Many countries record high rates of fireworks-related injuries, especially during national celebrations. In the Philippines, increases in the number of injuries reported around the New Year period in recent years have highlighted the importance of continued strengthening of national fireworks-related injury surveillance. The Philippines’ regional epidemiology and surveillance units play a significant role in surveillance by linking its key stakeholders, the sentinel hospitals and the Department of Health’s Central Office. More specifically, these units promote compliance with reporting standards among sentinel hospitals and support case data validation. Approximately half of the sentinel hospitals that contribute data to the surveillance system are in the nation’s capital, Metro Manila. This concentrated coverage prompted the Regional Epidemiology and Surveillance Unit staff in Metro Manila to implement low-cost, digital strategies to improve the quality and timeliness of fireworks-related injury reporting. During the 2023–2024 surveillance period (21 December to 5 January), the use of virtual coordination spaces and data dashboards contributed to reducing turnaround times for generating surveillance reports from 31 minutes to 8 minutes. Moreover, at least 80% of sentinel hospitals provided timely reports on 11 of the 16 days of the surveillance period. Staff commitment was a major contributing factor in overcoming the time and human resource constraints encountered during implementation of these strategies. However, it is important to recognize that beyond these digital innovations, policy reforms that increase funding are needed to enhance fireworks-related injury surveillance and secure its long-term sustainability and scalability in the Philippines.

BACKGROUND AND OBJECTIVES

Health promotion necessitates a multifaceted approach, focusing on individual, social, and environmental factors. Participatory Action Research (PAR) offers a process for community-level knowledge to inform these approaches, but little is known about its actual utilization. This review was conducted to explore the implementation and effectiveness of PAR in health promotion in the Philippine context. The specific objectives are: 1) to systematically map and analyze the existing literature on PAR in health promotion within the Philippine context; 2) to identify and categorize the levels of community participation in PAR initiatives; and 3) to evaluate the spheres of influence of health equity principles in PAR methodologies in health promotion.

METHODS

A scoping review was implemented following the protocol by Mak and Thomas (2022), guided by the Health Equity Framework and the New Economics Foundation's Ladder of Participation, highlighting the empowerment and participation of communities in health research to produce relevant and sustainable outcomes. PubMed, HERDIN, and Google Scholar were searched to gather a comprehensive range of literature, then analyzed for themes relating to community engagement in health promotion through PAR.

RESULTS

A total of 452 articles were obtained from the initial search. After applying inclusion and exclusion criteria, 12 articles were included for analysis. The results highlighted the importance of engaging community leaders and advocacy groups as entry points in engaging community members, which were seen to be more effective in collaborating with the community. PAR was able to effectively identify gaps in health systems, particularly in access to programs for vulnerable sectors. The studies also exhibited differing levels of participation of the researchers with diverse population groups. This diversity in participant engagement led to more tailored and community specific interventions, fostering social innovation and better community well-being.

CONCLUSION

The integration of PAR in health promotion demonstrates a robust approach to addressing health inequities, showcasing the potential for community driven research to foster equitable health outcomes. PAR enabled communities to lead and shape interventions, making them more relevant and effective. The spectrum of participatory activities reveals the diversity of PAR as a research approach, and an opportunity to develop guidelines on what constitutes PAR in the global context. This approach is crucial in developing sustainable health strategies that are responsive to the needs of diverse communities, ultimately contributing to the global discourse on community-driven health promotion and equity.

Health Promotion ; Research ; Philippines

BACKGROUND

Carney complex (CNC) is a rare multiple endocrine neoplasia syndrome caused by PRKAR1A gene mutation and  characterized by lentigines, myxomatous tumors and various endocrine neoplasms.

CASE PRESENTATION

This is a case of a 52-year-old male patient who underwent echocardiogram for intermittent palpitations and near-syncopal attack, which revealed a left atrial myxoma. The patient also exhibited multiple lentigines and had a history of histologicallyconfirmed papillary thyroid carcinoma. Surgical excision and subsequent histopathologic examination confirmed cardiac myxoma, fulfilling three major Stratakis criteria for CNC.

