Adolescent ; Adult ; Aged ; Aged, 80 and over ; Emergency Service, Hospital ; Female ; Humans ; Male ; Middle Aged ; Singapore ; Skin Diseases ; diagnosis ; Tertiary Care Centers ; Young Adult

OBJECTIVETo conduct a survey on the common name/s, traditional uses and cultural importance of the edible wild fruits in different municipalities of Benguet, Cordillera administrative region.

METHODSInterviews using questionnaires with barangay leaders and indigenous people were conducted with 176 key informants from June 2011 to July 2013.

RESULTSA total of 36 fruit species were found in different municipalities of Benguet. These fruit species belong to 27 genera and 20 families. Among the 13 municipalities of Benguet, Kibungan has the highest number of species. There are many uses of wild fruits which ranged from food (snack/dessert/table food), forage (especially for birds, monkeys and wild animals such as cloud rat and grass eaters), offertory, processed/preserved (as jam, jellies, candies, juice and wine), condiment or ingredient (for cooking), source of dye or ink, decoration (to garnish food) and as medicine to common ailments or health problems. Based on the inventory and calculated cultural importance index, Garcinia binucao (balokok) belonging to Clusiaceae is the most abundant fruit, hence it is the commonly used fruit for various purposes such as food, forage, processing/preservation and condiment/ingredient; Vaccinium myrtoides (ayusip) for offerings and as source of dye/ink; Saurauia elegans (uyok) for decoration, and, Antidesma bunius (bugnay) for medicine.

CONCLUSIONSBenguet province in the Cordillera region provides a diversity of edible wild fruits. The data gathered from the study signifies that collection, processing and utilization of edible wild fruits are still part of the daily activities of the people in Benguet.

Introduction: Knowledge, attitude, and practices among diabetes patients have been heavily studied topics in different settings. Organizations catering to diabetic patients such as community clubs play pivotal role in diabetes care and management. Objectives: This research explored the knowledge, attitudes and practices among adults living with Type 2 Diabetes Mellitus in an urban community. The objective of this study was to determine the KAP of DM patients attending a community-based DM Club. Methods: Using the DAS-3 and AACE Knowledge evaluation, this study was particularly interested in knowing the KAP of the patients in the different domains such as Nutrition, Exercise, Self-monitoring, and Treatment. Type 2 DM patients attending the community-based DM club were recruited and KAP questionnaires were administered among the 89 survey respondents. Results: The level of knowledge in each domain of AACE had a mean evaluation score of 50 and above. The results also show that majority of diabetic patients strongly believe in the need for special training in teaching, counselling and behavior change techniques among health care professionals, psycho-social impact of diabetes, and patients’ autonomy. Conclusion This research also emphasizes that a community-based diabetes club may play an important role in diabetes care and management providing patient education which may lead to increased KAP.
Diabetes Mellitus ; Knowledge ; Attitude ; Residence Characteristics

BACKGROUND

Coronavirus disease 2019 (COVID-19) has been associated with acute liver injury presenting as increased liver enzymes, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST). There is limited data in the prevalence of liver injury in COVID 19. We aim to determine the prevalence of acute liver injury among COVID-19 patients admitted in a tertiary hospital in the Philippines.

The study is a single center, retrospective cohort of all COVID-19 patients with baseline AST and ALT admitted at St. Luke’s Medical Center - Quezon City from January 2020 to December 2021. The population was divided into those with normal liver enzymes, mild (AST and/or ALT 1-3 times ULN), and severe (AST and/or ALT >3x ULN) acute liver injury. Association of liver injury to clinical outcome, COVID 19 disease severity, and length of hospital stay were determined. Among those with elevated AST/ALT, comparison of the levels before and after treatment with hepatoprotective agents were evaluated.

