Public interest in cognitive enhancement has driven the widespread availability of dietary supplements claiming to support brain health and memory. This comparative cross-sectional study explores the commercial availability and marketing claims of cognitive-enhancing dietary supplements across offline and online retail platforms. A dual-component design was employed in a comparative cross-sectional study. The first component involved assessing the commercial availability and marketing claims of cognitive-enhancing dietary supplements sold through offline retail outlets in Kuala Lumpur using a purposive sampling approach. The second component consisted of a parallel assessment conducted on online platforms, employing a convenience sampling strategy. A total of 13 products were identified on offline retail platforms in Kuala Lumpur, and 117 products were identified on online platforms. Capsules were the most common dosage form, both offline (46.2%) and online (79.5%). Products sold offline most frequently originated from Singapore (69.2%), whereas online products predominantly came from the United States of America (74.4%). The median prices of offline products were RM 190 (55.5), and online products were RM 196 (183), which are comparable, although the online products exhibited a wider price range (RM14–RM1,147). The most frequent claims were “brain health” for offline products and “memory” for online products. Natural or compound extracts were the most common active ingredients. This study’s findings found significant differences between offline and online dietary supplements in terms of availability, country of origin, price and marketing claims. These inconsistent findings underscore the need for stronger regulation and improved transparency in labelling to safeguard consumer health and ensure product credibility. Future research should focus on dosage accuracy, long-term safety, and mechanisms of action for supplements with cognitiveenhancing claims.

BACKGROUND

Perimyocarditis due to inflammation of the pericardium and myocardium results in myocellular damage. Myocarditis, or myocardial inflammation, occurs after cardiac injury. Gallbladder edema, in the absence of cholecystitis, may occur in numerous conditions including cardiac inflammation.

A 28-year-old previously healthy female presented with chest pain, orthopnea, exertional dyspnea and a history of fever. She also reported intermittent right upper quadrant pain. Physical exam revealed a pericardial friction rub. Electrocardiogram (ECG) showed sinus rhythm with nonspecific ST-T changes; troponin I was elevated. Echocardiography demonstrated segmental wall motion abnormalities, pericardial thickening and preserved systolic function. Initially managed as acute coronary syndrome, she was later diagnosed with perimyocarditis. On the second hospital day, she developed recurrence of right upper quadrant abdominal pain. Abdominal ultrasound revealed gallbladder edema with pericholecystic fluid, but no stones. Liver enzymes were elevated. Acalculous cholecystitis was considered and cholecystostomy offered instead due to aspirin therapy. However, repeat imaging showed resolution of cardiac and gallbladder findings, and surgery was deferred. Cardiac MRI postdischarge was unremarkable.

Perimyocarditis may present with gallbladder edema mimicking acalculous cholecystitis, potentially leading to unnecessary surgical intervention. This case emphasizes the importance of considering cardiac etiologies in atypical abdominal presentations.

BACKGROUND

Takayasu arteritis (TAK) is a rare, chronic large-vessel vasculitis affecting the aorta and its major branches, leading to stenosis, occlusion, or aneurysmal changes. The global incidence is approximately 1.11 cases per million person-years, with a strong female predominance (80%–90%), typically manifesting between 40 and 50 years of age. Although TAK occurs worldwide, its prevalence is highest in Asia with 61 reported cases in the Philippines. Clinical manifestations are heterogeneous, ranging from nonspecific systemic symptoms to severe vascular complications, often delaying diagnosis, particularly in atypical cases.

