Introduction: Staphylococcus aureus is the leading biofilmforming microorganisms in orthopaedic implant infections. The biofilms formed are difficult to eradicate and resistance to antibiotics. This current study aims to determine the effectiveness of povidone-iodine; an antiseptic solution in eradicating S. aureus biofilm on stainless steel alloy. In addition to the usual Colony-Forming Unit (CFU) used for verification, Scanning Electron Microscope (SEM) is used to validate the formation and eradication of the biofilms. Materials and methods: This is an in vitro study where the biofilm is formed by inoculating clinically isolated S. aureus, incubated for 24 hours onto stainless steel alloy 316L implants. The implants are then irrigated using povidoneiodine solution with varying concentrations (5 and 10%) and durations (30, 60, and 180 seconds). The anti-biofilm effect was evaluated using plating and SEM methods to confirm its effectiveness. The process is repeated after 24 hours of postirrigation reincubation to detect any rebound growth. Results: No biofilm seen after irrigation with povidoneiodine at 5% and 10% concentrations at 30, 60 and 180 seconds, respectively, in both CFU count and SEM. This result is replicated after 24 hours of reincubation, in assessing for rebound growth. Conclusion: Our study supports that a minimum of 5% povidone-iodine with a minimum irrigation time of 30 seconds are effective at eliminating S. aureus biofilm on stainless steel alloy implants. Both CFU count and SEM yield similar value in validating the presence of biofilm. Additionally, SEM allows visualisation of the morphology of the biofilm.

OBJECTIVES

Timely access to appropriate levels of care is essential for improving maternal, newborn,
and child health outcomes. To address persistent service delivery fragmentation and strengthen referral systems, the Philippine Department of Health issued Administrative Order 2020-0019 to guide the design of Health Care Provider Networks (HCPNs) under the Universal Health Care Act of 2019. This study assessed the extent to which sixteen municipalities across four provinces in Eastern Visayas comply with the HCPN service delivery guidelines in the context of maternal and newborn care.

The study employed a descriptive cross-sectional mixed-methods design, utilizing structured facility checklists to assess compliance with HCPN standards. Qualitative data were gathered through key informant interviews and focus group discussions with purposively selected stakeholders—decision makers, health personnel, and mothers—to contextualize findings. A three-lever framework for integrated care (policy, operational, and cross- cutting) guided the analysis

The findings revealed significant gaps between the current capacities of study health facilities and the requirements outlined in the HCPN guidelines. Major gaps included (1) weak cooperative governance mechanisms to support network-wide coordination; (2) limited systematic linkages between facilities, including fragmented referral protocols and non-interoperable health information systems; (3) inadequate investments in infrastructure, health human resources, and medical commodities; and (4) absence of performance monitoring systems across HCPNs.

BACKGROUND AND OBJECTIVE

Randomized controlled trials (RCTs) are essential for advancing evidence-based healthcare by evaluating the effectiveness and safety of health interventions. Despite the increasing recognition of clinical research, the Philippines has had limited contributions to global RCT output. This bibliometric analysis aims to assess the trends, characteristics, and impact of RCTs conducted in the Philippines and published online.

A systematic search of Medline (PubMed), and EMBASE, along with Acta Medica Philippina, was conducted to identify published RCTs from January 1990 to October 2022. Eligible studies were screened and analyzed based on publication trends, funding sources, study designs, research settings, and institutional contributions. Descriptive statistics were used to summarize key findings.

A total of 391 RCTs were identified, with a notable increase in number of RCTs published over time. Most studies (91.8%) were published in international journals, and funding was primarily sourced from pharmaceutical companies (47.1%). The predominant RCT design was two-arm parallel (64.7%), with hospitals being the most common research setting (54.2%). Research areas were led by infectious diseases, particularly vaccine-preventable illnesses (23.8%). While the University of the Philippines Manila (21.1%) and the Research Institute for Tropical Medicine (13.7%) were the leading institutions in terms of highest number of published RCTs, foreign authors accounted for nearly half (47.3%) of primary authorships. The most cited studies focused on cardiovascular diseases, infectious diseases, and oncology.

The increasing number of published RCTs in the Philippines reflects growth in research capacity and institutional engagement. Strengthening national research dissemination platforms and fostering regional collaborations will be essential in advancing the Philippines’ contribution to global clinical research.

