Objective: Research interest in minimally invasive spine surgery (MIS) is increasing; however, significant heterogeneity often exists among reported surgical techniques broadly classified as minimally invasive. High-quality data specifically addressing MIS techniques for intradural spinal pathology remain particularly scarce. Here, we present our experience, along with that of other groups, utilizing MIS techniques with an emphasis on tubular retraction for treating intradural extramedullary (IDEM) spinal pathology. Methods: Twenty-four patients with IDEM pathology were treated using MIS techniques, including tubular retraction, from 2006 to 2018. Additionally, a systematic literature review was conducted to enable a pooled analysis of patient demographics and perioperative outcomes. Results: In addition to our own patient series, 16 other case series were identified through systematic review. The resulting combined dataset from these 17 series included 323 patients available for pooled analysis. Nerve sheath tumors and meningiomas represented over 80% of the pathologies. Gross total resection was achieved in 93% of the pooled MIS IDEM cases. The mean estimated blood loss was 131 mL, the mean operative duration was 169 minutes, and the mean hospital stay was 4.1 days. Conclusion MIS resection using tubular retraction is a safe and effective approach for managing IDEM pathology. Our pooled cohort provides valuable comparative data for assessing outcomes against open surgical techniques.

Nipah virus (NiV), a pathogen with pandemic potential, lacks approved treatments or vaccines, highlighting the urgent need for research on immune-targeted antigenic determinants. A significant gap persists in NiV research, as studies on the fusion (F) protein critical for viral entry as well as the B cells epitopes, have primarily focused on computational prediction rather than experimental validation of immunogenic epitopes obtained through immunoinformatics approach. This study focused on the conserved F protein across NiV human isolates and employed an immunoinformatics approach to predict linear B-cell epitopes capable of direct immune activation. Predicted epitopes were screened for antigenicity, toxicity, and allergenicity. Molecular docking analysis was performed to evaluate its binding affinity with B-cell receptors (BCRs). To validate its immunogenicity, the LF6 peptide was synthesized and used in an indirect ELISA to test sera from cohort previously infected with NiV as well as with negative cohort. Epitope LF6 (LISNIEIGFCL) was identified as a strong candidate based on its immunogenic properties. Molecular docking showed favorable binding of LF6 with BCR. ELISA results revealed that one sera from the survival cohort showed positive response which is an IgG antibody response 2-fold higher (0.343) than the cut-off value (0.0171). This study provides the first reported evidence linking computational predictions with functional immune reactivity for a B-cell epitope of NiV. The findings suggest that LF6 has the potential to elicit specific immune responses. However, given the small sample size, further validation in larger cohorts is essential to confirm LF6’s vaccine relevance.

Introduction: ILeptospirosis is an important zoonotic disease commonly found in tropical or sub-tropical countries. The most severe form is Weil's syndrome which presents with jaundice, renal failure, and bleeding diatheses. Although jaundice occurs in 38% of patients with leptospirosis, no studies in Asia have focused on the liver biochemical profile of these patients. Characterization of liver biochemical profile and ultrasonographic findings may shed more light on the disease process. Identification of liver biochemical parameters that portend a poor prognosis may also allow for early aggressive intervention. Objective: To describe the liver biochemical profile and liver ultrasonographic findings in adult patients with laboratoryconfirmed leptospirosis, admitted at a tertiary hospital in Manila, Philippines. The association of clinical and laboratory features with clinical outcomes (i.e., severe liver injury, Weil’s syndrome, and mortality) was also investigated. Methods: This retrospective cross-sectional study reviewed all available cases of adult patients with laboratoryconfirmed leptospirosis admitted in the Philippine General Hospital from January 2009 to August 2018. The clinical features, liver biochemical profiles, and ultrasound findings were recorded and analyzed. Comparison between the means of each group based on clinical outcome (i.e., mortality, Weil’s syndrome) was done via Students’ t-test for continuous variables, and calculation of the Odds Ratio for categorical variables. Results: Total and direct bilirubin levels were elevated in patients with leptospirosis compared to serum aminotransferases and alkaline phosphatase levels which were only mildly elevated. Abdominal ultrasound showed typically un-enlarged livers with normal parenchymal echogenicity, normal spleens, and non-dilated biliary trees. Dyspnea was associated with an increased odds for mortality. Although jaundice was present in 39.5% of patients and significantly associated with severe liver injury, this was not associated with mortality. Liver biochemical test values did not differ among patients who expired and those who survived to discharge. The presence of myalgia and abdominal pain increased the odds for Weil's syndrome. Conclusion To date, no local studies have fully described the liver biochemical profile of patients with leptospirosis. Our findings are compatible with previous studies showing that leptospirosis typically presents with predominantly elevated direct bilirubin from cholestasis and systemic infection. Contrary to previous literature, however, our study found no association between jaundice and mortality.
Leptospirosis

