1.Research advances in the expression and regulation of non-coding RNAs in ischemic stroke
Journal of Apoplexy and Nervous Diseases 2026;43(1):85-91
Ischemic stroke is a cerebrovascular disease with high incidence and disability rates. Non-coding RNAs, as important regulatory factors for gene expression, play a key role in the development and progression of ischemic stroke, but their specific mechanisms of action remain unclear. This article systematically reviews the expression characteristics and regulatory roles of microRNAs, long non-coding RNAs, and circular RNAs in ischemic stroke and reveals the pathophysiological mechanisms of non-coding RNAs in ischemic injury by regulating the processes of cell apoptosis and autophagy, inflammatory response, blood-brain barrier integrity, and neuroregeneration. In addition, non-coding RNAs have shown the potential as biomarkers for the prediction, diagnosis, and prognostic evaluation of ischemic stroke. This article also analyzes the limitations of current research and proposes future research directions, so as to provide a theoretical foundation for exploring the mechanism of action of non-coding RNAs in ischemic stroke and developing innovative diagnostic and therapeutic strategies.
Review
2.Valacyclovir-Associated Neurotoxicity presenting as acute encephalopathy in an elderly hemodialysis patient: A case report.
Mark Jenzen H. TRIVILEGIO ; Joselito B. DIAZ
Journal of Medicine University of Santo Tomas 2026;10(1):1923-1927
Valacyclovir-associated neurotoxicity (VAN) is a recognized adverse effect in elderly patients with renal impairment but remains underdiagnosed due to its nonspecific presentation and overlap with acute neurologic emergencies. We report a 78-year-old Filipino female with end-stage renal disease on maintenance hemodialysis who developed acute disorientation, agitation, vivid visual hallucinations and generalized weakness shortly after initiation of valacyclovir for herpes zoster. Given the abrupt onset of neuropsychiatric symptoms, viral encephalitis was initially considered. Magnetic resonance imaging of the brain showed no evidence of acute infarction or encephalitis, while electroencephalography demonstrated diffuse generalized slowing consistent with an encephalopathic process. Review of the medication history revealed valacyclovir dosing that exceeded recommendations for patients with end-stage renal disease. Valacyclovir was discontinued and emergent hemodialysis was initiated resulting in marked improvement in sensorium after the second session and complete resolution of symptoms after the third. This case shows VAN as an important diagnostic mimic of acute encephalopathy in elderly patients with renal failure and emphasizes the critical role of early medication review in preventing unnecessary investigations and enabling prompt, reversible management.
Human ; Female ; Aged: 65-79 Yrs Old ; Magnetic Resonance Imaging ; Kidney Failure, Chronic ; Magnetic Resonance Spectroscopy ; Electroencephalography ; Medication Review ; World Health Organization
3.Cost-utility analysis of r-chop vs chop in patients with Non-Hodgkin's lymphoma:A systematic review.
Camille Francesca T. Cadag ; Althea B. Lorenzo ; Justine Marie M. Mercado ; Frances Lois U. Ngo
Acta Medica Philippina 2026;60(2):84-114
BACKGROUND AND OBJECTIVES
Non-Hodgkin Lymphoma (NHL) ranks 11th in cancer incidence and mortality in the Philippines with the combination chemotherapy composed of Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) being commonly used as treatment. However, the addition of Rituximab to CHOP (R-CHOP) has been shown to exhibit higher response rates and longer remissions, potentially improving quality of life. Currently, there is conflicting evidence on the cost-utility of CHOP versus R-CHOP. The study aimed to describe the patient- and country-specific factors, and treatment modalities used for NHL and systematically review cost-utility evidence of R-CHOP versus CHOP in adult NHL patients.
METHODSA systematic literature search of cost-utility studies on R-CHOP versus CHOP for NHL treatment was performed on eight databases: PubMed/MEDLINE, Scopus, Web of Science, EBSCOHost, Cochrane, York Research Database, Centre for Reviews and Dissemination Database, and HERDIN, where 607 studies were identified. Upon screening using an eligibility criteria, 10 studies were included and critically assessed using four appraisal tools: CHEERS, Drummond, Cooper, and ECOBIAS. These were performed independently by two authors with a third author assisting to help reach a consensus.
RESULTSAll studies from high-income countries (HICs) (n=8) and low-middle-income country (LMIC) (n=1) suggested that R-CHOP was more cost-effective for NHL treatment than CHOP in terms of utility outcomes. The study conducted in a low-income country (LIC) (n=1) suggested the opposite, favoring CHOP over R-CHOP. Methodological differences such as perspective, discount rate, willingness-to-pay (WTP), time horizon, and economic model were observed. Methodological limitations include completeness of data reported and credibility of sources used.