Background: s/Aims: Hepatocellularcarcinoma (HCC) is the most common form of liver cancer, with high mortality rates worldwide. The optimal treatment strategy for patients with multinodular early-stage HCC (BCLC-A) is still controversial, particularly regarding liver resection (LR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). This meta-analysis aims to evaluate the overall survival (OS) and disease-free survival (DFS) in patients with multinodular BCLC-A HCC treated with LR compared to RFA and TACE. Methods: A systematic literature review and meta-analysis were performed by searching PubMed, Embase, and the Cochrane Library for studies comparing LR with RFA and TACE. Pooled analyses of OS and DFS were performed using hazard ratios (HR) with 95% confidence intervals (CI). Results: Fifteen studies, including two randomized controlled trials and 13 cohort studies, with a total of 2,869 patients, were included. LR was significantly associated with improved OS (HR, 1.38; 95% CI, 1.03-1.84; P=0.01) and DFS (HR, 2.16; 95% CI, 1.26-3.70; P=0.001) compared with RFA. Similarly, LR demonstrated superior OS (HR, 2.11; 95% CI, 1.37-3.25; P<0.0001) and DFS (HR, 2.77; 95% CI, 1.04-7.36; P=0.04) when compared with TACE. The more pronounced benefit observed for DFS likely reflects improved local tumor control achieved with surgical resection. Conclusions In selected patients with multinodular BCLC-A HCC and preserved liver function (predominantly Child-Pugh A or B), LR is associated with significant improvements in OS and DFS compared with RFA and TACE when liver transplantation is not feasible. These findings support reconsideration of current treatment algorithms to prioritize LR in appropriately selected candidates.

BACKGROUND: Upon injury, tissue repair often leads to a loss in functionality, organisation, and structure. The immune system, particularly macrophages, is crucial during tissue healing. Macrophages polarise into pro-inflammatory M1 and anti-inflammatory M2 subsets, regulating various stages of tissue healing. Macrophages steer fibroblasts in the process of extracellular matrix degradation, synthesis, and rearrangement. However, the direct role of paracrine signalling by different macrophage phenotypes on fibroblast-induced structural tissue remodelling remains elusive. Therefore, this study aimed to explore how paracrine factors from M1, M2a, and M2c macrophages affect fibroblast remodelling abilities in an in vitro model system. METHODS: Macrophages were polarised in vitro, and their conditioned medium or cytokine-enriched medium containing specific macrophage-secreted factors was added to fibroblast-populated reconstituted collagen tissues. RESULTS: Macrophage-conditioned media led to changes in fibroblast-induced tissue compaction for all macrophage subsets. The presence of macrophage polarising factors in the conditioned medium, particularly LPS/IFNc, and high serum levels directly affected tissue compaction and matrix remodelling gene expression. Without these confounding factors, M1 cytokine-enriched medium led to reduced tissue compaction when compared to M2a/M2c cytokine-enriched media. MMP activity analysis showed that matrix degradation likely contributed to tissue compaction. CONCLUSION Factors secreted by M1 macrophages resulted in reduced tissue compaction compared to M2a/M2c macrophages in an in vitro model of tissue remodelling, suggesting a diminished capacity for fibroblasts to remodel the extracellular matrix. Importantly, factors to polarize macrophages and serum are regarded as confounding factors in studying the effect of paracrine signalling by macrophages on tissue remodelling.

Introduction: Accurate weight measurement is critical for assessing growth and nutritional status in children, yet errors due to equipment can affect reliability. This study evaluated reliability of weight measurements obtained by community health workers using four weighing tools: SECA model 878, NutriScale Digital, Tanita model HD-662, and mechanical hanging infant weighing scale. Methods: A cross-sectional study was conducted in two municipalities in Laguna, Philippines, where three pairs of end-users measured weight of 80 children aged 0-59 months in house-to-house and stationary setups across rural and urban areas. Inter- and intra-measurer reliability were assessed using correlation coefficients (CC), technical error of measurement (TEM), and coefficient of variation (CV). Benchmark values included TEM <0.1 kg and acceptable %TEM thresholds (≤1.5% intra-measurer; ≤2% inter-measurer). Results: All four tools demonstrated acceptable reliability. NutriScale and Tanita consistently recorded the lowest TEM and %TEM values across settings, followed by SECA, which also met acceptable standards. Variability in measurements, however, was observed between house-to-house and stationary setups, particularly in rural areas. Differences in tool performance appeared influenced not only by the device characteristics but also by contextual factors such as measurer consistency, child’s age, and environmental conditions. Conclusion: Although NutriScale and Tanita showed higher consistency, measurement accuracy cannot be attributed to the scale alone. Field variability, proper calibration, and adequate measurer training remain critical for reliable assessments. Future research with larger samples and age stratification is recommended to better evaluate scale performance and inform tool selection for community-based programmes such as Operation Timbang (OPT).

