Introduction: Staphylococcus aureus is the leading biofilmforming microorganisms in orthopaedic implant infections. The biofilms formed are difficult to eradicate and resistance to antibiotics. This current study aims to determine the effectiveness of povidone-iodine; an antiseptic solution in eradicating S. aureus biofilm on stainless steel alloy. In addition to the usual Colony-Forming Unit (CFU) used for verification, Scanning Electron Microscope (SEM) is used to validate the formation and eradication of the biofilms. Materials and methods: This is an in vitro study where the biofilm is formed by inoculating clinically isolated S. aureus, incubated for 24 hours onto stainless steel alloy 316L implants. The implants are then irrigated using povidoneiodine solution with varying concentrations (5 and 10%) and durations (30, 60, and 180 seconds). The anti-biofilm effect was evaluated using plating and SEM methods to confirm its effectiveness. The process is repeated after 24 hours of postirrigation reincubation to detect any rebound growth. Results: No biofilm seen after irrigation with povidoneiodine at 5% and 10% concentrations at 30, 60 and 180 seconds, respectively, in both CFU count and SEM. This result is replicated after 24 hours of reincubation, in assessing for rebound growth. Conclusion: Our study supports that a minimum of 5% povidone-iodine with a minimum irrigation time of 30 seconds are effective at eliminating S. aureus biofilm on stainless steel alloy implants. Both CFU count and SEM yield similar value in validating the presence of biofilm. Additionally, SEM allows visualisation of the morphology of the biofilm.

OBJECTIVES

Timely access to appropriate levels of care is essential for improving maternal, newborn,
and child health outcomes. To address persistent service delivery fragmentation and strengthen referral systems, the Philippine Department of Health issued Administrative Order 2020-0019 to guide the design of Health Care Provider Networks (HCPNs) under the Universal Health Care Act of 2019. This study assessed the extent to which sixteen municipalities across four provinces in Eastern Visayas comply with the HCPN service delivery guidelines in the context of maternal and newborn care.

METHODS

The study employed a descriptive cross-sectional mixed-methods design, utilizing structured facility checklists to assess compliance with HCPN standards. Qualitative data were gathered through key informant interviews and focus group discussions with purposively selected stakeholders—decision makers, health personnel, and mothers—to contextualize findings. A three-lever framework for integrated care (policy, operational, and cross- cutting) guided the analysis

RESULTS

The findings revealed significant gaps between the current capacities of study health facilities and the requirements outlined in the HCPN guidelines. Major gaps included (1) weak cooperative governance mechanisms to support network-wide coordination; (2) limited systematic linkages between facilities, including fragmented referral protocols and non-interoperable health information systems; (3) inadequate investments in infrastructure, health human resources, and medical commodities; and (4) absence of performance monitoring systems across HCPNs.

CONCLUSION

 

Human ; Information Systems ; Occupational Groups ; Referral And Consultation ; Universal Health Care ; Delivery Of Health Care

BACKGROUND AND OBJECTIVE

Randomized controlled trials (RCTs) are essential for advancing evidence-based healthcare by evaluating the effectiveness and safety of health interventions. Despite the increasing recognition of clinical research, the Philippines has had limited contributions to global RCT output. This bibliometric analysis aims to assess the trends, characteristics, and impact of RCTs conducted in the Philippines and published online.

METHODS

A systematic search of Medline (PubMed), and EMBASE, along with Acta Medica Philippina, was conducted to identify published RCTs from January 1990 to October 2022. Eligible studies were screened and analyzed based on publication trends, funding sources, study designs, research settings, and institutional contributions. Descriptive statistics were used to summarize key findings.

RESULTS

A total of 391 RCTs were identified, with a notable increase in number of RCTs published over time. Most studies (91.8%) were published in international journals, and funding was primarily sourced from pharmaceutical companies (47.1%). The predominant RCT design was two-arm parallel (64.7%), with hospitals being the most common research setting (54.2%). Research areas were led by infectious diseases, particularly vaccine-preventable illnesses (23.8%). While the University of the Philippines Manila (21.1%) and the Research Institute for Tropical Medicine (13.7%) were the leading institutions in terms of highest number of published RCTs, foreign authors accounted for nearly half (47.3%) of primary authorships. The most cited studies focused on cardiovascular diseases, infectious diseases, and oncology.

CONCLUSION

The increasing number of published RCTs in the Philippines reflects growth in research capacity and institutional engagement. Strengthening national research dissemination platforms and fostering regional collaborations will be essential in advancing the Philippines’ contribution to global clinical research.

Human ; Bibliometrics ; Bibliometric Analysis ; Philippines ; Publications

BACKGROUND

Continuing Medical Education (CME) serves as a cornerstone for maintaining clinical competence and improving patient care. In the Philippines, CME has become increasingly digital, with the UP Med Webinars emerging as a leading platform for physician education over the past decade. Despite this growth, there has been limited evaluation of how well these webinars align with national health priorities, particularly those reflected in PhilHealth hospital admissions and claims data, which provide insights into the country's disease burden and healthcare utilization patterns.

