INRODUCTION<p>Stroke is one of the top five leading causes of disability in the Philippines. It has a significant impact on the quality of life (QoL) of patients, particularly in the functional and psycho-emotional aspects. Thus, it is important to understand the health-related quality of life in stroke patients (HRQoLISP), which focuses on the clinical impact of the disease and disability. The assessment of a stroke patient’s QoL is prognostically significant as it can predict a patient’s treatment success and survival.p>OBJECTIVE<p>This study aims to translate the HRQoLISP-26 into Filipino and assess its content validity for Filipino adult stroke patients.p>METHODOLOGY<p>The HRQoLISP-26 was translated into Filipino using a forward translation protocol and an expert analyzed the forward translation. Selected expert committee members reviewed the first version to assess for content validity and the questionnaire was modified accordingly. The content validity index (CVI) was used for content validity.p>RESULTS<p>Majority of the revisions made were done to improve the semantic and grammatical accuracy of items in the Filipino version of the HRQoLISP-26. Only a few items had no revisions implemented. No revisions were done in the final version of the translated questionnaire as each item had a CVI of 1 indicating that it has good content validity.p>CONCLUSION<p>The Filipino translated HRQoLISP-26 questionnaire is a validated questionnaire that allows assessment of a stroke survivor’s QoL.p>
Quality Of Life ; Patients ; Life ; Health ; Adult ; Stroke

OBJECTIVES<p>Clinical pathways (CPs) ensure adherence to heart failure (HF) management guidelines. To optimize quality care in a low resource setting, an evidence-based care pathway for the management of acute HF was implemented at the emergency department (ED) of the Philippine General Hospital (PGH), the designated national tertiary hospital and referral center. This study aimed to describe the characteristics of adults with acute HF admitted at the ED and evaluate the quality of care they received, measured using physician adherence to the hospital’s acute heart failure CP.p>METHODS<p>This was a retrospective, descriptive cohort study. We reviewed the inpatient charts of all adult patients with acute HF admitted to the ED of the PGH and referred to the Division of Cardiovascular Medicine between December 1, 2022 and May 31, 2023. Quality of care was assessed based on adherence to quality indicators adapted from routine and conditional order sets detailed in the pathway. Descriptive statistics was utilized to describe patient characteristics, quality of care, and outcomes.p>RESULTS<p>Two hundred thirty-six (236) patients were included, with a mean age of 51.8 years. Majority were male (53.4%); hypertension (61.4%) and ischemic heart disease (53.8%) were the most common comorbidities, and infection the most common precipitant of decompensation (60.6%). There were optimal adherence rates to routine orders, which included referrals to Internal Medicine and Cardiology, baseline vital signs monitoring, fluid intake and output monitoring, chest radiograph, complete blood count, blood urea nitrogen, sodium, potassium, prothrombin time, partial thromboplastin time, arterial blood gas, urinalysis, and N-terminal pro b-type natriuretic peptide. Conditional orders, such as oxygen support, focused echocardiography, thyroid - stimulating hormone, and the use of vasopressors, diuretics, and venous thromboembolism prophylactic agents, were optimally performed when warranted. However, we noted suboptimal adherence to certain resource-intensive conditional orders, such as hourly monitoring of urine output (61.4%), hooking to cardiac monitor (53.8%), and performance of 12-lead ECG within 10 minutes (56.8%). Further, only 43.9% of patients were referred to the intensive care unit. Troponin I, calcium, magnesium, and albumin were ordered in excess.p>CONCLUSION<p>Overall adherence rate of physicians to the hospital’s Acute Heart Failure Pathway was satisfactory. Work is needed to improve adherence to hourly urine output monitoring, consistent hooking to cardiac monitor, and timely performance of 12-lead ECG – an effort that begins with expanding in-hospital diagnostic equipment and human resource supply. We recommend continuous pathway implementation with periodic evaluation and stakeholder feedback to further improve quality of care.p>
Human ; Male ; Female ; Middle Aged: 45-64 Yrs Old ; Adult ; Albumins ; Blood ; Blood Urea Nitrogen ; Calcium ; Cardiology ; Chart ; Charts ; Cohort Studies ; Critical Care ; Critical Pathways ; Diagnostic Equipment ; Disease ; Diuretics ; Echocardiography ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Equipment And Supplies ; Evaluation Studies As Topic ; Feedback ; Heart ; Heart Diseases ; Heart Failure ; Hormones ; Hospitals ; Hospitals, General ; Humans ; Hypertension ; Indicators And Reagents ; Infection ; Infections ; Inpatients ; Intensive Care Units ; Internal Medicine ; Lead ; Magnesium ; Male ; Medicine ; Myocardial Ischemia ; Natriuretic Peptide, Brain ; Natriuretic Peptides ; Nitrogen ; Overall ; Oxygen ; Partial Thromboplastin Time ; Patients ; Peptides ; Philippines ; Physicians ; Potassium ; Prothrombin ; Prothrombin Time ; Quality Of Health Care ; Referral And Consultation ; Sodium ; Statistics ; Tertiary Care Centers ; Thorax ; Thromboembolism ; Thromboplastin ; Thyroid Gland ; Time ; Troponin ; Troponin I ; Universities ; Urea ; Urinalysis ; Urine ; Venous Thromboembolism ; Vital Signs ; Work ; Workforce

