seconds ; Diagnostic ; Milk ; Hypersensitivity ; Cattle

The management of urinary tract infection (UTI) is fraught with challenges, especially, in an era of increasing antimicrobial resistance. Antibiograms that make use of local and population-based data aid clinicians in their treatment strategies. Objectives: This study aims to determine the common organisms isolated in the urine culture and the organism’s sensitivity pattern to antibiotics among inpatients and outpatients aged 0-18 years old at Chong Hua Hospital from January 1, 2003 to June 30, 2005. Methods: Data from inpatients and outpatients aged 18 years old and below with a urine culture of ³ 100,000 CFU of a single pathogen were collected from the Chong Hua Hospital Microbiology Laboratory within a 30-month period. The organisms cultured were identified and the resistance pattern of the 5 most common isolates was determined. The medical charts of inpatients were reviewed to determine the initial antibiotics started. Results: 140 patients were included in the study. UTI was most common in the >28 days to 1 year age group. UTI was more frequent in males aged >28 days to 1 year and in females aged 1 to 5 years. The common isolates were: Escherichia coli (75%), Proteus mirabilis (6%), Pseudomonas aeruginosa (6%), Enterobacter sp (5%), and Klebsiella pneumoniae (4%). Antibiotic susceptibility testing revealed that there was resistance to ampicillin (76%) and cotrimoxazole (64.15%). Less than 10% resistance was found with ceftriaxone, imipenem, gentamicin, ciprofloxacin, netilmicin, amikacin and cefepime. Cefuroxime was the most common antibiotic started in hospitalized patients. Conclusion: The most common etiologic agents of UTI were E. coli, P. mirabilis, P. aeruginosa, Enterobacter sp. and K. pneumoniae. There was high resistance to the recommended first-line antibiotics cotrimoxazole and ampicillin.
Urinary Tract Infections

The irritable bowel syndrome (IBS) is a complex disorder in which psychosocial, cultural and biological factors, interact. Recent knowledge in the pathophysiology of IBS, seem to combine issues such as a low grade inflammation or immune activation and dysbiosis that can trigger or exacerbate IBS. On the other hand, stress mediated through the hypothalamic-pituitary-adrenal axis can produce motility abnormalities that can modify the microbiota as well, with the subsequent immune activation in the mucosa and stimulation of nerve terminals, generating symptoms of IBS. Also, we speculate that, stress, dysbiosis or an underlying genetic predisposition, may increase the epithelial permeability leading to a contact between pathogens-associated molecular patterns and toll-like receptors in the deeper layers of the gut, developing a host immunity response and IBS generation. We believe that the role of toll-like receptors in IBS and elucidating the communication processes between the immune and the nervous system, warrant future research.
Axis, Cervical Vertebra ; Biological Factors ; Cytokines ; Genetic Predisposition to Disease ; Hand ; Immunity, Mucosal ; Inflammation ; Irritable Bowel Syndrome ; Metagenome ; Mucous Membrane ; Nervous System ; Permeability ; Stress, Psychological ; Toll-Like Receptors

Worldwide breast cancer remains as the most common malignancy in women and the numbers who form a subgroup with dense breast parenchyma are substantial. In addition to mammography, the adjuncts used for further evaluation of dense breasts have been anatomically based modalities such as ultrasound and magnetic resonance imaging. The practice of functionally based imaging of breasts is relatively new but has undergone rapid progress over the past few years with promising results. The value of positron emission mammography is demonstrated in patients with dense breasts and mammographically occult disease.
Breast Neoplasms ; Mammography

Vomiting ; Infant, Newborn

Before values ; Encephalitis

Objective: To investigate the effect of three preoperative anti-infective regimens on the sterility of anterior-chamber aspirates (ACA) in eyes undergoing extracapsular cataract extraction (ECCE). Methods: Ninety eyes scheduled to undergo ECCE were randomly assigned to receive one of the following preoperative anti-infective regimens: Group 1 (Control) - no additional preoperative preparation; Group 2 (Eye drop) - neomycin/ polymixin B/gramicidin eye drops applied 3 times daily for 3 days prior to surgery; and Group 3 (Lid scrub) - neomycin/polymixin B/ bacitracin ointment lid scrub applied 3 times prior to surgery. ACAs were obtained from all eyes at the conclusion of surgery and cultured. The patients were followed up for 3 months after the surgery. Results: Positive cultures developed from ACAs in 5 (16.6 percent) of 30 eyes from Group 1, in 0 of 30 from Group 2, and in 3 (10 percent) of 30 from Group 3. No eye developed endophthalmitis. Compared with the control group, preoperative neomycin/polymixin B/gramicidin eye drops significantly reduced the ACA contamination rate (p= 0.03). Conclusion: Preoperative neomycin/polymixin B/bacitracin eyedrops can improve the sterility of the anterior chamber during ECCE.
Human ; CATARACT ; ANTI-INFECTIVE AGENTS ; ENDOPHTHALMITIS ; NEOMYCIN ; GRAMICIDIN ; BACITRACIN ; CATARACT EXTRACTION ; EYE DISEASES ;

