BACKGROUND

The Philippines has a wide variety of plant species with potential to produce allergenic pollen grains. Most of the study subjects which are residents in Manila tested positive to Fabaceae and Amaranthaceae. Weeds, especially the Amaranthaceae and Fabaceae families, are relevant triggers of allergy as they are highly adaptive and can grow despite adverse weather conditions. However, only a few allergens have been identified among these families and listed in the International Union of Immunological Societies allergen nomenclature database. Currently, local pollen grains are being processed at the Medical Research Laboratory of our institution to produce crude pollen extracts for use in specific diagnostic skin tests and in subcutaneous immunotherapy of patients with respiratory allergies all over the country. However, these extracts have not been characterized and data of cross-reactivity is limited.

This study aimed to evaluate the IgE binding activity of allergen extracts from Philippine weeds and trees, and determine their cross-reactive components.

Pollen extracts from Amaranthus spinosus (pigweed), Mimosa pudica (makahiya), Tridax procumbens (wild daisy), Albizia saman (acacia), Leucaena leucocephala (ipil-ipil), Mangifera indica (mango), and Cocos nucifera (coconut) were extracted and analyzed for crossreactivity using ELISA and Western blot. 

Cross-reaction was observed between ipil-ipil and coconut, and between makahiya and wild daisy. IgE bound to protein components at ~20, 18, and 15 kDa of the weeds, while for the trees, IgE bound to protein components at ~35 and ~15 kDa which may be responsible for the cross-inhibitions observed.

Data may contribute to the development of immunotherapeutic strategies and diagnostic applications for respiratory allergies, comprising the production of standardized panel of allergens thus eliminating unwanted side effects and providing patients with safer diagnosis and therapy.

BACKGROUND

Acne vulgaris is a common condition among young people affecting body image. Despite being benign, its impact may be underestimated necessitating holistic treatment.

This study aimed to determine the relationship between quality of life (QoL) and acne severity, and its association to demographic characteristics in young people with acne vulgaris. Methods: A cross-sectional study was conducted among 75 patients with acne vulgaris aged 10 24 years seen at a tertiary hospital in the Philippines. Patients completed a self-administered questionnaire, the Cardiff Indeks ng Kapansanan nang may Tigyawat (CIKT), and were assessed using the Global Acne Grading System (GAGS). Statistical analysis examined correlations between acne severity, QoL and demographic factors.

The 75 participants recruited were mainly female, aged 19-24 with monthly family incomes between 9,520 and 43,828 pesos. Many had acne for over three years and were self assessed as moderate. On evaluation, most were classified as having mild acne with moderate QoL impairment. Data analysis revealed a moderate positive correlation between acne severity and QoL, indicating that with increased acne severity, the more significant patients’ QoL scores were affected. Self-evaluation and sex were linked to acne severity, with acne self-evaluation showing a statistical significance in relation to QoL. No significance was seen with sex and QoL

A personalized treatment is essential for young patients with acne vulgaris. Factors such as acne severity, self-evaluation, sex and the quality of life should be considered to address the impact of acne on patients’ lives.

Cohort studies is an epidemiologic study that follows a group of individuals who share a common characteristic at the start of the study to observe the emergence of outcomes. Cohort studies are classified based on the population characteristics from where they were drawn, the way the data collection occurred or if its open or closed. This allows the computation of the absolute risk or the incidence of an outcome. There are several advantages in conducting a cohort study, such as clarity of temporal relationship of the exposure and outcome, permits the computation of incidence, permits multiple effects of a single exposure, and avoids selection bias on admission. While there are advantages, there are also disadvantages in doing this study, such as it requires long follow-up, need of large sample size, maybe costly, and may make it difficult to argue causation due to the presence of confounding. The statistical test that can be used to analyze the results will depend on the type of variable used. Statistical test such as T-test, Chi square test, and Regression can be used. Writing the final report follows the STROBE guidelines.

Background: The global pandemic caused by COVID-19, the subsequent improvement in health situation caused by anti- COVID-19 vaccination and the developments in digital technology prompted changes in undergraduate medical education as to content delivery and assessment. This study determined the difference in the performance of first year medical students in traditional face-to face, online and Hyflex teaching strategy. Methods: A non-concurrent cohort study was done to determine the performance of students in three annual subjects in Year 1 undergraduate medical education for school years 2018 to 2023. One-way ANOVA at p=0.001 determined significance of differences of variables. Results: There was no difference in the profile of students as to their sex, pre-medicine course and scores in the National Medical Admission Test (NMAT). The performance in the written examinations in Anatomy and Physiology showed significant difference (p=0.001) when the conduct of examinations was shifted online on an emergency basis. There was no difference (p=0.001) in performance in the laboratory conference sessions in Physiology, as compared to the focused group discussion sessions in Biochemistry and practical examinations in Anatomy. Conclusion Significant difference in the performance of first year medical students was observed only during the emergency shift to online examinations, otherwise the performance was similar in traditional face-to face, online and Hyflex teaching strategy.

