Objectives: This study aimed to examine schizophrenic patient related factors- demographic, psychopathology, social function & premorbid social functioning - that would predict length of hospital stay and determine their relationship. Methodology: One hundred eighty four charts of schizophrenic patients admitted to Ward 7 of UP PGH from 2001- 2004 were reviewed. Data collected were the patient's demographic characteristics, psychopathology, premorbid social functioning and economic support system. Univariate and multivariate analyses were made to identify factors associated with length of hospital stay. Results: Of the 184 charts reviewed, 42 (23%) had a short hospital stay of 1- 14 hospital days while 142 ( 77%) were considered as having a long hospital stay i.e. more than 14 hospital days. Univariate analysis with p< 0.05 revealed that the number of IM medications and number of psychopharmacologic medications had a significant relationship with length of hospital stay. At a p value < 0.20, two additional predictors were identified: absence of heterosexual relationship and age of onset of illness. Multivariate analysis of these four factors revealed that age of onset of illness and number of psychopharmacologic interventions were patient related factors that predicted length of hospital stay. Conclusion Knowledge concerning patient related factors such as number of medications and age of onset were significant in predicting length of hospitalization for schizophrenic patients, which would be of help in formulating admissions and in patient policies for the hospital.
Length of Stay ; Demography

The prevalence of Toxoplasma gondii infection in free-range chickens in Jilin province, northeastern China was investigated. A total of 1095 serum samples were collected from nine administrative regions from July to October, 2012, and antibodies to T. gondii were examined by an in-house enzyme-linked immunosorbent assay (ELISA) using Toxoplasma lysate antigen (TLA). The detection results were confirmed by Western blot. The overall seroprevalence of T. gondii in free-range chickens was 17.6% (95% confidence interval [CI], 15.4–19.4%), ranging from 13.3% (95% CI, 6.3–20.4%) in Siping to 23.6% (95% CI, 15.7–31.6%) in Liaoyuan. There was no significant difference in T. gondii infection among different regions in Jilin province (P> 0.05). The widespread presence of T. gondii infection in freerange chickens of Jilin province implies the wide contamination with T. gondii oocysts in the living environment of people, and free-range chickens might be an important source of infection for humans.

A 21-year old woman, G1P0, was referred for further prenatal check-up with sonographic examination revealing conjoined twins at 29 weeks age of gestation. The fetuses were in breech presentation positioned face-to-face with fusion at the level of the thoraces and gastric bubble suggestive of thoracoomphalopagus twins. There was a definite communication between the two fetal circulations at the ventricular level as seen on fetal echocardiogram with a single cardiac rhythm shared between the two hearts. Close antenatal and fetal surveillance was done during the entire pregnancy duration. The patient was counseled about therapeutic options and explained of the complexity of their cardiac anatomy. The twins were delivered by cesarean section at 35 weeks due to preterm labor and a neonatal 2D-echocardiogram was done shortly after to re-assess their cardiac anatomy. Since the results revealed a shared ventricle, the twins were considered inseparable. The family was apprised of their poor prognosis and opted for natural death to occur.

Human ; Female ; Adult ; Pregnancy ; Breech Presentation ; Twins, Conjoined ; Gastric Balloon ; Cesarean Section ; Obstetric Labor, Premature ; Echocardiography ; Ultrasonography ; Fetus ; Prognosis

Newborn screening (NBS) was introduced in the Philippines in 1996. After 12 years of implementation, a review of performance of the NBS facilities shows that there is a wide range of NBS performance from zero to 100%. This paper aims to review the NBS facilities (NSFs) that have at least 90% NBS coverage and to identify the successful strategies that have pushed the high coverage.

