Arsenic trioxide (ATO) serves as a component of traditional Chinese medicine and a modern anticancer agent, demonstrating remarkable efficacy in the long-term treatment of acute promyelocytic leukemia. With increasing research into its application in solid tumors, ATO's diverse mechanisms of action and potential clinical value have attracted widespread attention. ATO can inhibit tumor cell proliferation by inducing various forms of cell death, such as apoptosis, autophagy, pyroptosis, necroptosis, and ferroptosis, as well as by regulating cell differentiation. Moreover, its modulatory effects on the tumor immune microenvironment provide a new aspectto its antitumor activity. Nevertheless, the clinical application of ATO in solid tumors faces challenges such as low bioavailability, inadequate targeting, and adverse effects. The development of nanocarriers and targeted delivery systems has emerged asa key strategy for enhancing the therapeutic efficacy of ATO. This review systematically summarizes the multiple mechanisms of action of ATO in solid tumors and recent advances in nanodelivery technologies, explores the potential of ATO-based combination therapies, and discusses future directions, aiming to provide a theoretical foundation and practical guidance for the clinical application of ATO in solid tumors.

Introduction: The primary issue following lumbar discectomy for disc herniation is the risk of reherniation in the post-operative period. Many surgical techniques have been proposed to treat disc reherniation, however, the optimal one remains variable. This meta-analysis aimed to investigate the prevalence of symptomatic reherniation after using a Bone-anchored annular closure device following lumbar discectomy and the contributing factors. Materials and methods: Identification of published literature was performed on PubMed, Google Scholar, Scopus, and Web of Science databases. Studies published until 14 February 2024 reported the prevalence of symptomatic reherniation after using a Bone-anchored annular closure device following lumbar discectomy and the associated contributing factors. A random effects model was used to conduct Bayesian frequentist network meta-analysis and pair-wise meta-analysis, with the assessment based on standardised mean difference (SMD) and 95% confidence interval (CI). Results: Eleven studies published in 2012 − 2022 recruiting a total of 5195 patients were included in the meta-analysis. The prevalence of reherniation in ACD and control groups was 23.2% (95% CI: 18.2% − 28.1%) and 36.4% (95% CI: 28.2% − 44.5%), respectively. The moderator effect of sample size is significant for pooled data of the ACD group (p-mod=0.002), but not for the control group (pmod=0.278). After the adjustment with sample size, the prevalence rates were 13.6% (95% CI: 6.2% − 21.1%) and 29.6% (95% CI: 14.9% − 33.2%) for ACD and control groups, respectively. Conclusion: Comparatively to lumbar discectomy alone, using a Bone-anchored annular closure device following lumbar discectomy decreased the symptomatic reherniation rate and post-operative complications, as well as the necessity for subsequent surgeries.

Sepsis is a life-threatening organ dysfunction resulting from a dysregulated host response to infection. Septic shock, a severe subset of sepsis, must be promptly recognized and managed as a medical emergency. We present the case of a 51-year-old male who developed shock during hospitalization for infected leg ulcers, with a background of chronic heart failure (HF), hypertension, and poorly controlled type 2 diabetes mellitus. Despite his history of HF, bedside echocardiography revealed low systemic vascular resistance and preserved cardiac output, findings more consistent with septic shock than cardiogenic shock. This case underscores the pivotal role of early hemodynamic assessment, particularly with echocardiography, in accurately identifying the type of shock in patients with pre-existing HF. Differentiating the underlying etiology is essential to initiate appropriate therapy and improve clinical outcomes.

Pulmonary atresia and ventricular septal defect (PA-VSD) with major aorto-pulmonary collaterals (MAPCAs) is a complex and extremely heterogeneous anomaly. Most untreated patients die in their first decade of life because of intractable congestive heart failure or respiratory distress. PA-VSD is characterized by a wide variety of anatomy of central pulmonary artery and nature of collateral lung perfusion. In most patients, collateral perfusion is provided either by MAPCAs or by patent ductus arteriosus (PDA). The management of infants and children with pulmonary atresia, ventricular septal defect, and MAPCAs has proven to be challenging. Therapeutic approaches include onestage surgical repair, staged unifocalization, shunting, and coiling of collateral vessels. Results have been variable and frustrating. In this case report, we discuss the characteristic, variants, and how far we can manage the patient who suffered from PA-VSD.

