Background: von Willebrand Diseases (vWD) is the most commonly inherited bleeding disorder. It is defined as a deficiency or abnormality of von Willebrand Factor (vWF) causing impaired hemostasis. Studies in a predominantly pediatric population reveal that the prevalence of vWD is 0.8-1.3 percent. Objective: To determine the prevalence of von Willebrand Diseases and to establish its clinico-hematologic profile. Methods: Ninety-nine patients with bleeding manifestations referred to the National Hemophilia Center from all over the Philippines were studied. Patients who fulfilled the inclusion criteria of at least 2 symptoms consistent with vWD, underwent initial screening tests: a complete blood count with actual platelet, blood typing, bleeding time, prothrombin time and activated partial thromboplastin time. Laboratory tests to diagnose vWD were done. Results: Thirty four patients (34.34 percent) with bleeding manifestations had vWD. Patients with vWD and those without were comparable as to age, sex distribution, family history of bleeding, blood type and bleeding manifestations. Among the patients with vWD, 11 (32.35 percent) had Type I vWD and 23 (67.65 percent) had Type 2 vWD. The mean FVIII, vWF: Ag and vWF: RCo were decreased. Conclusion: The study suggests that there is a high proportion of vWD among patients with bleeding tendency in the Philippines.
Human ; Male ; Female ; Adult ; Young Adult ; Adolescent ; Child ; VON WILLEBRAND DISEASES ; HEMORRHAGE

Purpose: Succinylcholine has been the agent of choice when clinical conditions require emergency airway protection during a rapid-sequence induction of anesthesia. However, the administration of succinylcholine is not without its problems. One of its side effects is the occurrence of fasciculations. To prevent fasciculations, a nonparalyzing dose of a nondepolarizing neuromuscular-blocking drug (pretreatment) is given prior to the actual administration of succinylcholine. Atracurium is one of the most popular nondepolarizing muscle relaxants used for pretreatment. Rocuronium is a novel non depolarizing muscle relaxant, that has a promising potential as a pretreatment drug. The objective of this trial was to determine the efficacy of rocuronium as a pretreatment drug and compare it with atracurium and placebo. Methods: Sixty ASA I and II patients about to undergo an emergency operation under rapid sequence induction of general anesthesia patients were enrolled in this double blind study. They were randomly divided into 3 groups of 20 according to the nondepolarizing pretreatment to be used: 0.9 percent NaCl (control), 0.05 mg/kg atracurium and 0.06 mg/kg rocuronium. Two minutes after pretreatment, succinylcholine at 1.5 mg/kg was injected. The presence and magnitude of fasciculations and the ease of tracheal intubation were assessed. Results: There was no difference among the three groups with respect to age, sex distribution and weight. Fasciculations occurred in 42 (70 percent) out of the 60 patients: 9 (45 percent) in the rocuronium group, 13 (65 percent) in the atracurium group and 20 (100 percent) in the saline group, P0.05. The severity of fasciculations was significantly lowest in the rocuronium group, followed by the atracurium group, and was highest with the saline or control group. Intubating conditions were rated as excellent, good, fair or poor in all patients. There was no statistically significant difference among groups. Conclusion: Rocuronium is superior to atracurium in preventing and reducing the intensity of fasciculations induced by succinylcholine, with no difference in the intubating conditions. Its use therefore in rapid-sequence induction of anesthesia as pretreatment is highly recommended, because it facilitates immediate airway intubation devoid of fasciculations and its undesirable effects. (Author)
Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Adolescent ; FASCICULATIONS ; ROCURONIUM ; ATRACURIUM ; SUCCINYLCHOLINE ; ANESTHESIA, GENERAL ; INTUBATION