BACKGROUND: School-aged children bear a lot of difficulties and discomforts brought about by the new normal during the COVID-19 pandemic. OBJECTIVES: This study aimed to examine the general well-being of children during the pandemic, how the children are coping with all the challenges, and parents' strategies to help their children cope METHODOLOGY: This study utilized a descriptive correlational research design with purposive sampling. Data was collected through an online survey. The standardized Kidcope-Child version was utilized to measure children's coping, while the Pediatric Quality of Life Inventory (PedsQL)™ 4.0 Short Form 15 Generic Core Scales was utilized to measure the children's well-being. RESULTS: A total of 134 parents participated in the study. No significant relationship was found between the age, sex, and coping strategies of the children, as well as between the age and well-being of children. Male children experienced more difficulty in physical functioning (p-value= 0.028), social functioning (p-value= 0.017), and overall well-being (p-value= 0.031) compared to female children. The computed mean for parents' helping strategies was between 2.67 to 2.78, which lies between the categories of sometimes (2) to always (3). CONCLUSION School-aged children were found to be using more positive coping strategies than negative coping strategies during the pandemic. They have “sometimes” to “almost no” experience of difficulty in terms of the five functions of well-being. Parents used the six fundamental tasks of parenting to help their children cope.
coping strategies ; well-being ; COVID-19 pandemic

Background: The escape of polyethylene microbeads from waste-water treatment facilities to aquatic habitats has been a major concern by scientific communities due to the adverse effects on aquatic organisms as well as the well-being of the marine and terrestrial ecosystems. Objective: This study was conducted to evaluate the embryotoxic and teratogenic effects of polyethylene microbeads on the early development of the zebrafish Danio rerio using the Fish Embryo Acute Toxicity Test (FET). Methodology: Sixty (60) zebrafish embryos were exposed to polyethylene microbead suspensions (PE-MBS) of 20 μg/L, 200 μg/L, and 2000 μg/L concentrations. Using FET, the toxicological endpoints (i.e., egg coagulation, lack of somite formation, non-detachment of tail, and lack of heartbeat) were observed every 24 hours until the 96th-hour exposure. Hatching of the embryo from the chorion was observed from 48-96 hpf (hours-post fertilization), and at least four parameters of teratogenicity (i.e., edema of the pericardium and yolk sac, bent axis, tail curvature, and collapsed swim bladder) was observed at 144 hpf. Results: Significant differences between means and variances in the embryotoxic and teratogenic effects were observed for all treatment groups in relation to the negative control (reconstituted water). The emulsifier control (0.01% Tween 80, p-value=0.9), the solvent control (1% DMSO, p-value = 0.9), and the 20 μg/L PE-MBS (p-value = 0.92) did not significantly differ with the negative control group. However, the positive control (5% ethanol, pvalue= 7.8) and 200 μg/L (p-value = 1.1), and 2000 μg/L (p-value = 1.48) of PE-MBS were significantly embryotoxic and teratogenic to the developing organism. Conclusion The high concentrations of PE-MBS (200 μg/L and 2000 μg/L) may induce early hatching, mortality, and malformations. Tukey Kramer post hoc test substantiated that PE-MBS toxicity is dose-dependent since embryotoxicity and teratogenicity increase at higher concentrations. Further studies should be conducted to know more about the adverse effects of polyethylene microbeads on the development, physiology, and genomics of freshwater fishes.
Zebrafish

Arthroscopy ; Follow-Up Studies ; Humans ; Rotator Cuff/surgery* ; Treatment Outcome

