OBJECTIVE

This review article aims to determine the properties, uses, toxicity, and other side effects of crosslinking agents in tissue scaffolds when applied in vitro and in vivo.

A literature search was performed using the PubMed-NCBI (MEDLINE) database (https://pubmed.ncbi.nlm. nih.gov/) with keywords: crosslinking reagent, collagen, hydroxyapatite, and bone regeneration. GRADE criteria were used to assess the quality of evidence.

A total of six articles were included in the study. Improved mechanical properties of collagen-hydroxyapatite scaffolds with high porosity can be achieved by employing crosslinking methods, including physical dehydrothermal (DHT) treatment, chemical treatment with glutaraldehyde (GA), Microbial Transglutaminase (mTGase), 1‐ethyl‐3‐(3‐ dimethylaminopropyl) carbodiimide (EDAC), or a combination of both DHT and EDAC. Furthermore, the crosslinking of EDAC and DHT can lead to forming ester bonds between activated carboxyl groups and hydroxyl groups.

The combination of DHT and EDAC crosslinking can increase mechanical strength, make the pore size appropriate, make the scaffold more stable, and support cell adhesion so that new cells can grow, and the process of osteogenesis can run more optimally.

WAGR syndrome is a rare congenital disorder, occurring in approximately 1 in 500,000 to 1,000,000 individuals, often presenting with ocular malformations such as aniridia. Glaucoma frequently develops when the iris and angle structures are affected, posing a significant risk of vision loss. We report a one-year and seven-month-old patient who presented with corneal opacity of the left eye. Examination revealed corneal opacity, aniridia, and markedly elevated intraocular pressure of 65 mmHg, while the fellow eye, also with aniridia, was normotensive. The patient underwent immediate combined trabeculectomy-trabeculotomy. Postoperative follow-up and timely management of complications allowed acceptable pressure control over one year, though visual prognosis remained guarded. This case highlights the challenges of managing glaucoma in WAGR syndrome, particularly in resource-limited settings. Medical therapy alone is often insufficient, making surgical intervention essential. Combined trabeculectomytrabeculotomy proved effective in maintaining pressure control when glaucoma drainage devices were not feasible. Multiple interventions and close monitoring are frequently required due to the risk of scarring and postoperative complications. Our experience emphasizes the need for a multidisciplinary ophthalmology approach to optimize outcomes. Despite pressure control, visual outcomes often remain poor due to structural anomalies and the challenges inherent to pediatric patients with this rare syndrome.

OBJECTIVE

To discuss the clinical presentation and management of idiopathic hypertrophic pachymeningitis that presented with multiple cranial neuropathies.

This is a case report.

A 37-year-old female presented with right-sided headache and ipsilateral cranial nerve (CN) I, II, III, IV, and V deficits which improved with nonsteroidal anti-inflammatory drugs (NSAIDs). Six months later she developed bilateral blurring of vision with pain on eye movement, which progressed to severe bilateral affectation that prompted admission and treatment with high-dose methylprednisolone therapy followed by prolonged oral steroid treatment which was gradually tapered. Recurrence was treated with oral steroids and azathioprine. Diagnostic modalities included an initial cranial contrast computed tomography (CT) scan which was inconclusive; contrast magnetic resonance imaging (MRI) clinched the diagnosis, as well as demonstrated thickening of the optic nerve perineurium. Visual field analysis 30-2 as well as optic nerve head optical coherence tomography (OCT) were used to support the diagnosis and document optic nerve affectation. Biologic testing was used to rule out tuberculosis, syphilis, fungal infection, granulomatosis with polyangiitis, polyarteritis nodosa, and rheumatoid arthritis. The patient had complete vision recovery in the left eye but only partial vision recovery in the right eye.

Pachymeningitis should be a diagnostic consideration in patients with headache and multiple cranial neuropathies. Clinicians should always perform independent evaluation of diagnostic modalities with the patient’s clinical presentation in mind. Pachymeningitis can involve the perineurium through contiguous spread of the lesion and present as optic perineuritis as well, with more insidious progression and lasting deficits than isolated optic perineuritis.

