I am sharing with you the first issue of the Philippine Journal of Pathology for 2021, our tenth issue since we breathed life into our society publication in 2016. We have two case reports of gynecologic tumors, and an autopsy case of a disseminated hematolymphoid malignancy. Four original articles include a molecular pathology study for lung cancer, a real-world observational study on pooled testing among asymptomatic individuals, a cost effectiveness study on diagnostics for leukemia in the Philippines, and a 5-year soft tissue tumor review. On top of these, we are featuring a new section – Opinion, and we have on board, Dr. Raymundo Lo, to regularly provide his take on issues relevant to our profession and practice. This issue also comes alive with the inclusion of the entries and winners of the PSP 69th Annual Convention Photomicroscopy Contest sponsored by Omnibus Biomedical Systems.
Editorial ; Pathology ; COVID-19

Human ; Male ; Adult ; Heart Failure ; Dwarfism ; Patients ; Electrocardiography ; Asthma

This patient is a 38 year old housewife who has been hypertensive and hypokalemic since age 23. She suffered her first stroke at age 32 and a seizure just one week prior to admission. This paper will discuss the clues to the diagnosis of secondary hypertension.
Human ; Female ; Adult ; HYPERTENSION ; CARDIOVASCULAR DISEASES ; VASCULAR DISEASES ; HYPOKALEMIA ; NUTRITIONAL AND METABOLIC DISEASES ; METABOLIC DISEASES ; WATER-ELECTROLYTE IMBALANCE ; MUSCLE WEAKNESS ; SIGNS AND SYMPTOMS ; PATHOLOGICAL CONDITIONS, SIGNS AND SYMPTOMS ;

The COVID-19 pandemic highlighted critical gaps in the Philippine health laboratory system, including limited testing capacities, insufficient trained personnel, and inadequate resource distribution. To address these issues, the Philippine government established the Office for Health Laboratories (OHL) and sought technical assistance from the Japan International Cooperation Agency (JICA) through the Project for Strengthening the Philippine National Health Laboratory Network for Infectious Diseases (PHeLNIDs). This project aims to enhance the National Health Laboratory Network's (NHLN) capacity for infectious disease surveillance and response. Phase 1 of the PHeLNIDs project included focus group discussions (FGDs) conducted across 17 regions to assess challenges and develop recommendations for a tier-based laboratory network. Key findings revealed logistical, workforce, transportation, and data management challenges that hinder the effectiveness of specimen referral workflows. Recommendations emphasized decentralizing diagnostic capabilities through subnational reference laboratories, strengthening logistics, and implementing an Integrated Laboratory Information Management System (ILIMS). This article underscores the importance of laboratory decentralization, capacity building, and improved resource management to enhance laboratory-based surveillance and response to emerging infectious diseases. The proposed interventions aim to bolster the Philippine laboratory network, reduce turnaround times, and improve public health outcomes.

Background and Objectives: Sample pooling of COViD-19 PCR tests has been recently proposed as a low-cost alternative to individual tests. This multi-site, laboratory-based, proof-of-concept study explores the feasibility of pooled SARS-CoV-2 RT-qPCR testing, by demonstrating the effect of pooling on sensitivity, specificity, accuracy, number of tests saved, and turnaround time. Methodology: The research was conducted in two experiments. In Experiment 1, archival nasopharyngeal (NPS) and oropharyngeal (OPS) swab samples were diluted to simulate 5, 10, and 20 sized pools, and tested for SARS-CoV-2 RNA using RT-qPCR. In Experiment 2, actual nasopharyngeal and oropharyngeal swab samples were collected from asymptomatic low-risk volunteers. Aliquots of the samples were pooled following the 5, 10-5, and 20-10-5 multi-staged Dorfman pooling methods and tested. The sensitivity, specificity, accuracy, test savings, and turnaround time for each pooling method were documented. Results and Conclusions The study provided evidence that pooling of NP and OP samples for SARS-CoV-2 RNA detection using RT-qPCR is feasible and can be implemented in the Philippines. A 2-stage Dorfman 5 pooling strategy appears to be the best method, because it has the highest over-all accuracy, while still achieving acceptable test savings, and turnaround time. Pooling of nasopharyngeal and oropharyngeal swab samples prior to RT-qPCR testing may be considered by select molecular diagnostic laboratories to further increase testing capacity and at the same time reduce the cost of testing.
COVID-19 ; SARS-CoV-2