BACKGROUND AND OBJECTIVE

Oral ivermectin, a broad-spectrum anti-parasitic drug, alone or in combination with permethrin, may be a cheaper and more convenient alternative drug to topical permethrin alone in the treatment of classic scabies. There are no previous studies on the treatment acceptability of the three interventions among individual patients with scabies in the Philippines. The purpose of this study was to understand the experiences and perceptions on treatment acceptability for oral ivermectin, topical permethrin or combination treatment among patients with scabies using the multiple-case study approach.

We conducted a qualitative multiple case study among adult Filipino patients with classic scabies who were prescribed oral ivermectin, topical permethrin or its combination at a government tertiary hospital dermatology outpatient clinic from December 2022 to September 2023. Semi-structured interviews were used as the primary source of data and analyzed together with chart reviews, Dermatology Life Quality Index (DLQI) scores, and clinical images. Interviews were transcribed, coded, and triangulated with other secondary data. A three-person research team employed a reflexive and iterative process of familiarization, coding, and thematic analysis using a modified Theoretical Framework of Acceptability (TFA) to generate case descriptions, within-case analyses, and cross-case syntheses.

The acceptability of scabies treatments (permethrin, ivermectin, and combination therapy) was generally positive. Permethrin, used in three patient cases, was generally perceived as effective but itch relief varied. The burden of whole-body application of permethrin was context-dependent, influenced by living arrangements and family support. Perceived affordability of permethrin was linked to socioeconomic status. Ivermectin, used by one patient case, was perceived as highly effective with no side effects. Its single dose use did not interfere with patient routine. Combination therapy was also considered effective but potential antagonistic effects and the cost of adding permethrin made it less preferred. Reluctance in taking oral pills was noted. All patients valued medical advice and deferred to their physicians for treatment decisions.

All three treatment options were considered effective and safe. Patients generally preferred permethrin over oral ivermectin due to its topical nature and perceived lower side effects. However, affordability and logistical challenges, especially for large households and low-income families, were noted with permethrin. Oral ivermectin elicited hesitation due to its controversial role in COVID-19 and veterinary use. Concerns about added costs and potential antagonism in combination therapy were raised. Despite these considerations, patients ultimately relied on physicians for treatment decisions. This study underscores the importance of understanding patient perspectives, experiences, and the patient-physician relationship in choosing scabies interventions. Addressing patient concerns, providing education, and ensuring ease of use and affordability can enhance treatment acceptability and adherence for better outcomes.

OBJECTIVE: To present two cases in which an improved rhombotrapezius flap design was utilized maximally to cover a wide and deep surgical defect after extirpation of a malignant tumor in the temporo-facial area. SETTING: Tertiary Hospital. PATIENTS AND METHODOLOGY: Two cases of malignancy involving the temporo-facial area of the head are presented. Surgical design for the reconstruction of this defect using rhombotrapezius flap is presented. RESULTS AND DISCUSSION: Large and deep temporo-facial defects are adequately closed by rhombotrapezius flap with adequate tissue coverage. Surgical design proved to be acceptable with good flap take and overall cosmetic result. CONCLUSION: Rhombotrapezius flap can be used to cover a large deep defect and can provide more than adequate tissue coverage and bulk to any temporo-facial defects. (Author)
CASE REPORTS

BACKGROUND

From 2013 to 2021, the University of the Philippines Community Health and Development Program (UP CHDP) was in partnership with Cavite and its five municipalities of Alfonso, Mendez, Indang, General Emilio Aguinaldo, and Amadeo (AMIGA). They aimed to improve the control of hypertension and diabetes through interventions such as the organization of community health clubs, as recommended by the Department of Health in 2016. Currently there is limited information on the experiences and outcomes related to this strategy. Data on this can help the community and public health institutions in understanding and maximizing the benefits of organizing community health clubs for noncommunicable disease control.

This study aimed to determine a community health club’s membership profile, its organization and maintenance processes, and the benefits, challenges, and enabling factors experienced.

This case study-mixed method was done in 2020 on the Challengers Health Club in Alfonso, Cavite. Group interviews of the club officers and barangay health workers were conducted to explore the club processes, their perceived benefits, challenges, and enabling factors. Health records were reviewed to determine the club’s membership profile.

The community health club showed an increase in membership since it was established. Most members are elderly, female, non-smoker, and hypertensive. There was increase in proportion of members with controlled hypertension after two years. However, this was not observed among those with diabetes. Perceived benefits for members were free, regular, and accessible services, improved knowledge and better control of their condition, and opportunity to socialize with others. Enabling factors were partnership with UP, teamwork and dedication of club leaders, effective management, and community support. The limited funding and supply of medicines, discontinuation of deployment of UP partners, and the COVID-19 pandemic were the challenges identified by the club.

This study described the experiences of a community health club established to control hypertension and diabetes. Benefits of this intervention were reported despite the challenges they encountered because of the support mechanisms that were in place.
 