We report a 43-year-old woman with hypertension, diabetes and chronic ischemic stroke without residuals who presented with a two-month history of easy fatigability, generalized weakness, arthralgia, intermittent claudication with progressive dark discoloration of both lower extremities, undocumented low-grade fever and alopecia. She developed acute respiratory distress with abrupt loss of consciousness requiring emergent intubation. Examination revealed a marked discrepancy in blood pressure between the upper extremities, diminished peripheral pulses and an audible abdominal bruit. Laboratory studies showed elevated Troponin I, ESR and CRP, with borderline ANA and normal complement levels. Neuroimaging demonstrated multiple acute and chronic cortical and cerebellar infarcts. Initially managed as a cerebrovascular accident, she required tracheostomy for ventilatory dependence. Antiplatelet and anticoagulant therapy was started after evidence of myocardial infarction. Progressive ischemia of the left lower extremity necessitated below-knee amputation. CT aortography later revealed diffuse thoracoabdominal aortic and iliac involvement with mural thickening, multiple aneurysms, dissection and unilateral renal artery stenosis. Further immunologic workup showed her to be negative for lupus anticoagulant. Immunosuppressive therapy with corticosteroids and methotrexate was initiated to control vascular inflammation and limit further progression.

This case highlights the diagnostic complexity of TAK with atypical, multi-organ ischemic presentations, emphasizing the importance of clinical vigilance, comprehensive vascular imaging and timely immunosuppressive therapy to mitigate complications and improve outcomes.

Mục tiêu: Đánh giá kiến thức, thái độ đối với người cao tuổi và một số yếu tố liên quan ở sinh viên điều dưỡng Trường Đại học Đại Nam. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên 252 sinh viên điều dưỡng từ năm thứ nhất đến năm thứ tư. Dữ liệu thu thập bằng bảng hỏi tự điền trực tuyến, sử dụng thang đo kiến thức FAQ (2015) đã điều chỉnh và thang đo thái độ KAOP. Phân tích số liệu bằng thống kê mô tả và kiểm định χ² với p<0,05. Kết quả: 28,2% sinh viên có kiến thức đạt về người cao tuổi; 71,8% chưa đạt. 96% sinh viên có thái độ tích cực. Mong muốn làm việc trong lĩnh vực chăm sóc người cao tuổi sau tốt nghiệp liên quan có ý nghĩa đến kiến thức và thái độ. Kết luận: Kiến thức về người cao tuổi của sinh viên điều dưỡng còn hạn chế, dù thái độ nhìn chung tích cực. Cần tăng cường nội dung lão khoa và trải nghiệm thực hành chăm sóc người cao tuổi trong chương trình đào tạo.

INTRODUCTION

A 23-year-old young female patient presenting with persistent diarrhea and eosinophilia, who had clinical improvement after administration of steroids.

A 23-year-old Filipino female, without comorbidities presented with abdominal pain, diarrhea and vomiting. Initial work-up showed peripheral eosinophilia. Computed tomography (CT) of the abdomen revealed massive ascites. An esophagogastroduodenoscopy (EGD) was done which revealed acute duodenitis. Gastric and duodenal biopsy revealed tissue eosinophilia. Total Immunoglobulin E (IgE) was elevated while work-up for intestinal parasitic infection was negative. On bone marrow biopsy, there was no eosinophilic infiltration. Oral prednisone was then started at 60mg/day and was subsequently tapered over 30 days resulting in resolution of symptoms.

This report illustrates a rare case of eosinophilic gastroenteritis (EGE). EGE may mimic a wide spectrum of gastrointestinal disorders, hence, prompt recognition of EGE and awareness of its clinical symptoms, diagnosis and treatment is important.

BACKGROUND AND OBJECTIVE

Tuberculosis (TB) remains to be prevalent in the Philippines and globally. Female genital tuberculosis has devastating and permanent consequences, hence, timely and adequate treatment is needed. Since more data regarding optimal duration of treatment of genital tuberculosis are needed, this study compares the treatment response at six months and after at least nine months of treatment, with the intention of determining the most practical management for genital tuberculosis.

A retrospective chart review was conducted for newly diagnosed cases of genital tuberculosis who met the inclusion criteria. Treatment response was categorized into clinical, microbiologic, histologic, radiologic, and sonographic responses. Responses to treatment were evaluated as either partial or complete at the 6th month and after at least 9 months of treatment, and the proportions were compared.

