Objective: Cervical cancer screening can reduce both the incidence and mortality rates of the disease. This study aimed to assess the diagnostic accuracy of conventional cytology, liquid based cytology and visual inspection with acetic acid in detecting pre-malignant and malignant cervical lesions. Methods: There were 249 patients who participated in the study. Of these, 6/249 (2.4%) turned out positive in papsmear, 7/249 (2.8%) turned out positive in liquid based cytology while 23/249 (9.2%) turned out positive in visual inspection with acetic acid. Colposcopic guided cervical biopsy was done on all 249 patients to confirm the results. Results: Fourteen turned out positive for cervical intraepthelial neoplasia, 1 patient had carcinoma in situ and 1 was positive for squamous cell carcinoma. Conclusion Among the three screening tests, VIA appears to be the most accurate, followed by liquid based cytology as compared to the conventional papsmear.
Vaginal Smears ; Cytology ; Cytodiagnosis

Introduction: A size of more than 10 cm suggests that a soft tissue tumor might be malignant. Pertinent ancillary diagnostic testing, such as immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), may be done to confirm the diagnosis. Several studies have shown that size may be a useful criterion in determining which tumors are candidates for further molecular testing. MDM2 and p16 are IHC markers for atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDLPS). Objectives: The primary objective of this study is to determine the proportion of tumors signed out as “lipomas” from 2017 to 2019, and measuring at least 10 cm, that express MDM2 and p16 on IHC and warrant revision as ALT/WDLPS. Methodology: This is a descriptive, retrospective cohort study in which all lipomas from 2017 to 2019 that measured at least 10 cm were included. The size, age of the patient, and location of each tumor were documented. The slides of all eligible cases were reviewed and immunohistochemically stained for MDM2 and p16. For each case, the intensity and immunoreactivity of each stain were assessed using a modified, four-tier scoring system. Fisher’s exact test was used to determine if a significant number of tumors expressed MDM2 or p16. Results: Thirty (30) cases satisfied the inclusion and exclusion criteria. The average size of these tumors is 15.10 cm. There is no sex predilection. The most common location of these tumors is the extremities. None of the tumors expressed MDM2, and only one case was p16-positive. The case positive for p16 also showed cytologic atypia and variability in cell size, resulting in the revision of its diagnosis from lipoma to atypical lipomatous tumor. The rate of diagnosis revision after slide review and IHC studies is 3.33%. Conclusion None of the adipocytic tumors that measured at least 10 cm in diameter and were signed out as lipomas was MDM2 positive, and only one case was p16-positive. Thus, morphology remains the cornerstone in the diagnosis of adipocytic tumors. Careful microscopic evaluation is necessary to establish the diagnosis of malignancy in these tumors. Ancillary tests should only be considered in cases where the pathologic features are equivocal.
Neoplasms ; Adipose Tissue ; Lipoma ; Extremities

A 63-year old Filipino female presented with epistaxis of undisclosed duration. Examination showed a vascular, pulsating, rubbery intranasal mass involving both nasal cavities. The clinical impression was that of a nasal hemangioma. She underwent excision of the tumor and the specimen was sent for histopathologic evaluation. The specimen consisted of several tan-brown irregular tissue fragments with an aggregate diameter of 2 cm. Microscopic examination showed a cellular spindle cell tumor underneath the respiratory mucosa. (Figure 1) The tumor cells formed a syncytial pattern arranged in whorls that were separated by thin fibrovascular bands. (Figure 2) The cells had round to oval nuclei with nuclear clearing and moderate amount of syncytial cytoplasm compatible with a meningothelial derivation. (Figure 3) There was absence of nuclear atypia, significant mitotic activity, and necrosis. Immunohistochemistry studies showed positivity for Epithelial Membrane Antigen (EMA) and Progesterone Receptors (PR), and absence of reaction for Smooth Muscle Actin (SMA) and CD34. (Figure 4) Our diagnosis was sinonasal tract meningioma. Primary extracranial meningioma of the sinonasal cavity is rare and thus secondary extension from a primary intracranial tumor should be ruled out. It involves a wide age range with no striking gender predilection.1,2 Most common symptoms include nasal obstruction, epistaxis, exophthalmos, and a mass. Etiogenesis is not completely established and is postulated to arise from meningocytes that are entrapped during closure of midline structures, very similar to the development of meningoceles.3 Histopathologic examination discloses a spindle cell tumor arranged predominantly in whorls composed of cells showing meningothelial differentiation. Most are histologically grade 1 tumors. Grade 2 and 3 sinonasal tract meningiomas are rare.4 Histologic differential diagnoses include a glomangiopericytoma, leiomyosarcoma, and a solitary fibrous tumor/hemangiopericytoma. Close histologic evaluation with appropriate immunohistochemistry studies point to the correct diagnosis. Meningioma shows strong diffuse positivity with EMA and PR, and is usually negative for other immunohistochemistry markers such as muscle actins (for glomangiopericytoma and leiomyosarcoma), and CD34 (for solitary fibrous tumor/hemangiopericytoma).1,3 A diagnosis of primary sinonasal meningioma should not be made if an intracranial mass is identified.4 Sinonasal meningiomas are benign tumors with no documented distant metastases.1,2 Although recurrences occur in about 30% (mostly due to incomplete excision), metastasis and malignant transformation has not been reported.
Human ; Female ; Middle Aged ; Meningioma ; Epistaxis ; Nasal Cavity ; Mucin-1 ; Immunohistochemistry ; Receptors, Progesterone ; Actins ; Meningeal Neoplasms ; Nose ; Hemangioma ; Respiratory Mucosa ; Muscle, Smooth

