patients. Their ages ranged from 2-155 months. Hydrocephalus was caused by aqueductal stenosis in 17 patients, tumors in 7, post-infectious in 3, Dandy-Walker malformation in 2 and arachnoid cyst in 1 patient. The outcome of ETV was evaluated in 26 of the cases that were available for follow-up
RESULTS: The overall success rate was 69.2 percent. Patients with non-communicating hydrocephalus from post-infectious causes, tumors and aqueductal stenosis had high success rates. Patients less than 6 months of age had a poor outcome. Complications included ventriculitis in 1 patient
CONCLUSION: ETV is a viable treatment option for non-communicating hydrocephalus secondary to post-infectious cause, aqueductal stenosis and tumors. A successful outcome is more likely if ETV is done in patients more than 6 months of age Patients who have previously undergone shunting and who have non-communicating hydrocephalus should undergo ETV at the time of shunt failure. These patients showed good outcome.

Human ; Male ; Female ; Infant ; Ventriculostomy ; Dandy-walker Syndrome ; Arachnoid Cysts ; Hydrocephalus, X-linked ; Hydrocephalus ; Cerebral Aqueduct ; Genetic Diseases, X-linked

X-linked dystonia parkinsonism (XDP) is a rapidly progressive and disabling neurodegenerative disease affecting mainly male Filiponos with origins from Panay Island. We reviewed all the past neurosurgical ablative procedures done for XDP patients listed in the Philippine XDP registry. From 1960 to 1982, six patients had undergone bilateral chemopallidotomies or bilateral thalomotomies stage over time. Half of these patients had significant improvement in their symptoms but five of the six patients (83%) developed postoperative morbidities, mainly speech impairment or hemiparesis, All the five reported GPi deep brain stimulation (DBS) cases for XDP were also reviewed, showing consistently immediate improvement of symptoms (61.5%-88.3% decrease in the Burke-Marsden Dystonia Rating Scale) lasting up to a year with effects noted. We also present the first Philippine case of GPi DBS done in the youngest XDP patients to date. This present case showed dramatic improvement(83.3% desrease of the Burke-Marsden_Fahn Dystonia Rating Scale) of his dystonic symptoms, without incurring any persistent adverse effects. The results of these early cases of pallidal DBS for XDP show that DBS is generally a safe and effective procedure for alleviating the disabling symptoms of XDP in contrast to previous ablative surgeries on these patient

Human ; Male ; Adult ; Deep Brain Stimulation ; Dystonia ; Dystonic Disorders ; Genetic Diseases, X-linked ; Globus Pallidus ; Diseases Neurodegenerative Diseases ; Paresis ; Parkinsonian Disorders

OBJECTIVE: To correlate glycemic control, as expressed by HbA1c levels, to the change in macular thickness in diabetic patients who undergo phacoemulsification.

METHODS: This was a prospective cohort study done at the Cataract and Medical Retina Clinics of the University of the Philippines Department of Ophthalmology and Visual Sciences (UP-DOVS), Sentro Oftalmologico Jose Rizal (SOJR) of the Philippine General Hospital, University of the Philippines - Manila. Participants included 15 diabetic patients with mature cataracts that warranted lens extraction surgery via phacoemulsification by a senior resident of the UP-DOVS. Participants were screened using pre-determined inclusion and exclusion criteria. Pre-operative best corrected visual acuity (BCVA) was obtained for both eyes using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Pre-operative central macular thickness (CMT) was measured using the Cirrus Ocular Coherence Tomography (OCT) machine. Patients then underwent monocular phacoemulsification by their respective surgeons and instilled antibiotic and steroid drops as instructed. One month after surgery, BCVA and post-operative CMTwere measured. Blood was extracted and sent for determination of glycosylated hemoglobin (HbA1c) levels. Ttest was done to compare the mean CMT and BCVA at baseline and at 1 month after phacoemulsification in the study and control eyes. T-test was also used to compare the mean change in CMT in the study and control eyes. Simple correlation between HbA1c and CMT, as well as CMT and BCVA, was done using Pearson's R.

RESULTS: Neither mean baseline nor mean post-operative CMT between study and control eyes were statistically different  and p=0.1562). There was a statistically significant greater mean CMT in the study eye group (p=0.004). There was a mean change in CMT of 16.7 ± 18.5 ?m, and 1.8 ± 8.8 ?m in the group of control eyes (p=0.011). Mean HbA1c was 8.19%. No positive correlation was established between HbA1c and mean CMT in both study eyes (r=-0.312) and control eyes (r=-0.289). No correlation was established between BCVA and CMT (r=0.426).

CONCLUSION: In diabetics, eyes that undergo phacoemulsification gain a significant change in CMT but this may not necessarily result in macular edema and may not parallel the severity of diabetic retinopathy. We were not able to demonstrate correlation between CMT and HbA1c levels or CMT and BCVA.

