INTRODUCTION

Acute coronary syndrome (ACS) and end-stage renal disease (ESRD) are both prevalent globally. The diagnosis and management of ACS in ESRD is difficult because the interplay of cardiovascular and renal disease is complicated. The guidelines for ACS may not be applicable to the ESRD population because the trials from which these are drawn mostly excluded ESRD patients.

To determine the clinical profile and outcomes of CKD patients on dialysis admitted for ACS in the Philippine General Hospital (PGH).

We did a retrospective cohort study and employed a retrospective review of electronic medical records among ESRD patients presenting with ACS in PGH from May 2021 to November 2023. The collected data was analyzed using univariate and bivariate statistics using PRISM software.

A total of 48 patients with ESRD were admitted for ACS in this study – 8 with STEMI and 40 with NSTEMI. The mean age was 61 years old and 33 (68.8%) were male. Among those with STEMI, six (75%) presented with Kilip II or more. While among those with NSTEMI, 17 (42.5%) had a GRACE score >140 and 27 (67.5%) had an NSTEMI TIMI risk score >2. On average, the patients were on hemodialysis for 31 months prior to admission. The most common comorbidities were hypertension (91.7%) and heart failure (83.3%). On admission, 18 (37.5%) presented with SBP >160, 7 (14.6%) patients presented with shock, and 4 (8.3%) patients presented with cardiac arrest. 38 (79.2%) patients had anemia on admission. 21 (43.8%) patients had left ventricular hypertrophy on electrocardiogram while 34 (70.8%) patients had cardiomegaly on chest radiography. The average left ventricular ejection fraction on echocardiogram was 46% and 27 (90%) patients had segmental wall motion abnormalities. The most common angiographic finding was 3-vessel coronary artery disease seen in 50% of patients. Almost all patients received dualantiplatelet therapy, high dose statin, and beta-blocker. The mortality rate was high at 43.8% with cardiovascular causes being the most common cause of death.

This study demonstrates the high mortality rate among patients with ESRD presenting with ACS. Our study portrays that patients with ESRD present with higher risk features including abnormalities in vital signs, laboratories, imaging, high prognostications score, and high in-hospital morbidity.

OBJECTIVE

Given that rabies remains endemic in the Philippines despite government interventions and the pandemicrelated restrictions have hampered its surveillance, this study aimed to estimate the effect of human population, anti-rabies vaccination efforts, and COVID-19 situation on the spread of rabies cases in the districts of Davao City, Philippines.

A retrospective study of the canine records at Davao City Veterinarians’ Office was done from January 2018 to June 2021. Monthly rabies cases were ascertained, and the effect of the human population, COVID-19 season, and vaccination ratio on rabies cases was estimated using panel regression models adjusting for confounding factors.

The reporting of rabies cases was lower during COVID-19 than during the non-COVID-19 season, with an IRR of 0.52 [95% confidence interval (CI): 0.33–0.82]. Furthermore, rabies cases increased by 2.23% (95% CI: 0.60–3.89) per 1% increase in vaccination ratio. Additionally, high-population districts recorded more rabies cases than low-population districts.

Consistency in monitoring rabies cases during the pandemic is suggested as a roadmap for future program initiatives. Vaccination efforts should be reinforced to increase rabies awareness and ensure early response to emerging diseases. Moreover, highpopulated districts should be prioritized in implementing rabies control interventions to gain optimal development.

BACKGROUND AND OBJECTIVE

Rabies continues to be a challenge in Davao City despite the efforts of the city’s local government to vaccinate primarily the non-stray dog population. Meanwhile, studies have shown that time-dependent vaccination strategy is considered a prime factor for a cost-effective rabies control strategy. Hence, this study aims to provide information that will determine the optimal vaccination strategy targeted to the stray dog population that minimizes the rabies-infected dog population and vaccination costs using optimal control theory (OCT).

OCT is used to identify the optimal level of key rabies control, i.e., vaccination. Here, OCT was applied to a modified Susceptible-Exposed-Infectious-Vaccinated (SEIV) compartmental model. The study's key parameters were derived from published articles on rabies in Davao City and similar regions, along with the city's rabies reports.

The findings revealed that while rabies remains endemic in the city, it is possible to reduce the number of cases through consistent implementation of vaccination programs to the exposed and susceptible dog populations. Nevertheless, the feasibility of these findings relies to the effective targeting of vaccine coverage for the dog population. From the simulations performed, the exposed dog population (i.e., pre-rabid dogs) was able to reach zero observation when the transmission rate (?) is 0.001 for all values of anti-rabies vaccine coverages for exposed (?) and susceptible (b) dog populations and ? = 0.01 only when ? = 0.7 and b = 0.7, ? = 0.7 and b = 0.5, and ? = 0.5 and b = 0.7. Consequently, the number of infectious dogs will thereby decrease. Moreover, a nonlinear correspondence was also observed in all scenarios between the vaccination rate and the number of rabies-exposed dogs such that the reduction in the incidence of rabies cases becomes apparent only when the vaccination rate is at least 0.9995.

