Objective: This study aimed to demonstrate the benefits of using SaTScan (Boston, MA, USA), a cluster-detection software programme, and whole genome sequencing to investigate a suspected outbreak of Serratia marcescens infections in a tertiary government hospital in the southern Philippines. The hospital is part of the national Antimicrobial Resistance Surveillance Program’s network of sentinel sites. Methods: The investigation followed national outbreak investigation protocols. In May 2022, when evaluation of daily hospital laboratory census data revealed an increase in the number of Serratia species in the hospital, an alert was triggered. A concurrent, routine SaTScan analysis of the hospital’s surveillance data by the Antimicrobial Resistance Surveillance Reference Laboratory confirmed a cluster of cases. The Reference Laboratory requested isolates from clinical specimens from the hospital for confirmation of bacterial identification, antimicrobial susceptibility testing and whole genome sequencing. Results: Six isolates were submitted for genomic analysis, two of which were from the identified cluster. Although originally identified as S. marcescens, five of the isolates were subsequently confirmed as S. sarumanii. Phylogenetic analysis showed that the two isolates from the cluster were closely related and belonged to the same clade, which may suggest a common source. Three antimicrobial resistance genes were identified, but their phenotypic expression was limited, with one isolate exhibiting resistance mechanisms. Discussion: This study highlighted the utility of SaTScan for the early detection of potential disease outbreaks. The use of whole genome sequencing enhanced the investigation by enabling the analysis of potential transmission pathways at the genetic level, identification of the outbreak source and the detection of novel species.

OBJECTIVES

This study determined the prevalence of BBD among toilet-trained children attending a tertiary hospital’s pediatric outpatient clinic, and to evaluate the effectiveness of standard urotherapy among affected children.

METHODS

A prospective interventional study was conducted among 144 toilet-trained children aged 7 to 12 years seen at the University of Santo Tomas Hospital outpatient clinic from August 2025 to September 2025. Sociodemographic data were collected, and BBD was screened using the validated Filipino version of the Dysfunctional Voiding Symptom Scores (DVSS) questionnaire. Children with BBD underwent standard urotherapy, which included behavioral and lifestyle interventions such as timed voiding, adequate hydration, constipation management and proper voiding posture. DVSS assessments were repeated at two and four weeks.

RESULTS

The overall prevalence of BBD was 22.9% (33 of 144). BBD was significantly more prevalent among females (31.88%) than males (14.67%) (adjusted OR = 2.96, 95% CI: 1.28–6.86; p = 0.011). At baseline, children with BBD had significantly higher mean total DVSS scores (9.15 ± 3.64) compared to those without (2.01 ± 1.80, pCONCLUSION

Standard urotherapy proved effective in reducing symptom scores within two weeks and resulted in complete clinical resolution after four weeks among those who continued therapy. Routine screenings for BBD using DVSS and early initiation of standard urotherapy in pediatric outpatient settings are recommended to prevent complications and improve children’s urinary and bowel health.

Human ; Child: 6-12 Yrs Old ; World Health Organization ; Outpatient Clinics, Hospital ; Mass Screening ; Tertiary Care Centers ; Constipation ; Ambulatory Care Facilities

BACKGROUND

The global impact of the COVID-19 pandemic has instigated a profound public health crisis, particularly affecting professionals like dentists who, due to their close interaction with saliva—a potential viral reservoir—and the aerosols generated during specific procedures, face elevated risks of infection. To mitigate this, the Centers for Disease Control and Prevention (CDC) and the Philippine Dental Association (PDA) have established guidelines for averting cross-infection in dental settings.

OBJECTIVE

This study, conducted in an urbanized Metro Manila City, delves into the infection control practices of dentists amid the pandemic.

METHODS

Dentists from a Metro Manila city dental chapter were invited to participate in an online survey (Google Forms) consisting of participants' demographics, patient triage, engineering, administrative controls, disinfection personal hygiene, personal protective equipment (PPE), and waste management practices. Descriptive statistics, employing frequency distributions and percentages, summarized the dentists' adherence to infection control protocols.

RESULTS

Out of forty-nine respondents (49), the majority (92%) provided their teams' orientation on COVID-19 infection control protocols before reopening. Notably, 57% deferred elective procedures and 43% postponed aerosolgenerating procedures (AGPs). Only 39% utilized rubber dam isolation during AGPs. Most respondents reported full implementation of recommended administrative controls during the pandemic, with 92% isolating their treatment areas from other parts of the clinic. Most respondents adopted high-efficiency particulate air (HEPA) filtration units (82%) as one of their clinic’s engineering controls, and an extraoral vacuum machine, accounting for 71% of the respondents. The most common disinfection product used by the participants was alcohol, which was at 94%. Additionally, over 90% adhered to all recommended hand hygiene practices for both dental staff and patients. For the waste management protocols, only 55% of the respondents have their infectious waste collected by third-party Treatment Storage and Disposal (TSD) facilities.