Human ; Male ; Female ; Aged ; Middle Aged ; Macular Edema ; Diabetic Retinopathy ; Phacoemulsification ; Hemoglobin A, Glycosylated ; Ophthalmology ; Anti-bacterial Agents ; Cataract ; Retina ; Visual Acuity

INTRODUCTION: Unregulated biomedical waste management is an emerging public health problem in the Philippines. This study aimed to differentiate the knowledge, attitudes, and practices of nurses and medical technologists toward biomedical waste management. METHODS: Using an analytic cross-sectional study design, an online survey of nurses and medical technologists from hospitals around the Philippines was conducted. A 27-item questionnaire covering knowledge, attitudes and practices was used. The percentages of correct answers and mean scores in each domain was compared between the nurses and medical technologists. RESULTS: A total of 196 respondents consisting of 77 registered nurses and 119 medical technologists were included in the study. Medical technologists had significantly better knowledge scores than nurses on disposal procedures for expired blood units and by-products waste (55% vs. 19%, p = 0.026). Both had low correct responses on adequate disposal of human tissue remains, throwing blood waste into domestic waste, and throwing of expired medications in domestic waste. There was no significant difference in the attitude of nurses and medical technologists. Nurses had significantly better practice scores on disposal of liquid waste in bags (84.4% vs. 68.9, p = 0.018), but medical technologists fared better at disposal of human tissue together with other waste (13.0% vs. 2.5%, p = 0.006). CONCLUSION Both nurses and medical technologists had adequate knowledge of some aspects but were lacking in others. There was no significant difference in the attitude of nurses and medical technologists towards biomedical waste management. Half of the respondents practiced proper biomedical waste management.
Medical Laboratory Personnel ; Waste Management ; Knowledge ; Attitude

Background: and Purpose Visual hallucinations (VH) and subjective cognitive complaints (SCC) are associated with cognitive impairment (CI) in Parkinson’s disease. Our aims were to determine the association between VH and SCC and the risk of CI development in a cohort of patients with Parkinson’s disease and normal cognition (PD-NC). Methods: Patients with PD-NC (total score of >80 on the Parkinson’s Disease Cognitive Rating Scale [PD-CRS]) recruited from the Spanish COPPADIS cohort from January 2016 to November 2017 were followed up after 2 years. Subjects with a score of ≥1 on domain 5 and item 13 of the Non-Motor Symptoms Scale at baseline (V0) were considered as “with SCC” and “with VH,” respectively. CI at the 2-year follow-up (plus or minus 1 month) (V2) was defined as a PD-CRS total score of <81. Results: At V0 (n=376, 58.2% males, age 61.14±8.73 years [mean±SD]), the frequencies of VH and SCC were 13.6% and 62.2%, respectively. VH were more frequent in patients with SCC than in those without: 18.8% (44/234) vs 4.9% (7/142), p<0.0001. At V2, 15.2% (57/376) of the patients had developed CI. VH presenting at V0 was associated with a higher risk of CI at V2 (odds ratio [OR]=2.68, 95% confidence interval=1.05–6.83, p=0.039) after controlling for the effects of age, disease duration, education, medication, motor and nonmotor status, mood, and PD-CRS total score at V0. Although SCC were not associated with CI at V2, presenting both VH and SCC at V0 increased the probability of having CI at V2 (OR=3.71, 95% confidence interval=1.36–10.17, p=0.011). Conclusions VH were associated with the development of SCC and CI at the 2-year follow-up in patients with PD-NC.

OBJECTIVE

This study compared the demographics, clinical profile, treatment, and outcomes of retinoblastoma patients seen at medical institutions in the Philippines between two time periods: 2010 to 2015 and 2016 to 2020.

METHODS

This was a multicenter, analytical, cohort study using review of medical charts and databases of retinoblastoma patients seen in 11 medical institutions from 2010 to 2020.

RESULTS

There were 636 patients (821 eyes) included in this study: 330 patients were seen in 2010 to 2015 while 306 in 2016 to 2020. More cases per annum were seen in the latter timeline. The number of patients with unilateral disease was not significantly different between the two time periods (p=0.51). Age at onset of symptom, age at initial consultation, and delay in consult were also not significantly different between the two time periods (p > 0.05). Patients had significantly different distributions of intraocular grades (p < 0.0001) and systemic staging (p < 0.0001) between the two time periods. Enucleation was the most common surgical treatment performed in both timelines. There was significant difference in the status of patients based on the need for systemic chemotherapy (p < 0.01). There was significant difference in outcome between the two time periods, including the proportions of living and deceased patients.

CONCLUSION

This study compared the most comprehensive data on retinoblastoma patients in the country. There was no improvement in early health seeking behavior based on similar age at initial consult and delay in consult. Enucleation remained the most common treatment mode as opposed to chemotherapy due to similar percentage of patients with unilateral disease, an indication for enucleation rather than chemotherapy.

Human ; Retinoblastoma ; Philippines ; Epidemiology ; Treatment ; Therapeutics