In high rabies transmissibility scenarios, a time-dependent vaccination strategy demonstrated a reduction in the number of rabies-infected dogs. However, this approach involves a trade-off, limiting the period during which monthly vaccinations can be relaxed. Consequently, a robust and timely vaccination program for dogs is crucial to manage high rabies transmission rates. Lastly, the model simulation underscores the importance of initiating monthly vaccinations.

BACKGROUND AND OBJECTIVE

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of hospital and community-acquired infections, showing antimicrobial resistance (AMR), which is an increasing public health concern. One of the commonly-used methods to evaluate resistance include the Kirby-Bauer disk diffusion method. However, this test is found to be time-consuming, lacking in terms of mechanization and automation, alongside its non-applicability to certain antibiotics such as vancomycin. Thus, the Clinical Laboratory Standards Institute (CLSI) recommends using the broth microdilution method in the evaluation of antibacterial activities against S. aureus. A rapid laboratory identification of MRSA is important in the treatment of patients. Therefore, this study aims to optimize and evaluate the effectiveness of a rapid microplate assay using resazurin dye as a colorimetric indicator in determining antibacterial activity against clinical isolates of MRSA and methicillin-susceptible S. aureus (MSSA).

Clinical isolates of MRSA and MSSA were obtained from the Philippine General Hospital (PGH) Microbiology Section, and American Type Culture Collection (ATCC) controls of both strains (ATCC 25923 and ATCC 43300) were acquired. These were then subjected to identification and confirmation procedures. A standardization of bacterial inoculum was performed by comparing its 24-hr growth in Mueller Hinton Broth to 0.5 McFarland Standard. The resazurin microplate assay (REMA) was set-up using two-fold serial dilution of control antibiotics such as oxacillin, vancomycin, and cefoxitin. Each plate was inoculated with standardized bacterial growth of controls and clinical isolates. To determine the time needed for the reduction of the resazurin dye, a qualitative assessment was conducted by comparing the reaction time between a 6.75 mg/mL dye with a 0.01 mg/mL dye. The plates were also subjected to different incubation times and dye concentrations, and the optical densities of the plates were compared using a microplate reader.

Results showed that there were no significant differences between the optical densities of the wells of those incubated for 5 hours and for 24 hours (p >0.05). Furthermore, there was a significant reduction in the reaction time of the dye (from 18 hours to 1 hour) when the dye concentration was reduced from 6.75 mg/mL to 0.01 mg/mL. The optimized REMA showed a significant difference between the minimum inhibitory concentrations (MICs) of the different antibiotics against the control and isolate strains of MRSA and MSSA, showing a W of -2.98 (pCONCLUSION

Based on the results presented, the researchers determined the optimal condition for the resazurin microtiter assay, which was 0.01 g/mL concentration of resazurin dye, at a 5-hour incubation period. This study has shown that an optimized REMA is an efficient and fast method to determine the antimicrobial activities of oxacillin, cefoxitin, and vancomycin against MRSA and MSSA.

The Strength, Weaknesses, Opportunities, and Threats (SWOT) Analysis of the Establishment of the University of the Philippines Pharmaceutical Science Service Laboratory (UPPSSL) delves into the critical role of pharmaceutical research and service laboratories in advancing drug development, ensuring patient safety, and fostering healthcare innovation. Through a meticulous examination encompassing a literature review, SWOT analysis and Key Informant Interviews (KII), this study evaluates the internal strengths and weaknesses of proposed services such as Product Development, Pharmacokinetic Studies, Therapeutic Drug Monitoring, and Biowaiver Studies. By aligning these services with market demands and regulatory standards, the UPPSSL aims to become a pivotal player in the pharmaceutical research landscape. The validation process through KII ensures that strategic decisions are informed by stakeholder perspectives, enhancing the laboratory's operational efficiency and contribution to the industry.

OBJECTIVE

This study compared the proportion of dry eye disease (DED) diagnosed using the Philippine criteria with that diagnosed using the Asia Dry Eye Society (ADES) criteria among participants, and characterized DED features using clinical tests and the OCULUS Keratograph® 5M (K5M; OCULUS Optikgeräte GmbH, Wetzlar, Germany).

This multicenter, cross-sectional study included participants with and without DED. Participants completed the Ocular Surface Disease Index (OSDI) questionnaire and underwent fluorescein tear breakup time (FTBUT) measurement, fluorescein staining of the cornea, lissamine green staining of the conjunctiva, Schirmer 1 test without anesthesia, and basal tear secretion test (BST). The OCULUS K5M was used to measure noninvasive tear breakup time (NIKBUT) and tear meniscus height (TMH), and to perform meibography.