DISCUSSION

This case highlights the importance of a thorough history and physical examination with a strong understanding of the syndrome’s features being key to recognizing the disease. Increasing awareness and reinforcing knowledge of CNC are crucial for preventing misdiagnosis and ensuring effective management of this rare condition. To our knowledge, this is the first published case report of CNC in the Philippines, emphasizing the need for heightened regional awareness.

CONCLUSION

CNC may present with subtle or nonspecific symptoms and atypical tumor locations. Early recognition through a high index of suspicion, targeted imaging and a multidisciplinary approach is critical to optimize outcomes and guide family screening in this rare syndrome.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Multiple Endocrine Neoplasia ; Carney Complex ; Myxoma ; Syndrome ; Neoplasms ; Mutation ; Lentigo ; Genes

A 40-year-old, gravida 3 para 2 (1-1-0-2), previous primary cesarean section for nonreassuring fetal status, presented at a tertiary hospital for confirmation of cesarean scar pregnancy (CSP). Transvaginal ultrasound confirmed a CSP at 8 2/7 weeks age of gestation with good embryonic cardiac activity, raising concern for early placenta accreta spectrum. A multidisciplinary team composed of an obstetrician, advanced pelvic surgeon, urologist, and anesthesiologist managed the patient. The patient underwent total abdominal hysterectomy with bilateral salpingectomy, as the patient has a completed family size. Before the procedure, she was given cefuroxime as prophylactic antibiotic. Intraoperatively, there were dense adhesions between the posterior bladder wall and the previous cesarean section scar. Inadvertent injury to the bladder wall was incurred during adhesiolysis. Cystorrhaphy was done by a urologist, while the rest of the surgery was unremarkable, with a 450 ml estimated blood loss. The postoperative course was unremarkable. Bladder rest was achieved by maintaining an indwelling Foley catheter, which remained in place upon discharge on postoperative day 3 and was continued for 7 days thereafter. At follow-up, a successful voiding trial was conducted, confirming the return of normal bladder function.

Human ; Female ; Adult: 25-44 Yrs Old ; Cesarean Section ; Salpingectomy ; Hysterectomy ; Fetal Distress ; Placenta Accreta ; Cefuroxime ; Catheters ; Cicatrix

Chemical exposure during prenatal development has significant implications for both maternal and child health. Compared to blood, saliva is a non-invasive and less resource-intensive, alternative. Given the temporal variability of xenobiotic metabolites (XM), repeated sampling is essential. Therefore, saliva offers a valuable tool for the longitudinal assessment of prenatal exposomes. Despite its potential, no studies have explored saliva for XM measurement. This study pioneered using saliva to assess XM detectability and investigate the associations between prenatal XM and endogenous metabolomes in pregnant women. Saliva samples were analysed using mass spectrometry from 80 pregnant women at 24-34 weeks gestation. Metabolomes and exposomes were annotated using the Human Metabolome and U.S. Environmental Protection Agency databases. Metabolome-XM associations were clustered using Glay community clustering. Linear regression models, adjusted for age, estimated associations between catecholamines and XMs. XM levels were validated in a cohort of women (n = 14) with and without preeclampsia. Our study identified 582 metabolomes and 125 XM in saliva, demonstrating its potential as a matrix for exposure measurement. After false discovery rate correction, 18 109 significant metabolome-XM associations were identified. Community clustering revealed 37 connected clusters, with the largest cluster (238 nodes) enriched in tyrosine and catecholamine metabolism. Food-contact-chemicals and food-additives were significantly associated with higher catecholamine and their metabolite levels. Subgroup analyses revealed higher concentrations of these chemicals in women with preeclampsia compared to healthy controls. This study demonstrates that saliva contains valuable molecular data for measuring exposomes. Food-related chemicals were associated with higher catecholamine levels, which may be relevant to the prevalence of hypertensive crises in pregnancy.
Humans ; Female ; Pregnancy ; Saliva/metabolism* ; Pre-Eclampsia/metabolism* ; Xenobiotics/analysis* ; Adult ; Metabolome ; Maternal Health ; Mass Spectrometry