Rheumatic fever is the main cause of mitral stenosis worldwide. Ortner’s syndrome (cardio-vocal syndrome) is a rare complication of rheumatic mitral stenosis. It is caused by recurring paralysis of the left laryngeal nerve, mainly caused by mechanosuppression of the nerve from enlarged cardiovascular structures. A 76-year-old woman with chronic rheumatic heart disease (RHD) complained of hoarseness for 17 days, accompanied by shortness of breath, nausea, and vomiting for 1 week. Auscultatory examination revealed a loud first heart sound in the mitral region as well as an irregular rhythm. An electrocardiogram examination revealed right axis deviation and atrial fibrillation. Chest X-ray showed cardiomegaly. Despite normal left and right ventricular function, echocardiography showed severe mitral stenosis with mild mitral regurgitation. Conservative treatment was given with a combination of diuretics, beta-blockers, vitamin K antagonists, and angiotensin receptor blockers. An otolaryngologist was consulted, and the patient was treated conservatively.

Ventricular septal rupture (VSR) after acute myocardial infarction (MI) is a rare yet fatal complication. Although surgical repair is essential, the optimal timing remains controversial. We report a case of ST-Elevation Myocardial Infarction (STEMI) complicated by VSR. Fibrinolytic therapy was initially considered successful; however, the patient developed worsening dyspnoea. Further evaluation confirmed an apical VSR by echocardiography. The patient received intensive monitoring and supported with an Intra-Aortic Balloon Pump (IABP). Surgical repair was performed on day 26. Hemodynamic initially improved postoperatively, but the condition deteriorated again on the ninth day after surgery, and the patient ultimately died. This case underscores that while surgical repair is the preferred definitive treatment for VSR, the timing of intervention is critical. Proper timing requires balancing surgical risks with tissue readiness and hemodynamic stability. The interval between VSR detection and surgical repair plays a pivotal role in determining patient survival.

INTRODUCTION

Hypertension is a serious public health issue that puts individuals at risk for various morbidity and mortality indicators. One of the most crucial factors in managing blood pressure and preventing complications is medication adherence which is linked to several determinants. This study explored the correlation between medication adherence among middle-aged hypertensive adults and the different domains of quality of life (QOL), which includes physical, psychological, social relationship and environment.

METHODS

This cross-sectional study involved 96 Filipino residents of Brgy. San Jose, Navotas City aged 35 to 65 years old diagnosed with hypertension and prescribed anti-hypertensive medications. Pearson’s correlation coefficient was used to calculate the correlation between different domains of QOL as well as the overall QOL score.

RESULTS

Results revealed a statistically significant but weak positive correlation between overall QOL and medication adherence (r = 0.336, p<0.001). Among the QOL domains, environmental domain had the strongest correlation with adherence (r = 0.446, p = 0.00), followed by physical health (r = 0.443, p = 0.01) and psychological well-being (r = 0.382, p = 0.01). The social relationship domain showed negligible correlation (r = 0.163, p = 0.4).

CONCLUSION

The study demonstrates that while medication adherence is modestly associated with better perceived QOL, especially in physical, psychological and environmental aspects, other factors likely influence both outcomes. These findings highlight the need for holistic, community-based interventions that address not only medication adherence but also environmental and psychosocial barriers to care in managing hypertension.

Human ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Quality Of Life ; Public Health ; Medication Adherence ; Antihypertensive Agents ; Blood Pressure ; Interpersonal Relations

INRODUCTION

The growing misuse of antibiotics and the escalating threat of antibiotic resistance in the Philippines pose significant public health concerns. While various Knowledge, Attitudes and Practices (KAP) questionnaires on personal antibiotic use have been employed in local studies, none have been fully validated and a standardized, culturally appropriate tool remains lacking.

OBJECTIVE

This study aims to develop a Filipino-translated and culturally adapted KAP questionnaire on personal antibiotic use (KAPQ-PAU-FIL) and evaluate its validity and reliability.

METHODOLOGY

The research consisted of two phases. The first phase is the translation and cross-cultural adaptation of the original questionnaire in collaboration with the UST Sentro sa Salin at Araling Salin. The second phase is the validity and reliability testing of the KAPQ-PAU-FIL using a sample of 176 Filipino adults. This included assessment of its face validity, content validity, construct validity, internal consistency, test-retest reliability and equivalent forms reliability.

