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

Introduction: Subclinical hypothyroidism (SH), or hyperthyrotropinemia, is an asymptomatic condition defined by elevated serum thyroid-stimulating hormone (TSH) levels and normal free thyroxine (FT4) levels. It can be detected in newborns or children, but there is no consensus regarding treatment criteria since FT4 levels often remain normal. [MOU1.1] Materials and methods: We included 116 participants, including infants and children up to 3 years old with subclinical hypothyroidism, born to mothers with autoimmune thyroiditis and those with Down Syndrome. Kaplan-Meier survival analysis determined the median time for TSH normalisation. Cox Proportional Hazards Re-gression was used to explore associated prognostic factors. Results: During the study, 98% of the 116 patients with subclinical hypothyroidism experienced normalisation of their TSH levels, with a median time of 4.0 weeks. Patients who were born term at birth, appropriate for gestational age (AGA), and birth weight of ≥2.5 kg; median (95 % CI):[4 (3.3,4.6)],[4 (3.3,4.6)] [4 (3.3,4.6)] and had a median time of TSH normalisation earlier compared to patients who were born preterm; [12 (0.0,27.1)], small for gestational age (SGA); [8 (4.7,11.2)] and birth weight of < 2.5kg; [8 (1.1,14.8)]. Preterm gestation was identified as a significant predictor for TSH level normalisation with an adjusted HR(95%CI): 0.389(0.2, 0.75), (p=0.005) from multiple Cox regression analysis. [MOU2.1]Conclusion: This study shows that premature patients have a 61.1% lower chance of reaching normal TSH levels, underscoring the signifi-cant challenges they encounter in achieving hormonal balance.

A unified consensus statement on medication-related osteonecrosis of the jaw (MRONJ) has not yet been established among the Asian member countries or regions of the Asian Federation of Osteoporosis Societies (AFOS). This study aimed to develop a consensus on MRONJ in patients with osteoporosis across these countries and regions. In this study, the term “Asia-Pacific” refers specifically to the Asian member countries and regions of AFOS. A structured survey consisting of nine MRONJ-related questions was distributed across 10 countries and regions to assess the level of agreement and summarize regional perspectives. In addition, a manual literature review and voting were conducted to evaluate the current evidence on MRONJ. The key aspects of MRONJ, including definition, staging, diagnosis, pathogenesis, risk factors, management, and prevention, were generally consistent among the AFOS countries and regions. The annual incidence and incidence rate of MRONJ associated with low-dose antiresorptive therapy in patients with osteoporosis ranged from 0.025% to 0.136% and 21 to 283 cases per 100,000 person-years, respectively. However, evidence regarding the benefits of drug discontinuation before dental surgery, such as tooth extraction, remains insufficient. Large-scale, multinational studies across AFOS countries and regions are warranted to determine the incidence of MRONJ better and evaluate the impact of antiresorptive drug discontinuation before dental procedures. These findings may contribute to the devel opment of effective evidence-based strategies for preventing MRONJ in patients with osteoporosis.

This study is a convergence study that empirically verifies the principles of the Hunminjeongeum Joongsung-Ja (中聲字, vowel) system, especially the principles of the pictorial patterns of the initial and re-involved characters, using magnetic resonance imaging (MRI). According to the principle stated in the Jejahae (制字解) of the Hunminjeongeum Haeryebon—that “the 28 characters of Jeongeum were each modeled after their shapes”—this study aimed to prove that all characters were devised to reflect the shape of the vocal tract when pronounced. Four participants, including both younger and older adults including both sexes were enrolled in this study, and real-time MRI scans and acoustic analysis were conducted. In the analysis of the Cho-Chul-Ja (初出字, /ㅗ, ㅏ, ㅜ, ㅓ/), clear differences were observed in the structure of the vocal tract and the shape of the resonance cavity according to the vowels, and the degree of lip opening and the length of the vocal tract showed a close relationship with the acoustic characteristics of each vowel. In the Jae-Chul-Ja (再出字, /ㅛ, ㅑ, ㅠ, ㅕ/), changes in the shape of the resonance cavity were observed along with changes in tongue movement and lip opening during diphthong utterances, and it was confirmed that this is directly related to acoustic characteristics. The results of this study confirmed that the principle of the Hunminjeongeum Joongsung-Ja (中聲字, vowel) is closely related to the form of resonance cavity in the actual articulation process. It was confirmed that it was created by the synthesis (Hapsung, 合成) of the three letters “Cheon-ji-in (天地人, /•, ㅡ, ㅣ/)”, and it was also confirmed that the pictorial principles of the first and second versions are based on the shape and movement of the resonance tube. It is significant in that it re-examines the scientific sophistication of the vowel system devised during the creation of Hunminjeongeum in the 15th century with modern technology. This shows that Hunminjeongeum is not just a philosophical symbol, but a writing system that reflects the anatomical structure and physiological movements of actual speech organs.