Background: A new diagnostic framework for clinical obesity, proposed by the Lancet Commission, defines obesity as excess adiposity with organ dysfunction, offering a more functional assessment than traditional body mass index (BMI)-based classification. However, it has not been applied to Asian populations, where obesity-related complications arise at lower BMI thresholds. Methods: We analyzed 57,863 Korean adults aged ≥20 years from the 2014 to 2023 Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative, cross-sectional dataset. Clinical obesity was defined as excess adiposity with ≥1 obesity-related complication or functional limitation; preclinical obesity was defined as excess adiposity without complications. Age, sex, and temporal trends were examined and compared with BMI-based classifications using complex sampling weights and age-standardization. Results: The prevalence of clinical obesity and preclinical obesity was 31.2% and 8.1%, respectively. Among those with BMI-defined obesity (≥25.0 kg/m²), 20.1% had no complications, while 19.4% of overweight individuals (BMI 23.0–24.9 kg/m²) met clinical obesity criteria. Clinical obesity increased with age despite stable BMI, driven by metabolic and functional decline. Cancer prevalence was highest among individuals with clinical obesity (1.77%). Applying Western waist circumference cutoffs drastically reduced the estimated prevalence of clinical obesity to 13.1%. Longitudinal analyses showed a rising trend in clinical obesity over ime. Conclusion This is the first large-scale study to apply the clinical obesity framework in an Asian population. The framework identifies high-risk individuals missed by BMI al

Objective: On 18 October 2022, diarrhoeal cases among the Sama Badjao indigenous community in the Philippines were reported from a tertiary hospital in Lucena City, Quezon Province. An investigation was conducted to confirm the outbreak, profile cases, identify the source of infection, and recommend prevention and control measures. Methods: Suspected cases were identified through medical records review, active case finding and key informant interviews. Identified cases were interviewed using a structured questionnaire to collect demographic, clinical and exposure information. Rectal swabs and environmental water samples were collected for bacterial isolation and confirmation. Results: A total of 75 cases were identified, with 40 (53.3%) hospitalized and four fatalities (case fatality rate: 5.3%). Ages ranged from 2 months to 20 years (median: 4 years). Nine of the 15 rectal swabs were positive for Vibrio cholerae Ogawa biotype El Tor. The community practised open defecation, and only 24.7% of households had basic sanitation. Although V. cholerae was not found in water samples, faecal contamination was noted in a community well, and Aeromonas species were isolated, indicating the presence of multiple gastrointestinal pathogens. Discussion: A cholera outbreak was confirmed among the Sama Badjao community in Lucena City. Environmental assessment indicated that poor sanitation, open defecation and unsafe water sources likely contributed to the outbreak. The high case fatality rate (5.3%) was influenced by delayed care and limited health-care access. These findings emphasize the need for interventions to improve water, sanitation and hygiene practices and provide culturally appropriate public health programmes to reduce cholera risk among vulnerable communities.

BACKGROUND<p style="text-align: justify;" data-mce-style="text-align: justify;">The relationship between pandemics and climate change has emerged as a critical area of study, particularly underscored by the COVID-19 pandemic, which exposed vulnerabilities in global health systems and environmental governance. Although direct evidence linking climate change to the spread of COVID-19 remains limited, rising global temperatures and ecosystem disruptions have intensified human–wildlife interactions, increasing the risk of zoonotic disease emergence.p>AIMS AND OBJECTIVES:<p style="text-align: justify;" data-mce-style="text-align: justify;">This study aims to synthesize existing research on the interconnections between climate change and emerging infectious diseases, identify key knowledge gaps, and provide insights to guide integrated health and environmental policy development.p>MATERIALS AND METHODS<p style="text-align: justify;" data-mce-style="text-align: justify;">A systematic literature review was conducted using peer-reviewed articles published within the past two decades. Relevant studies were identified through scientific databases, focusing on evidence linking climate variability, ecosystem shifts, and zoonotic transmission dynamics.p>RESULTS<p>Findings indicate that climate-induced changes—such as rising temperatures, altered precipitation patterns, and habitat disruption—affect vector ecology and wildlife migration, facilitating conditions for pathogen spillover. However, existing research remains fragmented, with limited longitudinal analyses and region-specific data to quantify these associations.p>CONCLUSION<p style="text-align: justify;" data-mce-style="text-align: justify;">The interconnectedness of human health, environmental health, and biodiversity underscores the need for a holistic One Health approach. Strengthening interdisciplinary collaboration and integrating climate resilience into public health strategies are vital to addressing the multifaceted challenges posed by climate change and emerging pandemics.p>
Human ; Climate ; Climate Change ; Literature ; Pandemics ; Review

