Bullous pemphigoid (BP) is a severe autoimmune blistering condition that characteristically presents as large tense bullae on a background of normal or erythematous skin. In atypical cases, presentation is widely variegated ranging from vesicular eruptions to erythrodermic presentations. This case highlights on a rare presentation of BP manifesting with varicella-like eruption. The recognition and early diagnosis of a unique presentation of this condition is of great importance as it may greatly influence the patient’s outcome and prognosis.

Vulvar syringoma is a rare presentation of a benign eccrine sweat gland tumor that is more commonly found on the face. It typically presents as small, flesh-colored papules on the labia majora. Unlike syringomas elsewhere, the vulvar variant can cause significant pruritus, often worsened by heat, sweating, menses, or pregnancy. While asymptomatic cases may not require treatment, options for pruritus and cosmetic concerns include topical medications and surgical modalities like excision or laser ablation. This case report details the successful management of intractable vulvar pruritus caused by syringoma in a 53-year-old Filipino female using electrodessication. We aim to highlight the importance of considering this often-overlooked condition in the differential diagnosis of vulvar lesions, particularly in cases of persistent pruritus.

Objective: To determine the prevalence and severity of retinopathy of prematurity (ROP) and its associated factors on initial examination of infants screened at a tertiary hospital. Methods: A descriptive retrospective study was done using clinical charts of infants screened for ROP at a tertiary hospital from January 2007 to August 2009. Results of the initial examination were collated and analyzed. Results: A total of 112 eyes of 56 infants were screened. Upon initial examination, 21(18.75%) eyes of 11 infants were positive for ROP. Of these, 14 (12.5%) eyes of 8 infants had severe ROP warranting laser or surgical intervention. Sixty-nine (61.6%) eyes of 35 infants had immature retina, while 22 (19.64%) eyes of 11 infants had mature retina. Three (2.68%) eyes had stage 5 ROP. The infants with stage 5 ROP had mean gestational age of 28 6/7 weeks by LMP and mean birth weight of 1,282 grams. The positive cases were most commonly associated with oxygen exposure (100%), sepsis (85.71%), and blood transfusion (80.95%). Conclusion The finding of more than half of the positive cases warranting laser or surgical interventions on initial examination merits re-evaluation of screening recommendations and their timing.
Retinopathy of Prematurity ; Gestational Age ; Sepsis ; Birth Weight

Objective: To compare the antimicrobial effects of locally available multipurpose contact lens solutions (MPS) on the growth of standard strains of contact lens-related ocular pathogens and to establish the recommended duration of exposure to these solutions to achieve maximal antimicrobial efficacy. Methods: This study, a single-blind controlled experiment, evaluated five locally available MPS in terms of their antimicrobial efficacy towards common contact lens-related ocular pathogens, such as P. aeroginosa, S. aureus, E. coli, F. solani, and C. albicans, using the stand alone criteria. Microbial viability counts were obtained at serial durations: after 1 hour, 3 hours, 6 hours, and 12 hours of exposure. Results: MPS containing polyquaternium-1 and myristamidopropyl dimethylamine (MAPD) and polyhexamide reduced the bacterial concentrations by 3 log and fungal concentrations by 1 log, enabling them to fulfill the stand alone criteria for disinfecting solutions as mandated by ISO/CD 14729. This antimicrobial efficacy was most evident at 6 hours of exposure to the challenge organisms. MPS containing polyquaternium-1 and MAPD also have the broadest spectrum of effectivity against gram-negative and gram-positive bacteria, and C. albicans. All MPS tested have poor microbial activity against F. solani. Conclusion Multipurpose contact lens solutions demonstrated variability in their antimicrobial activity. MPS with broad spectrum efficacy and effectivity, such as those containing polyquaternum and MAPD, are preferred to prevent contact lens-related ocular infections.
Contact Lenses