Background: Cervical cancer is the most common gynecologic malignancy in the Philippines despite being a preventable disease. Radical hysterectomy with pelvic lymphadenectomy is considered the standard surgical treatment of choice for patients with cervical cancer confined to the cervix up to the upper vagina. However, recent studies show that a less radical approach can be offered to these patients with comparable outcomes to radical hysterectomy, but with lesser perioperative and post-operative morbidity. Objectives: The purpose of this study was to compare the outcomes in terms of recurrence and survival among cervical cancer patients who underwent simple hysterectomy and radical hysterectomy seen in a tertiary government hospital. Methods: The records of all cervical cancer patients who underwent radical hysterectomy and simple hysterectomy for the past ten years were reviewed. Results: The incidence of cervical cancer patients who underwent simple hysterectomy from 2009-2018 is 0.37 per 100 person years or 0.592:16, lower than 1:16 ratio from 1964-1974, as reported by Manalo and Sotto.1 Only 9 out of 42 patients who underwent simple hysterectomy had cervical cancer screening within 1 year prior to surgery. Conclusion The most common indication for surgery was myoma uteri. Those who underwent radical hysterectomy had better recurrence free survival and overall survival than those who had simple hysterectomy.
Female ; Uterine Cervical Neoplasms ; Hysterectomy

BACKGROUND: Entamoeba histolytica is an important etiologic agent of diarrhea. Globally, it is estimated to infect 40 to 50 million people and cause 40,000 to 100,000 deaths per year. Metronidazole is effective but can cause adverse reactions in certain individuals. In search of alternatives, traditional medicinal plants are being studied. Several plants in Family Simaroubaceae have shown anti-amoebic activity. Quassia amara, a member of this family has not been tested.
OBJECTIVE: To determine the effect of Q. amara crude extract on Entamoeba histolytica in vitro.
METHODS: Initial testing of 104 µg/ml ethanolic bark extract was performed. Counts were made after 72 hours. Three trials in triplicates were performed.
Nine (9) dilutions of extract were then tested (18.8 to 5,00 µg/ml). Test tubes were checked for viable amoeba after 24-hour and 72-hour incubation. Minimum inhibitory concentrations (MIC) were determined for the two incubation periods. At least two trials in triplicates for each dilution were performed. metronidazole served as positive control.
RESULTS: At 104 µg/ml incubated for 72 hours, no viable amoeba was obtained and counted. The MIC after 24 hours was 5,000 µg/ml, while the MIC at 72 hours was 37.5 µg/ml.
CONCLUSION: Q. amara crude extract has inhibitory effects on E. histolycain vitro.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Child Preschool ; Infant ; Infant Newborn ; Quassia ; Metronidazole ; Entamoeba Histolytica ; Plants, Medicinal ; Amoeba ; Simaroubaceae ; Microbial Sensitivity Tests ; Diarrhea