BACKGROUND AND OBJECTIVES<p style="text-align: justify;" data-mce-style="text-align: justify;">COVID-19 has quickly spread over the world and became an unprecedented burden on health care systems. COVID-19 diagnosis necessitates the use of precise testing methods such as RT-PCR. This method is generally reported as positive or negative, however, studies have shown its semi-quantitative capability through Ct values. This study determined an association that exists between the Ct values, clinical features, and laboratory findings among COVID-19 patients admitted in a tertiary infectious disease hospital in Manila, Philippines. This attempts to further explore the utility of RT-PCR in disease severity classification and diagnosis.p>METHODS<p style="text-align: justify;" data-mce-style="text-align: justify;">This was an observational retrospective study that utilized a purposive sampling method, wherein patients were selected based on the DOH case definition of confirmed COVID-19, and were stratified according to disease severity. Baseline laboratory data of the patients were gathered from medical records covering the period of June 2021 to January 2022 using a Data Collection Form. Chi-square test was used to measure the degree of association between the groups and categorical variables. Regression Analysis was used to identify predictors for certain variables. SPSS Statistics for Windows, Version 25.0 was utilized for the statistical analysis.p>RESULTS<p style="text-align: justify;" data-mce-style="text-align: justify;">The total WBC, neutrophil, lymphocyte and monocyte counts, serum urea, LDH, CRP and PTT were found to be predictors of COVID-19 severity. There was no significant difference observed between the disease severity and the patient’s clinical outcome. All routine laboratory tests that were taken at baseline (ORF Gene, N-Gene, Hematocrit, White Blood Cells, Neutrophil, Lymphocyte, Monocyte, Platelet Count, Urea, Creatinine, SGPT, SGOT, Na, K, LDH, Ferritin, C Reactive Protein, Procalcitonin, D-Dimer, PT, PTT) were not significant predictors of the clinical outcome. Although WBC, neutrophil, lymphocyte, and monocyte count, urea, LDH, CRP, and PTT were predictors  of disease severity. The study also reported that the odds of having severe to critical disease increases by 20.6% for every one unit increase in neutrophil count, and 17.4% for every one unit increase in lymphocyte count. Among the laboratory parameters, neutrophil count (p=0.010654063) and urea (p= 0.04149874 have direct relationship with the N gene Ct values while Orf gene Ct Values have direct relationship with lymphocyte count (p=0.01269027). Similarly, regression showed that as monocyte count, creatinine levels, and serum ferritin decrease, Ct values increase. Sex was found to not be a significant predictor of disease severity and clinical outcome. There was also no significant difference observed between the disease severity and the patient’s clinical outcome.p>CONCLUSION<p style="text-align: justify;" data-mce-style="text-align: justify;">The study showed that the Ct values for both ORF and N genes were not significant predictors of both disease severity and clinical outcome. However, ORF gene Ct values have direct relationship with lymphocyte counts while N gene Ct values have direct correlation with neutrophil count and urea levels. Similarly, monocyte, creatinine, and ferritin are negatively correlated with Ct values. It is important to monitor the patient’s laboratory biomarkers in order to determine the proper course of treatment and management for each case.p>
Human ; Sars-cov-2 ; Covid-19

