OBJECTIVE

To report the demographics, clinical characteristics, and surgical outcomes after microvascular decompression (MVD) for hemifacial spasm (HFS) in the Philippine General Hospital (PGH).

Between January 2018 to December 2022, the division of Neurosurgery at PGH performed thirty-four MVD operations for Primary HFS. Records were retrospectively reviewed, and pertinent demographic, intra-operative findings, outcomes, and complications were analyzed.

The overall success rate is 88.2%, with a median follow-up at 15 months. Repeated measures ANOVA showed that post-op HFS and follow-up HFS grades were significantly lower than pre-op HFS grades (F=17.46, df=33, p < 0.0001). HFS average age of symptom onset was early at 38.5 years, 11.8% of which wereCONCLUSION

MVD at PGH is a viable choice treatment option for Filipino patients with success rates comparable to internationally published studies. Besides improving surgical technique, improvement of referral systems may help make surgery more accessible.

BACKGROUND

The Philippines has the highest number of new leprosy cases in the Western Pacific Region, with 1,000 to 2,000+ cases detected annually over the past decade. Out of 46 filariasis-endemic provinces in the country, 43 have eliminated lymphatic filariasis. However, many grade 2 disabilities acquired from these neglected tropical diseases (NTDs) remain undetected due to inadequate monitoring during and after treatment. This was further exacerbated by the detrimental impact of COVID-19 on healthcare access. The pandemic prompted initial adoption of teletraining, making a feasibility study necessary.

This study aimed to determine the feasibility of using telehealth and distance learning to train healthcare workers and patients in the integrated rehabilitation and prevention of impairments and disabilities from leprosy, lymphatic filariasis, mycetoma, diabetes, pressure ulcers, and other chronic wounds.

Selected rural health units, patients with disabilities, and their caregivers in a leprosy- and lymphatic filariasis-endemic region were recruited. Municipal health officers and leprosy coordinators helped in the conceptualization, planning, implementation, and evaluation of the teletraining program to ensure its acceptability and utilization. Asynchronous and synchronous methods were used. The main reference was the "Ten Steps" guide. Training materials were shared via Google Drive and flash drives sent to each study site. One-day didactics and skills trainings were conducted through live-interactive sessions using online platforms (Zoom or Google Meet). Topics focused on nerve function assessment (for leprosy and diabetes), problems of mobility, lymphedema, wound care, and self-care. Participants practiced and demonstrated their skills on local patients, with mentoring through Messenger chats. Knowledge and performance assessments were conducted.

The study was conducted from 2021 to 2022 and the actual training implemented within four months of 2022. Two municipalities of Sultan Kudarat province, Mindanao Island group with one rural health unit (RHU) each had participated. All participants (N=16; eight RHU personnel and eight village health workers) attended the synchronous skills training, 12 (75%) submitted return demo videos, and 13 (81.25%) had practicum patients. All participants rated the training as successfully attaining objectives and activities. All were generally satisfied with the teletraining because of improved knowledge and skills gained and were willing to continue it. Efficiency, speed, quality of training, and trainers had high ratings. Teletraining was considered effective in improving the wound care of their patients. Patients were also satisfied with the home care. However, the unreliable internet service in the study sites created difficulties during synchronous sessions and negatively affected appropriateness of teletraining. Finding patients for practicum was challenging. Some supplies were not available in local drugstores and had to be shipped from Manila, raising costs. Overall, the rating of the teletraining was good.

Teletraining of health workers from distant health units on integrated disability prevention and care is feasible in terms of implementation, acceptability, and practicality if stable internet connectivity is available. Larger studies are recommended.

BACKGROUND

Blood pressure is an important vital sign measured not only in hypertension but also among hospitalized patients for clinical evaluation of the actual hemodynamic status. In the digital era, mercury and aneroid sphygmomanometers are being replaced by automated monitors despite lacking validation and recommendations for their use, especially in acute illness.

To compare automated and manual blood pressure measurement among hospitalized medical patients with acute illness.

A crossover design was used in a single tertiary hospital. Blood pressure was recorded from 216 participants, with 432 observations from an automated monitor (Omron HBP1120) and a mercury sphygmomanometer. Automated and manual BP recordings were done twice following the same arm sequential method. The average of the two recordings was used for comparison.

Most participants were female, elderly, obese, and had cardiac complaints. Comparing automated and manual methods, the mean difference for systolic was 1.47 ± 12.12 (p = 0.08) and 1.82 ± 10.99 (p=0.02) for diastolic. Subgroup analysis revealed that males had higher manual systolic BP than females (pairwise p-value= 0.017). Overweight and obese participants had higher automated systolic and diastolic BP (p=0.04). Overweight and obese participants had significantly higher systolic and diastolic BP regardless of the method. Significantly higher diastolic BP for different age groups and areas of admission (p=0.02) were observed from the automated method.