Objective. The study evaluates the clinical profile of patients who underwent coronary artery bypass graft surgery (CABG) under the Philippine Health Insurance Corporation (Philhealth) Z Benefit Package (PZBP), as well as time intervals between PZBP screening, approval, and timing of surgery. Methods. A review of medical records was done to collect data on time intervals between the screening process and Philhealth approval in CABG patients under PZBP. The clinical profile and surgical outcomes of patients were also evaluated. Results. Sixty-three patients were included from March 2017 to December 2018. Most patients were under 61-70 years old. Hypertension was the most commonly observed comorbidity. Time intervals were analyzed including identification for surgery to eligibility screening (2–217 days, median 25 days), Philhealth approval (8–266 days, median 20 days), and surgery (9-403 days, median 33 days). Postoperative atrial fibrillation was seen in 22.58%. The most commonly observed complication prolonging hospitalization was pneumonia. Conclusion. This is the first local study which evaluated the timelines of PZBP. Results may be use as basis of follow up study in the future for identification of an acceptable timeline intervals. Several modifiable factors affecting time intervals were identified for further improvement of healthcare services. The leading cause of increase length in hospitalization were HAP and AF.
Coronary Artery Disease ; Vascular Diseases ; Vascular Surgical Procedures ; National Health Programs

Primary amenorrhea is a symptom caused by different rare pathologic conditions. It is commonly seen during adolescence due to the absence of menses during this period. Presented here is a rare case of primary amenorrhea in an 18 year old girl with delayed pubertal growth and short stature which on series of investigations revealed hypergonadotropic hypogonadism, absence of the uterus and non-visualized bilateral ovaries on MRI. Karyotyping showed 45,X0. The coexistence of MRKH and gonadal dysgenesis was considered in this case and has been reported in only a few studies up to this date. Its association is uncommon, hence, a multidisciplinary approach is warranted for the management of her case. Further implications on menses and future fertility options are the main considerations, affecting the quality of life.

Malaria is the most common vector-borne parasitic disease in Malaysia and Thailand, especially in Malayan Borneo and along the Thailand border areas, but little is known about the genetic diversity of the parasite. Present study aims to investigate the genetic diversity of Plasmodium falciparum isolates in these two countries and eventually contributes to more effective malaria control strategies, particularly in vaccine and antimalarial treatment. One hundred and seventy three P. falciparum isolates were collected from Malaysia (n = 67) and Thailand (n = 106) and genotyped using nested PCR targeting the polymorphic region of MSP-1, block 2. Sequence analysis was conducted to investigate the allele diversity of the isolates. Three allelic families were identified in Malaysian and Thailand P. falciparum isolates, MAD20, K1 and RO33. Sequence analysis revealed that there were 5 different MAD20, 1 K1 and 2 different RO33 for Malaysian isolates. Thailand isolates exhibited greater polymorphism because there were 13 different MAD20, 6 different K1 and 2 different RO33 identified in this study. Multiclonal infections were observed for the isolates in both countries, however, low multiplicity of infection (MOI) was observed for Malaysian (1.1) and Thailand (1.2) isolates. Phylogenetic analysis showed that P. falciparum isolates of Malaysia and Thailand were clustered in the same group for all the allelic families. Population structure of P. falciparum isolates in Malaysia and Thailand exhibit extensive genetic polymorphism but showed high similarities as well as comparable MOI.

INTRODUCTION: Several studies have suggested that music has a significant effect on memory. Classical music has been studied extensively. However, there are studies on other types of music like binaural beats which involve the introduction of tones of different frequencies. This study aimed to determine the effects of binaural beats stimulation compared to classical music on memory among high school students. METHODS: This was a randomized single-blind controlled trial among senior high school students in a selected private school assigned to listen to either binaural beats stimulation or classical music to determine their effect on memory as measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Pre- and post-intervention RBANS scores were compared within and between the two study groups. RESULTS: RBANS scores in both classical music and binaural beats stimulation groups improved with an increase of 20.58 ± 10.33 and 20.26 ± 12.06, respectively. The difference between the increase in scores was not significant. CONCLUSION Exposure to either binaural beats stimulation or classical music provided statistically and clinically significant increases in memory. Binaural beats stimulation increased memory to the same degree as classical music.