CONCLUSIONThe results of this review shall be interpreted with caution as those favoring R-CHOP over CHOP for NHL treatment in terms of cost-utility were concentrated in HICs. More economic evaluations from LICs, LMICs, and upper-middle income countries (UMICs) are needed for a robust conclusion. Additionally, establishing a universally recognized guideline for economic evaluations is essential to guide researchers effectively.
Cost-benefit Analysis ; Hodgkin Disease ; Lymphoma ; Systematic Review ; Lymphoma, Non-hodgkin
4.A systematic review of the Philippine plants' antibacterial properties against Staphylococcus aureus.
Ryan Christopher C. Lao ; Jessa Louise T. Turreda ; Monica Angelique O. Ramos-Saycon ; Ailyn Yabes
Acta Medica Philippina 2026;60(2):115-123
BACKGROUND AND OBJECTIVES
Staphylococcus aureus poses a significant public health threat globally, where both community and hospital-acquired infections are prevalent. The escalating antimicrobial resistance highlights the urgent need for alternative therapies. Hence, traditional medicine using plant extracts offers a potential avenue for novel antibacterial agents. This systematic review aimed to evaluate the existing literature on the antibacterial properties of Philippine plants against S. aureus to provide focus on drug development of a plant-derived antibacterial for this pathogen.
METHODSFollowing PRISMA guidelines, a comprehensive search was conducted in PubMed/Medline, SCOPUS, and Herdin databases. Inclusion criteria encompassed in-vitro studies evaluating the antibacterial activity of crude plant extracts sourced from Philippines plants against S. aureus. Data extraction and quality assessment were performed independently by two reviewers, with discrepancies resolved by the third and fourth reviewers.
RESULTSOf the 413 initial studies identified, nine (9) met the eligibility criteria. The highest zone of inhibition was demonstrated by Lippia micromera L. leaf essential oil at 26.3±1.5 mm, while moderate antibacterial activity was shown by essential oils from Alpinia elegans, Piper quinqueangulatum, and Alpinia cumingii at MIC values of 512 µg/mL, 512 µg/mL, and 1,024 µg/mL, respectively. Other Philippine plants showed a wide range of activity, with MIC values between 50 ?g/mL and 25 mg/mL, MBC values from 78 to 5000 ?g/mL, and ZOI ranging from 5 to 38 mm. However, the overall quality of evidence in these other studies are compromised by bias and incomplete reporting.
CONCLUSIONLeaf essential oils from Alpinia elegans, Piper quinqueangulatum, and Alpinia cumingii demonstrated moderate antibacterial activity against S. aureus. Additionally, the essential oils of Lippia micromera L., Plectranthus amboinicus Lour. Spreng, and Cymbopogon citratus exhibited antibacterial activity against both S. aureus and Methicillin-resistant S. aureus (MRSA) in disk diffusion assays. Majority of the studies gathered had high risk of bias according to the quality assessment criteria tool used in the study. Thus, this systematic review also emphasizes the need for improved methodological rigor on reported in-vitro antibacterial studies.
Staphylococcus ; Staphylococcus Aureus ; Systematic Review
5.Global Diagnostic Criteria for Gestational Diabetes Mellitus: A Scoping Review Protocol to Inform Policy in Malaysia
Siti Sarah Hamzah ; Shazana Rifham Abdullah ; Nur Zati Iwani Ahmad Kamil ; Liyana Ahmad Zamri ; Nur Azlin Zainal Abidin ; Sharifah Nortasya Sayed ; Muhamad Kamarudin
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):47-48
Introduction:
Gestational diabetes mellitus (GDM) is a common pregnancy complication associated with adverse maternal and
neonatal outcomes, including hypertensive disorders,
caesarean delivery, macrosomia, and increased lifetime
risk of type 2 diabetes. Despite its clinical importance,
considerable international variation exists in GDM
screening and diagnostic criteria. Multiple frameworks are currently used, including those from the World Health
Organization (WHO), International Association of Diabetes
and Pregnancy Study Groups, Carpenter and Coustan, and
the National Diabetes Data Group. Differences in glucose
thresholds, testing protocols (one-step versus two-step),
and universal versus risk-based screening contribute
to heterogeneity in reported prevalence and healthcare
burden. In multi-ethnic, middle-income settings such as
Malaysia, identifying an evidence-informed and contextappropriate diagnostic approach is critical.
