Forty patients undergoing clean-contaminated, contaminated, and dirty surgical procedures were studied to determine whether daily C-reactive protein (CRP) measurements for 10 days following surgery could predict the occurrence of septic complications before clinical recognition. Diagnostic criteria for septic complications and positive CRP response were defined in advance of the study. The CRP measurements were carried out using semiquantitative latex agglutination after the patients discharge from the hospital. Fifteen complications were diagnosed in fourteen patients. These complications consisted of wound infections (3), urinary tract infection (4), and pneumonia (3). The CRP examination was found to have a positive predictive value of 77% and a negative predictive value of 85%. We conclude that serial CRP determinations may be valuable as part of the armamentarium to surgical care in patients at considerable risk of post-operative septic complications. (Author)

Human ; Male ; Female ; Middle Aged ; Adult ; C-reactive Protein ; Latex ; Urinary Tract Infections ; Patient Discharge ; Postoperative Complications ; Pneumonia ; Wound Infection ; Agglutination

Background: Patients’ education and empowerment are essential parts of a disease management. Patients have to be educated on the disease as well as lifestyle changes that they need to practise for a holistic and consistent improvement in their disease status. This study examined patients’ knowledge on diabetes and nutrition as well as the role of dietician in the patient education. Methods: This was a cross-sectional study of patients aged more than 18 years, in a primary care centre in Kuala Lumpur. Patients responded to a pre-tested self-administered questionnaire which contains socio-demographic profiles of patients, knowledge on diabetes and nutrition. Patients were also asked on dietician consultation and the number of dietician visits. Patients were conveniently selected on the data collection days. Only consented patients and those who could understand Malay or English language were selected. Results: There were 110 patients who participated in the study. Overall the patients had good knowledge on diabetes and nutrition. The mean total knowledge score was 71.2% ± 9.34. Domains such as diabetes complications, exercise, meal practice, food sources and proportion need reinforcement. Only 60 (54.9%) patients had seen a dietician. Patients who had seen dietician showed significantly higher level of knowledge score (p=0.04). However frequent meeting with the dietician did not show any significant improvement in the knowledge (p=0.10). Factors such as patients’ gender, ethnicity, level of education, employment status, glycaemic level, duration of illness and body mass index did not show any significant association with the overall diabetic and nutrition knowledge. Conclusion: There is still a need to improve the overall diabetic education particularly in areas that patients were lacking such as diabetes complications, exercise, meal practice, food sources and proportion. It is equally necessary to encourage all diabetics to see a dietician since it helps to improve their level of knowledge as shown in this study.

g <3> ; Evaluation ; brushin ; Cellular aspects of

OBJECTIVES:The present study aims to determine the frequency of occurrence of NAT2*4, NAT2*5A, NAT2*6B, NAT2*7A and NAT2*14A alleles by PCR-RFLP among Filipino volunteers. These alleles correspond to substitutions in the following sites: C341T, G590A, G857A and G191A, respectively, of the NAT2 gene. The presence of specific SNP combination was also used to deduce acetylation status and estimate genotype frequency and describe them in comparison with other populations based on literature.
METHODS: Genomic DNA from peripheral blood lymphocytes from 129 healthy Filipino volunteers was used to amplify the NAT2 gene segment. The RFLP analysis was done by restricting the expected PCR product with Kpn1, Taq1, BamH1 and Msp1/Al1, respectively, to detect the 4 alleles: NAT2*4, NAT2*5A, NAT2*6B, NAT2*7A and NAT2*14A.
RESULTS:The calculated allelic frequencies in Hardy-Weinberg equilibrium of NAT2*5A (C481T), NAT2*6B (G590A), NAT2*7A (G857A) and NAT2*14A (G191A) were 0.058, 0.097, 0.182 and 0.046, respectively. NAT2*4 had an allele frequency of 0.617. Nine genotypes were determined: NAT2*4/*4, NAT2*4/*5A, NAT2*4/*6B, NAT2*4/*7A, NAT2*4/*14A, NAT2*5A/*7A, NAT2*6B/*7A, NAT2*6B/*14A and NAT2*7A/*14A. From these genotypes, acetylator phenotypes were deduced. A trimodal pattern of distribution was established: rapid, intermediate and slow acetylators with the following percentages, 47.3%, 41.1 % and 11.6%. Among the slow acetylator SNPs determined, NAT2*7A was found as the most frequent allele and NAT2*14A was found as the least frequent allele.
CONCLUSION:The study showed the mutation profile and observed genotypic similarities and differences of Filipinos with other Asian populations and Americans and other Caucasians based on literature. The results also suggest a trimodal pattern of distribution of acetylators and lesser number of slow acetylators among Filipino populations, a characteristic similar to other Asian populations but significantly different from Americans and other Caucasians. The occurrence of NAT2*7A and NAT2*14A can be further sequenced to verify the observed genotype.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Acetylation ; Alleles ; Asian Continental Ancestry Group ; Base Sequence ; Dna ; Gene Frequency ; Genomics ; Genotype ; Lymphocytes ; Merozoite Surface Protein 1 ; Mutation ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; United States ; Volunteers ; Genes ; Polymorphism, Genetic

