BACKGROUND AND OBJECTIVES

Diet compliance is critical in managing Maple Syrup Urine Disease (MSUD) to prevent physiological and neurological damage. However, there is a lack of studies looking at factors critical to diet compliance. This study determined the caregivers’ nutrition knowledge, attitudes, and feeding practices (KAP); and its relationship to Filipino MSUD children’s leucine level, nutritional status, and nutrient intake.

A cross-sectional, sequential explanatory research approach using survey was utilized. Data tools were questionnaires and food records.

The participants were 20 caregivers and 21 MSUD children (aged 6 to 83 months). Caregivers had moderately high feeding practices and knowledge scores and had positive attitudes towards providing adequate nutritional care; still, they were struggling with diet compliance.

Their nutrition knowledge was related to their attitude (p-value: 0.021), feeding practices (p-value: 0.037), and their children’s weight-for-age (p-value: 0.036). Furthermore, knowledge and feeding practices were related to the children’s natural-protein status (p-value: 0.043 and 0.006, respectively). The caregivers’ sex was related to the children’s leucine (p-value=0.010), those with female caregivers had lower leucine by 470 μmol/L on average. Moreover, children with good leucine control belonged to higher-income households (p-value=0.049).

With caregiver's nutrition knowledge having been possibly associated with the children’s weight-forage, and their knowledge and feeding practices with the children's natural protein status, as well as knowledge positively affecting both attitude and feeding practice, interventions for improving all caregivers’ nutrition knowledge and feeding practices are recommended. Additionally, with caregivers’ sex and income having been found to be related to metabolic control, it is suggested that strategies to better manage these barriers be carried out. These may include improving support for male caregivers, with children under their care having higher leucine than those cared for by their female counterparts. Added provisions may likewise be planned for further reducing the impact of income-related barriers.

INTRODUCTION

The Bachelor of Science in Nursing (BSN) program spans four years and includes general education and professional courses. Student nurses attend lecture hours, clinical duties, and related learning experiences that might be affecting their time in attending to a healthy lifestyle. Health-promoting lifestyle is a multi-dimensional pattern of activities and perceptions that begins with self-motivation and assists in promoting self-improvement and health. The domains of health-promoting lifestyle are essential factors to further improve their way of dealing with daily challenges. Multiple factors can also influence student nurses’ lifestyles, including their separation from family, busy schedules, and dietary choices. A study highlights various factors affecting student nurses' lifestyles, underscoring the need for tailored health promotion strategies and curriculum enhancements. Research into these domains can better equip future healthcare leaders. Gender, year level, and living arrangements influence student nurses' lifestyles, prompting researchers to investigate the extent of health-promoting lifestyles among them and differences based on these factors. By addressing these domains and conducting further research, nursing education and practice can better prepare future healthcare leaders to promote health and lifestyle effectively within their communities.

To determine the extent of health-promoting lifestyle among student nurses and identify the significant differences according to gender, year level, and living arrangement. 

A quantitative, descriptive research design was used with 360 respondents, employing Yamane’s formula and quota sampling. The study adopted the Health-Promoting Lifestyle II questionnaire with a validity of 0.962.

Student nurses often engage in health promoting behaviors (mean=2.56). Male student nurses reported higher scores in health responsibility, physical activity, spiritual growth, and stress management compared to female students (p=0.40). Level IV students engaged in health-promoting activities more frequently than Level I students (p=0.74). Living arrangements did not significantly impact health-promoting lifestyles (p=0.99).

No significant difference in health-promoting lifestyles among student nurses. Respondents demonstrated the least health-promoting lifestyle behaviors in the domains of health responsibility, nutrition, and physical activity. In contrast, spiritual growth, interpersonal relations, and stress management attained the highest mean scores.

BACKGROUND

Six-pyruvoyl-tetrahydrobiopterin synthase (6-PTPS) deficiency is an inherited metabolic disorder which results in tetrahydrobiopterin (BH4) deficiency causing hyperphenylalaninemia.