Objective: This study determined the incidence of and risk factors for color-vision abnormalities among Filipino patients undergoing directly observed treatment short-course (DOTS) for tuberculosis. Methods: A prospective single-cohort study involving newly diagnosed patients with category-1 tuberculosis, recruited from DOTS health centers in Manila, was conducted. All patients were given a fixed-dose combination of rifampicin, isoniazid, ethambutol, and pyrazinamide for 60 days, after which treatment was continued with rifampicin and isoniazid for 4 more months. The participants underwent complete eye evaluation including color-vision testing and were followed up every month up to the conclusion of treatment. Results: Out of 93 patients initially enrolled, 64 completed the prescribed follow-up and constituted the study group. Baseline color vision was normal. After 1 month of therapy, color vision tested with the Ishihara plates remained normal in all patients, but one failed the Farnsworth Panel D 15 and was classified as tritan while 30 (47.88%) failed the Lanthony Desaturated test. The type of abnormality was unclassified in 20 (66.67 %)patients and tritan in 10 (33.3%). Visual acuity remained unchanged from baseline. Repeat testing after ethambutol and pyrazinamide were stopped showed that color vision was normal using the Ishihara plates and the Farnsworth test, while 5 failed the Lanthony test. Of these, 3 were unclassified and 2 were tritan. In the 3rd to 6th months follow-up, no color-vision abnormalities were noted in the 3 tests. The only risk factor identified was age (p = 0.01) with older patients having a higher risk. Conclusion The incidence of color-vision abnormalities among patients undergoing DOTS was 47.88% using the Lanthony Desaturated test after an average of 39.66 days on quadruple anti-TB therapy. Age was the only significant risk factor observed. The color-vision abnormalities returned to normal within an average of 37.85 days after discontinuing ethambutol and pyrazinamide.
Ethambutol ; Tuberculosis ; Color Vision

Background: The shift to online learning during the COVID-19 pandemic has caused students to experience several challenges in their academic lives. A strategy that may assist in mitigating these challenges and facilitating students' positive adaptation to online learning is the promotion of self-regulated learning (SRL). However, SRL is underexplored in the context of health sciences students. Objectives: This study aimed to describe the extent and examine the nature of SRL of allied health students in a fully remote learning environment. Methodology: This is a cross-sectional online survey study. Data were collected online using Qualtrics. Descriptive statistics and confirmatory factor analysis were used to determine the extent and nature of SRL, respectively. Results: Responses from 241 participants show that students had a mean self-regulated learning score of 82.80 out of 120 (SD=12.68). Of the dimensions of SRL, students had higher scores in environmental structuring, time management, and self-evaluation than the other dimensions. A six-factor second-order model of self-regulation showed adequate model-data fit (χ2=673.88, CFI=0.95, TLI=0.95, SRMR=0.09, RMSEA=0.09 [90% CI=0.08-0.09]). Conclusion Health science students showed a high level of SRL; SRL for these students is adequately measured using the six dimensions of goal setting, environmental structuring, tasks strategies, time management, help seeking, and self-evaluation. The results indicate the value of understanding the extent and nature of SRL as a first step in planning strategies to support learning and student success in remote environments.
Surveys and Questionnaires

Background: The shift to online learning during the COVID-19 pandemic has caused students to experience several challenges in their academic lives. A strategy that may assist in mitigating these challenges and facilitating students' positive adaptation to online learning is the promotion of self-regulated learning (SRL). However, SRL is underexplored in the context of health sciences students. Objectives: This study aimed to describe the extent and examine the nature of SRL of allied health students in a fully remote learning environment. Methodology: This is a cross-sectional online survey study. Data were collected online using Qualtrics. Descriptive statistics and confirmatory factor analysis were used to determine the extent and nature of SRL, respectively. Results: Responses from 241 participants show that students had a mean self-regulated learning score of 82.80 out of 120 (SD=12.68). Of the dimensions of SRL, students had higher scores in environmental structuring, time management, and self-evaluation than the other dimensions. A six-factor second-order model of self-regulation showed adequate model-data fit (χ2=673.88, CFI=0.95, TLI=0.95, SRMR=0.09, RMSEA=0.09 [90% CI=0.08-0.09]). Conclusion Health science students showed a high level of SRL; SRL for these students is adequately measured using the six dimensions of goal setting, environmental structuring, tasks strategies, time management, help seeking, and self-evaluation. The results indicate the value of understanding the extent and nature of SRL as a first step in planning strategies to support learning and student success in remote environments.