The analysis included 344 eyes from 172 patients with DED and 44 eyes from 22 normal participants. Patients with DED were mostly female (66.3%). Compared to normal participants, patients with DED were older (42.7 ± 14.6 years) and had higher OSDI scores (28.6 ± 21.0). Among those diagnosed with DED using the Philippine criteria, 53.2% met the ADES criteria. Evaporative DED was the predominant type (53.2%). DED eyes had lower FTBUT (5.0 ± 3.3 seconds) and NIKBUT (12.3 ± 5.9 seconds) than controls (p CONCLUSION

There were disparities between the Philippine and ADES criteria for DED diagnosis and differences in tear measurements using clinical tests and the OCULUS Keratograph, indicating the need to harmonize diagnostic standards.

OBJECTIVES

Workers are continuously exposed to occupational hazards and risks. By analyzing recent data on the status of occupational safety and health (OSH) in the Philippines, this study aimed to determine the common occupational injuries and diseases among Filipino workers, and preventive and control measures/activities and occupational safety and health policies and programs implemented across the country.

A review of data on Philippine OSH from the Integrated Survey of Labor and Employment (ISLE) by the Philippine Statistics Authority (PSA) covering data from 2015/2016, 2017/2018, and 2019/2020 was done. The number of occupational injury cases, types of injuries, and types of diseases were assessed as well as the implementation of OSH policies and programs. Descriptive statistics, simple T-test, and Pareto analysis were used to analyze the collated data sets.

The number of occupational injury and diseases in the Philippines across industries are decreasing. Superficial injuries and open wounds (56.47%), and Work-related Musculoskeletal Diseases (WMSDs) (61.82%) top the list as the most common injury and disease across industries, respectively. In 2018, OSH programs and preventive and control measures underwent reforms due to the implementation of the Republic Act (RA) 11058. For OSH programs, there is an increase in implementation between 2015 and 2019.

Occupational injury and occupational diseases in the Philippines across industries are declining. In terms of OSH measures and programs, there has been a significant change over the years, especially after the introduction of RA 11058 in 2018. A rise in the implementation of measures and policies was noted. However, there are still gaps that need to be addressed.

Objective:To develop and pilot test a 3D-printed human laryngeal model designed for laryngeal framework surgery training, aimed at enhancing the skills of ENT specialists and residents.

Methods:
Design:Surgical Innovation
Setting:Tertiary Government Training Hospital
Participants:Consultants and residents of the Department of ORL-HNS

Results:This surgical innovation described the step-by-step production of a 3D-printed human larynx which was used as a model for an advanced laryngeal workshop by ENT residents, consultants and phonosurgeons. It was evaluated to be easy to use and effective in simulating different laryngeal framework surgeries such as Isshiki Thyroplasty Types I to IV.

Conclusion:The 3D-printed human larynx may be used as a tool for laryngeal framework surgery training during workshops for ENT specialists.

Parasitic dermoid cysts may form from autoamputation of the ovarian mass secondary to torsion or rupture. It may then reimplant in surrounding structures and undergo subsequent neovascularization and further growth. The true incidence of these cases is unknown, however, a study reported a 0.04% incidence among 1,007 cases of dermoid cysts. This report describes the case of a 30-year-old multigravida who presented with an ultrasound finding of an ovarian dermoid cyst, which, upon laparoscopic surgery, turned out to be a parasitic dermoid cyst adherent to the bladder, with grossly normal bilateral ovaries. Theories on the development of parasitic dermoid cyst are also presented.
Human ; Female ; Adult: 25-44 yrs old ; dermoid cyst ; laparoscopy

BACKGROUND AND OBJECTIVE

Accurately diagnosing bacterial meningitis and ventriculitis in children is challenging due to nonspecific symptoms and the lack of specificity in conventional CSF parameters. Cerebrospinal fluid (CSF) procalcitonin (PCT) is a promising diagnostic marker but studies on its utility in children are lacking. We aimed to assess the diagnostic value of CSF procalcitonin for bacterial meningitis and ventriculitis in children and establish a clinically relevant cut-off level.

A total of 131 patients were included in the study, and the CSF PCT levels were measured in two groups. Group 1 comprised of patients with bacterial meningitis and ventriculitis (n=21), while Group 2 consisted of patients with tuberculous meningitis, fungal meningitis, viral encephalitis, autoimmune encephalitis, central nervous system (CNS) leukemia, and non-infectious or inflammatory CNS conditions (n=110).

CSF PCT demonstrated an area under the curve of 96.57% in the receiver operating characteristic analysis. With a cut-off of 0.19 ng/mL, it achieved high sensitivity (90.48%) and specificity (91.82%), making it an excellent test for distinguishing between bacterial meningitis and ventriculitis from control diseases.

CSF procalcitonin is highly effective in distinguishing pediatric bacterial meningitis and ventriculitis. Especially in clinical scenarios where the conventional laboratory tests are inconclusive, it can complement clinical assessment to diagnose CNS infections accurately and guide prudent antibiotic use.