Introduction: The global impact of the coronavirus disease 2019 (COVID-19) pandemic has continually jeopardized vulnerable populations encompassing children, youth, elders, and individuals with immunodeficiency and comorbidities. Methods: In recognizing the crucial role of predictive analytics in shaping public health decisions, this study utilizes a predictive design, drawing on official data from the Department of Health (DOH) in the Davao Region, Philippines, spanning 57 days from March 15 to May 10, 2020. By comparing the Susceptible, Infected, Recovered (SIR) model and the Autoregressive Integrated Moving Average (ARIMA) model, the research aims to provide a scientific foundation for informed decision-making by public health authorities. Result: Analysis revealed that the SIR model emerged as the most effective in identifying trends and forecasting future cases. Despite both models indicating a substantial reduction in infection rates, caution is advised against discontinuing control and preventive measures due to the latent potential for another surge. The findings underscore the necessity for scientifically forecasted data to guide decision-makers in enhancing the responsiveness of public health services during similar and potentially worsening conditions. Conclusions Hence, this study contributes to the ongoing pandemic preparedness and responsiveness discourse. Its emphasis on predictive analytics, particularly the SIR model, offers valuable insights for authorities tasked with safeguarding public health. The significance lies in addressing the current situation in the Davao region and providing a template for future scenarios. As the world grapples with the unpredictable nature of infectious diseases, informed decision-making based on scientific forecasts becomes imperative for effective public health management.

Background: Consumption and abuse of alcohol remains a significant cause of concern worldwide. Furthermore, there is evidence of the association between chronic alcohol use and reduced life expectancy. Objectives: To study the effects of Garcinia binucao extract (GBE) supplementation on lifespan of Drosophila melanogaster, in the presence or absence of chronic alcohol exposure. Methods: D. melanogaster was mass cultured and given GBE supplementation in high (1 mg/mL) and low (200 µg/mL) sublethal doses. D. melanogaster flies were divided into groups - with and without chronic alcohol exposure, and their respective lifespans were monitored. Results: In D. melanogaster without alcohol exposure, mean lifespan was highest in the control flies (38.15 days), followed by high-dose GBE (34.42 days), low-dose GBE (33.24 days), and DMSO (22.29 days). In D. melanogaster chronically exposed to alcohol, the longest mean lifespan was observed in flies treated with high-dose GBE (33.80 days), followed by low-dose GBE (33.63 days), the DMSO group (30.30), and the control group (29.65 days), but the differences were not statistically significant. Comparing groups with and without chronic alcohol exposure, the mean lifespan of the control group chronically exposed to alcohol significantly decreased by 9.51 days (p < 0.05). In GBE treatment groups, mean lifespan significantly decreased by 0.82 days in high-dose set-up (p < 0.05), and significantly increased by 0.39 days in the low-dose set-up (p < 0.05) upon chronic alcohol exposure. Conclusion Garcinia binucao extract supplementation ameliorated the observed reduction in lifespan of Drosophila melanogaster chronically exposed to alcohol.
Drosophila melanogaster ; Longevity

INTRODUCTION: The landscape of work has changed since the start of the COVID-19 pandemic as more companies shifted from face-to-face to the work-from-home (WFH) setup. This change has affected several aspects of human life especially the motivation to WFH. The study aimed to determine the motivation of WFH among office workers in the National Capital Region (NCR) from March 2020 to February 2022 METHODS: Using a descriptive cross-sectional study design, an online survey of WFH office workers around the NCR, Philippines was conducted. A 26-item questionnaire on motivation covering dimensions of availability (flexibility), safety (work-life balance), and meaningfulness (work performance) was used. Data was analyzed using SPSS version 24. RESULTS: A total of 252 respondents were included in the study, with a majority identifying as females aged 21 to 30, never married, and college graduates. Additionally, respondents reported having one to five years of work experience and were employed in professional/technical/managerial fields. Regarding the impact of remote work, the findings indicated that most individuals who worked from home (WFH) felt motivated by this setup due to its positive effects on availability, time and cost savings from reduced commuting, and the flexibility it provided for managing their schedules according to personal preferences. Furthermore, in terms of safety and conducive work environment, WFH office workers expressed agreement that the remote work setup contributed to a favorable work environment, leading to increased job satisfaction. This setup allowed them to effectively balance work responsibilities with personal and family commitments. The study also revealed that WFH office workers perceived a sense of meaningfulness in their work, as they felt trusted and valued by their employers. This sentiment contributed to their overall well-being, both physically and mentally CONCLUSION Work-from-home office workers are generally always motivated in terms of availability (flexibility), safety (work-life balance) and meaningfulness (work performance).
motivation ; flexibility ; work-life-balance ; work performance

Introduction. The COVID-19 pandemic presented an extraordinary challenge to the operations of private hospitals involved in neurological residency training. Numerous adaptations were made to restructure the hospital, including the special units and diagnostic centers. Teaching and training activities were swiftly transitioned to online platforms and research activities were streamlined. Manpower allocation into teams with active duties followed by mandatory quarantine periods became the norm.

