Transbronchial needle aspiration(TBNA) is able to provide definitive answers for a wide variety of pulmonary benign and malignant diseases including infectious diseases,cystic lesions, granulomatous diseases, pulmonary and mediastinal mass, etc. It's proved particularly revolutionary to stage bronchogenic carcinoma during routine flexible bronchoscopy. What's more, TBNA is an extremely safe procedure with no reported major complications. This review introduces the techniques about identifying the target, obtaining the specimen and preparing and interpreting the specimen when conducting TBNA. The complications, a through unusual, and major limitations are also touched in this review.

Objective: To determine the effect of ascorbic acid supplementation in addition to lifestyle modifications as a treatment for Stage I hypertension. Design: Randomized prospective crossover study Setting: Tertiary hospital, outpatient department. Methodology: A total of 62 patients out of 72 prospective subjects aged 60 years old and above, diagnosed to have Stage I hypertension were included in the study. Subjects were assigned to two (2) groups, Groups I and II through random allocation method. Both groups had 32 subjects initially and underwent two (2) phases, each phase lasting for 3 months. In phase I, Group I was given ascorbic acid 500 mg in addition to lifestyle modification instructions and Group II with lifestyle modifications only. A washout period was observed for one (1) week after the first phase. In phase II, ascorbic acid was withheld from Group I and given to Group II, with both still receiving lifestyle modification instructions. All participants were instructed to return every month for blood pressure determination in all phases of the study. Data gathered were analyzed using Epi-Info and Epi Stat software. Results: Two (2) patients dropped out from Group I. The mean age of Group I was 68.59 and Group II at 69.02. There were more males in both groups at 56 percent in Group I and 65 percent in group II. Most were married. More subjects in Group I (56 percent) had normal BMI while more subjects in Group II (53 percent) were overweight. Six patients (9 percent) had noted side effects but had not warranted to stop treatment. A significant decrease of 9.8 mmHg from the baseline was noted from those receiving ascorbic acid in addition to lifestyle modifications compared to 7.2 mmHg decrease in those practicing lifestyle modifications only. Conclusion: This study has shown that an addition of 500 mg ascorbic acid daily to lifestyle modifications is more beneficial in lowering blood pressure in stage I hypertension as compared with lifestyle modifications only.
Human ; Male ; Female ; Aged 80 and over ; Aged ; Middle Aged ; LIFE STYLE ; AGED ; ASCORBIC ACID ; HYPERTENSION

We are reporting the LASIK cases and the results done by two different surgeons. Patients were selected based on a thorough history taking and complete ophthalmologic examination. The variability was decreased by only reporting the cases done by the co-authors since the operative technique followed by the two were virtually similar. Pre-operative corneal topography, videokeratography, and pachymetry were taken together with a thorough routine ophthalmologic history and examination. All patients who were screened were included in the study. The Schwind Microkeratome was used to create the corneal flap, the stromal ablation was then performed using the Schwind Microkeratome-F by Coherent with the Lambda Physik COMPex Excimer Laser. Pre-operative visual acuity was compared from the post-operative results. Likewise, intra-operative and post-operative complications were reported. Regular follow-up was done at 1 day, 1 week, 1 month and 6 months post-op. Visual acuity and refraction were closely monitored during the follow-up. (Author)
Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; OPHTHALMOLOGY ; CORNEA

Translational research in medicine aims to inform the clinic and the laboratory with the results of each other’s work, and to bring promising and validated new therapies into clinical application. While laudable in intent, this is complicated in practice and the current state of translational research in cancer shows both striking success stories and examples of the numerous potential obstacles as well as opportunities for delays and errors in translation. This paper reviews the premises, promises, and problems of translational research with a focus on radiation oncology and suggests opportunities for improvements in future research design.