OBJECTIVES

This study aimed to determine the extent to which the topics and reach of UP Med Webinars correspond with the Philippine health system’s most pressing clinical demands. Specifically, it aimed to analyze the trend in number of webinars by year; analyze the distribution of webinar topics by medical field; assess physician attendance as a proxy for clinical interest and engagement; evaluate the alignment between UP Med Webinar content and national health priorities based on PhilHealth’s top conditions, procedures, and reimbursed claims.

METHODS

The study used a qualitative content analysis of all Continuing Professional Development (CPD)-accredited UP Med Webinars from 2015 to 2024, supported by descriptive statistics. Webinar titles were coded thematically and categorized by topic and medical field. Attendance figures were analyzed to identify high-demand topics. These results were compared with PhilHealth Claims Reports (2020–2024), focusing on the top reimbursed medical diagnoses and procedures, to assess alignment with disease burden and health service delivery trends. These findings can help inform strategic planning for CME programs to ensure they remain responsive to the country's evolving public health needs.

RESULTS

From 2015 to 2024, a total of 686 CPDaccredited UP Med Webinars were conducted, attended by 685,994 participants. The annual number of webinars and attendees steadily increased, peaking during the COVID-19 pandemic (2020–2022) with heightened demand for virtual CME and pandemic-related topics. Internal Medicine consistently emerged as the most frequently covered field, accounting for 54.1% of webinars and 48.8% of total attendance, followed by Obstetrics and Gynecology (14.4% of webinars; 19.6% of attendance) and Pharmacotherapeutics (6.0% of webinars; 6.9% of attendance). Certain fields, including COVID-19 and Psychiatry, attracted disproportionately high attendance despite fewer sessions, indicating strong interest during periods of public health urgency. The top 10 webinar topics included Diabetes, Pregnancy, Cancer, Hypertension, Reproductive Health, COVID-19, Heart Disease, Antimicrobial Treatment, Vertigo, and Vaccination, reflecting a mix of chronic disease management, maternal health, infectious diseases, and emergent health concerns.

Comparison with PhilHealth claims data (2020– 2024) revealed a high disease burden in Internal Medicine, Obstetrics, and Pediatrics, with top medical conditions including Pneumonia, Dengue, Hypertensive emergencies, and Stroke. These findings indicate a strong alignment between the most covered webinar topics and national healthcare utilization trends, particularly in high-burden clinical areas.

CONCLUSION

Findings suggest that the UP Med Webinars have generally aligned with national health priorities, as indicated by PhilHealth claims data, particularly in highburden fields such as Internal Medicine and Obstetrics. However, gaps in coverage for certain high-priority conditions and procedures point to opportunities for more inclusive and data-driven CME planning. Aligning CME content with evolving health system needs can enhance its relevance, support clinical practice improvements, and ultimately contribute to better population health outcomes in the Philippines.

Education, Medical, Continuing ; Medicine ; Health Priorities

BACKGROUND

Self-management is crucial for individuals with chronic illnesses. While mobile applications (mAPPs) have emerged to support diverse health needs, evidence regarding their efficacy for self-management among chronically ill Filipino patients is inconsistent and limited, particularly in provincial settings.

OBJECTIVE

To investigate the effectiveness of the Health Storylines mAPP compared to a traditional pamphlet for enhancing self-management among individuals with chronic illnesses in Baguio City, Philippines.

METHODS

We conducted a two-arm quasi-experimental study with 33 participants diagnosed with cancer, type 2 diabetes, or heart disease/hypertension. Participants were recruited via convenience sampling and allocated to an intervention group (n=17), which used the Health Storylines mAPP for four weeks, or a comparison group (n=16), which received a traditional pamphlet. Selfmanagement was assessed pre- and post-intervention using the Self-Management Assessment Scale (SMASc).

RESULTS

Participants demonstrated a high level of selfmanagement at baseline (μ=5.20, SD=0.70). After four weeks, the intervention group showed a non-significant decrease in self-management scores (from μ=5.25 to 5.00, p=0.27), while the comparison group exhibited a non-significant increase (from μ=5.19 to 5.37, p=0.61). There was no statistically significant difference in posttest self-management scores between the two groups (U=83.50, p=0.23).

CONCLUSION

In a population of chronically ill patients already proficient in managing their condition, the Health Storylines mAPP had a marginal impact on selfmanagement, while the use of a traditional pamphlet showed a slight positive effect. The findings suggest that for this population, familiar, low-barrier resources remain valuable, and mHealth interventions must account for baseline self-management capabilities and digital literacy. Chronic Illness; Health Storylines mAPP; Self-management; mHealth; Philippines.

Chronic Disease ; Chronic Illness ; Self Care ; Self-management ; Telemedicine

The surface electrocardiogram (ECG) can provide many clues to a patient’s underlying medical condition or tendency for arrhythmogenesis. An 80-year-old man with severe aortic stenosis and an implantable cardioverter-defibrillator (ICD) for advanced heart block presented with burping, chest discomfort and intermittent pounding sensations. His ECG showed atrial fibrillation with intermittent ventricular pacing at 60 bpm characterized by irregularly irregular rhythm, absent P waves, narrow intrinsic QRS complexes alternating with wide-paced beats (left bundle branch block [LBBB] morphology, superior axis) and visible pacing spikes. Device interrogation revealed ventricular tachycardia (VT) storm with multiple appropriate ICD shocks explaining his pounding sensations. This report highlights two key teaching points: recognizing atrial fibrillation during ventricular pacing—a frequently missed diagnosis affecting nearly half of patients with pacemakers—and managing VT storm to reduce shock burden. After device reprogramming and antiarrhythmic adjustment, the patient became asymptomatic.