Objective. To evaluate the effect of the COVID-19 pandemic on the neurology training program by comparing two periods: pre-pandemic and pandemic periods.

Methods. We reviewed the changes implemented by the hospital in response to the pandemic. We also looked into our residency training program pre-pandemic and the subsequent changes instituted to adapt to the pandemic.

Results. Due to the community quarantine imposed by the government, there was a drastic drop by as much as 70.5% in the out-patient census, 38.4% in the in-patient census, and 46.9% in neurodiagnostic (electroencephalography and electrodiagnostic medicine). The residents were reorganized into three teams of 4 residents, further divided into COVID and non-COVID rotations for 5 days straight duty. Consultants were also stratified into high-risk (on-call for emergency referrals in a work-from-home scheme) and non-high-risk (COVID patient rounds). Teleconsultation was likewise utilized. Academic activities were shifted to blended online learning.

Conclusion. There was a need to reorganize resident staffing brought about by the hospital changes as well, to ensure safety during the pandemic. The pandemic has forced us to shift to alternative methods of teaching and examination, such as teleneurology. Regular assessments and adjustments to the training program will need to be done to adapt to an evolving situation.

Family and community practitioners sometimes will decide on what community-oriented interventions to propose and implement. The cost and effectiveness of such interventions are often debated by policy makers. A set of formal, quantitative methods for comparing alternative strategies in resource use and expected outcomes is known as health economic analysis. This article presents a tool to help family and community practitioners decide on the cost and effectiveness of such interventions.
Evidence-Based Practice ; Economics, Medical

