Objective: To present 3 cases of Möbius sequence exposed in utero to misoprostol and discuss their clinical presentations, etiopathogenesis, and management. Methods: Medical records of 3 patients with Möbius sequence and prenatal exposure to misoprostol were reviewed. Clinical findings were compared with those reported in the literature. Results: Lack of facial-muscle movement, lagophthalmos with secondary exposure keratitis, decreased ability to crease forehead, and shallow nasolabial fold imply facial-nerve dysfunction. Small- and large-angle esotropia and apparent orthotropia with abduction limitation showed varying degrees of abducens nerve involvement. Two patients had early prenatal exposure to misoprostol during the first 3 months of gestation. Conclusion A history of misoprostol exposure should be routinely elicited from parents of children with Möbius sequence. Associated deficiencies in Möbius sequence and its variants require a multidisciplinary approach.
Abducens Nerve Vestibulocochlear Nerve Paralysis

Delivery Of Health Care ; Research ; Health ; Operations Research

A prospective study on the refractive changes after horizontal extraocular muscle surgery was conducted involving 51 eyes of 41 subjects. Three variables were measured: axis, cylinder power, and sphere power up to 30 days postoperatively. The behavior and progression of these variables were also evaluated in the postop period Mean changes in axis and cylinder power were found to be significant between the preop and 1 day postop. Mean changes in sphere power were only significant between the 1 day postop and 15 days postop. Mean changes of the three variables between preop and 30 days postop were not significant. The results showed that the effects of horizontal extraocular muscle surgery on the refractive state were only transient and it decreased over time. (Author)
Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Child Preschool ; REFREACTION ; REFRACTIVE ERRORS/ETIOLOGY ; OPHTHALMOLOGIC SURGICAL PROCEDURES/ADVERSE EFFECTS ; STRABISMUS/SURGERY ; CORNEAL TOPOGRAPHY ; OCULOMOTOR MUSCLES/SURGERY ; HUMAN ; FEMALE ; MALE ; PROSPECTIVE STUDIES

OBJECTIVES: 

1. To describe the performance of medical students in comprehensive examinations given after each learning unit or year level. 

2. To correlate the scores of the students in the comprehensive examinations to the general weighted average grade (GWAG) for the same learning unit.

3. To correlate the scores in the subject-based part of the comprehensive examinations to the scores in the Physicians Licensure Examination (PLE)

 

METHODS: The scores of graduates of the University of the Philippines Manila College of Medicine (UPCM) for the years 2009-2011 in the comprehensive examinations, their general weighted average grade per learning unit, and scores in the PLE were retrieved and analyzed. Correlation coefficients of comprehensive examination score and GWAG, and comprehensive examination score and PLE score were computed.

RESULTS: A total of 434 out of 463 graduates from UPCM were included in this study. There was no trend observed in the performance of students in the comprehensive examinations as they progressed from one learning unit to the next. Performance in both portions of the comprehensive examinations was observed to have significant correlation to students' LU GWAG for most of the learning units, with the exception of LU 6 and LU 7 for Class B. Performance in the subject-based portion of the comprehensive examinations was observed to have significant correlation to students' PLE scores.

CONCLUSIONS: The students' scores in the comprehensive examinations had moderate to strong correlation with the GWAG for the corresponding learning unit. Similarly, scores in the subject-based portion of the comprehensive examination had moderate to strong correlation with PLE scores.

Human ; Male ; Female ; Students, Medical ; Philippines ; Learning ; Licensure ; Physicians ; Physical Examination

OBJECTIVES: This study was conducted to examine the validity of the National Medical Admissions Test (NMAT) score, Pre-Medicine general weighted average grade (Pre-Med GWAG) in predicting the academic performance in medical school, as measured by the medical school general weighted average grade (Med GWAG) and Physician Licensure Examination (PLE). It also aimed to study which among the NMAT, pre-medicine GWAG and MedGWAG best correlates with PLE.

METHODS: Records of graduates of th UPCM from 2004 to 2009 were retrieved and data regardin the following entry characteristics were collected: National Medical Admissions Test (NMAT) scores, pre-Medicine general weighted average grade (MedGWAG). Average and individual subject scores in the PLE were retrieved for this study. Statistical analysis using the Pearson correlation analysis was performed using STATA.

RESULTS: The NMAT, MedGWAG and PLE scores of the direct and lateral entrants were not significantly different from each other. There was weak correlation between NMAT and Pre-Med GWAG and weak to moderate correlation between NMAT and Med GWAG. Except for the 2009 graduates where no correlation between NMAT and PLE scores was noted for 2004-2008 graduates. There was moderate to strong correlation between Pre-Med GWAG and Med GWAG and weak correlation between Pre-Med GWAG and PLE scores. There was strong correlation between Med GWAG and PLE scores.

CONCLUSIONS: Pre-Med GWAG had higher correlations to Med GWAG than NMAT scores. In Terms of PLE scores, the Medicine GWAG showed the highest correlation followed by Pre-Med GWAG, then NMAT scores.