CONCLUSION

The data shows that with the guidelines posted by both the PDA and CDC, the city’s dental practitioners could still provide services to the community in the safest manner at the time by being updated and following the infection control practices suggested by both organizations. Although some areas could have been improved, such as third-party waste management and the utilization of RT-PCR testing, some of these problems could have been attributed to the lack of availability in their areas.

Human ; Male ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; World Health Organization ; Residence Characteristics ; Quarantine ; Public Health ; Centers For Disease Control And Prevention (u.s.) ; Covid-19 ; Centers For Disease Control And Prevention, U.s.

Human ; Communication ; Counseling ; Family ; Genetic Counseling ; Risk

BACKGROUND

End-stage renal disease (ESRD) has been increasing in prevalence in recent years. The true prevalence of depression in hemodialysis patients is still not known. Cross-cultural studies showed prevalence ranging from 20-90%. Dimaano translated the Beck’s Depression Inventory Scale into the Visayan language and used this as a screening tool for depression among hemodialysis patients - and this was the first cross-cultural translation of the Beck’s Depression Inventory Scale to the Visayan language (BDI-Visayan).

GENERAL OBJECTIVE

Determine the accuracy of Beck’s Depression Inventory - Visayan in screening for Major Depressive Disorder (MDD) among Visayan-speaking ESRD patients.

STUDY DESIGN

Cross-sectional survey

STUDY POPULATION AND SETTING

Adult Visayan-speaking patients, ≥ 18 years old with ESRD, with GFR < 15 ml/min/1.73 m2 and ongoing hemodialysis for at least 3 months at the Chong Hua Hospital Mandaue Renal Unit.

METHODOLOGY

The 73 subjects underwent both the BDI-Visayan and the Structured Clinical Interview for DSM Disorders. Data was gathered to determine the accuracy of the BDI-Visayan in detecting Major Depressive Disorder.

RESULTS

Of the 73 subjects, 19.2% were identified with MDD, based on the SCID, while 37.0% were identified as depressed using the BDI-Visayan. Analyzed data showed that the accuracy of BDI-Visayan to detect MDD was 67.75%, with a sensitivity of 57.14%, and specificity of 67.8%.

CONCLUSION

BDI-Visayan had an acceptable accuracy in screening for MDD, however, it may tend to have an overdiagnosis in the ESRD population – emphasizing its role as a screening tool for suspected MDD cases.

Human ; Depression ; Dialysis ; Screening

Torcular dural sinus malformations (tDSMs) with high-flow fistulas pose complex management challenges due to their vascularity and the delicate neuroanatomy involved. This report presents the case of a child with tDSM and hydrocephalus, who underwent 3 staged embolization procedures but required a redo intervention due to residual malformation and venous hypertension. Utilizing the pressure cooker technique (PCT) in a redo setting allowed for high-pressure, targeted embolic delivery with minimized reflux, achieving near-complete occlusion and significant symptom relief. This case highlights PCT’s potential to improve outcomes in multi-stage treatments of high-flow tDSM, reducing reflux and enhancing safety in technically demanding cases.

Torcular dural sinus malformations (tDSMs) with high-flow fistulas pose complex management challenges due to their vascularity and the delicate neuroanatomy involved. This report presents the case of a child with tDSM and hydrocephalus, who underwent 3 staged embolization procedures but required a redo intervention due to residual malformation and venous hypertension. Utilizing the pressure cooker technique (PCT) in a redo setting allowed for high-pressure, targeted embolic delivery with minimized reflux, achieving near-complete occlusion and significant symptom relief. This case highlights PCT’s potential to improve outcomes in multi-stage treatments of high-flow tDSM, reducing reflux and enhancing safety in technically demanding cases.

