INTRODUCTION: Alternative agents have been proposed for the management of kidney or ureteral stones. This study aimed to investigate the safety and efficacy of Blumea balsamifera (sambong) compared with a terpene combination drug as treatment for ureterolithiasis. METHODS: Patients with clinically stable kidney function and ureteral stones of ≤ 5 mm were randomized to receive a special terpene combination (Rowatinex ®) or Blumea balsamifera. All patients had a physical examination, and diagnosis of kidney stones was made by ultrasound at baseline and after 6 and 12 weeks of treatment. Primary outcomes were change in stone size and stone-free status, defined as obviously successful expansion of calculi/fragments, documented by ultrasound. RESULTS: After 6 weeks, five patients in the sambong group and six in the terpene group were stone free (p = 0.90). After 12 weeks, seven in the sambong and eight in the terpene group were stone free (p = 0.31). In terms of stone size, there was a significant decrease in the mean diameter in the sambong group (1.81 ± 2.01 mm, p = 0.008 and 1.12 ± 1.43 mm p<0.005) at 6 and 12 weeks, respectively. However, there was no significant difference between the two groups. Urine pH also increased in both groups compared to baseline but the difference was not statistically significant when comparing the two arms. CONCLUSION Blumea balsamifera is comparable with a terpene combination in the dissolution of urolithiasis and is well-tolerated and safe.

Methods: Patients with congenital scoliosis who underwent SSPPCF using a pedicle screw system were reviewed. We identified the following three surgical indications: (1) hemivertebra or wedge vertebra over the thoracic or thoracolumbar region with structural lumbar curves, (2) hemivertebra or wedge vertebra at the lumbar region with significant pelvic obliquity or sacral slanting, and (3) mixed or complex congenital scoliosis. The demographic, perioperative, and radiographic data of these patients were collected. Results: Thirty-four patients were reviewed. The mean patient age was 14.6±3.4 years. There were 13 hemivertebrae, three wedged vertebrae, two butterfly vertebrae, three hemivertebrae with butterfly vertebra, eight unsegmented bars, and five multiple complex lesions. The average surgical duration was 219.4±68.8 minutes. The average blood loss was 1,208.4±763.5 mL. Seven patients required allogeneic blood transfusion. The mean hospital stay duration was 6.1±2.5 days. The complication rate was 11.8% (4/34): one patient had severe blood loss, one had rod breakage, and two had distal adding-on. The Cobb angle reduced from 65.9°±17.4° to 36.3°±15.3° (p<0.001) with a correction rate (CR) of 44.8%±17.4%. The regional kyphotic angle decreased from 39.9°±20.5° to 27.5°±13.9° (p=0.001) with a CR of 19.3%±49.6%. Radiographic parameters (radiographic shoulder height, clavicle angle, T1 tilt, cervical axis, pelvic obliquity, coronal balance, and apical vertebral translation) showed significant improvement postoperatively. Conclusions SSPPCF was a feasible option for adolescent patients with congenital scoliosis who were skeletally matured.

In the last two decades gastroesophageal reflux disease (GERD), initially thought to be a disease only common  in the West, is described  increasingly in Asia, including the Philippines. A recent local report indicated that the prevalence of erosive esophagitis (EE), a common complication of GERD, has more than doubled, i.e., 2.9% to  6.3%,  between the two time periods of 1994-1997 and 2000-2003, respectively. GERD causes recurrent annoying symptoms which are common  reasons  for  clinic  visits  and consultations thus, it is the objective of these guidelines to provide both primary care physicians  (PCPs) and specialists a current, evidence-based, country-specific recommendations for the optimal management  of  GERD.  These  guidelines  are  intended   to   empower   PCPs   to   make   a   clinic-based diagnosis of GERD, to start an empiric acid-suppressive therapy in the appropriate patient,and direct them to select which GERD patient may need to undergo investigations to ascertain further the diagnosis of GERD or to assess outcomes of therapy. We acknowledge that studies published in the future may influence the impact on our confidence on the recommendations enumerated in  these guidelines thus, we commit to update this document when it is deemed appropriate.

Physicians, Primary Care ; Prevalence ; Specialization ; Gastroesophageal Reflux ; Ambulatory Care ; Esophagitis ;