Objectives: To compare the effects of clomiphene citrate with conjugated equine estrogen (early or beginning day 2 of menses vs. late or beginning day 7 of menses) and clomiphene citrate alone on endometrial thickness and pattern (i.e. trilaminar or non-trilaminar) among patients for induction of ovulation. Study Design: Prospective, randomized Setting: tertiary care hospital Inclusion criteria: Women aged 25-40 years old with infertility of at least 2 years duration who are candidates for ovulation induction. Exclusion criteria: Women on hormonal treatment 1 month prior to ovulation, with ovarian cysts, mullerian abnormalities, myomas or uterine cavity abnormalities. Results: Fifty-four women were included in the study with mean age 31.093 years +/- 4.655 (range 21 to 40 years), duration of infertility 4.954 +/- 3.228 (range 2 to 20 years), and day of the cycle when dominant follicle was noted was 11.907 +/- 1.751 (range of 8 to 16 days). Mean endometrial thickness was 0.960 cm in group I, 1.053 cm in group II and 0.850 cm in group III with a p value of 0.040625. There was significant improvement in thickness from baseline with a p value of 0.015166. There was no significant effect on endometrial pattern (p value = 0.236146). Conclusion: The addition of conjugated equine estrogens in ovulation induction with clomiphene citrate improves endometrial thickness.
Human ; Female ; Adult ; ESTROGENS, CONJUGATED (USP) ; CLOMIPHENE ; ENDOMETRIUM

Introduction: In line with the regional aim of eliminating rubella and congenital rubella syndrome (CRS), phased introduction of rubella-containing vaccines (RCV) in the Philippines’ routine immunization programme began in 2010. We estimated the burden of CRS in the country before widespread nationwide programmatic RCV use. Methods: We performed a retrospective chart review in four tertiary hospitals. Children born between 1 January 2009 and 31 December 2014 and identified as possible CRS cases based on the presence of one or more potential manifestations of CRS documented in hospital or clinic charts were reviewed. Cases that met the clinical case definition of CRS were classified as either confirmed (with laboratory confirmation) or probable (without laboratory confirmation). Cases that did not fulfil the criteria for either confirmed or probable CRS were excluded from the analysis. Results: We identified 18 confirmed and 201 probable cases in this review. Depending on the hospital, the estimated incidence of CRS ranged from 30 to 233 cases per 100 000 live births. The estimated national burden of CRS was 20 to 31 cases per 100 000 annually. Discussion: This is the first attempt to assess the national CRS burden using in-country hospital data in the Philippines. Prospective surveillance for CRS and further strengthening of the ongoing measles-rubella surveillance are necessary to establish accurate estimates of the burden of CRS and the impact of programmatic RCV use in the future.

BACKGROUND: Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) are increasingly reported as pathogens in urinary tract infections (UTIs). However, in Sri Lanka, the clinical and molecular epidemiology of ESBL-PE implicated in UTIs has not been well described. MATERIALS AND METHODS: We conducted prospective, laboratory-based surveillance from October to December 2013 at a tertiary care hospital in southern Sri Lanka and enrolled patients ≥1 year of age with clinically relevant UTIs due to ESBL-PE. Isolate identity, antimicrobial drug susceptibility, and ESBL production were determined. Presence of ß-lactamase genes, bla(SHV), bla(TEM), and bla(CTX-M), was identified by polymerase chain reaction. RESULTS: During the study period, Enterobacteriaceae were detected in 184 urine samples, with 74 (40.2%) being ESBL producers. Among 47 patients with ESBL-PE who had medical records available, 38 (80.9%) had clinically significant UTIs. Most UTIs (63.2%) were community acquired and 34.2% were in patients with diabetes. Among 36 cultured ESBL-PE isolates, significant susceptibility (>80%) was only retained to amikacin and the carbapenems. The group 1 bla(CTX-M) gene was present in 90.0% of Escherichia coli isolates and all Klebsiella pneumoniae and Enterobacter cloacae isolates. The bla(SHV) and bla(TEM) genes were more common in K. pneumoniae (75% and 50%) and E. cloacae (50% and 50%) isolates than in E. coli (10% and 20%) isolates, respectively. CONCLUSION: The majority of UTIs caused by ESBL-PE were acquired in the community and due to organisms carrying the group 1 CTX-M ß-lactamase. Further epidemiologic studies of infections due to ESBL-PE are urgently needed to better prevent and treat these infections in South Asia.
Amikacin ; Asia ; Carbapenems ; Cloaca ; Enterobacter cloacae ; Enterobacteriaceae* ; Epidemiologic Studies ; Escherichia coli ; Humans ; Klebsiella pneumoniae ; Medical Records ; Molecular Epidemiology ; Pneumonia ; Polymerase Chain Reaction ; Prospective Studies ; Sri Lanka* ; Tertiary Healthcare ; Urinary Tract Infections* ; Urinary Tract*