This is from a 76-year-old male with a fungating maxillary antral mass that extends into the nasal cavity. (Author)
CARCINOSARCOMA

The exciting information engendered by developments in neuroscience are essential in understanding the mechanisms of various psychiatric disorders as influenced by psychosocial forces. Contemporary psychiatric research has conclusively demonstrated that mind/brain responds to biological and social vectors and its jointly constructed by both. Major brain pathways are specified in the genome, detailed connections are fashioned by the consequently reflect socially mediated experience in the world.
PSYCHOTHERAPY ; PSYCHIATRY ; NEUROSCIENCES

OBJECTIVE. This study was conducted to describe areas of concern with respect to occupational health and safety (OHS) program administration at eleven (11) Metro Manila hospitals, particularly: level of OHS knowledge and skill of personnel, the nature of occupational hazards perceived to exist in the hospitals, and how these relate to OHS program staffing and implementation.
METHODS. Participants were surveyed on OHS knowledge and skills, as well as perceived occupational hazards, during the pilot of the "Occupational Health and Safety for Hospital Workers" training course held last April 2009.
RESULTS AND DISCUSSION. The participants needed improvement in many of the OHS knowledge and ability items assessed. Familiarity and mastery of some items were demonstrated, but for effectiveness to be assured, it is necessary for other areas to be improved. Occupational hazards from all categories (chemical, ergonomic, physical, biological, and safety-related) are observed in the hospitals, with the most frequently cited being chemical and ergonomic in nature. Health and safety committees and OHS programs exist, but staff abilities limit their operation and effectiveness.
CONCLUSION AND RECOMMENDATIONS. Improvement of certain OHS personnel abilities in the hospitals surveyed is suggested, and may help improve administration of OHS programs.

In Vitro Fertilization (IVF) is an established treatment approach for infertility based on the developments the past quarter century. However, there are still a number of reasons which prevent both doctors and patients from embarking on this available treatment option. The current indication for IVF (including endometriosis, tubal pathology, anovulation, male factor infertility-and unexplained infertility) are reviewed considering prognosis for pregnancy using IVF as compared to no/more conventional treatment. Evidence-based data are presented. Also, maternal age as a factor for success in IVF treatment is reviewed. Local setting situations which contribute to delays in treatment are also tackled.
FERTILIZATION IN VITRO

Background: The doctor-patient relationship has been recognized throughout the history of medicine and its importance was emphasized in the delivery of healthcare services and health outcomes. One of the major roles of empathy is changing a pathologic mind’s configuration, and the establishment of a linkage between a doctor and patient is a crucial element of a strong therapeutic alliance and health outcome. This is an element to gain trust and comprehension to sustain a good communication and to eliminate burden for both the doctor and the patient. Objective: To determine the empathy scores of Physicians of Region 1 Medical Center (R1MC) Department of Family and Community Medicine (DFCM) towards patients. Methods: This was a purely descriptive study thru survey of DFCM physicians conducted among patients catered at the DFCM OPD of R1MC. Result: In this study, the authors had a total 614 respondent from the six different districts in Pangasinan. All of them were able to answer the questionnaire based on Consultation and Relational Empathy (CARE) model which was utilized in this study in assessing the empathy score of Family and Community Medicine Department Physicians in Region I Medical Center. The overall mean CARE Measure score was 48.77 (SD 3.38) and 77.2% achieved the maximum possible score of 50. Conclusion Based on the findings and analysis of the data gathered in this research study using CARE Measure, we therefore concluded that physicians from the Department of Family and Community Medicine of Region I Medical Center showed great empathy towards patients as based on the empathy score of excellent.
Physician-Patient Relations

Objectives: To determine the efficacy of a 7-day treatment of methylprednisolone 16mg in reducing the size of nasal polyps and on improvement of nasal symptoms. Methods: Design: Randomized double-blind placebo-controlled trial Setting: Out-patient department of the East Avenue Medical Center Patients: Patients 18 years old and above with nasal polyposis determined by history and endoscopic examination Results: There was a significant decrease in polyp size by an average of 16 percent (P < .05) among 12 out of the 23 patients (52.17 percent) in the steroid group versus placebo. The treatment group also exhibited an improvement in nasal symptoms of rhinorrhea, congestion and anosmia compared to the placebo. Conclusion: Medical treatment with oral methylprednisolone given at a low dose of 16 mg for one week resulted in reduction of the size of nasal polyps and improved the symptoms of rhinorrhea, nasal congestion and anosmia. Other associated symptoms like headache, epistaxis, sneezing, itchiness, epiphora, cough, postnasal drip, throat discomfort, facial pain, eyecomplaints and fever did not differ between the steroid and placebo groups. Recommendation: One week of oral steroids can be used to treat nasal polyps initially. If there is response, this mode of management can be combined with a long-term course of intranasal steroid sprays. Patients who do not respond may be referred for surgery. (Author)
NOSE DISEASES METHYLPREDNISOLONE OLFACTION DISORDERS POLYPS NASAL POLYPS