OBJECTIVES

This study determined the prevalence of BBD among toilet-trained children attending a tertiary hospital’s pediatric outpatient clinic, and to evaluate the effectiveness of standard urotherapy among affected children.

METHODS

A prospective interventional study was conducted among 144 toilet-trained children aged 7 to 12 years seen at the University of Santo Tomas Hospital outpatient clinic from August 2025 to September 2025. Sociodemographic data were collected, and BBD was screened using the validated Filipino version of the Dysfunctional Voiding Symptom Scores (DVSS) questionnaire. Children with BBD underwent standard urotherapy, which included behavioral and lifestyle interventions such as timed voiding, adequate hydration, constipation management and proper voiding posture. DVSS assessments were repeated at two and four weeks.

RESULTS

The overall prevalence of BBD was 22.9% (33 of 144). BBD was significantly more prevalent among females (31.88%) than males (14.67%) (adjusted OR = 2.96, 95% CI: 1.28–6.86; p = 0.011). At baseline, children with BBD had significantly higher mean total DVSS scores (9.15 ± 3.64) compared to those without (2.01 ± 1.80, pCONCLUSION

Standard urotherapy proved effective in reducing symptom scores within two weeks and resulted in complete clinical resolution after four weeks among those who continued therapy. Routine screenings for BBD using DVSS and early initiation of standard urotherapy in pediatric outpatient settings are recommended to prevent complications and improve children’s urinary and bowel health.

Human ; Child: 6-12 Yrs Old ; World Health Organization ; Outpatient Clinics, Hospital ; Mass Screening ; Tertiary Care Centers ; Constipation ; Ambulatory Care Facilities

BACKGROUND

Corticosteroids have been used in ophthalmology for its potent anti-inflammatory and immunosuppressive actions. Although the role of corticosteroid treatment is pivotal in the treatment of numerous inflammatory diseases and as postoperative management of patients who undergo ocular surgeries, intraocular pressure (IOP) elevation has been a significant ocular side effect that could result after steroid use. Evaluating the changes in IOP in pediatric eyes will provide early detection and timely intervention to prevent glaucomatous optic neuropathy.

OBJECTIVE

This study aimed to determine the incidence of IOP elevation among pediatric patients given corticosteroids after strabismus surgery in a tertiary hospital in Manila, Philippines.

METHODS

This is a single-center, retrospective, observational study that employs review of the clinical records of pediatric patients who underwent strabismus surgery between January 2015 and December 2022. This study was conducted last February to November 2023. Data were gathered and descriptively summarized regarding patient demographics, ophthalmologic diagnosis, type of strabismus surgery performed, preoperative and postoperative IOP readings, frequency and duration of postoperative topical steroid use, and treatment received and response to elevated IOP.

RESULTS

Forty-five (28.48%) out of the 158 pediatric patients who had strabismus surgery during the study period met the inclusion criteria for the study. The mean age of pediatric patients was 11.38 ± 5.28 years (range 2-18 years old). There were more males (55.6%) than females. All patients were administered Tobramycin + Dexamethasone eyedrops, ointment or both. The baseline, peak, and net change in IOP were 13.5 ± 2.7 mmHg, 23.1 ± 8.8 mmHg and 10 ± 8.4 mmHg respectively. IOP increased in thirty-seven (82.2%) of the patients from baseline, and 21 (56.7%) of them had a considerable rise. For most patients with considerable rise of IOP, topical steroid medication was either stopped or immediately tapered off. Nine patients received topical IOP-lowering medicine, and most of them returned to normal IOP levels two months following surgery. After then, topical IOP-lowering drugs were stopped.

CONCLUSION

IOP elevation following strabismus surgery was frequently associated with topical steroid usage, and most patients experienced considerable IOP elevation. It is highly advised to closely monitor IOP following strabismus surgery, particularly in children receiving topical steroid treatment.

Human ; Male ; Female ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Strabismus ; Intraocular Pressure ; Ophthalmology ; World Health Organization ; Optic Nerve Diseases ; Volition ; General Surgery

Diffuse infiltrating retinoblastoma is an extremely rare form of retinoblastoma which is characterized by its atypical growth pattern. This unusual presentation adds complexity to the diagnostic process. The purpose of this paper is to report a rare presentation of diffuse infiltrating retinoblastoma presenting after an ocular trauma. We described a 7-year-old Filipino boy presenting with total hyphema following an ocular trauma. Comprehensive ophthalmologic clinical and diagnostic evaluations were performed including visual acuity, slitlamp biomicroscopy, ocular ultrasound, neuroimaging, and histopathology post enucleation to determine diagnosis. The misleading, atypical presentation of diffuse infiltrating retinoblastoma may delay diagnosis. While this dilemma is expected in these scenarios, it should be remembered that timing of diagnosis in retinoblastoma is crucial, as this also equates to optimal management. One should remain vigilant for these uncommon presentations especially in the setting of any intraocular inflammation in children.