BACKGROUND: Osteogenesis imperfecta (OI) is a group of connective tissue disease characterized by propensity to fractures following minimal trauma. OI is a lifelong inheritable disease and currently has no definitive cure. Management goals are directed towards prevention of fractures, controlling the symptoms, maximizing independent mobility, and developing optimal bone mass and muscle strength. Bisphosphonates are the mainstay of pharmacologic fracture-prevention therapy for most forms of OI. The University of the Philippines-Philippine General Hospital Bisphosphonate Treatment Program for OI was started in 2006 by the Clinical Genetics Service. For more than a decade now, the program has been serving more than 50 OI patients. This study evaluated the clinical outcomes of the patients who were included in the program to add to the body of knowledge on Filipino patients with OI. OBJECTIVES: This study sought to determine the clinical outcomes of children with OI on intravenous pamidronate treatment at the Philippine General Hospital (PGH) from January 2010 to December 2018. METHODS: The study utilized a retrospective review of medical records of 24 patients diagnosed with OI on pamidronate therapy seen at the PGH from January 2010 to December 2018. Descriptive statistics were used to summarize the demographic and baseline clinical characteristics of the patients. Median annualized fracture rates before and during treatment were calculated and compared. The patient functional mobility before and during pamidronate infusion was classified accordingly based on the Gross Motor Function Classification System (GMFCS) and were compared. RESULTS: Twenty-four patients, which include seven males and 17 females, with ages at the time of conduct of the study ranging from four years to 11 years, fulfilled the inclusion criteria. There were four patients with OI type I, six with OI type III, 11 with OI type IV and three with OI type V. The annualized long bone fracture rate decreased significantly from a median of 2.0/year (range 1-2.75) to 0.75/year (range 0-1) after more than a year on pamidronate infusion (p < 0.001). There is a note of overall improvement in terms of functional mobility using the 5-point scale of the GMFCS during pamidronate infusion from the baseline. However, the difference is not statistically significant. CONCLUSION Cyclic intravenous pamidronate treatment in young children with moderate-severe OI is well tolerated and associated with reduced fracture frequency with a tendency to improvement of gross functional mobility.
Human ; Osteogenesis Imperfecta ; Bisphosphonate ; Diphosphonates

BACKGROUND AND OBJECTIVE

Orthodontic brackets predispose dental biofilm accumulation causing caries and gingivitis. Chlorhexidine is an adjunct to mechanical plaque removal, but has side-effects (tooth staining, bacterial resistance) due to long term use. This study tested the efficacy of Photodynamic Therapy, which produces reactive oxygen species, to reduce Streptococcus mutans in dental biofilm on orthodontic brackets.

METHODS

A 5-day S. mutans biofilm was grown on forty enamel-bracket specimens. Thirty-nine specimens were randomized to three treatment groups: A. Distilled Water; B. 0.12% Chlorhexidine (CHX); C. Photodynamic Therapy (PDT) using Toluidine Blue O (TBO) as a photosensitizer, activated by red LED (630nm). After treatment, one random specimen from each group was viewed under Environmental Scanning Electron Microscopy (ESEM); the other 12 specimens, biofilms were collected, weighed, and cultured onto BHI agar plates to determine the number of CFU/mg. For baseline evaluation, one clean and one untreated specimens were preserved for ESEM.

RESULTS

Based on Tukey HSD test, group A had the most S. mutans (37.0573 CFU/mg) and was significantly different (p < 0.05) from groups B (0.1712 CFU/mg) and C (1.1193 CFU/mg), where both showed less bacteria than group A. The statistical difference between groups B and C was insignificant. ESEM images showed specimen A covered with more abundant and denser S. mutans biofilm than specimens B and C, with almost similar morphology showing sparse, less dense, and disintegrated biofilm with unclear cellular walls and presence of amorphous masses.

CONCLUSION

Both Photodynamic Therapy and 0.12% Chlorhexidine showed a significant reduction of S. mutans in dental biofilm on orthodontic brackets. However, there is no significant difference between them in reducing S. mutans CFU/mg. Photodynamic therapy could be an alternative adjunctive tool to mechanical removal of plaque adhered to orthodontic brackets.

Bacteria ; Photochemotherapy ; Photodynamic Therapy ; Microscopy, Electron, Scanning ; Biofilms ; Orthodontic Brackets ; Chlorhexidine

Torcular dural sinus malformations (tDSMs) with high-flow fistulas pose complex management challenges due to their vascularity and the delicate neuroanatomy involved. This report presents the case of a child with tDSM and hydrocephalus, who underwent 3 staged embolization procedures but required a redo intervention due to residual malformation and venous hypertension. Utilizing the pressure cooker technique (PCT) in a redo setting allowed for high-pressure, targeted embolic delivery with minimized reflux, achieving near-complete occlusion and significant symptom relief. This case highlights PCT’s potential to improve outcomes in multi-stage treatments of high-flow tDSM, reducing reflux and enhancing safety in technically demanding cases.