Schools, Medical ; Licensure ; Medicine ; Physicians ; Academic Performance

Objective: This study determined the correlation between the performance in the Philippine Board of Ophthalmology (PBO) written qualifying examinations and the Ophthalmology In-Training Proficiency Examinations (OPEX). Methods: PBO written certifying examinations and the OPEX scores of residency graduates covering the years 2005 to 2010 and 2004 to 2009 respectively were retrieved for this study. ANOVA statistical test compared OPEX scores through residency (Y1, Y2, Y3, and Y4) and determined if the number of times the OPEX was taken reflected significant differences in the PBO scores of the different groups. Pearson’s test determined the correlation between OPEX and PBO written examination scores. Results: Of the 165 subjects included in the study, 5 took the OPEX four times during their residency, 87 thrice, 39 twice, and 34 once. Mean OPEX scores for the different levels of residency training was observed to be statistically different from each other (p < 0.001). Mean PBO scores improved with increase in the number of times that OPEX was taken during residency (p < 0.001). Significant positive correlation was observed between the PBO scores and OPEX scores for all year levels of residency, average OPEX scores and terminal OPEX scores (r = 0.57 to 0.73, p < 0.0001) with the highest correlation noted between terminal OPEX and PBO scores. Based on the number of OPEX taken, significant correlation was strongest for the group with three OPEX taken (r = 0.73, p < 0.001). Conclusions There is a positive correlation between residents’ performance in the OPEX to their future performance in the written certifying examinations of the PBO.
Ophthalmology ; Education

Objective: This study described the demographics of pediatric patients who sustained open globe injuries, determined the visual outcome of open globe injuries in pediatric patients and the factors associated with final visual acuity. Methodology: The medical charts of 195 patients aged 0-18 years seen for open globe injury in a Philippine tertiary hospital for three years were reviewed. Results: The average age of patients was 7.9 years with 41% belonging to the 5-9 years old group. Seventy-five percent (75%) of the patients were males. Ninety-five percent (95%) of the open globe injuries were accidental, mostly from play (67%). The most common agents of injury were metallic objects (42%) followed by wooden objects (24%). The cornea was injured in 80% of the cases, cornea and sclera in 10%, sclera in 7%, and globe rupture in 3%. Eighty-six percent (86%) of the patients underwent surgery. Initial visual acuity was associated with the presence of complication and the site of injury. Final visual acuity was associated with the initial visual acuity, the interval from injury to consultation, the site of injury, and the presence of complications. Conclusions The majority of the injuries were accidental and thus avoidable. The education of parents and caregivers on proper storage of potentially harmful objects at home and proper supervision of children at play are important in addition to early consultation after the injury as well as a timely intervention.
Child

Objective: To determine the visual outcome of amblyopia treatment and describe the relationship between age of onset and consult, compliance as measured by a patch diary, amblyopia subtype, and severity with the final visual outcome. Methods: Thirty-two consecutive, newly-diagnosed cases of amblyopia, aged 3-8 years on initial consult, with no history of prior amblyopia treatment, were included. Patching was done based on current AAO recommendations and patients were followed up monthly for 6 months. Treatment success was defined as best corrected visual acuity (BCVA) better than 20/30 (0.17LogMAR), or a 3-line improvement from baseline, or stable isoacuity for at least 3 months. Treatment failure was defined as no improvement of BCVA after 3 months of occlusion therapy or a regression of 2 lines. Descriptive and correlation statistics were performed comparing age of onset and consult, amblyopia subtype, severity, and compliance with the main outcome measure of BCVA at 6 months. Results: Sixteen (50%) attained treatment success. Patients seen earlier (age 2-5 years) had higher rates of success (75%) than those seen later (age 6-8 years) (35%). A moderately strong negative correlation (r=-0.48, p=0.01) existed between severity of amblyopia and final BCVA at 6 months. overall compliance to patching was 88±18%, with good compliance in the success group (92%) compared to fair compliance in the failure group (84%) and a moderate correlation between compliance and BCVA (r=0.37, p=0.05). Conclusion Treatment success was related to severity, compliance, and younger age of treatment. In the presence of good compliance, severity was a strong prognostic variable.
Amblyopia ; Compliance ; Sensory Deprivation ; Anisometropia

Background: Optical coherence tomography (OCT) can accurately assess the optic nerve and retinal fiber layer (RNFL) to closely look at the anatomical ocular pathology of amblyopia. Objectives: This study aimed to determine and compare optic nerve parameters and RNFL in amblyopic and normal Filipino children using OCT. Methodology: Forty-two eyes of 21 normal participants and 40 eyes of 20 amblyopic participants underwent complete eye examinations and OCT scanning of optic nerve and RNFL. The following data were collected: age, refraction, intraocular pressure, optic nerve parameters (including rim area-vertical cross-section, average nerve width, disc diameter, cup diameter, rim length, vertical integrated rim area, horizontal integrated rim width, disc area, rim area, cup area, cup to disk area ratio, cup-to-disk horizontal ratio, cup to disc vertical ratio), and peripapillary RNFL. Results: There was a statistically significant difference between normal and amblyopic groups with regard to the following parameters: cup area, rim area, cup-disc area ratio, cup-disc horizontal ratio, cup-disc vertical ratio, superior RNFL, and inferior RNFL. The rim area was significantly smaller in amblyopic eyes compared to normal whereas the cup-disc area ratio, cup area, cup-disc vertical and horizontal ratios were significantly larger in amblyopic eyes. The RNFL inferiorly and superiorly were also thinner in amblyopic eyes. Conclusion As measured by OCT, some optic nerve parameters and RNFL thickness in Filipino children were significantly different in amblyopic eyes compared to normal.
Optic Nerve ; Amblyopia