Human ; Male ; Child: 6-12 Yrs Old ; Wounds And Injuries ; Visual Acuity ; Retinoblastoma ; Research Report ; Neuroimaging ; Inflammation ; Hyphema ; Contusions

BACKGROUND AND OBJECTIVE

Foreign body (FB) ingestion is a common pediatric concern in the Philippines, but local studies on flexible endoscopic management are lacking. This study aimed to describe the clinical profile and outcomes of children referred for flexible endoscopic management and identify factors associated with poor outcomes.

METHODS

This retrospective cohort study included 145 patients aged

RESULTS

Most FB ingestions (96.55%) were accidental, with coins as the most common FB (56.55%). Patients were admitted an average of 40.42 hours post-ingestion and referred for endoscopy within 9.28 hours. Flexible endoscopy was performed in 44.83% of cases, with a 98.46% success rate and an average procedure time of 32.25 minutes. Spontaneous passage occurred in 50.34% of cases. Poor outcomes were linked to age 48 hours; OR: 15.43, p = 0.0181), and prolonged procedures (>30 minutes; OR: 12, p = 0.0318). Good outcomes were associated with unremarkable physical exams (OR: 0.078; p = 0.0018), early admission (CONCLUSION

Flexible endoscopy is effective and safe for FB extraction in children. Early admission and timely intervention significantly improve outcomes, while delays and prolonged procedures increase the risk of complications.

Human ; Adolescent: 13-18 Yrs Old ; Child: 6-12 Yrs Old ; Foreign Bodies ; Endoscopy ; Child ; Retrospective Studies ; Aged ; Cohort Studies ; Eating ; Methods ; Numismatics ; Patients ; Philippines ; Physical Examination ; Time

Distal vaginal agenesis (DVA) is a rare form of female genital tract malformation that presents as cryptomenorrhea. It results from the failure of the urogenital sinus to form the caudal portion of the vagina. Through a thorough history, physical examination and appropriate imaging studies, an accurate diagnosis is integral in selecting the correct intervention for the patient. This is a case of distal vaginal agenesis in a 10-year-old nulligravid, who presented with fecal retention from an abdominopelvic mass. The patient had no bowel movement for four days, and abdominal enlargement. On inspection, there was a 12.0cm x 10.0cm palpable abdominal mass. Inspection of the external genitalia, the introitus appeared concave, with no appreciable introital opening. On digital rectal examination, an anterior bulge was palpated 0.5 cm from the anal verge. A pull-through vaginoplasty was performed with an unremarkable post-operative course. The patient was discharged with a patent vagina and resolution of her gastrointestinal symptoms. On follow-up, the patient had monthly menstruation after surgery with no recurrence of her gastrointestinal symptoms.

Human ; Female ; Child: 6-12 Yrs Old ; Congenital Abnormalities ; Digital Rectal Examination ; Defecation

OBJECTIVE

This paper reports a rare presentation of diffuse intraocular inflammation following reversed vaulted multipiece intraocular lens (IOL) implanted in the sulcus of a 7-year-old child.

METHODS

This is a case report.

CASE PRESENTATION

A 7-year-old child presented with persistent posterior pole inflammation and optic disc swelling after an improperly placed multipiece intraocular lens in the sulcus. Comprehensive eye and wholebody evaluations were performed with the aid of optical coherence tomography (OCT), magnetic resonance imaging (MRI) and systemic work-up to rule out other causes of uveitis to definitively diagnose the case. The reverse-vaulted lens was eventually explanted. After 1 week post-explantation, the visual acuity improved markedly to 20/100 with the appropriate spectacle prescription. The patient recovered from the ocular inflammation 8 months postoperatively.

CONCLUSION

This paper reports significant posterior pole inflammation as an uncommon yet potentially visually-disabling consequence of a reverse-vaulted sulcus placement of a multipiece intraocular lens in a child. Careful attention is warranted to ensure proper IOL orientation during implantation, especially in pediatric cataract surgery. Visual rehabilitation is important postoperatively

Human ; Male ; Child: 6-12 Yrs Old ; Multiple Chronic Conditions ; Lenses, Intraocular ; Edema

Human ; Male ; Female ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Urology ; Transitional Care ; Philippines ; Adult

Persistent cloaca is a rare congenital anomaly characterized by a single opening in the perineum for the urinary, genital, and gastrointestinal tracts. This case report presents a pediatric patient with persistent cloaca who underwent vaginal reconstruction using the Singaporean flap, or the pudendal artery thigh flap in our institution. The vaginal reconstruction aimed to create a functional and aesthetically acceptable vaginal canal, allowing normal sexual function and urinary continence. The importance of multidisciplinary care involving urologists, gynecologists, and plastic surgeons is emphasized for optimal management of this complex condition.

