BACKGROUND AND OBJECTIVES

Pelargonium sidoides DC. Root (PELARGO) 20 mg capsule is approved by the Philippine Food and Drug Administration (FDA) for the symptomatic treatment of common cold. In compliance with FDA, this post-authorization safety study was conducted to determine the incidence of signs and symptoms of liver injury with PELARGO intake. It also aimed to look at symptom improvement and the incidence of other adverse events.

METHODS

This non-interventional post-authorization safety study enrolled 300 adult patients with common cold, pre- scribed with Pelargonium sidoides DC. 20 mg capsule three times a day for seven days during routine clinical care from May 2023 to December 2023 in Cavite, Philippines. Demographic, clinical, and physical exam data were collected at baseline. Physical exam data, signs and symptoms of liver injury, symptom improvement, and other adverse events were determined post-treatment. Descriptive statistics were computed to characterize the participants at baseline (day 0) and end-study visit (day 8).

RESULTS

There were 300 enrolled patients, 53% female and 60% single. The mean age was 36 years and the mean BMI was 26 kg/m2. Vital signs at baseline were mostly within normal limits and most had respiratory f indings. Two hundred ninety-eight (298) completed the study. Only a few had respiratory findings at end-study visit. There were no signs and symptoms of liver toxicity nor serious adverse events after seven days of PELARGO intake. Reported adverse effects with 2.0% to 1.3% incidence in seven days include dizziness, drowsiness, headache, and polyphagia. Others wereCONCLUSION

There is no evidence of liver toxicity after seven days of PELARGO intake for common cold among Filipino adults. The drug was well tolerated, and most patients experienced significant symptom improvement. Results should be interpreted with caution in the light of study limitations.

Human ; Pelargonium ; Common Cold

Agarwood (Aquilaria spp.) is a resinous wood traditionally used in various medicinal systems across Asia for treating inflammation-related ailments. Despite its longstanding ethnopharmacological use, scientific validation of its anti-inflammatory effects remains fragmented. This scoping review aims to systematically evaluate and synthesize current evidence from animal studies investigating the anti-inflammatory potential of agarwood. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science. Inclusion criteria focused on original animal studies assessing the anti-inflammatory effects of agarwood extracts, essential oils, or derivatives. Data on study design, animal models, agarwood species, treatment dosage, duration, biomarkers, and outcomes were extracted and summarized narratively due to methodological heterogeneity. Eight studies met inclusion criteria, involving models of inflammation-related conditions such as pain, neuroinflammation, gastrointestinal injury, cancer, and toxicity. Agarwood treatment consistently reduced pro-inflammatory cytokines (e.g., IL-1β, IL-6, TNF-α), modulated oxidative stress markers (e.g., NO, SOD, GSH), and regulated signalling pathways including NF-κB, p38 MAPK, and Nrf2–ARE. Notably, improvements were observed in behavioural and histological outcomes across models, with evidence of dose-dependent effects in several studies. In conclusion, preclinical evidence supports agarwood’s broadspectrum anti-inflammatory and antioxidant properties across multiple organ systems. These findings provide mechanistic insights and a scientific basis for its traditional use. However, variability in species, extraction methods, and study designs highlights the need for standardised protocols and clinical validation to advance agarwood as a potential therapeutic agent.

BACKGROUND

Central diabetes insipidus (CDI) is a common complication following transsphenoidal surgery for pituitary adenomas, but CDI as an initial presentation in pituitary adenomas is extremely rare. We report a case of a 67-year-old Filipino male with pituitary macroadenoma presenting as central diabetes insipidus, manifesting as a two-month history of severe frontotemporal headache, increased thirst, and polyuria, which was managed with desmopressin followed by transsphenoidal surgery. Three months postoperatively, the thyroid and adrenocorticotropic axis remained intact, and pituitary bright spot recovery was observed. He was clinically stable; hence, desmopressin was gradually tapered and discontinued. This case report presents a unique case of a pituitary adenoma that initially presented with central DI but later showed a complete resolution of symptoms along with the normalization of the "bright spot" seen on MRI, a hallmark of the posterior pituitary. Treatment options for preoperative CDI may include surgical or medical management, with some cases reported as self-limiting. However, the rarity of such cases underscores the urgent need for more clinical studies to fully understand the course of this condition. This case highlights a unique presentation of central diabetes insipidus in a pituitary macroadenoma and the possibility of complete resolution of symptoms coinciding with pituitary bright spot recovery post operatively.