Report a case of patient Tran Đ.V. born at December 26th 2002 in Ninh Thuan district, Khanh Hoa province, admitted hospital at November 25th 2003 due to hirsutism and developed genitalia. Ultrasound and CT scan examinations showed a mass in his right adrenal gland, which was subsequently removed surgically. The histopathological findings were consistent with an adreno-cortical carcinoma. This is a rare tumor with frequency 1/10.000 adrenal tumors in adult. In children, there are some cases and most frequently in girls. Adreno-cortical carcinoma combining with isosexual precocious pseudopuberty is rarer in boys
Puberty, Precocious ; Case Reports

Study on 3 cases of splenic tuberculosis with HIV(-), without pulmonary lesions, treated in Pham Ngoc Thach Hospital of Ho Chi Minh city. Among them, the first one might be a single splenic tuberculosis patient, because there was not any lesion in other areas; the second case was glandular tuberculosis combined with splenic tuberculosis; the third case perhaps was splenic tuberculosis combined with symptoms of tuberculous meningitis occurred 15 days after splenectomy. All 3 cases had major symptoms including mild fever and dull pain in left slope lasting from several months to a year. Ultrasound and abdominal computed tomography scan (CT-scan) showed numerous lesions in the spleen with <2cm size and unspecific decreased dark level with or without big spleen, however, dark increased area should be seen in ultrasound. 2/3 cases of splenectomy with pathological results was splenic tuberculosis, one case was not indicated surgery, making biopsy found a glandular tuberculosis. Splenic tuberculosis treatment with regime of anti-tuberculosis drug during 12 months was suitable
Tuberculosis, Splenic ; Case Reports

OBJECTIVES: This case report aims to (1) Present the differential diagnosis of chronic cough without neglecting uncommon causes (2) Increase awareness of diagnostic challenges that may arise in the face of a compromised airway (3) Elucidate the therapeutic complexity of airway management; (4) Emphasize the value of a multi-disciplinary team approach in such cases; Illustrate the vital role otolaryngologists play in the diagnosis and management of airway problems DESIGN: Case Report SETTING: Tertiary Care Hospital in Quezon City, Philippines PATIENTS: One Patient RESULTS: This is the case of an eleven-year old male that presented with chronic cough that was refractory to conventional empiric medical therapy. As his symptoms progressed, further evaluation revealed a mass that was obstructing a large portion of the airway. Timely and methodical investigation and intervention proved to be life-saving. CONCLUSION: A working knowledge of the differential diagnoses of chronic cough is crucial in the diagnosis and management of the compromised airway. A high index of suspicion, systematic and thorough investigation and a multi-disciplinary approach are vital components of the treatment plan. Bronchoscopy in the hands of a skilled practitioner is still a diagnostic and therapeutic mainstay. (Author)
CASE REPORTS [PUBLICATION TYPE]

Objective: To describe a novel harpoon design for a low cost, self retaining tympanostomy tube with applicator used in a 38-year-old female for otitis media with effusion. Methods: a. Study design: Instrumental Innovation/Case Report b. Setting: Tertiary Hospital in Metro Manila Results: The tympanostomy tube was inserted under endoscopic guidance within 10 seconds, remained in place for two months with relief of symptoms, and spontaneously extruded by the seventh month of follow-up. Conclusion: The harpoon-designed tube with applicator provided ease of insertion and good anchorage in the tympanic membrane. Maximizing the use of a stylet-needle as both perforator and applicator simplified the tympanostomy and ventilating tube insertion procedures into a single maneuver. (Author)
EAR VENTILATION CASE REPORTS

Case reports remain to be an essential part of knowledge generation in health care. It is a research design that involves writing about a patient’s illness with either an unusual, new, unexpected, or unique characteristic. It can be about new findings, a novel diagnostic test, unfamiliar adverse events or innovative medical and surgical interventions. It is a detailed description of a patient’s course of illness including symptoms, physical examination findings, laboratory results, treatment modalities and outcomes. The essential element of writing a case report or series is to contribute to the generation of new knowledge. Wellwritten manuscripts have a valuable purpose in medicine as they present new illness, unexpected effects of treatment, novel diagnostic exams or unforeseen patients’ outcomes. The sections of a case report include an Abstract, Introduction or Background, Case Presentation [history, physical examinations, investigations or laboratories, differential diagnosis (if relevant), treatment (if relevant), outcome/follow-up, Discussion, Learning points/Take home messages, Patients perspectives and References. Manuscripts written as case reports or case series by nature of their design are not required to get approval from an Ethics Review Board (ERB). However, there should be an institutional process to clear and register papers. Case reports or a case series has its own distinctive writing components and features as not all single or series of clinical cases are reportable. This article aimed to define case reports/series, describe the different parts, how to write and evaluate a case report manuscript using the CARE guidelines.

From the year 1985 – 1997, 250 cases of corneal transplatation were reviewed. The diameter of grafted cornea varied from 8-15mm, among them 113 cases of graft larger than 10mm. After the operation, visual acuty was improved in almost patients. In the case of internal therapy is impossible, this surgery is the only approach to save the eyeball, moreover, the optical function was restored significantly. In the case of progressive infection, which is not responded to the therapy, threatening the eyeball corneal transplantation must be indicated early.
Corneal Transplantation ; Case Reports ; Epidemiology

Ultrasound cross-sectional prospective investigation on 16 patients with Dengue fever, showed that 15/16 cases, gall bladder wall thickness was a factor of prognosis, standard for patients with high risk of volume dropping shock related to kidney syndrome, 12/16 cases with abdominal cavity fluid, 7/16 cases there was perirenal collection of fluid, 3/16 cases of fluid subcapsular collection in the liver, pleural effusion. In addition, there may be large pancreas and spontaneous rupture of the kidney.
Dengue/ultrasonography ; Case Reports ; Gallbladder