Environmental and Health Impacts of Pesticide-Based Malaria Control in Low- and Middle-Income Countries: A Scoping Review Introduction Malaria remains a major public health challenge in tropical and subtropical regions, necessitating effective vector control strategies. This scoping review aims to evaluate the environmental and health impacts of pesticide-based malaria control in low-and middle-income countries (LMICs). Methods A comprehensive search was conducted across Scopus, Web of Science and PubMed for studies published between 2004 and 2024, using a predefined search string based on the PEO framework. Inclusion criteria focused on studies addressing malaria control programmes and their effects on the environment and human health. Data extraction followed PRISMA 2020 guidelines. Results 12 studies were included, most of which focused on indoor residual spraying (IRS) and insecticide-treated nets (ITNs). The review identified significant direct and indirect impacts. While effective in reducing malaria transmission, IRS and ITNs pose substantial risks. Direct health effects included acute poisoning and long-term neurodevelopmental issues linked to pesticide exposure, with residues detected in breast milk. Environmental impacts included soil and water contamination, biodiversity loss and ecological disruption. The overlap of pesticide use in malaria control and agriculture was found to exacerbate insecticide resistance in mosquito populations. Conclusions Pesticide-based malaria control, while crucial, carries significant unintended consequences for human health and the environment. The findings underscore the urgent need for Integrated Vector Management (IVM) strategies that reduce reliance on chemical pesticides, mitigate resistance, and ensure environmental sustainability and public health safety.

Objective: An investigation team was deployed to determine the cause of an outbreak of a cluster of cases of fever and rash in a public elementary school in Antipolo City, Philippines, after the Public Health Unit was notified on 24 October 2022. The team also aimed to identify the source of the outbreak and to guide prevention measures. Methods: Active case-finding for hand, foot and mouth disease was conducted at the school. A suspected case was defined as any learner who developed acute febrile illness with a papulovesicular rash on the palms and soles of the feet during 16–30 October 2022. Interviews with key informants were conducted and included school staff and parents. Oropharyngeal swabs were collected for polymerase chain reaction (PCR) testing. Results: Nineteen suspected cases of hand, foot and mouth disease were detected, predominantly in grade 1 learners (16, 84%). Most cases (14, 74%) were 6 years old, and just over half were male (11, 58%). The first case occurred in a 6-year-old in grade 1 who attended class with a papulovesicular rash. Twelve learners (63%) from the same section developed symptoms, two of whom were seatmates of the first case. Two out of the 10 swabs collected were tested by PCR, both of which were positive for coxsackievirus A16. Discussion: The causative agent of this outbreak was identified as coxsackievirus A16. Disease transmission occurred through close contact with the index case and possibly through shared classroom objects. Follow-up actions included dissemination of a memorandum about preventing the disease to all public elementary and secondary schools that emphasized symptom screening (i.e. for fever and rash), self-isolation at the onset of symptoms, regular disinfection of classroom surfaces and regular handwashing, especially before and after eating.

Human ; Case Reports ; Publications

Objectives: Hypertension, commonly known as high blood pressure, is a prevalent and serious condition affecting a significant portion of the adult population globally. It is a chronic medical issue that, if left unaddressed, can lead to severe health complications, including kidney problems, heart disease, and stroke. This study aims to develop a feature selection model using the XGBoost algorithm to identify specific single nucleotide polymorphisms (SNPs) as biomarkers for detecting hypertension risk. Methods: We propose using the high dimensionality of genetic variations (i.e., SNPs) to build a classifier model for prediction. In this study, SNPs were used as markers for hypertension in patients. We utilized the OpenSNP dataset, which includes 19,697 SNPs from 2,052 samples. Extreme gradient boosting (XGBoost) is an ensemble machine learning method employed here for feature selection, which incrementally adjusts weights in a series of steps. Results: The experimental results identified 292 SNPs that exhibited high performance, with an F1-score of 98.55%, precision of 98.73%, recall of 98.38%, and overall accuracy of 98%. This study provides compelling evidence that the XGBoost feature selection method outperforms other representative feature selection methods, such as genetic algorithms, analysis of variance, chi-square, and principal component analysis, in predicting hypertension risk, demonstrating its effectiveness. Conclusions We developed a model for predicting hypertension using the SNPs dataset. The high dimensionality of SNP data was effectively managed to identify significant features as biomarkers using the XGBoost feature selection method. The results indicate high performance in predicting the risk of hypertension.