This study aimed to describe the clinical, biochemical, and radiologic profiles, and neurologic and developmental outcomes of patients diagnosed with 6-pyruvoyl tetrahydrobiopterin (PTPS) deficiency through newborn screening and confirmed by BH4 loading test, pterin analysis, and gene sequencing who were following-up with the metabolic team.

The research was a single-center descriptive case series study design that was done at the Philippine General Hospital, a tertiary government hospital. The clinical, biochemical, radiologic profiles and neurodevelopmental evaluation of each patient were described.

Nine patients from 1 year 2 months to 14 years 5 months of age were enrolled in the study. Clinical manifestations before treatment were hypotonia, poor suck, and seizure. The most common clinical manifestation even after treatment initiation was seizure. The mean phenylalanine level on newborn screening was 990.68 umol/L, but after treatment was started, mean levels ranged from 75.69 to 385.09 umol/L. Two of the patients had focal atrophy of the posterior lobe on brain imaging. Pathogenic variants on molecular analysis were all missense, with two predominant variants, c.155A>G and c.58T>C. Eight of the nine patients had varying degrees of developmental delay or intellectual disability, while the remaining patient had signs of a learning disorder.

Newborn screening has played a crucial role in the early identification and management of patients with hyperphenylalaninemia due to 6-PTPS deficiency. Confirmation of diagnosis through determination of DHPR activity, urine pterins and/or molecular analysis is necessary for appropriate management. However, despite early initiation of treatment, neurodevelopmental findings of patients with 6-PTPS deficiency were still unsatisfactory.

BACKGROUND

The migration from classroom learning to real patient encounters during clinical clerkship is a transformative journey that carries with it many challenges which serve as rich sources of meaning. The actual patient interactions are pivotal opportunities that provide transcendental meanings which contribute to the well-rounded development of medical clerks, ultimately enhancing their ability to deliver better patient care.

Utilizing a qualitative phenomenological approach, the study allowed exploration of intricate layers of meaning embedded within the encounters of three female medical clerks in a medical university hospital in Manila, Philippines. The gathered narratives were analyzed and meanings were derived from these statements. The identified meanings were then organized into themes and essential insights that represented the core essence of the phenomenon being studied.

The reflections extracted from narratives revealed the emergence of 10 significant major themes stemming from medical clerks’ patient encounters. These encounters were consistently described as a sacred responsibility, providing opportunities for profound connections, resilience, deepened faith and comprehensive personal and professional development within a caring and compassionate environment.

The transformative journey was marked by profound personal and spiritual growth among medical clerks. Beyond developing their clinical skills, they experienced a transcendence that spoke to human desire for meaning beyond the material world. This "spirituality of encounter" fostered deeper connections with patients and enriched their perspectives on clinical practice that can further enhance their holistic development as medical students.

INTRODUCTION

The Bachelor of Science in Nursing (BSN) program spans four years and includes general education and professional courses. Student nurses attend lecture hours, clinical duties, and related learning experiences that might be affecting their time in attending to a healthy lifestyle. Health-promoting lifestyle is a multi-dimensional pattern of activities and perceptions that begins with self-motivation and assists in promoting self-improvement and health. The domains of health-promoting lifestyle are essential factors to further improve their way of dealing with daily challenges. Multiple factors can also influence student nurses’ lifestyles, including their separation from family, busy schedules, and dietary choices. A study highlights various factors affecting student nurses' lifestyles, underscoring the need for tailored health promotion strategies and curriculum enhancements. Research into these domains can better equip future healthcare leaders. Gender, year level, and living arrangements influence student nurses' lifestyles, prompting researchers to investigate the extent of health-promoting lifestyles among them and differences based on these factors. By addressing these domains and conducting further research, nursing education and practice can better prepare future healthcare leaders to promote health and lifestyle effectively within their communities.

To determine the extent of health-promoting lifestyle among student nurses and identify the significant differences according to gender, year level, and living arrangement. 

A quantitative, descriptive research design was used with 360 respondents, employing Yamane’s formula and quota sampling. The study adopted the Health-Promoting Lifestyle II questionnaire with a validity of 0.962.