Methodology:
This scoping review follows the Joanna Briggs Institute
methodology and will be reported in accordance with the
PRISMA Extension for Scoping Reviews (PRISMA-ScR).
PubMed, Scopus, and ScienceDirect will be searched for
English-language studies, reviews, guidelines, and consensus statements reporting GDM diagnostic criteria. Two
reviewers will independently screen and select studies.
Results:
Data will be charted on country, study type, diagnostic
criteria, gestational age at screening, and reported
challenges. Findings will be synthesized descriptively and
presented in tables and figures. No formal risk-of-bias
assessment will be conducted.
Conclusion
This review will provide a comprehensive overview of
global diagnostic practices, highlight variations and gaps,
and support evidence-based selection of a suitable GDM
screening and diagnostic strategy for Malaysia.
Diabetes, Gestational
;
Malaysia
;
Policy
;
Review Literature as Topic
6.Publication woes in the AI era.
Philippine Journal of Cardiology 2026;54(1):147-148
Scientific publishing faces growing challenges from rapid technological change, artificial intelligence (AI), research integrity concerns, and resource limitations, particularly in low- and middle-income countries. Editors, authors, and peer reviewers must navigate increasingly complex editorial requirements while operating within constrained institutional and financial environments. The emergence of AI-generated content and fabricated citations further threatens scholarly integrity and adds to editorial burdens. The unique challenges confronting regional journals necessitate strengthening editorial capacity, ethical governance, reviewer competency, and requires collaborative effort to sustain scientific publication that is relevant to the region.
Artificial Intelligence ; Peer Review ; Publishing ; Research ; Editorial ; Publications
7.Publication woes in the AI era.
Philippine Journal of Cardiology 2026;54(1):147-148
Scientific publishing faces growing challenges from rapid technological change, artificial intelligence (AI), research integrity concerns, and resource limitations, particularly in low- and middle-income countries. Editors, authors, and peer reviewers must navigate increasingly complex editorial requirements while operating within constrained institutional and financial environments. The emergence of AI-generated content and fabricated citations further threatens scholarly integrity and adds to editorial burdens. The unique challenges confronting regional journals necessitate strengthening editorial capacity, ethical governance, reviewer competency, and requires collaborative effort to sustain scientific publication that is relevant to the region.
Artificial Intelligence ; Peer Review ; Publishing ; Research ; Editorial ; Publications
8.The effect of cycled light exposure on clinical outcomes of preterm infants admitted in neonatal intensive care units
Roffell D. Felisilda ; Katrina Mae G. Lee ; Christine Corina Grace L. Basilla
The Philippine Children’s Medical Center Journal 2025;21(1):27-41
BACKGROUND:
Hospitalization in neonatal intensive care units (NICU) exposes preterm infants to adverse stimuli, including continuous 24-hour lighting. There is currently no standardized NICU layout advised for the best development of preterm neonates. This meta-analysis aimed to assess the impact of cycled light (CL) exposure on clinical outcomes in premature infants admitted to NICU as synthesized in previous studies.
MATERIALS AND METHODS:
This meta-analysis protocol was developed following the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. A search was performed in PubMed/MEDLINE, EMBASE, Scopus, and Cochrane databases using the MeSH/key words: ―light exposure‖ AND pre-term AND cycled AND (RCT OR trials OR ―randomized controlled trial). The pooled Mean Difference with corresponding 95% CI was computed for weight gain, duration until start of enteral feeding, and duration of ICU stay using the Mantel–Haenszel random-effect model.
RESULTS:
Nine studies were included. The pooled mean difference showed that among preterm infants who had cycled light exposure, average daily weight gain (MD=6.24 grams, 95%CI=1.36 to 11.13, p=0.01) was significantly higher than those with continuous light exposure. The average time to start enteral feeding (MD=-3.84 days, 95%CI=-7.56 to -0.13, p=0.04) and average ICU stay (MD=-8.43 days, 95%CI=-12.54 to -4.31, p<0.0001) among neonates who had cycled light exposure were significantly shorter.
CONCLUSION
Benefits were seen in preterm infants when exposed to cycled light as opposed to continuous light. CL exposed infants showed a daily weight gain that was 6.24 grams higher, on average, and began enteral feeding nearly 4 days sooner. It led to a decrease in the duration of ICU stay by around 8 to 9 days on average. Further trials to determine the impact of cycled light exposure on morbidity and mortality among preterm neonates is recommended.