Human ; Male ; Aged: 65-79 Yrs Old ; Thorax ; Teaching ; Tachycardia, Ventricular ; Electrocardiography ; Atrial Fibrillation ; Bundle-branch Block ; Constriction, Pathologic

Superior mesenteric artery syndrome (SMAS) is a rare but important cause of acute upper gastrointestinal obstruction resulting from compression of the duodenal third portion between the superior mesenteric artery and aorta. While SMAS has been described after corrective spinal surgery, it is rarely reported following pediatric trauma. We describe an 8-year-old boy involved in a high-speed motor vehicle collision who sustained multiple severe injuries, such as traumatic diaphragmatic hernia, mesenteric vascular injury, hepatosplenic laceration, and L1–L2 seatbelt-related Chance fracture-dislocation. After surgical stabilization of the spine on day 6, he presented on day 12 with bilious vomiting and abdominal distension, indicating the presence of intestinal obstruction. Contrast-enhanced computed tomography and an upper gastrointestinal series demonstrated narrowing of aorto-mesenteric angle with compression of the duodenal third portion, confirming the diagnosis of SMAS. Through nasojejunal tubal feeding, he was able to meet nutritional requirements without parenteral nutrition. This case underscores the need for heightened awareness of SMAS in pediatric trauma patients who develop postoperative duodenal obstruction symptoms, as prompt recognition and conservative management in the postoperative setting can lead to excellent outcomes.

Background: s/Aims: The benefits of nasogastric intubation after pancreaticoduodenectomy are not well understood, and it remains unclear which patients may need nasogastric intubation in the immediate postoperative period. This study evaluated the effectiveness of nasogastric intubation following pancreaticoduodenectomy and identified factors influencing the reintubation rate. Methods: We conducted a retrospective case-control cohort study involving adult patients who underwent pancreaticoduodenectomy for either benign or malignant periampullary disease, with a 90-day follow-up. Patients were divided into two groups: the nasogastric tube (NGT) was removed at the end of the procedure (NGT-removed group, n = 110; case group) or retained during the postoperative recovery (NGT-retained group, n = 100; control group). Results: The overall postoperative complication rate (grades I–IVb) was 40.4%. The only significant difference between the groups was a higher incidence of nausea and vomiting in the NGT-removed group (p = 0.02). Additionally, 14.8% of patients required NGT reinsertion postoperatively. No preoperative or intraoperative factors were found to influence the NGT reinsertion rate. Although patients requiring reinsertion experienced a higher rate of postoperative complications, no factor remained significant in the multivariate analysis. Conclusions There were no significant differences in clinical outcomes, reinsertion rates, or postoperative complications between the two groups, indicating that the removal of the NGT after pancreaticoduodenectomy is safe. However, univariate analysis revealed that postoperative complications significantly affected the need for NGT reinsertion, suggesting that nasogastric decompression may be crucial for patients at high risk for complications.

Objective: Endoscopic techniques are rapidly evolving, with surgery becoming much safer and less invasive. One of these procedures is lumbar interbody fusion (LIF). Although the principle of the operation is consistent among surgeons, the technique varies greatly. This study aimed to assess the clinical outcomes of Full Endoscopic Transforaminal Lumbar Interbody Fusion (e-TLIF) and report the results. Methods: In this retrospective study, data were collected from a hospital database. All patients who underwent e-TLIF from January 2022 to June 2024 were included. Results were analyzed on the basis of the visual analogue scale (VAS) for pain outcomes and the Oswestry Disability Index (ODI) for functional disability at 3 and 6 months. Results: In total, 53 patients were identified during the study period. All patients underwent full-endoscopic LIF through a posterior approach. The average hospital stay was 24 hours. The mean follow-up period was 20.9 (range, 6–36) months. Significant improvement in VAS and ODI was observed at 6 months. All patients had satisfactory outcomes. Conclusion Full-endoscopic transforaminal lumbar interbody fusion is a safe and effective procedure.

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease, is the fastest-growing cause of chronic liver disease worldwide, affecting approximately 30% of the global population.Imaging is vital for detecting, quantifying, and monitoring hepatic steatosis—the defining abnormality of MASLD—and subsequent fibrosis—the key determinant of liver-related outcomes. This review summarizes the principles, clinical usage, efficacy, and advancements in various imaging modalities for the noninvasive assessment of hepatic steatosis and fibrosis, with an emphasis on ultrasound, CT, and MRI. Additionally, this review explores the evolving landscape of MASLD diagnostic approaches, including machine-learning techniques, opportunistic screening, standardized imaging guidelines, and therapies, emphasizing the pivotal role that radiologists can play in shaping these developments.