This is a case of an 11 year old female presented with a common channel or persistent cloaca who underwent double barrel transverse colostomy as a neonate from a different institution and was referred to our institution for definitive surgical management. Vaginoplasty was performed using an ipsilateral Singaporean pudendal artery perforator thigh flap created as a tunnel for the neovaginal canal by the Plastic surgery team. A posterior anorectoplasty was done by the Pediasurgery team, and urethroplasty was done by the Urosurgery team with comanagement with the Gynecology team preoperatively and postoperatively as well.

Human ; Female ; Child: 6-12 Yrs Old ; Cloaca ; Genitalia ; Perforator Flap ; Perineum ; Surgery, Plastic ; Gynecology

INTRODUCTION

With the introduction of COVID-19 vaccines, schools around the world have slowly started to reimplement on-site classes with guidelines to prevent outbreaks. The University of Santo Tomas has devised their own set of guidelines, including safety protocols, vaccinations and daily health declarations. These were monitored using the
Thomasian Online Medical Services and Support (ThOMedSS).

METHODOLOGY

Through a case-control study design, the study aims to determine an association between the vaccination status of UST Faculty of Medicine and Surgery (UST-FMS) students and breakthrough COVID-19 infections in the first semester of the academic year 2022-2023, with population data acquired via records of students participating in face-to-face classes from the UST Health Service Office, and categorized based on breakthrough infections and vaccination status.

STATISTICAL ANALYSIS

Results were analyzed using Pearson’s chi-square test and Fisher’s exact test (pCONCLUSION

The study suggests that vaccination status did not have a statistically significant association (p = 0.3451) with breakthrough infections. The majority (99.94%) of students have received the complete primary COVID-19 vaccination series and only 6.61% of this population developed breakthrough COVID-19 infections, all occurring in those completely vaccinated. Breakthrough infections were 1.76 times more likely for those with booster shots than those without. The possible reason for this is the emergence of the Omicron variant. To improve the study, external exposures and individual behaviors must be considered as potential factors influencing infection rates.

Human ; Male ; Female ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Young Adult: 19-24 Yrs Old ; Association ; Case-control Studies ; Covid-19 ; General Surgery ; Faculty ; Incidence ; Infections ; Medicine ; Universities ; Vaccination

BACKGROUND

Six-pyruvoyl-tetrahydrobiopterin synthase (6-PTPS) deficiency is an inherited metabolic disorder which results in tetrahydrobiopterin (BH4) deficiency causing hyperphenylalaninemia.

OBJECTIVE

This study aimed to describe the clinical, biochemical, and radiologic profiles, and neurologic and developmental outcomes of patients diagnosed with 6-pyruvoyl tetrahydrobiopterin (PTPS) deficiency through newborn screening and confirmed by BH4 loading test, pterin analysis, and gene sequencing who were following-up with the metabolic team.

METHODS

The research was a single-center descriptive case series study design that was done at the Philippine General Hospital, a tertiary government hospital. The clinical, biochemical, radiologic profiles and neurodevelopmental evaluation of each patient were described.

RESULTS

Nine patients from 1 year 2 months to 14 years 5 months of age were enrolled in the study. Clinical manifestations before treatment were hypotonia, poor suck, and seizure. The most common clinical manifestation even after treatment initiation was seizure. The mean phenylalanine level on newborn screening was 990.68 umol/L, but after treatment was started, mean levels ranged from 75.69 to 385.09 umol/L. Two of the patients had focal atrophy of the posterior lobe on brain imaging. Pathogenic variants on molecular analysis were all missense, with two predominant variants, c.155A>G and c.58T>C. Eight of the nine patients had varying degrees of developmental delay or intellectual disability, while the remaining patient had signs of a learning disorder.

CONCLUSION

Newborn screening has played a crucial role in the early identification and management of patients with hyperphenylalaninemia due to 6-PTPS deficiency. Confirmation of diagnosis through determination of DHPR activity, urine pterins and/or molecular analysis is necessary for appropriate management. However, despite early initiation of treatment, neurodevelopmental findings of patients with 6-PTPS deficiency were still unsatisfactory.

Human ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Learning Disorders ; Brain ; Diagnosis