Adenoma ; Diabetes Insipidus ; Diabetes Insipidus, Neurogenic ; Neoplasms ; Pituitary Neoplasms ; Research Report

Malignant peripheral nerve sheath tumors (MPNSTs) are rare soft tissue sarcomas with poor prognosis due to their high recurrence rates. The prevalence of MPNST in the general population is 0.001%, with tumors arising from the retroperitoneum accounting for only 1% of all MPNSTs. In this report, we present a case of a 59-year-old male with pancreatic MPNST. To the authors’ knowledge, this is the first documented case of pancreatic MPNST in the Philippines.

The patient initially presented with a 3-month history of abdominal pain, weight loss, and anorexia. On abdominal computed tomography (CT) scan, a large cystic mass involving the pancreatic head and body, with an enhancing peripheral solid component in the superior region was seen. The patient underwent distal pancreatectomy, en bloc splenectomy and excision of duodenal cyst. Post-operative histopathology and immunohistochemistry staining were consistent with pancreatic MPNST with tumor very near the margin of resection adjacent to the portal vein. Adjuvant systemic chemotherapy and radiotherapy were not performed due to lack of evidence of benefit over risk for this population. Disease recurrence (nodal-peritoneal metastases) was noted six months post-operatively and he was given palliative chemotherapy with single-agent doxorubicin. However, disease progression was noted after five cycles of chemotherapy. Second-line regimen was planned but the patient died of a pulmonary embolism prior to the initiation of chemotherapy.

Due to the rarity and highly aggressive nature of MPNSTs, furthering knowledge on these tumors is important, particularly in their inclusion among the differential diagnoses for pancreatic tumors. Prompt diagnosis and histopathologic confirmation by a pathologist specializing in sarcomas are crucial in the treatment planning and prognostication of these tumors. Lastly, further studies are needed to establish more effective treatments in unresectable or metastatic disease.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Sarcoma ; Pancreas

BACKGROUND AND OBJECTIVE

Retinopathy of Prematurity (ROP) is a significant cause of blindness in childhood. It is the leading cause of vision loss worldwide and 8.4% of childhood blindness in the Philippines. It is potentially avoidable if detected early and treated promptly. The study's objective was to prevent the dreaded complication of lifelong blindness from ROP in premature babies admitted at our institution by ensuring timely referrals, timely screenings, and prompt treatment.

METHODS

An observational, single-center study was conducted from August 2022 to July 2023. ROP monitoring and screening system with an automated computer alarm was developed. A total of 241 admitted babies with ROP risk factors were enrolled in the database. We were guided by the computer alarm system on the proper timing of referrals and screenings for ROP and detecting patients with missed screenings.

RESULTS

The study included 241 babies. All patients (100%) were screened for ROP. There were 15 (6%) patients diagnosed with ROP upon initial screening. For timeliness, 234 (97%) have timely referrals, and 232 (96%) have timely screenings. The most common reason for delayed referrals and screenings was waiting to wean patients off the ventilation support before referring them for ROP screening. No patient enrolled in the database missed ROP screening. However, in comparison with the total number of admissions with risk factors for ROP versus the total number of patients in the database, two (2%) were not enrolled in the database due to the resident’s confusion in the ROP referral parameter (born term with low birth weight). Problems during the implementation were identified and addressed.

CONCLUSION

The database and alarm system for monitoring and screening ROP was a helpful tool to healthcare workers for a timely interdepartmental referral and screening system for premature patients at risk for ROP. ROP screenings were recommended even if patients were hooked to assisted ventilation.

Retinopathy Of Prematurity

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.

Public Health ; Philippines ; Interprofessional Education ; World Health Organization ; Centers For Disease Control And Prevention, U.s. ; Centers For Disease Control And Prevention (u.s.)

Suicide left ventricle describes the development of dynamic intraventricular gradients after aortic valve replacement due to acute hemodynamic changes that happen after relieving the obstruction leading to hemodynamic collapse. This is a rare complication in transcatheter aortic valve replacement and is underreported in surgical aortic valve replacement (SAVR). We present the case of a male patient who presented with suicide left ventricle after SAVR.