The primary clinical manifestation of osteoarthritis (OA) is pain, yet considerable variability exists in the pain experience among OA patients. This narrative review aims to explore the mechanisms driving OA pain heterogeneity to inform the development of targeted interventions that improve treatment efficacy and patient outcomes. A comprehensive literature search was conducted across multiple databases (PubMed, Scopus, and Google Scholar) for papers published between January 1, 2020, and December 31, 2024. Inclusion criteria focused on studies addressing pain mechanisms and therapeutic interventions in OA. This review identifies key mechanisms of OA pain, including joint alterations, angiogenesis, nervous system involvement, peripheral and central sensitization, and psychosocial factors. It highlights the underlying distinct mechanisms in OA pain, which contribute to the variability in individuals' responses to treatment. It was suggested that interactions between neuroimmune and neurovascular systems are key contributors to chronic pain in OA. This narrative review emphasizes the complexity of OA pain, highlighting the importance of thoroughly understanding the underlying mechanisms for developing personalized and effective pain management strategies. Additional research is required to refine treatment approaches and explore long-term effects.
Humans ; Osteoarthritis/complications* ; Pain Management/methods* ; Chronic Pain/etiology*

Purpose: Retroperitoneal sarcomas (RPS) are rare tumors that present unique challenges, often due to late presentation, and the proximity of critical organs makes complete surgical resection challenging. This study aimed to assess the feasibility of neoadjuvant short-course radiotherapy (SCRT) targeting margins-at-risk and to assess its potential impact on outcomes. Materials and Methods: This is a single-center, prospective, non-randomized feasibility study. SCRT was administered via image-guided volumetric modulated arc therapy, consisting of 5 fractions of daily radiotherapy followed by immediate surgery. As a starting dose, patients were prescribed 25 Gy in 5 fractions. For the escalation stage, patients were prescribed 30 Gy in 5 fractions. Only the presumed threatened surgical margins were delineated for large tumors. Results: Patients with either primary or recurrent RPS were recruited. Eight patients underwent SCRT but one patient did not have a resection as planned. Seven patients underwent surgical resection, of whom one passed away 3 months postoperative from a cardiac event. After a median follow-up of 20.5 months for the six postoperative survivors, there were no overt long-term toxicities and one patient relapsed out-of-radiotherapy-field. Conclusion SCRT to RPS with a margin boost followed by immediate surgery is worth investigating. A starting dose of 30 Gy in 5 fractions is recommended for further studies. Longer-term follow-up is necessary.

Objectives: Global concern is increasing about the health effects of electronic waste (e-waste). This study examines the health impacts of heavy metal (HM) exposure among e-waste workers (EWWs) and community-dwelling adults (CDAs) in Northeastern Thailand and identifies factors associated with adverse health outcomes. Methods: A cross-sectional study was conducted of 164 EWWs and 164 CDAs. A survey was employed to collect data on participant characteristics, symptoms, anxiety, depression, and sleep quality. Urine samples were analyzed for lead (Pb) and cadmium (Cd) levels using atomic absorption spectrometry. Multiple logistic regression analysis was used to identify factors impacting health. Results: Across all participants, urinary Pb and Cd levels ranged from 5.30 µg/g to 29.50 µg/g creatinine and from 0.60 µg/g to 4.00 µg/g creatinine, respectively. The most frequently reported health issues pertained to musculoskeletal disorders (MSDs) at 38.70%, central nervous system (CNS) issues at 36.60%, and skin disorders at 31.10%. Multivariable analysis indicated that the presence of MSDs was significantly associated with exposure to Pb and Cd. Poor sleep quality (PSQ) was significantly linked to CNS problems, while body mass index was significantly related to skin disorders. Factors including primary education level or below, smoking, cleaning the house more than 3 times weekly, and PSQ were significantly linked to depression. Anxiety was significantly associated with PSQ. Conclusions Environmental exposure to Pb and Cd can have adverse health impacts in the form of MSDs. Depression and anxiety are common conditions among CDAs. Public health officials should monitor HM exposure and mental health within the community.