Automated BP monitoring showed a significant difference in diastolic BP recordings. Automated BP monitors should be used with caution, especially in interpreting diastolic BP among hospitalized patients.

OBJECTIVE

This study aimed to determine and quantify the presence of the active components in Thai propolis extracts using high performance liquid chromatography (HPLC). Moreover, the anti-caries potential of Thai propolis extract and its active ingredients were tested.

Fifty milligrams of Thai propolis were extracted using either 100%, 90%, 80%, or 70% ethanol and subsequently analyzed using HPLC with a mobile phase gradient system of 10-100% acetonitrile in 0.05% aqueous ortho-phosphoric acid, flow rate of 0.8 mL/min, and detection wavelength of 280 nm. Varying concentrations of Thai propolis extracts as well as four active ingredients were subjected to agar well diffusion test against the growth of Streptococcus mutans (S. mutans) or Lactobacillus caseii (L. caseii).

The concentrations of the four active ingredients: vicenin-2, vitexin, apigenin, and cinnamic acid, were significantly affected by ethanolic concentrations. The chromatographic peaks of all active ingredients from 70% and 80% ethanolic extracts appeared more defined, as compared to those which used higher concentrations of ethanol for extraction. Except for the absolute ethanolic extract, all of the examined propolis extracts, as well as its active ingredients inhibited both S. mutans and L. caseii.

Thai propolis extracts contain vicenin-2, vitexin, apigenin, and cinnamic acid as part of its active ingredients. These were found to be significantly affected by the increase in ethanol during its extraction. The presence of these active ingredients might have contributed to the anti-caries potential of Thai propolis extracts.

Background: Hypertension is associated with the improvement of cardiovascular disease and all-cause mortality. A healthy diet based on consuming natural foods can prevent and control hypertension. Objective: The aim of this study was to analyze the effectiveness of tomato and cucumber juice in reducing the blood pressure of hypertensive patients. Methods: The study used a quasi-experiment pretest-posttest control group design. The target population are people with hypertension Stage 1, people living in urban area - Cibiru Health Centre Work Area. Purposive sampling was used and the sample size was calculated using the average comparison formula with effect size=0.9, α=0.05, β =0.2. Forty-five subjects involved in the study were divided into three groups (15 subjects were given tomato juice, 15 subjects were given cucumber juice, and 15 subjects were given treatment with mineral water (control group)., This research used 100 grams of ripe red tomatoes, 100 grams of fresh cucumber, and 200 ml of water. The data collected were patient characteristics and blood pressure. The ANOVA analysis test and the Bonferroni Post Hoc test were used to analyze the data. Results: The results of the study showed a difference in blood pressure reduction in each group. The decrease in systolic blood pressure in the tomato juice group was 7.3+3.1, the cucumber juice group was 4.2+3.3, and the control group was -0.0+2.5 (p=0.0001). The decrease in diastolic blood pressure in the group given tomato juice was 9.2+3.1, the group given cucumber juice was 7.6+3.4, and the control group was 0.4+2.1 (p=0.0001). Conclusion There is a difference in blood pressure reduction between the group given tomato juice and the control group, and there is a difference in blood pressure between the group given cucumber juice and the control group.
Blood Pressure

INTRODUCTION

Hysteroscopy is the gold standard procedure for the evaluation and diagnosis of intrauterine pathologies. The optimal time to do hysteroscopy is during the proliferative phase. However, for women with irregular bleeding, the optimal time is unpredictable. Besides pharmacological means, mechanical endometrial preparation could be done.

The objective of this study was to determine the effect of suction curettage on visualization, operative time, fluid deficit, and histopathologic diagnosis among perimenopausal women with abnormal uterine bleeding (AUB) and unprepared endometrium prior to operative hysteroscopy.

Thirty-four (34) perimenopausal women admitted for AUB with unprepared endometrium for operative hysteroscopy who consented to participate were recruited and randomly divided into two groups: 18 women had suction curettage done prior to operative hysteroscopy and 16 women had operative hysteroscopy done alone. The following data were obtained for each group: (1) improvement in clarity (i.e., visualization of fundus and both tubal ostia), (2) operative time from entry to withdrawal of the resectoscope (measured in minutes), (3) fluid deficit, and (4) final histopathological diagnosis. P 

Women who underwent suction curettage prior to operative hysteroscopy had improved visualization (72.2%, P < 0.001), shorter operative time (29.06 ± 7.06 min vs. 35.5 ± 7.2 min, P = 0.013), no difference in fluid deficit (P = 0.276), and the histopathologic diagnosis (P = 0.470).