OBJECTIVES:To determine the prevalence of breastfeeding-related skin problems as well as the knowledge, attitude and practices on breastfeeding among mothers in Barangay Batasan Hills, Quezon City.   
METHODOLOGY: This is a cross-sectional study conducted at the Superhealth Center in Barangay Batasan Hills, Quezon City, Metro Manila, Philippines. Included in the study were women of reproductive age who had breastfed at least on child in the past or who were breastfeeding at the time of the survey. An exploratory phase was conducted to determine the extent of the problem. Data gathered from this phase helped in the formulation of a questionnaire. A cross sectional survey was then conducted to determine the common reasons for breastfeeding, the average number of children being breastfed by the participants, the frequency and duration of breastfeeding per child, the hygienic practices of breastfeeding women, the prevalence of breastfeeding-related skin conditions, health seeking behavior of those who experienced the skin conditions, and the common reasons for discontinuation of breastfeeding.   
RESULTS: Ninety-four women participated in the survey. The most common reason for breastfeeding given was, "breast milk is good for the health of the baby" (59.6%). Most of the women learned about breastfeeding from their mothers (41.5%). Most of the participants were able to breastfeed one child (43.6%). The average time spent for breastfeeding one child was three hours per day. Most of the mothers used damp cloth/cotton balls (38.3%) or tepid water (34.0%) to prepare their nipple prior to breastfeeding. Majority of them (72.3%) did not experience any breastfeeding-related skin problems. Among the 27.7%, who experienced skin problems, nipple cracks or fissures (15.0%), breast engorgement (10.6%), and nipple pain (4.2%) were the top three reported skin problems. None of the respondents discontinued breastfeeding due to breastfeeding-related skin problems. A minority of interviewed women (7.0%) discontinued breastfeeding because they were unable to express milk.   
CONCLUSION: The proportion of women with breastfeeding-related skin problems in Barangay Batasan Hills, Quezon City was 27.7%. More than half of those who experienced such problems still continued to breastfeed without any intervention. There was a low rate of discontinuation of breastfeeding (7.4%) among the participants of this study. This finding may be due to the prevalent support of the respondents' mothers and relatives as well as the active promotion of breastfeeding by the local health units and centers in the barangay.

Human ; Female ; Adult ; Infant ; Breast Feeding ; Lactation Disorders ; Milk, Human ; Mothers ; Nipples ; Pain ; Prevalence ; Water

Background: Olfactory dysfunction (OD) in COVID-19 presents as a sudden onset smell loss commonly seen in mild symptomatic cases with or without rhinitis but can occur as an isolated symptom. The reported prevalence of OD among COVID-19 patients ranged from 5% to 98%. Although numerous studies have been conducted about their association, these were mainly based on self-reported cases and subjective questionnaires. Objective: This study investigates whether there is a significant difference in the prevalence of olfactory dysfunction between self-reported and objective testing using validated objective olfactory tests among RT-PCR confirmed COVID-19 patients. Methods: PubMed (MEDLINE), Cochrane, Web of Science, and Google Scholar were searched for studies investigating the prevalence of OD by using objective olfactory tests among patients who self-reported OD (November 1, 2019 to July 31, 2020). All studies were assessed for quality and bias using the Cochrane bias tool. Patient demographics, type of objective olfactory test, and results of self-reported OD and objective testing were reported. Results: Nine studies encompassing 673 patients met the inclusion criteria. Validated objective olfactory tests used in the included studies were CCCRC, SST and SIT. Overall prevalence of OD among patients who self-reported was higher after objective testing (71% versus 81%). This was also seen in when we performed subgroup analysis based on the objective tests that were used. However, meta-analysis using random effects model showed no significant difference in the overall prevalence of OD (p value=.479, 95% CI 56.6 to 84.0 versus 71.2 to 89.8) as well as in the subgroups. Conclusion To the best of our knowledge, this is the first meta-analysis that statistically reviewed articles that evaluated the difference between self-reported and objective tests done on the same patients. Results showing that self-reporting OD approximates the results of the objective tests among COVID-19 positive patients may imply that self-reporting can be sufficient in contact tracing and triggering swabbing and self quarantine during the time of COVID-19 and objective tests can be used as an adjunct in the diagnosis particularly in research. However, this study was limited by small sample size and articles done in European countries hence, interpretation and application of the results of this study must be approached with care. Further studies documenting the difference between self-reporting and objective test in large scale setting involving different countries may be helpful in establishing a definitive consensus.
Anosmia ; SARS-CoV-2 ; Pandemics

Extramammary Paget Disease (EMPD) is a rare intraepithelial cancer often mistaken for inflammatory and infectious skin conditions, leading to diagnostic delays and increased morbidity. It constitutes 6.5% of cutaneous Paget Disease, predominantly affecting older individuals aged 50 to 80, with a higher prevalence in women. Notably, 10% to 30% of EMPD cases are linked to concurrent visceral malignancies, highlighting the importance of cancer screening.

This is a case of a 77-year-old Filipino male with a four-year history of a solitary, well-defined, irregularly-shaped, erythematous plaque with erosions on the perianal area. Despite two years of self-administered hydrocortisone cream, the lesion progressively expanded into an 8x4x2 cm plaque, accompanied by intermittent pruritus and stinging pain. On consultation, dermoscopy showed milky-red areas, telangiectasias, and hyperpigmentation. Histopathology revealed polygonal neoplastic cells with pleomorphic vesicular nuclei, conspicuous nucleoli, and pale eosinophilic cytoplasm above the basal epidermis. Immunohistochemistry was positive for CK7, GCDFP15, CEA, and EMA, and negative for CK20. Further imaging showed no evidence of concurrent malignancies, reinforcing the diagnosis of primary EMPD. While awaiting further evaluation by other specialties, he was managed with an eight-week course of topical Imiquimod 5% cream, resulting in a reduction in both erythema and lesion thickness.

Overall, this case highlights the importance of recognizing cutaneous cancers that mimic benign skin conditions. The application of diagnostic tools in dermatology, such as dermoscopy, histopathology, and immunohistochemical staining, is crucial for identifying key disease features and establishing an accurate diagnosis, enabling timely and appropriate intervention.

Human ; Male ; Aged: 65-79 Yrs Old ; Paget Disease, Extramammary ; Imiquimod ; Neoplasms ; Tumors