Medicine has, in recent years, incorporated wave after wave of new scientific discoveries and technologies. Molecular medicine is one of these technologies and shows a dramatic example of the impact of advances in basic science. Advances in molecular biology have revolutionized daily clinical practice, particularly in developed countries, such that practitioners who received their medical education decades ago now need to adapt to this new discipline. While molecular medicine may not be a priority health issue in developing countries such as Papua New Guinea, it is equally important to ensure that the basic principles of knowledge and understanding of what goes on in that field form part of today's teaching of all practitioners of medicine and allied health workers. The three papers in this series aim to present molecular biology and its medical applications in as simple and lucid a manner as possible so that its scientific basis and principles as well as its potential for diagnosis and management of diseases are well appreciated.
Allied Health Personnel - education ; Anemia, Sickle Cell - genetics ; Clinical Competence ; Cloning, Molecular ; DNA - genetics ; Papua New Guinea

No abstract available
DNA Fingerprinting ; Developing Countries ; Genetic Linkage ; Genetic Technique ; Humans Immunoblotting Molecular Biology - methods ; New Guinea ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Sensitivity and Specificity

Introduction: Syringocystadenoma papilliferum (SCAP) is a relatively rare benign adnexal skin tumor which can manifest in a variety of clinical forms. Nearly one-third of cases are known to develop within a pre-existing nevus sebaceus (NS). The peculiar feature of this case was the appearance of a large exophytic tumor within a congenital verrucous plaque, which raised the suspicion of a malignant transformation. This is a case of a young Filipino adult with an unusual presentation of syringocystad- enoma papilliferum in a nevus sebaceus mimicking squamous cell carcinoma. Case report: A 27-year-old Filipino female presented a persistently enlarging exophytic pedunculated cribriform tumor within a congenital verrucous plaque on the left temporal area. The tumor started to appear when she was 20 years old. One month prior to consult, it rapidly increased in size and bled on gentle manipulation. She has neither comorbidities nor any family history of a similar condition. Her physical examination was normal, with no palpable lymphadenopathies. The biopsy showed syringo- cystadenoma papilliferum on a nevus sebaceus. She underwent carbon dioxide (CO2 ) laser excision under local anesthesia. The procedure was uneventful and the patient is on regular follow-up and close monitoring for any possible malignant change or recurrence. Conclusion A case of syringocystadenoma papilliferum on a nevus sebaceus mimicking squamous cell carcinoma in a Filipino female treated with carbon dioxide laser excision was presented. The unusual presentation of SCAP can mimic malignancy and histopathologic evaluation is warranted to rule out malignant transformation for proper management.
Tubular Sweat Gland Adenomas