Out of 140 charts retrieved, only 43 were included. Statistically significant difference was found only in clinical response, primarily due to patients who did not achieve resumption of menstruation within the f irst six months of treatment. The rest of the treatment responses and adverse drug events are equally the same for both time periods.

Results of this study show that the proportion of patients with microbiologic, histologic, radiologic, and sonographic response to treatment at the 6th month did not significantly differ to the proportion of patients who responded at the 9th or 12th month of treatment. This leads to a conclusion that the 6-month treatment regimen will be more practical in treating genital tuberculosis, except in amenorrheic premenopausal women who may warrant extension of treatment. Further studies on post-treatment rates of relapse and sonographic resolution are needed.

BACKGROUND

Due to the COVID-19 outbreak, schools had to switch online. The sudden transition to blended teaching and learning (BTL) poses challenges for students and teachers, especially for health science programs that require hands-on practical experience. The validity, reliability, and responsiveness of these self-report questionnaires (SRQs) should be established to ensure the accuracy of the results as intended by the SRQ.

This study critically appraised, compared, and summarized the psychometric properties of SRQ evaluating BTL among health science university students. This review determined the SRQ’s reliability, internal consistency, various forms of validity (content, criterion, construct), and responsiveness.

Following a 10-step procedure based on COSMIN guidelines, we conducted a systematic review of SRQs used by health science university students to evaluate blended teaching and learning. Studies were eligible if they reported psychometric properties of SRQs related to blended learning among university health science students; exclusions included studies focusing on perceptions, attitudes, self-efficacy, and satisfaction, as well as articles such as biographies, editorials, and conference materials. Searches covered multiple electronic databases until April 26, 2023, including PubMed, EMBASE, Web of Science, MEDLINE (OVID), PsycInfo, CINAHL, EBSCOHOST, ERIC, Scopus, Science Direct, Google Scholar, JSTOR, Acta Medica Philippina, Philippine Journal of Health Research and Development, and HERDIN, managed through Zotero. Two independent reviewers performed database searches, title and abstract screening, and full-text evaluations, with a third reviewer resolving any disputes. The COSMIN Risk of Bias Checklist was employed to evaluate included studies on the development and various measurement properties of SRQs. The reviewers assessed SRQ standards, including validity, reliability, internal consistency, measurement error, responsiveness, interpretability, and feasibility. Data extraction and result tabulation were independently completed, with content comparison by two health education experts. This evaluation categorized the SRQs into three quality and validity levels.

The study examined five articles; four were rated as 'doubtful' and one as 'inadequate' in the overall development of SRQ. All four 'doubtful' studies demonstrated questionable content validity when university students were asked about the questionnaire's relevance, comprehensiveness, and comprehensibility. Only half of these studies achieved an 'adequate' rating for content validity based on expert opinions on relevance and comprehensiveness. All but one study scored from 'very good' to 'adequate' in structural validity. Three out of the four studies scored a very good rating for internal consistency, while one was deemed 'inadequate' in internal consistency, cross-cultural validity, and reliability. Three out of four studies scored 'very good' on construct validity, but all overlooked criterion validity and responsiveness. Conducted in various locations, including Australia, Romania, Turkey, and Taiwan, these studies highlighted both common characteristics and limitations in questionnaire development according to the COSMIN guidelines. Four studies were deemed reliable and valid for BTL constructs (Category A); Wu et al. requires further validation (Category B). Study limitations included heterogeneity in populations, settings, and questionnaire versions, potential subjective bias in SRQ content comparison, and the evolving nature of SRQs in blended learning contexts.