Background: Human Immunodeficiency Virus (HIV) infection/Acquired Immunodeficiency Syndrome (AIDS) remains a major challenge worldwide. Physicians have a crucial role in the struggle against HIV/AIDS and must be equipped with proper knowledge, attitude and practices (KAP). No study has been done to assess the KAP of dermatologists related to HIV-AIDS. Objective: The study’s objective was to determine the KAP of Philippine Dermatological Society (PDS) members related to HIV/AIDS. Methods: A cross-sectional study was done among PDS members from February to November 2017 utilizing a questionnaire consisting of socio-demographic questions and KAP questions related to HIV. Results: Out of 210 participants, 71.43% show good working knowledge, 60.95% show negative attitudes, 55.71% show bad practices related to HIV/AIDS. Members aged 29 to 37 years old, having worked as dermatologists for 1 to 8 years, and having worked in the health care sector for 1 to 8 years have better working knowledge on HIV/AIDS. Although with lesser duration of work as dermatologist, these members have more positive attitudes towards HIV/AIDS. These findings may be attributed to greater exposure to HIV cases and better ability to access information by internet among younger dermatologists. Gender is not significantly associated with KAP related to HIV/AIDS. Practice related to HIV/AIDS is not significantly associated with any demographic variables. Bad working knowledge related to HIV/AIDS is associated with negative attitude and bad practices. This can be attributed to insufficient training in the field of HIV/AIDS. Conclusion Majority of PDS members show negative attitudes, bad practices, but good working knowledge related to HIV/AIDS.
HIV ; Acquired Immunodeficiency Syndrome ; Knowledge ; Attitude ; Dermatologists

OBJECTIVE

This study compared the proportion of dry eye disease (DED) diagnosed using the Philippine criteria with that diagnosed using the Asia Dry Eye Society (ADES) criteria among participants, and characterized DED features using clinical tests and the OCULUS Keratograph® 5M (K5M; OCULUS Optikgeräte GmbH, Wetzlar, Germany).

This multicenter, cross-sectional study included participants with and without DED. Participants completed the Ocular Surface Disease Index (OSDI) questionnaire and underwent fluorescein tear breakup time (FTBUT) measurement, fluorescein staining of the cornea, lissamine green staining of the conjunctiva, Schirmer 1 test without anesthesia, and basal tear secretion test (BST). The OCULUS K5M was used to measure noninvasive tear breakup time (NIKBUT) and tear meniscus height (TMH), and to perform meibography.

The analysis included 344 eyes from 172 patients with DED and 44 eyes from 22 normal participants. Patients with DED were mostly female (66.3%). Compared to normal participants, patients with DED were older (42.7 ± 14.6 years) and had higher OSDI scores (28.6 ± 21.0). Among those diagnosed with DED using the Philippine criteria, 53.2% met the ADES criteria. Evaporative DED was the predominant type (53.2%). DED eyes had lower FTBUT (5.0 ± 3.3 seconds) and NIKBUT (12.3 ± 5.9 seconds) than controls (p CONCLUSION

There were disparities between the Philippine and ADES criteria for DED diagnosis and differences in tear measurements using clinical tests and the OCULUS Keratograph, indicating the need to harmonize diagnostic standards.

Objectives. Polymorphisms in metabolic genes which alter rates of bioactivation and detoxification have been shown to modulate susceptibility to colorectal cancer. This study sought to evaluate the colorectal cancer risk from environmental factors and to do polymorphism studies on genes that code for Phase I and II xenobiotic metabolic enzymes among Filipino colorectal cancer patients and matched controls. Methods. A total of 224 colorectal cancer cases and 276 controls from the Filipino population were genotyped for selected polymorphisms in GSTM1, GSTP1, GSTT1, NAT1 and NAT2. Medical and diet histories, occupational exposure and demographic data were also collected for all subject participants.Results. Univariate logistic regression of non-genetic factors identified exposure to UV (sunlight) (OR 1.99, 95% CI: 1.16-3.39) and wood dust (OR 2.66, 95% CI: 1.21-5.83) and moldy food exposure (OR 1.61, 95% CI:1.11-2.35) as risk factors; while the NAT2*6B allele (recessive model OR 1.51, 95% CI :1.06-2.16; dominant model OR 1.87, 95% CI: 1.05-3.33) and homozygous genotype (OR 2.19, 95% CI: 1.19-4.03) were found to be significant among the genetic factors. After multivariate logistic regression of both environmental and genetic factors, only UV radiation exposure (OR 2.08, 95% CI: 1.21-3.58) and wood dust exposure (OR 2.08, 95% CI: 0.95-5.30) remained to be significantly associated with increasing colorectal cancer risk in the study population.Conclusion. This study demonstrated that UV sunlight and wood dust exposure play a greater role in influencing colorectal cancer susceptibility than genotype status from genetic polymorphisms of the GST and the NAT` genes.
Colorectal Neoplasms ; Polymorphism, Genetic