RESULTS

Most items were translated without difficulty, though four items were modified to better fit the linguistic and cultural context. The KAPQ-PAU-FIL demonstrates strong psychometric properties, with face validity (SFVI/Ave = 0.99), content validity (SCVI/Ave = 0.99), construct validity (CFI = 0.92, RMSEA = 0.06, SRMR = 0.04; FL = 0.60-0.85; ITC = 0.58-0.71), test-retest reliability (ICC = 0.83), internal consistency (α = 0.929) and equivalent forms reliability (p>0.05; κ = 0.62-0.74).

CONCLUSION

The KAPQ-PAU-FIL is the first ever, Filipino-translated, culturally adapted questionnaire designed to assess KAPQ-PAU-FIL, demonstrating strong validity and reliability to support public health programs against antibiotic misuse.

Surveys And Questionnaires ; Public Health ; Knowledge ; Anti-bacterial Agents ; Philippines ; Program

Background: The World Health Organization published the 2019 Integrated Care for Older People (ICOPE) framework to guide, assess, and promote the intrinsic capacity (IC) of older adults, referring to their physical and mental health. This study aims to investigate the relationship between IC and frailty among older adults. Methods: This cross-sectional study was conducted in a medical center in Taiwan in 2021. Two hundred ten patients over 65 admitted to the geriatric ward were invited to participate. The questionnaire included an IC measure, Fried Frailty Scale, and demographic items. The IC measure was ascertained using the six domains of ICOPE (cognition, mobility, nutrition, visual, hearing, and depressive symptoms). The Fried Frailty Scale was used to categorize participants as robust (Fried Frailty Scale=0), prefrail (Fried Frailty Scale=1-2), or frail (Fried Frailty Scale ≥3). Multinomial logistic regression was used to analyze the association between individual ICOPE domains and frailty stages, while adjusting for confounders. Results: Among the participants, 39.0% were prefrail, and 28.6% were frail. Limited mobility and depressive symptoms were significantly associated with prefrail (adjusted odds ratio [aOR]=4.44, 95% confidence interval [CI] 1.82–10.82; aOR=8.41, 95% CI 1.75–40.37) and frail (aOR=11.57, 95% CI 3.63–36.93; aOR=13.77, 95% CI 2.62–72.49) individuals, respectively. Malnutrition (aOR=4.01, 95% CI 1.18–13.62) and hearing loss (aOR=4.37, 95% CI 1.09–19.66) were significantly associated with frail older adults. Conclusion Limited mobility and depressive symptoms occurring at the prefrail stage could be used as assessment items for early detection of prefrail.

Background: s/Aims: Left lateral sectionectomy (LLS) is a commonly performed liver resection. The Rex-recess technique, an extrahepatic Glissonian approach through the umbilical fissure, provides earlier extrahepatic vascular control, potentially resulting in safer and faster resections. However, comparative data between these approaches is limited. This study aims to compare the Rex-recess technique with the standard technique for LLS regarding operative parameters, intraoperative blood loss, and postoperative outcomes. Methods: This retrospective cohort study included 48 consecutive adult patients who underwent open LLS at a tertiary hepatobiliary centre between January 2021 and November 2025. Patients were categorized based on the surgical technique used: standard technique (n = 25) and Rex-recess technique (n = 23). Primary outcomes assessed included operative time, blood loss, transfusion requirements, and postoperative complications. Secondary outcomes focused on selected early postoperative recovery parameters. Results: Baseline demographics were comparable between groups. The Rex-recess technique significantly reduced operative time (90 ± 17.1 minutes vs. 162 ± 27.2 minutes; p < 0.0001) and intraoperative blood loss (80 ± 42.3 mL vs. 250 ± 67.2 mL; p < 0.0001).Other postoperative outcomes, including complication rates and length of hospital stay, were comparable between the two groups. Conclusions The Rex-recess approach appears to be a feasible and anatomically sound technique for LLS, offering advantages in operative efficiency, such as reduced operative time and blood loss. However, due to the retrospective design and non-randomized allocation, these findings should be interpreted with caution. Further prospective studies are needed to validate these results.