1.Retinal microvascular abnormalities in different stroke subtypes: A cross-sectional study
Monique Therese S. Punsalan ; Antonio Miguel C. Unabia ; Jose Luis G. De Grano ; Rene B. Punsalan
Health Sciences Journal 2017;6(1):28-34
Introduction:
This study aimed to describe retinal microvascular changes in patients diagnosed to
have stroke and determine the association between retinal microvascular changes and type of
stroke (lacunar and non-lacunar).
Methods:
This is a cross-sectional descriptive study conducted among stroke patients seen at the
Neurology Ward and Neurology Out-Patient Clinic of the UERM Memorial Medical Center. The
patients' demographic characteristics and risk factors were obtained through a standardized
questionnaire. Retinal photographs of both eyes were taken in eligible patients who consented to join
the study. Retinal vascular changes were identified and their association with the type of stroke was
determined.
Results :
Thirty-seven patients, 64% of whom had small artery occlusion type of lacunar stroke, were
enrolled in the study. The most prevalent retinal abnormalities for each type of stroke were AV
nicking and focal arteriolar narrowing. The prevalence of abnormal retinal findings between
patients with lacunar stroke and non-lacunar stroke were compared and showed insufficient
evidence to demonstrate a statistical significance between abnormal retinal findings and lacunar
stroke.
Conclusion
There is no significant association between abnormal retinal findings and lacunar
stroke.
Stroke
;
Stroke, Lacunar
2.Spectrum of CNS infections in the Philippines.
Rene B. Punsalan ; Aida Salonga ; Esteban Pasol ; Marcelino Ostrea ; Pia Banico ; Paul Pasco ; Teresita Rabanal ; Ma. Antonia Valencia
Philippine Journal of Neurology 2020;23(1):25-32
The CNS Infection Censuses for 2011 and 2012 from 9 neurology training programs in 7 institutions in the
Philippines were collated to determine the types of CNS infections seen in the country and their relative
frequencies. A comparison with a similar survey done in 1999 was made. A total of 1629 cases of CNS
infections were recorded. There were 23 categories. Bacterial meningitis (34.3%) and TB meningitis
(30.7%) were the top two infections, constituting more than half of all CNS infections seen. When the adult
and pediatric census were separated, TB meningitis came up to be the most common infection in adults
(43%) with bacterial meningitis a poor second at 19.4%. The reverse is seen in the pediatric population –
bacterial meningitis (41.7%) vs. TB meningitis (24.6%). Cryptococcal meningitis was more frequent in the
adult census (8.1%) compared with the pediatric census (0.1%). These patterns were seen in a similar
census done in 1999. A significant increase in relative frequency in cryptococcal cases was seen in the later
census (2.8% vs. 2.0%), the increase being due to the marked increase in the adult group (8.1% vs. 4.3%),
probably due to the upward trend in the incidence of HIV cases in the country. No increase in this category
was seen in the pediatric population. The benefits of collaboration among institutions in coming up with a
large number of cases of CNS infections and a greater variety to study was highlighted. The study was
conducted by the CNS Infection Council of the Philippine Neurological Association.
Central Nervous System Protozoal Infections
;
Censuses
;
Philippines
3.Acute carbon monoxide poisoning in a Filipino household
Louraine Mae J. Bagares ; Philip Rico P. Mejia ; Rene B. Punsalan ; Marc Conrad C. Molina
Philippine Journal of Neurology 2023;26(2):15-19
There have been multiple reports already regarding acute carbon monoxide/CO poisoning in
the Philippines secondary to misuse of portable generators, especially during the times of
typhoon. We present a case of unintentional carbon monoxide poisoning in a Filipino household
wherein three of its members were found dead and leaving other five unconscious before they
were rushed to the hospital. The index patient had increased serum fraction percentage of
carboxyhemoglobin level and presented with rhabdomyolysis during admission. Neuroimaging
confirmed a hypoxic-ischemic encephalopathy secondary to carbon monoxide intoxication.
Even without hyperbaric oxygen therapy, patient improved with adequate hydration, early
rehabilitation and trauma-focused psychotherapy.
Carbon Monoxide Poisoning
;
Carbon Monoxide
;
Family Characteristics