Suction curettage prior to operative hysteroscopy among perimenopausal women with AUB and unprepared endometrium improved visualization and shortened operative time without affecting fluid deficit and histopathologic diagnosis.

OBJECTIVES

The aim of this study is to establish a Reversed Phase – High Performance Liquid Chromatographic (RP-HPLC) method for the quantification of Rhein from Cassia fistula L. leaves.

A Shimadzu system equipped with a C18 Column (150 x 4.6 mm, 5 μm) with an isocratic elution of Acetonitrile (solvent A) and 0.1% trifluoroacetic acid aqueous solution (solvent B) (Merck, 1.08178.0050) with a 55:45 ratio, respectively and a flow rate of 1.0 mL/min and sample injection of 10 μL detection was done at 230 nm. Standard solution of Rhein (Chengdu Biopurify) was prepared for method development. This study was validated using the guidelines set under “ICH Topic Q2 R2 or the Validation of Analytical Procedures”. Procedures for linearity, precision, accuracy, limit of detection, and limit of quantitation were performed.

The retention time of Rhein standard was determined at 5.10 minutes. LOD and LOQ were determined to be 1.278 mcg/mL and 3.872 mcg/mL, respectively with good linearity (R2 ≥0.996) with a linear range of 2.5-20 ug/mL of the Rhein standard. The accuracy of the method was determined based on % recovery method and ranged from 94.75%-100.32% (intraday, n=3) with %RSD of 0.71. The intraday precision %RSD was 2.92 (n=6) while interday precision %RSD was 3.75 (n=3). The method was able to check the Rhein quantity among 10 samples of Cassia fistula L. leaves from different locations in the Philippines.

The method was found to be sensitive and accurate for the quantification of Rhein. The method was found to be useful for the quantification of the amount of Rhein and can be used as a Quality Control tool for the assessment of Cassia fistula.

BACKGROUND Hypertension is the most common risk factor for cardiovascular disease in the Philippines. Despite the availability of antihypertensive medications that are effective, safe, and tolerated by Filipino patients, the numbers of uncontrolled hypertensives are still increasing. Several factors play in the poor control of blood pressure, particularly resistant hypertension and hyperactive sympathetic nervous system. Renal denervation therapy is a novel device that has been shown to lower blood pressure in patients with resistant and difficult-to-treat hypertension and is deemed safe in clinical trials. A Philippine Working Group composed of specialists in cardiology, hypertension, vascular surgery, and clinical epidemiology has come up with consensus statements in identifying patients who will benefit from the procedure. Locally, there is a need to have hypertension centers treating uncontrolled and resistant hypertension and offer renal denervation therapy to appropriate Filipino patients.
Blood Pressure

Objectives: The aim of this study is to establish a Reversed Phase – High Performance Liquid Chromatographic (RP-HPLC) method for the quantification of Rhein from Cassia fistula L. leaves. Methods: A Shimadzu system equipped with a C18 Column (150 x 4.6 mm, 5 μm) with an isocratic elution of Acetonitrile (solvent A) and 0.1% trifluoroacetic acid aqueous solution (solvent B) (Merck, 1.08178.0050) with a 55:45 ratio, respectively and a flow rate of 1.0 mL/min and sample injection of 10 μL detection was done at 230 nm. Standard solution of Rhein (Chengdu Biopurify) was prepared for method development. This study was validated using the guidelines set under “ICH Topic Q2 R2 or the Validation of Analytical Procedures”. Procedures for linearity, precision, accuracy, limit of detection, and limit of quantitation were performed. Results: The retention time of Rhein standard was determined at 5.10 minutes. LOD and LOQ were determined to be 1.278 mcg/mL and 3.872 mcg/mL, respectively with good linearity (R2 ≥0.996) with a linear range of 2.5-20 ug/mL of the Rhein standard. The accuracy of the method was determined based on % recovery method and ranged from 94.75%-100.32% (intraday, n=3) with %RSD of 0.71. The intraday precision %RSD was 2.92 (n=6) while interday precision %RSD was 3.75 (n=3). The method was able to check the Rhein quantity among 10 samples of Cassia fistula L. leaves from different locations in the Philippines. Conclusion The method was found to be sensitive and accurate for the quantification of Rhein. The method was found to be useful for the quantification of the amount of Rhein and can be used as a Quality Control tool for the assessment of Cassia fistula.
Cassia ; Chromatography, High Pressure Liquid

Animals ; Macaca mulatta ; Optic Disk ; Glaucoma ; Craniocerebral Trauma ; Intraocular Pressure ; Low Tension Glaucoma