Background/Aims: The integration of artificial intelligence (AI)-powered image analysis and mucosal exposure devices, such as distal attachment caps, has been demonstrated to significantly improve the adenoma detection rate (ADR) during colonoscopy. This study aimed to compare AI-assisted colonoscopy (AIC) with cap-assisted colonoscopy (CAC). Methods: This retrospective propensity score-matched cohort study was performed at a tertiary care hospital between January 2022 and May 2022. Data were extracted from the electronic health record system and colonoscopy video recordings. Adult patients aged 40 years who underwent screening or surveillance colonoscopies were included. The primary outcome was the ADR, whereas the secondary outcome was the polyp detection rate (PDR). Results: A 1:1 propensity score-matched analysis was performed, resulting in 49 well-matched patient pairs. One patient from each pair was assigned to the CAC group, whereas the other was assigned to the AIC group. No significant difference in ADR was observed between the CAC and AIC groups (47% vs. 51%, p=0.69). Similarly, PDR did not significantly differ between the two groups (80% vs. 71%, p=0.35). Conclusions Both CAC and AIC have the potential to increase ADR and PDR. However, neither modality offers a significant advantage.

Introduction: Sports nutrition is critical for optimising athletes’ performance, recovery, and health. Despite its importance, significant gaps in knowledge, attitudes, and practices (KAP) among athletes often lead to suboptimal dietary habits and impaired energy balance. Sports nutrition education interventions have emerged as a promising strategy to address these deficiencies. This scoping review examined effectiveness of sports nutrition education programmes on KAP, eating behaviours, and energy availability among athletes from 2015 to 2024. Methods: A systematic search of PubMed, Google Scholar, and Scopus was conducted using relevant keywords. Out of 394 studies initially screened, 12 met inclusion criteria, comprising intervention-based study designs, including randomised-controlled trials, quasi-experimental studies, and pre-post studies. Studies were considered eligible if they involved athletes, incorporated a nutrition education component, and assessed at least one outcome related to KAP, eating behaviour, or energy availability. Results: Most studies reported significant improvements in nutrition knowledge, attitudes, and practices, accompanied by positive changes in dietary behaviours. Interventions delivered via classroom instruction, digital platforms, or blended methods demonstrated varying levels of effectiveness. Key findings included increased energy availability, better dietary adherence, and favourable changes in body composition. Variations in duration of intervention programme delivery and participant characteristics led to the wide range of outcomes observed. Conclusion: Sports nutrition education can improve athletes’ nutrition knowledge and encourage healthier dietary practices. These interventions may contribute to better energy management, improved health, and enhanced sports performance, although further research is needed to evaluate their long-term effectiveness across different athlete populations.

Introduction: Diabetic ketoacidosis (DKA) is a life-threatening complication associated with significant morbidity and healthcare burden. Despite advances in diabetes care, recurrent DKA remains common, often reflecting gaps in treatment adherence and patient education. Identifying predictors of recurrence is crucial for risk stratification and targeted intervention. Methodology: We conducted a retrospective observational study of all adult DKA admissions to a tertiary centre between 2001 and 2025. Electronic medical records were reviewed for demographic data, biochemical parameters, precipitating factors, and clinical outcomes. DKA was defined using standard biochemical criteria. Recurrent DKA was defined as ≥2 admissions during the study period. Factors associated with recurrent DKA admissions were analyzed. Patients under the age of 18 years and those with missing vital information were excluded. Results: A total of 667 DKA admissions, comprising 566 patients, were identified, of which 101 admissions (15.1%) were recurrent, involving 65 patients. Among recurrent DKA episodes, the most common precipitating factors were infection (64.4%) and insulin omission (62.4%). After multivariate analyses, patients with type 1 diabetes mellitus (T1DM) were more likely to develop recurrent DKA compared to those with type 2 diabetes mellitus (aOR 4.16; 95% confidence interval [CI] 2.58–6.70; p <0.001). Insulin omission was strongly associated with recurrent DKA (aOR 2.29; 95% CI 1.46–3.60; p <0.001). In contrast, baseline glycated hemoglobin and chronic kidney disease were not significantly associated with recurrence. Diabetic counseling during the first DKA admission did not reduce recurrent DKA. There were no significant differences in mortality (3.9% vs 6.2%, p = 0.524) or critical care admission rates (40.6% vs 38.7%, p = 0.718) between recurrent and first DKA episodes. Conclusion Recurrent DKA accounts for a substantial proportion of DKA admissions and is strongly associated with insulin omission and T1DM. Our findings suggest that recurrent DKA is driven predominantly by behavioral and adherencerelated factors, indicating the need for multidisciplinary interventions beyond standard inpatient counseling.
Diabetic Ketoacidosis ; Retrospective Studies