The systematic review reports the development and evaluation of SRQs for BTL while identifying gaps in their applicability to health science programs. The Blended Learning Scale (BLS) of Lazar et al. and the Blended Learning Questionnaire (BLQ) of Ballouk et al. showed an ‘adequate' rating for content validity. BLS revealed very good structural validity, internal consistency, and adequate content validation. Although the BLQ lacked Confirmatory Factor Analysis, it yielded valuable constructs for evaluating health sciences students' experiences in BTL. Both tools require improvements on recall period, completion time, interpretability, and feasibility. The review underscores the necessity for cont inuous assessment and enhancement of such instruments in BTL, advocating a rigorous scale development process. Furthermore, it encourages the customization of teaching and learning evaluation tools to suit specific institutional contexts while promoting further validation of these questionnaires across different populations in future research.

INTRODUCTION: Medical errors commonly occur in medical imaging departments. These errors are frequently influenced by patient safety culture. This study aimed to develop a suitable patient safety culture assessment tool for medical imaging departments. METHODS: Staff members of a teaching hospital medical imaging department were invited to complete the generic short version of the Safety Attitude Questionnaire (SAQ). Internal consistency and reliability were evaluated using Cronbach's α. Confirmatory factor analysis (CFA) was conducted to examine model fit. A cut-off of 60% was used to define the percentage positive responses (PPR). PPR values were compared between occupational groups. RESULTS: A total of 300 complete responses were received and the response rate was 75.4%. In reliability analysis, the Cronbach's α for the original 32-item SAQ was 0.941. Six subscales did not demonstrate good fit with CFA. A modified five-subscale, 22-item model (SAQ-MI) showed better fit (goodness-to-fit index ≥0.9, comparative fit index ≥ 0.9, Tucker-Lewis index ≥0.9 and root mean square error of approximation ≤0.08). The Cronbach's α for the 22 items was 0.921. The final five subscales were safety and teamwork climate, job satisfaction, stress recognition, perception of management and working condition, with PPR of 62%, 68%, 57%, 61% and 60%, respectively. Statistically significant differences in PPR were observed between radiographers, doctors and others occupational groups. CONCLUSION The modified five-factor, 22-item SAQ-MI is a suitable tool for the evaluation of patient safety culture in a medical imaging department. Differences in patient safety culture exist between occupation groups, which will inform future intervention studies.
Humans ; Surveys and Questionnaires ; Patient Safety ; Attitude of Health Personnel ; Diagnostic Imaging ; Reproducibility of Results ; Male ; Female ; Adult ; Job Satisfaction ; Factor Analysis, Statistical ; Middle Aged ; Hospitals, Teaching ; Safety Management ; Organizational Culture ; Medical Errors/prevention & control*

INTRODUCTION: Adolescent depression is prevalent, and teen suicide rates are on the rise locally. A systemic review to understand associated risk and protective factors is important to strengthen measures for the prevention and early detection of adolescent depression and suicide in Singapore. This systematic review aims to identify the factors associated with adolescent depression in Singapore. METHODS: A systematic search on the following databases was performed on 21 May 2020: PubMed, EMBASE and PsycINFO. Full texts were reviewed for eligibility, and the included studies were appraised for quality using the Newcastle Ottawa Scale. Narrative synthesis of the finalised articles was performed through thematic analysis. RESULTS: In total, eight studies were included in this review. The four factors associated with adolescent depression identified were: (1) sociodemographic factors (gender, ethnicity); (2) psychological factors, including childhood maltreatment exposure and psychological constructs (hope, optimism); (3) coexisting chronic medical conditions (asthma); and (4) lifestyle factors (sleep inadequacy, excessive internet use and pathological gaming). CONCLUSION The identified factors were largely similar to those reported in the global literature, except for sleep inadequacy along with conspicuously absent factors such as academic stress and strict parenting, which should prompt further research in these areas. Further research should focus on current and prospective interventions to improve mental health literacy, targeting sleep duration, internet use and gaming, and mitigating the risk of depression in patients with chronic disease in the primary care and community setting.
Humans ; Singapore/epidemiology* ; Adolescent ; Risk Factors ; Depression/etiology* ; Protective Factors ; Male ; Female ; Life Style ; Suicide