Background and Objectives The Alberta Stroke Program Early CT Score (ASPECTS) is a standardized system used to quantify the extent of ischemic involvement in cases of acute middle cerebral artery (MCA) infarct. It aids in clinical decision-making to identify patients who are more likely to benefit from thrombolytic therapy. This study aimed to determine the interobserver variation of ASPECTS among training and expert radiologists in a real-time, low-resource setting.
Stroke

Background: Cervical cancer is the second most common malignancy among Filipino women. The recent 2018 FIGO guidelines recommend imaging in cases of grossly invasive disease to determine the presence of hydronephrosis, which would immediately classify the disease as at least stage IIIB. CT and MRI are state-of-the-art modalities that can provide such information; however, these are costly and may not be accessible in areas with limited resources. Sonography is a safe and inexpensive alternative in this regard.

Objective: This study aimed to evaluate the diagnostic performance of renal sonography in identifying the presence of ureteral obstruction or hydronephrosis among patients with grossly invasive cervical cancer, with non-enhanced CT as the reference standard.

Methods: A blinded, prospective study was conducted among patients diagnosed with grossly invasive cervical cancer from the Philippine General Hospital. Participants underwent same-day evaluation with both renal sonography and non-enhanced CT. The presence of either ureteral obstruction or hydronephrosis secondary to cervical cancer was independently determined. The sensitivity, specificity, positive predictive value, and negative predictive value of renal sonography were calculated, with non-enhanced CT as the reference standard.

Results: A total of 127 participants were enrolled. The mean age was 46 years, with a range of 24 to 65 years. The majority had stage IIB (41.7%) and stage IIIB (52.0%) disease. On non-enhanced CT, 46 (36.2%) showed evidence of ureteral obstruction or hydronephrosis, while 81 (63.8%) had negative results. On renal sonography, 46 (36.2%) had positive results, and 81 (63.8%) had negative findings. The sensitivity, specificity, and positive and negative predictive values of sonography were 91.3%, 95.1%, 91.3%, and 95.1%, respectively. Among patients with stage IIIB disease, sonography was shown to have higher sensitivity and specificity of 92.1% and 96.4%, respectively. Meanwhile, among patients with stage IB to IIB disease, its sensitivity and specificity were 87.5% and 94.3%, respectively.

Conclusion: Renal sonography has high sensitivity and specificity in the diagnosis of ureteral obstruction or hydronephrosis in patients with grossly invasive cervical cancer. Its sensitivity is higher when used in patients with stage IIIB disease, compared with those having lower-stage tumors.

Uterine Cervical Neoplasms ; Hydronephrosis ; Ureteral Obstruction ; Ultrasonography

Background and Objective: Transarterial chemoembolization (TACE) is a locoregional therapy used in patients with unresectable intermediate-stage hepatocellular carcinoma (HCC). It has proven benefit on overall survival, but considerable side effects and potential complications may occur. Preservation of quality of life is a concern in many cancer-related therapies, and the same goal should apply in TACE. This study aimed to determine the effect of TACE on the immediate health-related quality of life (HRQoL) of Filipino patients with unresectable HCC. Methods: A prospective observational survey study of 18 HCC patients who underwent TACE was conducted. HRQoL scores were measured using the validated EORTC QLQ-C30 and QLQ-HCC18 questionnaires, 1-2 days before and two weeks after TACE. Baseline clinical data, which included tumor characteristics, Child-Pugh score, and performance status score, were also obtained. Changes in HRQoL scores before and after TACE, and any association of demographic and clinical variables with HRQoL outcomes were assessed. Results: Patients experienced overall decline in their global health status and functional scores with increase in their symptom scores after undergoing TACE. Statistically significant deterioration was observed in global health status (-13.9%), physical functioning (-23.0%), and role functioning (-31.4%). Alcohol users had lower global health status scores at baseline and follow-up, although there was no significant difference in the degree of decline in their post-TACE scores compared with non-alcohol users. Patients with BCLC stage C disease also had lower global health status scores at baseline, although scores were no longer significantly different from patients of other stages on post-TACE follow-up. Patients with BCLC stage B tumor experienced significant decline in their global health status scores. The presence of minimal ascites at baseline was associated with less deterioration in physical function scores after TACE. Largest and significant increases in symptomatology were seen for appetite loss (+41.1%), fever (+30.3%), fatigue (+28.5%), and general pain (+25.1%). Conclusion TACE can negatively affect the HRQoL of Filipino patients in the early phase after treatment, with significant deteriorations in global health status, physical, and role functioning, and increased severity in symptoms, especially appetite loss, fever, fatigue and pain. Knowledge of these changes should be used to improve patient care, compliance, and expectations.
Human ; carcinoma, hepatocellular ; health-related quality of life ; quality of life

OBJECTIVE: This study aimed to determine the knowledge, attitudes and practices (KAP) of a selected population of patients on herbal dietary supplements (HDS).
METHOD: Methodological triangulation was used to generate a conceptual framework on HDS KAP. A survey of 175 patients was performed to measure knowledge and attitudes regarding HDS and SPSS was used for data analysis. Inverviews and focus group discussions (FGDs) were conducted to further explore the attitudes and practices, and constant comparison method was used for analysis of responses.
RESULTS: Respondents were generally aware of HDS. Majority of survey respondents believed that HDS are different from conventional drugs (52.0%, p<0.05). However, knowledge on the role of the Food and Drug Administration (FDA) in regulating HDS and understanding of "No Approved Therapeutic Claims" were poor.
The attitude toward HDS was generally positive. Majority (64.0%, p<0.05) were positive toward their perceived health benefits as claimed for the prevention of diseases, while a smaller percentage (46.9%, p<0.05) believed in their benefit for the treatment of diseases. A favorable attitude regardings HDS safety was observed due to the idea of their being "herbal" and "natural".
Among the survey respondents, only 22% were HDS users. Family was shown to promote use while cost deterred their use.
CONCLUSION: Individual knowledge and attitudes on HDS exert significant influence toward HDS practices. Factors that promote use are poor knowledge and positive attitudes toward HDS. Good knowledge seems to lead to judicious use or non-use.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Focus Groups ; United States Food And Drug Administration ; Awareness ; Perception ; Safety ; Attitude ; Dietary Supplements