The objective of the present study was to monitor and characterize morphological alterations in ovaries of agouti (Dasyprocta prymnolopha), reared in captivity, by using abdominal ultrasonography. All animals underwent daily vaginal cytological examination to identify the current cycle phase. For each phase of the estrous cycle, ultrasound examinations were carried out to identify and describe the morphology of both ovaries. Topographic parameters in an ultrasound window were established to locate the ovaries. The agouti estrous cycle lasted an average of 29.94 ± 6.77 days. During vaginal cytology examinations, all cell types were identified, and each phase of the estrous cycle was established by cell counts. No significant alterations were observed in the assessed ovarian morphometry measurements. In 75% of the animals examined, ovarian follicle presence was observed in the proestrus phase.
Animals ; Cell Count ; Dasyproctidae ; Epithelium ; Estrous Cycle ; Female ; Gonads ; Investigative Techniques ; Ovarian Follicle ; Ovary ; Proestrus ; Reproduction ; Ultrasonography

Background: One of the World Health Organization (WHO) nutrition target by 2025 is 50% exclusive breastfeeding rate among infants until age 6 months. Kangaroo mother care (KMC) known to increase breastfeeding rates, especially in preterm and low birth weight (LBW) infants. Objectives: This study determined the effect of KMC to the rate of exclusive breastfeeding among preterm and LBW infants at 6 months of age. Methods: Conducted searches in MEDLINE and CENTRAL databases, likewise hand searched local publications December 1996 until June 2018. Included several randomized controlled trials and prospective observational studies comparing KMC and conventional care among preterm and LBW infants. The primary outcome was exclusive breastfeeding of infants at six months of age. Two authors independently assessed trial quality and extracted data the statistical analysis applied using Review Manager version 5.3. Results: Identified nine eligible trials involving 1,202 neonates. All studies had low-to-moderate risk of bias. KMC significantly noted to increase the likelihood of exclusive breastfeeding by 1.9 times at birth up to 6 months (OR 1.93 [1.18,3.17], p=0.009). Conclusion KMC can increase exclusive breastfeeding among preterm and LBW infants from birth up to 6 months of age.
Kangaroo-Mother Care Method ; Breast Feeding ; Infant, Low Birth Weight

Objectives: This study determined whether the use of an N95 face mask was associated with changes in ocular surface parameters and dry eye symptomatology among healthcare workers with no baseline dry eye disease. Methodology: This was a prospective, analytical, quasi-experimental study. The ocular surface and dry eye symptomatology of 33 healthcare workers (n=66 eyes) were evaluated at baseline and 3 hours after use of 3M™ VFlex™ Particulate Respirator 9105 N95 mask (3M, Minnesota, USA). The following parameters were measured: ocular surface disease index (OSDI), tear break-up time (TBUT), tear break-up pattern (TBUP), non-invasive TBUT (NIKBUT), tear meniscus height (TMH), meibography, and bulbar conjunctival redness. Results: Among all the parameters tested, only OSDI and bulbar redness showed significant changes when pre-N95 and post-N95 values were compared. Although each was interpreted as normal, the median OSDI score improved from 7 to 1 (p < 0.001). Median bulbar conjunctival redness score worsened from 0.9 to 1.1 (p < 0.001). Conclusion Among healthcare workers with no dry eye disease, the use of the 3M™ Vflex™ Particulate Respirator 9105 N95 mask was not associated with changes in TBUT, TBUP, NIKBUT, TMH, and meibogaphy. An improvement of dry eye symptoms was reported after VFlex™ mask use.
COVID-19 ; Dry Eye Syndromes

Background: Consumption and abuse of alcohol remains a significant cause of concern worldwide. Furthermore, there is evidence of the association between chronic alcohol use and reduced life expectancy. Objectives: To study the effects of Garcinia binucao extract (GBE) supplementation on lifespan of Drosophila melanogaster, in the presence or absence of chronic alcohol exposure. Methods: D. melanogaster was mass cultured and given GBE supplementation in high (1 mg/mL) and low (200 µg/mL) sublethal doses. D. melanogaster flies were divided into groups - with and without chronic alcohol exposure, and their respective lifespans were monitored. Results: In D. melanogaster without alcohol exposure, mean lifespan was highest in the control flies (38.15 days), followed by high-dose GBE (34.42 days), low-dose GBE (33.24 days), and DMSO (22.29 days). In D. melanogaster chronically exposed to alcohol, the longest mean lifespan was observed in flies treated with high-dose GBE (33.80 days), followed by low-dose GBE (33.63 days), the DMSO group (30.30), and the control group (29.65 days), but the differences were not statistically significant. Comparing groups with and without chronic alcohol exposure, the mean lifespan of the control group chronically exposed to alcohol significantly decreased by 9.51 days (p < 0.05). In GBE treatment groups, mean lifespan significantly decreased by 0.82 days in high-dose set-up (p < 0.05), and significantly increased by 0.39 days in the low-dose set-up (p < 0.05) upon chronic alcohol exposure. Conclusion Garcinia binucao extract supplementation ameliorated the observed reduction in lifespan of Drosophila melanogaster chronically exposed to alcohol.
Drosophila melanogaster ; Longevity