Human
;
Male,Female
;
Systematic review
;
Meta-analysis
;
Infant, Premature
;
Intensive care units, Neonatal
;
Intensive care, Neonatal
;
Light
;
Lighting
;
Critical care
9.Effects of Vitamin D supplementation on pediatric attention deficit hyperactivity disorder: A meta-analysis and systematic review
Cheska Marie G. Latorre ; Anna Lizza Mañ ; alac
The Philippine Children’s Medical Center Journal 2025;21(1):42-55
OBJECTIVE:
Attention Deficit Hyperactivity Disorder (ADHD) is a common mental disorder in children. It is unclear how nutrition and dietary components relate to ADHD. Some studies suggest that children with ADHD have lower serum levels of vitamin D than healthy controls. In the current study, the effects of Vitamin D supplementation on ADHD were reviewed and analyzed using available literature.
MATERIALS AND METHODS:
A meta-analysis and systematic review were performed. Children less than 18 years old diagnosed with ADHD given Vitamin D supplementation or placebo were included. A search was performed in PubMed/MEDLINE, EMBASE, Scopus, Cochrane, and Google Scholar databases from inception to August 2024 using the MeSH keywords: "Vitamin D" AND (ADHD OR Attention Deficit Hyperactivity Disorder) AND (children OR pediatric OR adolescents) AND randomized controlled trial. Standardized Mean Difference (SMD) was used as an effect measure and pooled using random effects meta-analysis.
RESULTS:
The pooled SMS showed significantly lower ADHD scores (SMD=-0.59, 95%CI=-1.06 to -0.11, p=0.01), lower inattentive scores (SMD=-0.61, 95%CI=-1.00 to -0.23, p=0.002), and lower hyperactivity scores (SMD=-0.64, 95%CI=-1.08 to -0.20, p=0.004) in children given Vitamin D supplementation. The adverse events reported were minor only and did not vary significantly between intervention and control groups.
CONCLUSION
Vitamin D treatment as an adjuvant to methylphenidate alleviated ADHD symptoms without significant adverse effects, correlating with enhanced vitamin D levels. Given the robust evidence and well-structured randomized controlled trials, we strongly advocate for the integration of vitamin D supplementation with ADHD treatment.
Human
;
Male,Female
;
Adolescent: 13-18 yrs old
;
Child Preschool: 2-5 yrs old
;
Child: 6-12 yrs old
;
Vitamin D
;
meta-analysis
;
systematic review
10.Common frameworks for translating research evidence into policy and practice: A scoping review
Art Gregor A. Nerbes ; Erlinda C. Palaganas
Philippine Journal of Nursing 2025;95(1):38-49
The way health policies and practices have evolved is largely influenced by translational research, which uses various conceptual and theoretical frameworks to connect evidence with real-world applications. This scoping review had set out to map and to summarize the existing literature on the most used frameworks for turning research into practice and policy. Instead of providing definitive clinical recommendations, it focused on showcasing the current state of evidence to guide future research efforts. To conduct this review, a systematic search was carried out across seven databases, covering peer-reviewed articles, theses, dissertations, and academic literature in health and science. These studies were screened and analyzed following the guidelines set by the Joanna Briggs Institute (JBI). A total of 73 studies were reviewed, encompassing 58 distinct frameworks, with eight emerging as the most frequently applied: CFIR (Consolidated Framework for Implementation Research), ARCC Model (Advancing Research and Clinical practice through close Collaboration), KTA (Knowledge-to-Action) Framework, aSSKINg (Assessing risk, Skin assessment and care, Surface selection, keep moving, Incontinence management, Nutrition, and Giving information ) Framework, CATs (Critically Appraised Topics) Framework, Delphi Technique, HIRAID (History including Infection risk, Red flags, Assessment, Interventions, Diagnostics, communication, and reassessment) Framework, and MRC (Medical Research Council) Framework. The review pinpointed these eight frequently referenced frameworks that served as essential tools for implementing research-informed practices and policies; however, the successful application of these frameworks was affected by various contextual factors, such as the availability of resources, workforce capacity, professional skills, and the suitability of timing and setting. The findings revealed variations in framework orientation, context of application, and stakeholder engagement, highlighting the importance of adaptability, contextsensitivity, and co-design in effective evidence translation. Given the limited range of databases examined, it was suggested that future research should involve a wider and more diverse array of sources to bolster the evidence base and to improve the generalizability of the findings. The review called for greater methodological rigor in framework selection and use, as well as the development of decision-support tools to optimize translational outcomes.
Human ; Scoping Review


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