Among the 669 patients included in the analysis, 448 (67%) developed liver injury of which 50 (7.5%) had severe liver injury and 398 (59.5%) developed mild liver injury. Chi squared analysis showed that acute liver injury (OR:2.64,CI:1.90-3.69, p < 0.01) was associated with COVID-19 severity. However, acute liver injury was not associated with clinical outcome (p = 0.347) and length of hospital stay (p = 0.317). There was no association between the use of hepatoprotective agents and changes in level of transaminases (p=0.087).

This study revealed that mild liver injury is commonly found in patients with COVID-19 infection. Severity of liver injury is significantly associated with COVID-19 severity, but not with clinical outcome and length of hospital stay. In this study, treatment with hepatoprotective agents did not lead to a decrease in liver enzymes. Further evaluation is needed to recognize those patients at higher risk of complications and identify effective therapies in providing better clinical outcomes.

Objectives: To compare the vector analysis, visual, and refractive outcomes of femtosecond-assisted laser insitu keratomileusis (LASIK) and small incision lenticule extraction (SMILE) among myopic patients with moderate myopic astigmatism. Methods: This was a single-center, retrospective, cohort study that compared eyes that underwent femtosecond LASIK or SMILE for the correction of myopia and astigmatism of 0.75 to 3.0 diopters. Vector analysis and standard graphs for reporting visual and refractive outcomes were utilized for analysis. Results: There were 82 femtosecond LASIK-treated eyes and 80 SMILE-treated eyes with similar preoperative characteristics except for slightly higher mean preoperative sphere refraction in the SMILE group (-4.2±2.4 D vs -4.9±1.6 D, p=0.03). At 3 months, femtosecond LASIK group had better mean uncorrected distance visual acuity (UDVA) (LogMAR 0.006±0.06 vs 0.06±0.09, p=0.00) and had more eyes achieving postoperative UDVA of 20/20 or better (88% versus 56%). Although there were similar postoperative spherical equivalents, residual astigmatism was higher in the SMILE group (0.11±0.22 D vs 0.32±0.30 D, p=0.00). Vector analyses showed significantly better outcomes for femtosecond LASIK than for SMILE in terms of difference vector (DV), index of success (IOS), torque, and flattening index (FI). A trend for undercorrection for higher astigmatism was seen in both groups that was greater in the SMILE group. Both groups showed high safety with the majority of eyes showing postoperative corrected distance VA (CDVA) within 1 line of preoperative CDVA (98.8% versus 91.2%). Conclusion Although femtosecond LASIK and SMILE have similar predictability at 3 months, femtosecond LASIK has relatively better efficacy and superior astigmatic outcomes than SMILE for the correction of moderate myopic astigmatism.
Astigmatism

Introduction: Basal cell nevus syndrome is not a common disorder. It has an estimated prevalence of 1 in 57,000-164,000 persons.1,2 It presents as a spectrum of phenotypic abnormalities that include developmental anomalies and postnatal tumors, particularly basal cell carcinomas. More than 100 clinical abnormalities have been reported in patients with basal cell nevus syndrome. The most typical features include: (1) basal cell carcinomas; (2) palmar and/or plantar pits; and (3) odontogenic cysts of the jaw. Early diagnosis of basal cell nevus syndrome is imperative to prevent developmental delay and increased risk for physical impairment. Case report: This case involves a 48-year-old Filipino male who showed multiplewell-defined hyperpigmented gray-black papules and nodules on the scalp, face, trunk, and back. Pertinent family history revealed three family members with multiple biopsy-proven basal cell carcinomas. On physical examination, the patient was noted to have frontal bossing and multiple palmar and plantar pits. Dermoscopy and skin punch biopsy of multiple sites were consistent with basal cell carcinoma, both superficial and nodular subtypes. Additional work-up included a panoramic x-ray of the jaw, which revealed a solitary odontogenic cyst on the left. A plain cranial MRI was also done, revealing thickened and hypointense falx cerebri suggestive of calcifications. Conclusion: Based on the presence of multiple biopsy-proven basal cell carcinomas, multiple palmar and plantar pits, and the solitary odontogenic cyst, the patient was diagnosed with basal cell nevus syndrome. Other findings that aid in the diagnosis are the presence of frontal bossing and calcifications of the falx cerebriin the patient.