Introduction: Residential settlement is seen as a contributing factor to the diet of children. This study aimed to investigate infant and young child feeding (IYCF) practices between coastal and inland communities of Camarines Sur, Philippines. Methods: A descriptive cross-sectional study was conducted among 628 caregivers of infants and young children aged 0-23.9 months. Socio-demographic data were gathered. IYCF practices were assessed through face-to-face interviews using a list of indicators from World Health Organization guidelines. Descriptive and inferential statistics using chi-square test of association were done. Results: The majority of children were breastfed (coastal=97.1%; inland=96.8%; p=0.83), with most breastfed within 1 hour after birth (coastal areas 85.3%; inland areas 86.7%). However, the practice of exclusive breastfeeding for 6 months was low for both areas (57.0% and 47.0%, respectively, p=0.58). Minimum meal frequency, continued breastfeeding until 23.9 months, and appropriate complementary feeding for children 6-8 months were also low in both areas. Meanwhile, unhealthy food consumption (inland: 85.4%; coastal: 79.8%) and zero consumption of vegetables or fruits were higher in inland areas. Consumption of meat products and sweet beverages was observed to be higher in coastal areas (coastal: 26.8%; inland: 16.9%). Conclusion: Minimal differences were seen in IYCF practices of caregivers between coastal and inland communities. However, the study found a notable difference in the consumption of sweet beverages, where coastal areas had significantly higher rates. This suggests that interventions must be made to educate caregivers to improve the diets of infants and young children

OBJECTIVES

Adiposity rebound (AR), the childhood period at which body mass index (BMI) rises from its lowest point, is linked to increased risk of later obesity. The study aims to determine the average age at AR, describe baseline characteristics and analyze the correlation between these characteristics and timing of AR in a population of Filipino pediatric outpatients.

Seven subjects born between 2016 and 2019 from a University Hospital Outpatient Department participated in this cross-sectional analytic study. Childhood anthropometrics were retrospectively collected to determine the age at AR by plot visual inspection. Sex, birth weight and gestational age were obtained from hospital records; breastfeeding duration, maternal BMI, parental obesity, maternal age, maternal smoking, education, parity and family income were gathered through a questionnaire completed by mothers or guardians. Associations were assessed using bootstrap univariate linear regression.

The mean age at AR was 3.2 years (SD = 1.2). Vaginal delivery was significantly associated with later age at AR compared to cesarean section (p = 0.035). Socioeconomic status at ages 2 to 5 showed positive association with delayed AR. Higher monthly family income (≥₱19,000) at ages 2 to 5 years was significantly associated with delayed age at AR. Other baseline childhood and parental factors showed no significant correlation with age at AR.

These results highlight the complex and context-dependent nature of AR, emphasizing the need for further studies to better understand and mitigate early obesity risk in Filipino children.

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.

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.

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.

INRODUCTION

The growing misuse of antibiotics and the escalating threat of antibiotic resistance in the Philippines pose significant public health concerns. While various Knowledge, Attitudes and Practices (KAP) questionnaires on personal antibiotic use have been employed in local studies, none have been fully validated and a standardized, culturally appropriate tool remains lacking.

This study aims to develop a Filipino-translated and culturally adapted KAP questionnaire on personal antibiotic use (KAPQ-PAU-FIL) and evaluate its validity and reliability.

The research consisted of two phases. The first phase is the translation and cross-cultural adaptation of the original questionnaire in collaboration with the UST Sentro sa Salin at Araling Salin. The second phase is the validity and reliability testing of the KAPQ-PAU-FIL using a sample of 176 Filipino adults. This included assessment of its face validity, content validity, construct validity, internal consistency, test-retest reliability and equivalent forms reliability.

Most items were translated without difficulty, though four items were modified to better fit the linguistic and cultural context. The KAPQ-PAU-FIL demonstrates strong psychometric properties, with face validity (SFVI/Ave = 0.99), content validity (SCVI/Ave = 0.99), construct validity (CFI = 0.92, RMSEA = 0.06, SRMR = 0.04; FL = 0.60-0.85; ITC = 0.58-0.71), test-retest reliability (ICC = 0.83), internal consistency (α = 0.929) and equivalent forms reliability (p>0.05; κ = 0.62-0.74).

The KAPQ-PAU-FIL is the first ever, Filipino-translated, culturally adapted questionnaire designed to assess KAPQ-PAU-FIL, demonstrating strong validity and reliability to support public health programs against antibiotic misuse.