BACKGROUND AND OBJECTIVE

Meningiomas represent the most prevalent benign intracranial tumors, comprising 13- 26% of primary intracranial neoplasms. These tumors derive their blood supply from both extracranial and intracranial circulation. Over recent decades, pre-operative embolization (POE) has emerged as a potential adjunctive therapy to surgery, aiming to reduce tumor vascularity. Our study seeks to explore the potential correlation between the extent of devascularization following POE of meningiomas and intraoperative blood loss.

This cross-sectional study involved nine meningioma patients at a tertiary hospital, involving chart review of patients across four years. These patients were referred for POE due to angiographic evidence of a hypervascular mass between January 2018 and January 2022. We collected demographic data, tumor characteristics (including location, size, and vascular supply), and intraoperative variables such as total operative time and blood loss. Statistical analyses aimed to uncover correlations between vascularization degree and various factors.

Our population consists predominantly of females (53.68%), with a mean age of 45.85 ± 13.65 years. Only one mortality was recorded (7.7%). Pre-operative embolization achieved devascularization in the majority (69.2%) of cases, with approximately two-thirds (66.7%) experiencing complete devascularization. Mean total operative time stood at 336.11 ± 301.88 minutes, with a mean post-operative blood loss of 985.56 ± 1013.72 milliliters. Additionally, for those with recorded recovery times, the mean recovery time was 14.32 ± 13.51 hours.

Mortality rates showed no association with sex, devascularization status, or number of feeding vessel zones. Furthermore, the extent of devascularization did not correlate with age, sex, number of feeding vessel zones, postoperative blood loss, total operative time, or recovery time (p >0.05).

In summary, this study represents a significant endeavor to elucidate factors influencing meningioma outcomes following pre-operative embolization. Despite limitations regarding patient numbers, our study offers valuable insights into operative parameters and embolization considerations for future analyses in our tertiary center.

BACKGROUND

Coronavirus Disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, presents not only as a respiratory ailment but also poses risks of neurological complications whose underlying mechanisms remain unclear. These complications range from mild to severe and may involve direct invasion of the central nervous system (CNS), disruption of the blood-brain barrier, or systemic cytokine effects. Diagnostic challenges persist due to the suboptimal sensitivity of RT-PCR assays.

The present study aimed to review the contrast and non-contrast enhanced cranial CT images of all diagnosed COVID-19 patients in a tertiary referral center with the clinical impression of non-traumatic and nonoperative CNS pathologies.

We conducted a cross-sectional study analyzing CT images of COVID-19 patients with neurological symptoms. Among 51 included patients, plain CT scans were predominantly used, revealing no acute infarcts or hemorrhages in the majority, while frontal lobe involvement was notable in cases with pathology. Chronic infarcts or ischemic changes were observed in over half of the cases, primarily affecting the anterior circulation. Only one case of meningitis was documented.

In the final analysis, 51 patients met the inclusion criteria out of the initial 64 enrolled. The study population, predominantly male with a mean age of 58.02 ± 20.87 years, mainly comprised patients solely diagnosed with COVID-19. Plain CT scans were favored over contrast-enhanced scans (76.50%, n = 39). While most patients had no acute infarcts or hemorrhages, the frontal lobe was commonly affected among stroke patients (9.8%, n = 5). Additionally, a significant portion of patients without acute stroke findings exhibited chronic infarcts or ischemic changes (57.69%, n = 15).

This study sheds light on the radiological patterns of CNS involvement in COVID-19 patients, highlighting frequent frontal lobe involvement possibly attributed to hypercoagulability and endotheliitis. Further research with larger sample sizes and MRI utilization is recommended to enhance our understanding of CNS manifestations in COVID-19. This study contributes to understanding COVID-19 neurological sequelae, particularly in terms of radiological patterns, among patients presenting with neurological symptoms. The findings highlight the need for comprehensive evaluation and management of neurological complications in COVID-19 patients.

INTRODUCTION

Respiratory infections are a leading cause of pediatric hospitalizations, particularly pneumonia. In Metro Manila, many cases lack identifiable causes, underscoring the need for advanced diagnostics. The RT-PCR Respiratory Panel 2.1 enables rapid pathogen detection, improving diagnosis and treatment. Examining demographic and clinical factors linked to severe outcomes provides valuable local insights.

This study aimed to identify and compare respiratory pathogens detected by the RT-PCR panel and determine demographic and clinical factors associated with severe outcomes in pediatric patients at a private tertiary hospital in the Philippines.

A retrospective cohort study was conducted, analyzing pediatric patients (0–18 years) admitted for respiratory infections from August 2023 to August 2024. Descriptive statistics summarized patient characteristics, while regression analyses identified factors linked to mechanical ventilation, oxygen use, and prolonged hospital stays.

Of 118 patients, 85.6% tested positive for respiratory pathogens, predominantly viral (RSV 23.7%, human rhinovirus/enterovirus 22.9%), with cases peaking in late 2023. Most patients had elevated WBC with neutrophilic redominance. Oxygen support was required in 22.9% of cases, primarily in infants under six months with RSV, who had a four-fold increased risk. Difficulty breathing was the strongest predictor of oxygen use, while the presence of neurological conditions (e.g., cerebral palsy, seizure disorders) were significantly associated with mechanical ventilation and prolonged hospital stays.

Seizure disorder, cerebral palsy, and younger age influenced severe outcomes. Pathogen specific trends in demographics, clinical findings, and oxygen support needs may help guide physicians in recognizing illnesses caused by the most common viral respiratory pathogens identified by the RT-PCR Respiratory Panel 2.1

INTRODUCTION

Vasectomy is a simple and reliable method of permanent contraception in men causing obstructive azoospermia. As many as 50 million men worldwide have relied on vasectomy for family planning. However, it is estimated that around 6% of these men who underwent vasectomy will ultimately seek vasectomy reversal for various reasons. Vasectomy reversal is the most cost effective option for couples desiring children after vasectomy and is the most challenging microsurgical procedures. This study presents local experience, outcomes and complications of microsurgical reconstruction of the male ductal system in the Philippines setting.

This is a retrospective study of 157 post-vasectomy patients who underwent microsurgical vasectomy reversal by a single surgeon from January 2001 to March 2024. Outcomes such as patency and pregnancy rates were documented and analyzed.

One hundred and fifty seven (157) underwent microsurgical vasectomy reversal. One hundred five (105) patients underwent bilateral microsurgical vasovasostomy. Forty eight (48) patients underwent combined microsurgical vasovasostomy and vasoepididymostomy. Three patients underwent bilateral vasoepididymostomy and one crossed microsurgical vasoepididymostomy (left to right). Four patients had no child, 87 patients had 1 child, 34 patients had 2 children, 29 had 3 children and 3 patients had 4 children prior to vasectomy. Age of wife was between 20 to 32 years old. Mean interval from vasectomy was 9 years. Vas deferens was patent in 120 (76%) of patients. Clinical pregnancy with successful delivery was achieved in 99 (63%) patients. There were only three who had postoperative hematoma (0.02%) and one developed surgical site infection (0.001%).

Microsurgical vasectomy reversal is an excellent option in men post vasectomy to achieve natural clinical pregnancy with minimal complications. The study confirms the effectiveness of male infertility microsurgery for vasectomized men who wish to father children.