Original article: Kroemer S, Frühauf J, Campbell T, Massone C, Schwantzer G, Soyer H, Hofmann-Wellenhof R. Mobile teledermatology for skin tumour screening: diagnostic accuracy of clinical and dermoscopic image tele-evaluation using cellular phones. Br J Dermatol. 2011;164(5):973-979. Aim: The original article aimed to evaluate the diagnostic accuracy of clinical and dermoscopic image tele-evaluation for mobile skin tumor screening. Setting and population: The tumors examined in the study were selected prospectively from an outpatient clinic in Graz, Austria in a duration of 3 months. They are from men or women with benign and/or malignant skin tumors of either melanocytic or non-melanocytic origin. A total of 104 tumors from 80 patients using a mobile phone camera were gathered. The lesions were from the head and neck area, trunk, legs and feet and genital area. Study examination: A board-certified dermatologist with clinical expertise in teledermatology and dermoscopy reviewed the clinical and dermoscopic pictures with clinical information separately. The results from the review of the pictures were compared with those obtained by face-to-face examination and the gold standard face-to-face examination plus histopathology. Outcome: Tumors were classified under four categories: benign non-melanocytic, benign melanocytic, malignant non-melanocytic and malignant melanocytic. The table (Table 1) below shows the final diagnoses of the skin tumors examined per category. Results: Among these 104 lesions, 25 (24%) benign non-melanocytic, 15 (14%) benign melanocytic, 58 (56%) malignant non-melanocytic and six (6%) malignant melanocytic lesions were identified. Clinical and dermoscopic tele-evaluations showed high sensitivity and specificity. For malignant non-melanocytic tumors, sensitivity for both clinical and dermoscopic lesions is 97%; specificity for clinical and dermoscopic lesions are 91& and 94%, respectively. For classifying malignant melanocytic lesions, sensitivity for both clinical and dermoscopic lesions is 100% while specificity is 98% and 97%, respectively Conclusion: Clinical image tele-evaluation might be the method of choice for mobile tumor screening. Both clinical image tele-evaluation and teledermoscopy achieved excellent and equally high concordance rates with the gold standard.
dermatology ;

Background: Uterine fibroids are the most common benign tumors in women. Management of symptomatic fibroids may ultimately require surgery and for those desirous of fertility, laparoscopically assisted myomectomy and the conventional laparoscopic procedure are conservative treatment options, with the former providing a less technically demanding approach. Objectives: This study aims to evaluate the clinical outcomes for laparoscopically assisted myomectomy (LAM) versus laparoscopic myomectomy (LM) done at a tertiary hospital. Methods: This is a retrospective chart review of 118 patients with symptomatic myomas who underwent LM (n=66) or LAM (n=52) at a tertiary hospital from January 2010 to December 2017. Results: There were significantly more fibroids removed in the LAM group compared to the LM group, but with no significant difference in the average diameter of fibroid removed. Complex plastic reconstruction with more than 2 layers of repair was done more often in the LAM group (p<0.001). The mean operative time was longer and more blood loss was incurred in the LM group, but this was not statistically significant. Almost 14% of patients in the LM group had blood transfusion compared to 4.1% in the LAM group (p=0.085). The rate of perioperative complications was similar for both groups. The length of hospital stay was shorter in the LM group, but was not statistically significant. A trend towards higher odds of pregnancy was seen in the LAM group. Majority of patients were delivered via cesarean section with no incidence of uterine rupture. The recurrence of fibroids was seen more in the LAM group (17.9% versus 13.7% for LM), however this was not statistically significant. Conclusions The surgical, reproductive, and long-term clinical outcomes for both LAM and LM are similar, thus, LAM provides a non-inferior minimally invasive approach and a conservative option for patients desirous of future fertility.
Uterine Myomectomy ; Laparoscopy