No abstract available.
Blood Platelets* ; Stroke*

Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive and self-limited deformation of the subcutaneous tissue volume on one side of the face that creates craniofacial asymmetry. We present the case of a patient with a five-year history of progressive right facial hemiatrophy, who underwent facial volumetric restoration using cell-assisted lipotransfer (CAL), which consists of an autologous fat graft enriched with adipose-derived stem cells (ASCs) extracted from the same patient. ASCs have the capacity to differentiate into adipocytes. They also promote angiogenesis, release angiogenic growth factors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissue atrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome. Currently, CAL has showed promising results in the long term by decreasing the rate of fat reabsorption. The permanence and stability of the graft in all the injected areas has showed that autologous fat grafts enriched with stem cells could be a promising technique for the correction of defects caused by this syndrome.
Adipocytes ; Atrophy ; Facial Hemiatrophy ; Humans ; Intercellular Signaling Peptides and Proteins ; Stem Cells ; Subcutaneous Tissue ; Tissue Therapy ; Transplants

Sex-linked dystonia parkinsonism (XDP, DYT3, "Lubag") is an adult-onset, progressive, debilitating movement disorder first described in Filipino males from Panay Island in 1975. XDP manifests predominantly as torsion dystonia, later combined with or sometimes replaced with parkinsonism. Within the Island of Panay, the preva-lence rate is highest in the province of Capiz, where 1:4000 men suffer from the disorder. There is a high degree of penetrance and generalization. While women often serve as carriers, XDP is not limited to men. An updated XDP Philippine registry (as of January 2010) has identified 505 cases, with 500 males and 5 females. While some report that females may carry a milder form of the disorder, in our experience, both sexes generally follow a similar progressive clinical course.

Human ; Male ; Female ; Aged ; Adult ; Dystonia ; Dystonia Musculorum Deformans ; Dystonic Disorders ; Genetic Diseases, X-linked ; Islands ; Parkinsonian Disorders ; Penetrance

INTRODUCTION: Metro Manila is at risk from “the big one”, a magnitude 7.2 earthquake caused by the movement of the West Valley Fault, thus awareness and preparedness of the people are very important. The study compared the levels of earthquake awareness and preparedness of households in a high-risk area and a low risk area. METHODS: This was a cross-sectional study among 376 households each from a high- and a low-risk barangay in Metro Manila using a self-administered household-based survey questionnaire consisting of questions on awareness and preparedness. The prevalence of households classified as aware and wellprepared was computed; the significance of differences between the high- and low risk barangays was determined through Fisher’s exact test. RESULTS: There were fewer households classified as aware in the high-risk barangay compared with the low risk barangay, but the difference was not significant (PR = 0.98, 95% CI 0.84, 1.01, p = 0.078, Fisher’s exact test). Less than half of households were classified as well-prepared in both high- and low risk barangays (49.7 vs 46.5%) and the difference was not significant (PR = 1.07, 95% CI 0.92, 1.24, p = 0.422, Fisher’s exact test). Television was the most common source of information in both barangays. Households in the high-risk barangay were more likely to be well-prepared when a member was at least a high school graduate (PR = 2.54, 95% CI 1.24, 5.22, p = 0.001, Fisher’s exact test). CONCLUSION There was no difference in the levels of awareness and preparedness between high and low risk barangays. Television was the most common source of information in both high and low risk barangays. The presence of at least one high school graduate in the household from a high-risk barangay was associated with preparedness but not awareness.
environment ; earthquake ;

BACKGROUND: Injuries are common causes of hospital visits and deaths in the Philippines. The national healthcare-associated expenses due to these injuries have not been established.

OBJECTIVE: To estimate the healthcare-associated expenses due to injuries in the Philippines. Methods. Review of patient charts and patient interviews were conducted in 21 hospitals in the Philippines. A convenience sample of patients was interviewed to ascertain other direct medical and non-medical expenses.

RESULTS: Median admission costs based on hospital bills were: road injuries: PhP10,192.25, poisoning: PhP4,402.00, burns: PhP6,521.53, animal-related: PhP5,105.92, other accidents: PhP7,545.71 and intentional injuries: PhP8,023.00. Based on survey, other expenses not stated in hospital bills include medical supplies (PhP4,000.00), diagnostic tests (PhP 2,000.00), and post-discharge expenses (PhP 1,000.00).

CONCLUSION: Expenses due to injuries varied according to cause. Admission expenses recorded in the bill were not the only healthcare-related expenses shouldered by the patient and accounted for 68.6-159.0% of the bill value.

Human ; Philippines ; Wounds And Injuries