The influence of Age of Onset (AO) of Second Language Acquisition (SLA) on learners‟ Ultimate Attainment (UA) potential is well documented. The issue of Second Language Acquisition (SLA) potential enters a qualitatively different, pragmatic dimension in most multilingual developing nations (including Papua New Guinea), where English, a second language for most children, is also the language of education, and where, consequently, students‟ English proficiency necessarily affects their academic potential and the quality of their education. This study investigates whether the academic performance of students in the School of Humanities and Social Sciences (SHSS) University of Papua New Guinea (UPNG) is affected by their linguistic backgrounds. Specifically, we examined the effect of three factors in the students‟ Early Language Education – their Age of Onset of learning English (AO), their Age at Literacy (AGELIT), and their Early Learning Language (ELL) – on their Semester 1, 2017 Grade Points Average (GPA). A purposive cross-sectional sampling method was used for the selection of students. All full-time registered students in the SHSS during the 2017 academic session were eligible to participate in the study. A self-designed pretested questionnaire consisting of nine short questions was used to collect data on SHSS students‟ language education backgrounds, including their AO, AGELIT and ELL. Our results show a strong and statistically significant inverse correlation between students‟ AO/AGELIT and their GPAs, as well as a strong positive link between ELL English and students‟ GPAs, which contrasts sharply with a significant decrease in GPAs in the presence of ELL Tok Pisin. The ELL Vernacular category was too small (sample size N=34) to yield statistically significant results. Our current results corroborate the findings of our earlier studies which established a highly significant inverse correlation between students‟ AO and their academic performance in the National High Schools, as well as in the University of Papua New Guinea.

OBJECTIVE: To determine the risk factors and the current actual incidence of surgical site infection (SSI) following a cesarean delivery in te Philippine General Hospital.

METHODS: In a case-control study, 729 patients admitted at PGH's post-partum clinic, emergency room and obstetrical wards, from November 2007- May 200, were interviewed using a data sheet from that included mother's age, gravidity and parity, body mass index, smoking history, steroid and illicit drug use, previous surgeries, co-morbidities and questions on personal hygiene, as part of the ongoing infection surveillance. Operation-related and obstetric-related variables were documented through review of medical records. Definitions of the Centers of Disease Control of surgical site infection were used.

RESULTS: Thirteen percent of patients developed SSI among 713 patients recruited in the study. Although univariate analysis of risk factors did not show statistically significant results, steroid use , smoking and illicit drug use, previous surgery, anemia prior to operation, longer duration of labor and rupture of membranes and longer duration of operation appear to predispose patients to surgical site infections after cesarean section. The incidence of SSI was significantly lower in patients with hypertensive complications.

Human ; Pregnancy ; Gravidity ; Parity ; Surgical Wound Infection ; Risk Factors ; Maternal Age ; Cesarean Section ; Obstetrics ; Smoking ; Street Drugs ; Anemia ; Hygiene

Posttraumatic stress disorder (PTSD) is a psychiatric diagnosis made when someone including children who experiences traumatic stressor. Those who are exposed to a more severe trauma have highest level of PTSD. The aim of this study was to measure the prevalence of PTSD and its associated factors among 219 children who were affected by a form of natural disaster which is the tsunami waves in a rural area in Malaysia. A cross sectional study was carried out among children aged 10-12 years 6 months after the traumatic event. Child Posttraumatic Stress Disorder –Reaction Index (CPTSD-RI) was used as a screening instrument which was answered by the affected children through a self-administered questionnaire. Forty six percent of these children had PTSD symptoms; 31.1% of these children had mild, 11.4% had moderate, 3.7% had severe PTSD and none had very severe PTSD. Result also showed that 91.8% had re-experiencing symptoms, 28.3% had numbing/avoidance symptoms and 49.3% had hyperarousal symptoms. Children with low social support (Adj OR = 2.3 (95% CI: = 1.3- 4.2)), and children who experienced deaths among someone close to them (Adj OR = 3.7 (95% CI =1.2 - 11.5)) were more likely to have symptoms of PTSD. This showed that children are at higher risk of developing PTSD as early as 6 months after the event and thus early intervention should be offered to them. Future longitudinal study can be carried out among affected children to assess whether these PTSD symptoms persist over time.