Neonatal Screening ; Philippines

Objective To investigate the CT and MRI features of levamisole induced encephalopathy. Methods The CT and MRI features of 6 cases with clinically proven levamisole induced encephalopathy were retrospectively analyzed. Gd-DTPA enhancement examinations were performed in 5 cases. CT examinations were performed in 4 cases before MRI. Results MRI features: Lesions were mainly located in bilateral periventricular and hypophloeodal white matter, scattered as multifocal lesions, and were different in sizes. Most of the lesions presented as irregular plaques (masses), with round/oval or spotty nodules in second. The lesions had low signal intensity on T 1WI and high signal intensity on T 2WI, and commonly without enhancement. Edema and mass effect were slight. CT features: Two cases showed multiple irregular plaque-sheet low density lesions scattered in bilateral periventricular white matter. One showed symmetrical low density in bilateral putamina nuclei. Another one was negative. Conclusion CT and MRI are valuable for the diagnosis and differentiated diagnosis of levamisole induced encephalopathy. MRI has higher sensitivity and specificity than CT does, and can favorably evaluate the treatment and prognosis.

The internationally accepted definition of dyspepsia is "chronic or recurrent pain or discomfort centered on the upper abdomen."Gastro-esophageal reflux disease on the other hand is defined as the presence of risks of physical complications of gastroesophageal reflux, or the experience of clinically significant impairment of health-related well being (quality of life) due to reflux related symptoms. Several theories have been proposed regarding the etiology of these disorders, including acid exposure, visceral hypersensitivity, impaired fundal accommodation, delayed gastric emptying, and H. pylori infection. There seems to be a significant overlap of pathophysiological disorders between dyspepsia and GERD. The diagnosis of dyspepsia is challenging. The use of self administered questionnaires in routine clinical care has been questioned by other authors as studies showed that the rate of recognition of heartburn differed between questionnaires. Endoscopy is the preferred procedure to detect lesions in the upper gastrointestinal tract. However, experts suggest empiric treatment over prompt endoscopy because of cost and limited availability of endoscope facilities. After a diagnosis of dyspepsia or GERD, the primary care physician can choose between the following strategies: symptom-guided empirical treatment, direct referral for endoscopy, non-invasive testing for H pylori and subjecting the H pylori positive patients to endoscopy ("test-and-scope"), and. non-invasive testing for H pylori and treatment of the infection in H pylori positive patients ("test-and-treat"). While the role of H pylori in peptic ulcer has been clearly established, its role in dyspepsia is still being debated. A recent meta-analysis suggested that there is a small benefit of about 10% over placebo. Considering the pathophysiology as acid reflux and dysfunctional motility as being the main problem, the combination of a prokinetic like domperidone and a PPI like pantoprazole may offer improved response to empiric treatment. Starting the patient on high potency drugs or combination treatment (step-down approach) is therefore a new strategy that has potential impact to improve response. Potential advantages of the step-down approach include faster healing, maximum symptom relief and a more rapid improvement in the patient's quality of life. Adherence to treatment is also an issue for a chronic and relapsing illness like dyspepsia and GERD. Adherence to prescribed self-administered medication is low in patients with chronic conditions. It is estimated to average only 50%. Fixed dose and sustained release formulations are designed to decrease the number of pills to be taken and the frequency of dosing Le. simplifying the treatment regimen thereby improving adherence. Dyspepsia is a multi-factorial syndrome. Abnormalities include disturbances of GI motor and sensory function as well as specific psychological disorders including depression and anxiety. An intensive medical treatment targeting GI abnormalities with psychological interventions will result to better long-term improvement of symptoms.
DYSPEPSIA ; INDIGESTION

A 1-month randomized study comparing the intraocular pressure (IOP) reducing effect of latanoprost 0.005% administered in the evening with unoprostone 0.12% given twice a day in primary open angle glaucoma and ocular hypertension was performed.A total of 27 patients were included:12 were in the latanoprost group and 15 in the unonoprostone group.Mean IOP was reduced from 27.38 mm HG with latanoprost and from 26.59 to 22.16 mm Hg with unoprostone as determined at the end of the 1-month period.No upward drift in IOP was seen with either drug during the treatment period.Thus,latanoprost 0.005% administered once daily in the evening, reduced IOP more than the unoprostone given twice daily in primary open angle glaucoma and ocular hypertension.
Human ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; GLAUCOMA ; LATANOPROST ; UNOPROSTONE