Student nurses often engage in health promoting behaviors (mean=2.56). Male student nurses reported higher scores in health responsibility, physical activity, spiritual growth, and stress management compared to female students (p=0.40). Level IV students engaged in health-promoting activities more frequently than Level I students (p=0.74). Living arrangements did not significantly impact health-promoting lifestyles (p=0.99).

No significant difference in health-promoting lifestyles among student nurses. Respondents demonstrated the least health-promoting lifestyle behaviors in the domains of health responsibility, nutrition, and physical activity. In contrast, spiritual growth, interpersonal relations, and stress management attained the highest mean scores.

OBJECTIVE

To report a case of parotid cholesteatoma and concurrent squamous cell carcinoma of the temporal bone in a 51-year-old woman.

Design: Case Report

Setting: Tertiary Government Training Hospital

Patient: One

A 51-year-old woman with a left parotid mass and ipsilateral external auditory canal mass and chronic bilateral otorrhea had parotid biopsy histological features of cholesteatoma and temporal bone imaging suggestive of middle ear cholesteatoma and possible parotid region abscess. She underwent subtotal petrosectomy, mastoid obliteration and excision of the parotid mass. Histopathological examination of the parotid mass was consistent with cholesteatoma but tissue from the middle ear cavity showed well-differentiated squamous cell carcinoma.

While cholesteatomas typically arise within the temporal bone, they may occasionally present in atypical or distant sites. In cases where a cholesteatoma demonstrates an unusual location, aggressive behavior, or atypical clinical progression, a high index of suspicion should be maintained for the possibility of an underlying or coexisting temporal bone squamous cell carcinoma.

OBJECTIVE

This study compared the demographics, clinical profile, treatment, and outcomes of retinoblastoma patients seen at medical institutions in the Philippines between two time periods: 2010 to 2015 and 2016 to 2020.

This was a multicenter, analytical, cohort study using review of medical charts and databases of retinoblastoma patients seen in 11 medical institutions from 2010 to 2020.

There were 636 patients (821 eyes) included in this study: 330 patients were seen in 2010 to 2015 while 306 in 2016 to 2020. More cases per annum were seen in the latter timeline. The number of patients with unilateral disease was not significantly different between the two time periods (p=0.51). Age at onset of symptom, age at initial consultation, and delay in consult were also not significantly different between the two time periods (p > 0.05). Patients had significantly different distributions of intraocular grades (p < 0.0001) and systemic staging (p < 0.0001) between the two time periods. Enucleation was the most common surgical treatment performed in both timelines. There was significant difference in the status of patients based on the need for systemic chemotherapy (p < 0.01). There was significant difference in outcome between the two time periods, including the proportions of living and deceased patients.

This study compared the most comprehensive data on retinoblastoma patients in the country. There was no improvement in early health seeking behavior based on similar age at initial consult and delay in consult. Enucleation remained the most common treatment mode as opposed to chemotherapy due to similar percentage of patients with unilateral disease, an indication for enucleation rather than chemotherapy.

Background: Six-pyruvoyl-tetrahydrobiopterin synthase (6-PTPS) deficiency is an inherited metabolic disorder which results in tetrahydrobiopterin (BH4) deficiency causing hyperphenylalaninemia. Objective: This study aimed to describe the clinical, biochemical, and radiologic profiles, and neurologic and developmental outcomes of patients diagnosed with 6-pyruvoyl tetrahydrobiopterin (PTPS) deficiency through newborn screening and confirmed by BH4 loading test, pterin analysis, and gene sequencing who were following-up with the metabolic team. Methods: The research was a single-center descriptive case series study design that was done at the Philippine General Hospital, a tertiary government hospital. The clinical, biochemical, radiologic profiles and neurodevelopmental evaluation of each patient were described. Results: Nine patients from 1 year 2 months to 14 years 5 months of age were enrolled in the study. Clinical manifestations before treatment were hypotonia, poor suck, and seizure. The most common clinical manifestation even after treatment initiation was seizure. The mean phenylalanine level on newborn screening was 990.68 umol/L, but after treatment was started, mean levels ranged from 75.69 to 385.09 umol/L. Two of the patients had focal atrophy of the posterior lobe on brain imaging. Pathogenic variants on molecular analysis were all missense, with two predominant variants, c.155A>G and c.58T>C. Eight of the nine patients had varying degrees of developmental delay or intellectual disability, while the remaining patient had signs of a learning disorder. Conclusion Newborn screening has played a crucial role in the early identification and management of patients with hyperphenylalaninemia due to 6-PTPS deficiency. Confirmation of diagnosis through determination of DHPR activity, urine pterins and/or molecular analysis is necessary for appropriate management. However, despite early initiation of treatment, neurodevelopmental findings of patients with 6-PTPS deficiency were still unsatisfactory.