Background: Diarrhea is among the common causes of morbidity and mortality in children. It is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual). It does not include frequent passing of formed stool and passing of loose, pasty stools by breastfed babies. It is usually a symptom of an infection in the intestinal tract, caused by variety of organisms, which is spread through contaminated food or drinking water, or from person-to-person as a result of poor hygiene. Diarrhea can last several days and can leave the body without the water and salts that are necessary for survival causing significant number of mortality and morbidity among children. At the level of primary care, diagnosis, management and treatment of food- and waterborne-diseases, which commonly present as diarrhea, lack the necessary protocols and standards, thus, the creation of this clinical pathway. Objective: The main goal of this clinical pathway was to provide guidance to family and community physicians, and other primary care physicians in managing acute diarrhea among immunocompetent pediatric patients. Methods: ADAPTE process was used in CPG development. Existing guidelines on acute diarrhea among pediatric patients were retrieved and appraised using the AGREE II tool. Recommendation statements from the guidelines that passed the AGREE II tool were reviewed. Recommendation statements that will help answer the clinical questions posed in the creation of the clinical pathway were adapted. For clinical questions were not answered by the available guideline recommendations, a de novo method was conducted. The adapted recommendation statements and the supporting summary of evidences were sent for external review prior to consensus development. Suggestions provided in both steps were discussed and incorporated in the final manuscript, as appropriate. Key Recommendation Statements: These key recommendation statements addressing the clinical assessment, diagnosis, interventions (pharmacologic and nonpharmacologic), and patient outcomes that are relevant in the outpatient or primary care setting in the Philippines were based on the summarized key evidences from the systematic review of literature conducted using the ADAPTE process. Clinical Assessment Recommendation 1. A focused medical history that includes questions on duration, frequency, characteristics, associated symptoms, consumption of raw, ill-prepared, or rotten food; intake of antibiotics, contaminated food or water; and history of travel should be obtained. (Strong recommendation, High quality evidence) Recommendation 2. Physical examination should be done to assess the nutritional status, degree of dehydration, severity of disease, and presence of complications and comorbid conditions. (Strong recommendation, High quality evidence) Recommendation 3. Degree of dehydration should be classified into No Dehydration, Mild to Moderate Dehydration, or Severe Dehydration. (Weak recommendation, Moderate quality evidence) Recommendation 4. Children with acute infectious diarrhea who have any of the following conditions should be admitted to the hospital: severe dehydration, inability to tolerate fluids orally, suspected electrolyte abnormalities, altered consciousness, abdominal distention, respiratory distress, pneumonia, meningitis/encephalitis, sepsis, moderate to severe malnutrition, suspected surgical condition, or conditions for safe follow-up and home management are not met. (Strong recommendation, High quality evidence) Diagnostic Tests Recommendation 5. Routine diagnostic tests are not necessary among children with acute diarrhea. (Strong recommendation, Low quality evidence) Recommendation 6. Stool examination may only be requested if the patient present with moderate to severe condition, bloody diarrhea, or amoebiasis and parasitism is being considered at time of epidemic. (Strong recommendation, High quality evidence) Recommendation 7. Diagnostic tests may be requested if concomitant conditions like pneumonia, urinary tract infection, sepsis or meningitis are suspected; or if abdominal distension is observed post-hydration. (Strong recommendation, High quality evidence) Recommendation 8. Stool culture, serologic test, rapid diagnostic test, PCR determination and serum biomarkers are not recommended in family and community practice. (Strong recommendation, High quality evidence) Pharmacologic Treatment Recommendation 9. Reduced osmolarity oral rehydration solution (ORS), commercial or home-made is recommended to replace previous and ongoing losses. (Strong recommendation, High quality evidence) Recommendation 10. The volume and frequency of reduced osmolarity oral rehydration solution (ORS) should be dependent on patient’s age or weight, severity of dehydration and ongoing losses. (Strong recommendation, High quality evidence) Recommendation 11. Severe dehydration should be managed in the hospital with intravenous hydration. (Strong recommendation, High quality of evidence) Recommendation 12. Routine empiric antibiotic treatment is not recommended in children with acute infectious diarrhea. (Strong recommendation, Very low quality evidence) Recommendation 13. Antibiotic treatment may be given to children with Cholera, Shigella, typhoidal Salmonella, amoebiasis, and giardiasis. The choice of antibiotic must be guided by the local Antibiotic Surveillance Program. (Strong recommendation, High quality evidence) Recommendation 14. In general, antibiotic treatment should not be given in children with non-typhoidal Salmonella. It may be given in children with underlying conditions i.e., immunodeficiency, corticosteroid or immunosuppressive therapy. (Strong recommendation, Very low quality evidence) Recommendation 15. Among children older than six months, zinc supplementation of 10-20 mg per day for 10-14 days may be offered to reduce the duration and severity of diarrhea, and recurrence in the next two to three months (Strong recommendation, High quality evidence) Recommendation 16. Racecadotril may be offered to reduce ongoing loss of water and electrolytes. (Strong recommendation, High quality evidence) Recommendation 17. Probiotics may be offered to reduce the duration of diarrhea. Lactobacillus rhamnosus GG (LGG), Saccharomyces boulardii and Lactobacillus reuteri are strains with evidence of effectiveness. (Strong recommendation, High quality evidence) Recommendation 18. Anti-emetics and antidiarrheal drugs are generally not recommended because of their side-effects. (Strong recommendation, High quality evidence) Non-pharmacologic Interventions Recommendation 19. Among children with acute diarrhea, age-appropriate feeding should be continued. There is no need to modify or restrict diet. (Strong recommendation, Moderate quality of evidence) Recommendation 20. Among infants with diarrhea, breastfeeding must be continued. (Strong recommendation, High quality evidence) Recommendation 21. If diet was restricted because of frequent vomiting, early refeeding must be done. (Strong recommendation, Moderate quality evidence) Recommendation 22. All members of the family must be encouraged regular hand washing with soap and water. (Strong recommendation, Moderate quality evidence) Recommendation 23. Family members must observe proper food handling, have access to safe drinking water, and observe proper waste disposal. (Strong recommendation, Low quality evidence) Recommendation 24. Community level intervention that encourages hand washing, proper food handling, appropriate waste disposal and ensuring safe drinking water must be done. (Strong recommendation, Low quality evidence) Expected Patient Outcomes Recommendation 25. After each encounter the patient or guardian must understand the nature of acute diarrhea, its management and potential complications. (Strong recommendation, Low quality evidence) Recommendation 26. The management plan must be a mutual agreement between the family physician and the guardian. (Strong recommendation, Low quality evidence) Recommendation 27. For the management of a child with acute diarrhea, the family physician must target for resolution of dehydration, resolution of diarrhea, prevention of relapse, hospitalization, complications and early detection of adverse events. (Strong recommendation, High quality evidence) Dissemination and Implementation This clinical pathway will be published in the “The Filipino Family Physician” journal, which is accessible in the PAFP journal website. PAFP’s Committee on Research will disseminate the clinical pathway through distribution to its subspecialty and affiliate societies, chapters, training programs, and primary care practitioners; and continuing development sessions of the PAFP. Monitoring of the uptake of the clinical pathway will be through the number of downloads at the website and requests for copies. This clinical pathway may be used as a guide by family and community physician and primary care physicians in a primary care setting. Tabular presentation of the clinical pathway was included as a tool for implementation. Monitoring of implementation will be via continuous quality improvements activities, which can be a self-initiated activity of the member as recommended in the Universal Healthcare, or as a chapter or group activity.