BACKGROUND: The prevention of maternal hypotension by traditional crystalloid preloading prior to spinal anesthesia in obstetric patients undergoing spinal anesthesia has recently been questioned by many. A review of published data with unbiased comparison comparing preloading and no preloading prior to spinal anesthesia was attempted to assess the relative benefits and side-effects in terms of incidence of maternal hypotension, dose of vasopressors given and APGAR scores at one and 5 minutes. METHODS: A medline search of published randomized controlled trials (RCT) from 1966-1997 comparing crystalloid and no crystalloid preloading prior to spinal anesthesia in patients for cesarean section was done. Search for available meta-analysis on preloading, only three met the criteria for analysis. The outcome measures were limited to three due to lack of available data for comparison. RESULTS: Using the Peto Odds Ratio, analysis of the three studies showed no significant difference in the incidence of hypotension between those who were preloaded and those who were not. But a trend towards a lower incidence of hypotension among those who were preloaded was seen. Using the weighted means difference (WMD) to analyze the dose of vasopressors given, there was no significant difference between preloading and no preloading but a trend towards a greater total dose of vasopressors was seen in those not preloaded. There was no significant difference in APGAR scores in the three studies. CONCLUSION: There is no sufficient evidence to support a change in practice to no preloading prior to spinal anesthesia for elective cesarean section based on the results of this meta-analysis. Further studies must be done to increase the validity and precision of results comparing preloading and no preloading.
Human ; Female ; ANESTHESIA, SPINAL ; CESAREAN SECTION ; OBSTETRICS ; HYPOTENSIONS

Two women presenting with recurrent pregnancy loss were both diagnosed to have septate uterus. After hysteroscopic resection of the septum under laparoscopic guidance, successful term pregnancy was achieved in one patient, while second patient is currently on her 24th week of gestation. Septate uterus is the most common type of congenital uterine anomaly and has long been known to be associated with recurrent miscarriages, late-term abortion, and preterm labor. The pre-treatment abortion rate is 90%, which is both distressing for the patient and frustrating for the physician. Hysteroscopic septal resection under laparoscopic guidance is considered the standard for treatment, and is shown to improve reproductive outcome.
ANOMALY ; SEPTATE UTERUS ; RECURRENT PREGNANCY LOSS

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is considered a rare disease. In the Philippines, there are currently no local registry for such rare disease thus clinical features that may be unique to the country is difficult to characterize.
OBJECTIVE: To characterize the TTP patients seen in our institution based on the demographic, clinical and laboratory profile of these patients.
RESULTS: A total of eight patients were described in this report. Median age was 38 years (range, 20-63) with a female predominance. All patients had neurologic  symptoms and microangiopathic hemolytic anemia. Minor neurologic symptoms (confusion, headache and dizziness) were more frequently observed. Renal dysfunction (serum creatinine >1.4mg/dL), fever (>38.0°C), and thrombocytopenia were observed in four patients (50%), seven patients (87.5%) and six patients (75%) respectively. Patients underwent median of three sessions of Plasma Exchange (range, two to 38). Of the six patients who received therapeutic plasma exchange, five were discharged alive.
CONCLUSION: Fifty percent of the patients in this report presented with the classic pentad. This feature should be kept in mind as TTP is a true hematopologic emergency. A high index of suspicion, prompt evaluation and treatment of patients are necessary because multi-organ thrombosis may not be reversible. If treatment is not urgently administered, Therapeutic Plasma Exchange is the management of choice and should be done immediately once TTP is recognized.

Human ; Male ; Female ; Adult ; Purpura, Thrombotic Thrombocytopenic ; Patients ; Thrombocytopenia ; Plasma Exchange