Background: Apart from its role in bone health, recent developments have shown that vitamin D also has anti-inflammatory properties, and therefore may have a role in inflammatory bowel disease (IBD) in children. Objectives: To determine the effect of vitamin D supplementation on the disease activity of pediatric patients with IBD. Design: Random-effects meta-analysis Data Sources: : Studies were searched at Cochrane Library, PubMed, EBSCO Host, ScienceDirect, Google Scholar, and Wiley Online. Review Methods: Experimental studies measuring the effect of vitamin D on the disease activity of pediatric patients with IBD were included. The proportion of disease activity, measured as remission rate or inactivity using Pediatric Crohn’s Disease Activity Index (PCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI), and the mean and standard deviation of mean serum vitamin D [25(OH)D] level, change in 25(OH)D, and different inflammatory markers [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)] were extracted or estimated and recorded in an abstraction form. Standardized mean difference and odds ratio were used as summary effect measures and estimated using Stata/Multiprocessor. Results: The serum 25(OH)D (SMD = 1.75, z = 2.33, p = 0.001) and change in 25(OH)D (SMD = 3.37, z = 2.34, p = 0.019) was significantly higher among those who received a high dose of vitamin D. However, a significantly high heterogeneity was estimated (I2 >50%). For the disease activity of IBD, the standard mean difference of mean ESR (SMD = –1.10, z = 5.35, p = 0.001) was significantly lower with high-dose vitamin D. The likelihood of remission rate using the Pediatric Crohn’s Disease Activity Index (PCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI), and standardized mean difference of CRP were not significantly different among those who received high-dose and low-dose vitamin D. Conclusion Cognizant of the functions of vitamin D in enhancing intestinal flora balance, regulating immunologic response, and improving intestinal mucosal barrier, vitamin D can be recommended as a supplementary treatment for IBD among the pediatric population. Nevertheless, there is still insufficient evidence for the cut-off level of adequate levels of serum 25(OH)D among pediatric patients with IBD, thus necessitating further studies.
Vitamin D Deficiency

Objectives: The aim of this study was to assess the prevalence of nomophobia in university students. Methods: A systematic search was conducted of the following databases: Web of Science/ Core Collection, Scopus, PubMed, Embase, and Ovid/ MEDLINE until March 2021. Cross-sectional studies reporting the prevalence of nomophobia in undergraduate or postgraduate university students that assessed nomophobia with the 20-item Nomophobia Questionnaire (NMP-Q) tool were included. Study selection, data extraction, and risk of bias assessment were performed in duplicate. A meta-analysis of proportions was performed using a random-effects model. Heterogeneity was assessed using sensitivity analysis according to the risk of bias, and subgrouping by country, sex, and major. Results: We included 28 cross-sectional studies with a total of 11,300 participants from eight countries, of which 23 were included in the meta-analysis. The prevalence of mild nomophobia was 24% (95% confidence interval [CI], 20%–28%; I2 = 95.3%), that of moderate nomophobia was 56% (95% CI, 53%–60%; I2 = 91.2%), and that of severe nomophobia was 17% (95% CI, 15%–20%; I2 = 91.7%). Regarding countries, Indonesia had the highest prevalence of severe nomophobia (71%) and Germany had the lowest (3%). The prevalence was similar according to sex and major. Conclusions We found a high prevalence of moderate and severe nomophobia in university students. Interventions are needed to prevent and treat this problem in educational institutions.