World Health Organization ; Transcatheter Aortic Valve Replacement ; Suicide ; Research Report ; Hemodynamics ; Heart Ventricles ; Aortic Valve

OBJECTIVES

To present a rare case of a 17-year-old girl with multiple odontogenic keratocysts, skeletal abnormalities, central nervous system and cutaneous anomalies.

METHODS

Design:Case Report

Setting:Tertiary Government Training Hospital

Patient: One

RESULTS

A 17-year-old Filipino girl presented with a one-year history of progressive left mandibular swelling. Orthopantomography revealed multiple cysts involving the mandible and maxillae. Histopathologic examination of incision biopsy specimens confirmed odontogenic keratocysts. Other physical examination findings included coarse face and multiple palmar and plantar pits. Radiologic investigations demonstrated calcification of the falx cerebri and tentorium cerebelli, bifid rib and cervicothoracic scoliosis. Based on clinical, radiological, and histopathological findings, a diagnosis of Gorlin-Goltz syndrome was established. The patient underwent enucleation and curettage of the cysts with peripheral ostectomy, and there was no recurrence on repeat orthopantomography at six months and two years post-operatively. However, on the fourth year, the patient claimed there was a mandibular cyst which was not verified as she was lost to follow-up.

CONCLUSION

This case highlights the importance of recognizing multiple odontogenic keratocysts as a potential manifestation of Gorlin-Goltz Syndrome. Early diagnosis enables appropriate management and long term surveillance to monitor for other manifestations of this syndrome that may occur later in life.

Human ; Female ; Adolescent: 13-18 Yrs Old ; Basal Cell Nevus Syndrome ; Mandible ; Radiography, Panoramic ; Focal Dermal Hypoplasia ; Ribs ; Scoliosis ; Spinal Cord ; Women ; History ; Lost To Follow-up ; Diagnosis

METHODOLOGY

A descriptive, cross-sectional design was utilized, involving the translation of the SS-QOL from English to Filipino through Collaborative Translation Protocols, which centered on group consensus. Three Filipino language experts rigorously evaluated the initial translation for linguistic and cultural appropriateness. To assess content and face validity, an expert committee of three neurology consultants provided ratings, which were analyzed using the item-level content validity index (i-CVI). Subsequently, a pilot testing phase was conducted with 10 stroke survivors recruited via purposeful sampling in Metro Manila to evaluate the SS-QOL-Filipino’s clarity, layout, understandability and answerability, while also measuring the intraclass correlation coefficient (ICC) to assess consistency and agreement among items

RESULTS

This study successfully developed a stroke-specific HRQOL tool for the Philippines, addressing a critical need for objective measures in patient-centered care. The use of Collaborative Translation Protocols ensured the questionnaire’s conceptual, linguistic and cultural equivalence, incorporating nuances specific to the Filipino context in areas like eating habits, emotional expressions and technological terms. The high face and content validity, coupled with strong consistency and high understandability observed during pilot testing underscore the SS-QOL-Filipino’s suitability for the target population, positioning it as a valuable instrument for both clinical practice and research.

CONCLUSION

The SS-QOL scale was successfully translated into Filipino using Collaborative Translation Protocols and rigorously validated. The SS-QOL-Filipino version demonstrates high content and face validity, strong consistency and excellent understandability and answerability, affirming its status as a reliable and appropriate outcome measure for assessing the QOL among stroke patients in Metro Manila.

Human ; Male ; Female ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Adult: 25-44 Yrs Old ; Life ; Quality Of Life ; Stroke ; Survivors

OBJECTIVES

This study evaluated the effectiveness of the hearWHO application in rapid screening of hearing loss among Philippine Air Force military personnel and verifies its results with Pure Tone Audiometry. It aimed to establish baseline data for future research on technological advancements in otolaryngology

METHODS

The study employed a cross-sectional design and recruited 44 volunteer subjects from the Philippine Air Force using inclusion criteria. Six participants withdrew due to an urgent mission, leaving 38 subjects who were screened using the hearWHO application and subsequently tested with Pure Tone Audiometry. A statistician analyzed the collected data.

RESULTS

A one-sample t-test revealed negative mean differences between hearWHO and Pure Tone Audiometry results indicating that they were not significant. Confounders such as testing room location, use of adapters and non-purposive sampling may have affected the results.

CONCLUSION

The results suggested that the hearWHO application was not effective in rapid screening of hearing loss among the military personnel of the Philippine Air Force.