INTRODUCTION: The landscape of work has changed since the start of the COVID-19 pandemic as more companies shifted from face-to-face to the work-from-home (WFH) setup. This change has affected several aspects of human life especially the motivation to WFH. The study aimed to determine the motivation of WFH among office workers in the National Capital Region (NCR) from March 2020 to February 2022 METHODS: Using a descriptive cross-sectional study design, an online survey of WFH office workers around the NCR, Philippines was conducted. A 26-item questionnaire on motivation covering dimensions of availability (flexibility), safety (work-life balance), and meaningfulness (work performance) was used. Data was analyzed using SPSS version 24. RESULTS: A total of 252 respondents were included in the study, with a majority identifying as females aged 21 to 30, never married, and college graduates. Additionally, respondents reported having one to five years of work experience and were employed in professional/technical/managerial fields. Regarding the impact of remote work, the findings indicated that most individuals who worked from home (WFH) felt motivated by this setup due to its positive effects on availability, time and cost savings from reduced commuting, and the flexibility it provided for managing their schedules according to personal preferences. Furthermore, in terms of safety and conducive work environment, WFH office workers expressed agreement that the remote work setup contributed to a favorable work environment, leading to increased job satisfaction. This setup allowed them to effectively balance work responsibilities with personal and family commitments. The study also revealed that WFH office workers perceived a sense of meaningfulness in their work, as they felt trusted and valued by their employers. This sentiment contributed to their overall well-being, both physically and mentally CONCLUSION Work-from-home office workers are generally always motivated in terms of availability (flexibility), safety (work-life balance) and meaningfulness (work performance).
motivation ; flexibility ; work-life-balance ; work performance

INTRODUCTION: Gadget use with its diverse range of functions from communication to navigation and
entertainment, has brought increasing concerns about its effects on psychological health. Despite
growing evidence on its effect among children, its effect on the adolescent age group, particularly on
the socio-emotional dimension remains uncertain.

METHOD: An analytical cross-sectional study was done to identify a possible association between duration
of gadget use and socio-emotional difficulties of an adolescent. A cluster sample of junior high school
students aged 13-17 years old from four selected private schools were invited to answer the Strengths
and Difficulties Questionnaire (SDQ) to measure socio-emotional difficulties and provide information on
the type and duration of gadget use. Scores derived from the SDQ were classified as normal, borderline
and abnormal based on the questionnaire's scoring guide. Association between duration of gadget use
and strengths and difficulties was tested using chi-square, controlling for sex and age groups.

RESULTS: Majority of the 315 respondents had normal scores on the strengths and difficulties sub-scales.
Regardless of the duration of gadget use, majority of the respondents had normal prosocial behavior
and likewise scored normal on all dimensions of the Difficulties subscale. There was no significant
association between duration of gadget use and Strength (p = 0.47) and Difficulties scores (p = 0.35).
Stratifying by sex and age groups likewise resulted in insignificant associations (p > 0.05). Those with
prolonged gadget use were 1.68 times more likely to have abnormal scores on the Difficulties subscale
compared with those with normal gadget use but the association was not significant (95% CI 0.82, 3.34).

CONCLUSION: There was no significant association between duration of gadget use and socio-emotional
difficulties of adolescents in selected private schools, controlling for sex and age groups.

Objective: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily targets the respiratory system. This study describes the characteristics associated with mortality among patients infected with SARS-CoV-2 at a single hospital in Baguio City, Philippines. Methods: We reviewed medical records (including history, laboratory results and treatment regimen) of 280 confirmed COVID-19 patients admitted to a single hospital during March–October 2020. Clinical characteristics and outcomes (frequency and type of complication, recovery rate and mortality) were evaluated. Multiple logistic regression was used to analyse factors associated with mortality. Results: The mean age of COVID-19 patients was 48.4 years and the female-to-male ratio was 1.8:1. Hypertension, cardiovascular disease (CVD) and diabetes were the most frequent comorbidities reported. Common presenting symptoms were respiratory and constitutional, with 41% of patients not reporting symptoms on admission. Patients with moderate, severe and critical disease comprised 45%, 8% and 4%, respectively. A total of 15% had complications, health care-associated pneumonia being the most frequent complication. The recovery rate was 95%; 5% of patients died, with multiorgan failure being the most common cause. The presence of CVD, chronic kidney disease, prolonged prothrombin time and elevated lactate dehydrogenase (LDH) were associated with mortality. Discussion Most COVID-19 patients in our population had asymptomatic to moderate disease on admission. Mortality from COVID-19 was associated with having CVD, chronic kidney disease, elevated LDH and prolonged prothrombin time. Based on these results, we emphasize that people should take all necessary precautions to avoid infection with SARS-CoV-2.