OBJECTIVE: To compare the visual, refractive, and patient-reported outcomes of eyes implanted with one of 3 trifocal intraocular lenses (IOLs). METHODS: This is a cross-sectional, comparative, non-interventional study wherein subjects implanted with FineVision Micro F, AT LISA tri 839MP or AcrySof IQ PanOptix trifocal IOL after phacoemulsification were recruited. Manifest refraction, uncorrected and corrected visual acuity (VA) at distance, intermediate and near vision, contrast sensitivity, modulated transfer function (MTF) values and questionnaire answers were compared among the 3 groups using analysis of variance (ANOVA). RESULTS: Fifty-seven (57) eyes were included in the study: 21 eyes with FineVision (group A), 21 eyes with LISA tri (group B), and 15 eyes with PanOptix IOL (group C). The post-operative mean manifest spherical equivalent was -0.01D, -0.07D, and 0.05D, respectively (p=0.083). Uncorrected distance VA and best-corrected distance VA were similar among the groups. Groups A and C had better uncorrected and corrected intermediate VA at 80 cm and at 60 cm compared to group B. Group A had significantly better uncorrected near visual acuity than groups B and C (p=0.032). Mesopic contrast sensitivity testing showed group C had higher contrast sensitivities without glare in at the spatial frequency of 6 CPD (p=0.038) and with glare at 3 CPD (p=0.039) and at 12 CPD (p=0.009). MTF average height analysis showed that the group A had significantly superior resolution in far targets compared to groups B and C (p=0.001). At near targets, groups A and C had better resolutions compared to group B (p=0.017). There was no significant difference in patient satisfaction for far, intermediate and near VA among the groups. CONCLUSION: Eyes implanted with any of the 3 trifocal IOL designs achieved excellent uncorrected and bestcorrected distance, intermediate and near vision. FineVision and PanOptix provided significantly better intermediate vision than LISA tri at both 80 cm and 60 cm testing distance. FineVision had better near visual outcomes than PanOptix and LISA tri. Patient satisfaction was high in all 3 trifocal IOLS
Lenses, Intraocular ; Vision, Ocular

Objective This study determined the prevalence of color-vision deficiency among male high-school students in a public school. Methods Male high-school students were screened for color-vision deficiency using 6 plates of the Ishihara pseudoisochromatic plates. All students with one or more errors were reexamined at a later date with the full 15 Ishihara plates and the Farnsworth D15 (FD15) test. A detailed history was taken and an ocular examination was conducted. Students who identified less than 10 plates correctly on the FD15 were classified as color-deficient and underwent the Farnsworth Munsell 100 hue (FM 100) test. The results were statistically analyzed. Results A total of 1,258 male high-school students, aged 12 to 16 years, were included in the study, 122 of whom failed the screening test. Of these, 106 completed the 15 Ishihara plates. Sixty-five failed and were classified as color-visiondeficient, of which 64 (98%) were deutans. Deutan was also the most common deficiency determined using the FD15 (78.95%) and FM100 (44.19 %) hue tests. Conclusion The prevalence of color-vision deficiency among male students in a public high school was 5.17% (65/1,258). The most common deficiency was the deutan type.
Color Vision Defects

Objectives: The authors' aim was to conduct a dosimetric analysis of the incidental radiation dose to the internal mammary node (IMN) region using a three-field chest wall technique (TFCWT).

Methods: This retrospective study utilized 3D-conformal radiotherapy plans of 50 postmastectomy patients (25 left-sided and 25 rightsided). All plans used the TFCWT, composed of narrowed tangents matched medially to an AP electron field, and prescribed a total dose of 50 Gy in 28 fractions. The IMNs were not intentionally treated in all included plans.

Results: The mean dose to the IMN-planning target volume (IMN-PTV) was 45.1 Gy (26.4 - 55.6, SD 6.5). Minimum doses received by 95% and 90% of the IMN-PTV were 29.3 Gy (8 - 49, SD 10.0) and 34.0 Gy (10.0 - 52.0, SD 8.6), respectively. The percent volume of IMN-PTV receiving 100%, 95%, 90%, and 80% were 47.4% (3 - 94, SD 21.6), 55.6% (6 - 97, SD 22.4), 61.92% (7 - 98, SD 22.2), and 72.61% (18-100, SD 20.2), respectively. The average ipsilateral lung V20 Gy (with supraclavicular fields) was 25.0% (16 - 29, SD 3.4), and the average heart mean dose was 2.5 Gy (0.5 - 7.9, SD 1.58).

Conclusion: Although the results suggest increased IMN radiation doses with the TFCWT when compared historically to standard tangents, the incidental doses are comparatively less than that traditionally prescribed to the IMNs in high-risk patients. It is unknown whether this incidental IMN dose confers any clinical benefit.