Objectives: Hypertension, commonly known as high blood pressure, is a prevalent and serious condition affecting a significant portion of the adult population globally. It is a chronic medical issue that, if left unaddressed, can lead to severe health complications, including kidney problems, heart disease, and stroke. This study aims to develop a feature selection model using the XGBoost algorithm to identify specific single nucleotide polymorphisms (SNPs) as biomarkers for detecting hypertension risk. Methods: We propose using the high dimensionality of genetic variations (i.e., SNPs) to build a classifier model for prediction. In this study, SNPs were used as markers for hypertension in patients. We utilized the OpenSNP dataset, which includes 19,697 SNPs from 2,052 samples. Extreme gradient boosting (XGBoost) is an ensemble machine learning method employed here for feature selection, which incrementally adjusts weights in a series of steps. Results: The experimental results identified 292 SNPs that exhibited high performance, with an F1-score of 98.55%, precision of 98.73%, recall of 98.38%, and overall accuracy of 98%. This study provides compelling evidence that the XGBoost feature selection method outperforms other representative feature selection methods, such as genetic algorithms, analysis of variance, chi-square, and principal component analysis, in predicting hypertension risk, demonstrating its effectiveness. Conclusions We developed a model for predicting hypertension using the SNPs dataset. The high dimensionality of SNP data was effectively managed to identify significant features as biomarkers using the XGBoost feature selection method. The results indicate high performance in predicting the risk of hypertension.

BACKGROUND

Acne vulgaris is one of the common skin diseases prompting dermatologic consult. Although prevalent worldwide, knowledge of the public about acne is still lacking. Due to this, content related to acne vulgaris has been a topic of choice on social media platforms.

A cross-sectional study was conducted among 120 patients diagnosed with acne vulgaris aged 18-50 years-old consulting via teledermatology and face-to-face consultation at the Rizal Medical Center. Patients completed a self-administered questionnaire and global acne severity was assessed.

A total of 120 newly d iagnosed patients with acne vulgaris were included in the study, with a mean age of 23.25 years, with a female predominance, household average monthly income less than PhP 10,957 and with mild to moderate acne severity. Majority of the participants used social media to look for treatment options and to gain more knowledge about the disease. The most used platforms were Youtube, Facebook and Tiktok. Short videos were viewed more often and content from dermatologists were preferred. Most commonly tried products are over-the-counted non-pharmaceutical topical products. There was a significant association between the use of social media with age and educational attainment. Furthermore, a significant association between self-medication practices and average household monthly income was seen. No association was seen between acne severity, social media use and self-medication practices.

In summary, the use of social media to access acne-related content was prevalent among young female patients, of lower socioeconomic status diagnosed with mild-moderate acne severity at a tertiary hospital in the Philippines.

Acrodermatitis continua of Hallopeau (ACH) is a rare, chronic, and recalcitrant inflammatory disorder classified as a localized variant of pustular psoriasis. Patients usually present with relapsing episodes of subungual pustules, nail dystrophy, and scaling. We report a case of ACH in a 32-year-old female, which developed following a nail infection and exacerbated during pregnancy, with no medication for 2 years. She presented at the clinic with severe manifestations of anonychia and multiple bone resorption on the distal phalanges. The patient was started on topical medication of combination corticosteroid and vitamin D analogue and oral methotrexate initially at l0mg/week then increased to 15mg/week due to poor response. Despite compliance to medications and avoidance of possible irritants, the patient still had relapse of pustules on the nails.

Several treatment options for ACH are available such as topical steroids, vitamin D analogue, systemic biologics, and non-biologics such as methotrexate and cyclosporine. However, systemic biologics are considered the most efficacious for ACH but financial constraints often limit their use in resource-poor settings.