OBJECTIVE<p style="text-align: justify;" data-mce-style="text-align: justify;">To describe the trend and landscape of Coronavirus Disease (COVID-19)-related publications in nursing authored by at least one Philippine-based author.p>METHODS<p style="text-align: justify;" data-mce-style="text-align: justify;">This study is a bibliometric analysis of documents retrieved from Scopus using the search terms “COVID-19” and “nurs*” in the article title, abstract, and keywords. The documents were limited to those published in English, affiliated with Philippine-based authors, and those published from 2020 to 2023. We used the ‘analyze report’ function in Scopus to analyze the data including the number of publications, types, sources, authors, and affiliations. We used VOSViewer for the co-authorship analysis of countries and co-occurrence analysis of author keywords.p>RESULTS<p style="text-align: justify;" data-mce-style="text-align: justify;">A total of 136 documents were found. Majority of these documents were classified as original articles (83%). There was a rapid increase in COVID-19 publications in nursing authored by at least one Philippine-based researcher published from 2020 to 2021 and plateaued from 2022-2023. Co-authorship analysis showed that Philippine-based authors have written documents with authors from 111 countries most notably from Saudi Arabia, the United States, Indonesia, and Australia. Most documents were published in the Belitung Nursing Journal. Authors from the University of Santo Tomas had the most publications. The most cited articles focused on psychosocial impacts, resilience, workplace stress, and online education. Author keywords commonly used in the documents were COVID-19, nursing, and nursing students, covering topics such as pandemic impacts, workplace impacts, nurse well-being, psychosocial impacts, and nursing education. Keywords have evolved through the pandemic period with a recent focus on stress and professional values.p>CONCLUSION<p style="text-align: justify;" data-mce-style="text-align: justify;">Philippine-based authors actively contributed in understanding the impact of COVID-19 on nurses and nursing education. Their scientific productivity was driven partly by their collaboration with foreign-based researchers. To sustain this trend in productivity and collaboration, policies, programs, and strategies are needed to promote, support, and foster research collaboration among local and international nursing researchers and institutions.
p>
Human ; Bibliometrics ; Covid-19 ; Nursing ; Philippines

BACKGROUND<p style="text-align: justify;" data-mce-style="text-align: justify;">The National Cochlear Implant Program (NCIP) is a national program to address the increasing prevalence of hearing loss, especially in the pediatric population here in the Philippines. In its pilot implementation, it included three tertiary hospitals to represent Luzon, Visayas, and Mindanao and was able to enroll 20 patients who successfully underwent cochlear implantation.p>OBJECTIVES<p style="text-align: justify;" data-mce-style="text-align: justify;">The aim of this study is to evaluate the auditory outcomes of the patients who underwent cochlear implantation under the NCIP using the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) Questionnaire and Categories of Auditory Performance (CAP) score questionnaire.p>METHODS<p style="text-align: justify;" data-mce-style="text-align: justify;">The study included all recipients of the cochlear implants, under NCIP from December 2019 to December 2021, except 1 with incomplete data during the course of his followup. The outcomes measured included the PEACH Questionnaire score and CAP Questionnaire score and were compared on various factors which included patient's sex and age, parents'  socioeconomic status, duration of hearing aid use prior to CI, pre CI imaging findings and CI electrode placement using nonparametric statistical tests .p>RESULTS<p style="text-align: justify;" data-mce-style="text-align: justify;">The mean PEACH score of the 19 patients was 53.59% ± 12.76% (range: 30% - 75%) while the mean CAP score was 3.16 ± 1.04 (range: 1 - 4.3). Parents of the included patients who have a higher educational background and those in which the electrode was located on the ideal location, scala tympani, have a statistically significant higher PEACH score (p-value of 0.017 and 0.012, respectively). In comparing the CAP scores, those who have unremarkable or normal preoperative imaging have a statistically significant higher score (p-value 0.013)p>CONCLUSION<p style="text-align: justify;" data-mce-style="text-align: justify;">Patients who had normal preoperative imaging, proper placement of electrodes and those patients with parents belonging to a higher educational background had statistically significant better auditory outcomes after cochlear implantation. Patients who had the cochlear implantation before 36 months of age and hearing aid use of 7 to 18 months prior to cochlear implantation had higher PEACH and CAP scores, however these were not statistically significant. Further studies with a larger sample size is recommended.p>
Cochlear Implantation

BACKGROUND AND OBJECTIVE<p style="text-align: justify;" data-mce-style="text-align: justify;">COVID-19 has been associated with cardiac injury, often detectable through electrocardiographic (ECG) changes. This study seeks to characterize the cardiovascular and electrocardiographic profiles of adult patients diagnosed with COVID-19.p>METHODS<p style="text-align: justify;" data-mce-style="text-align: justify;">This study included adult patients with confirmed COVID-19 from June 2021 to June 2022. Clinical profiles and 12-lead ECG tracings were obtained from electronic medical records and reviewed independently by three cardiologists. Descriptive analysis was performed to summarize the cardiovascular and electrocardiographic findings in this population.p>RESULTS<p style="text-align: justify;" data-mce-style="text-align: justify;">The study included 998 COVID-19 patients (mean age: 50 years; 53.7% male). The most common comorbidities were hypertension, diabetes, and dyslipidemia. A majority (31.36%) presented with severe COVID-19 infection. The most frequent significant ECG abnormalities observed at admission were sinus tachycardia (22.8%), and atrial fibrillation (11.02%). Additional ischemic findings included ST segment depression (2.91%), T-wave inversion (1.70%), and ST segment elevation (2.71%).p>CONCLUSION<p style="text-align: justify;" data-mce-style="text-align: justify;">The baseline ECG findings among COVID-19 patients were predominantly normal; however, significant abnormalities were also identified. The most frequent abnormalities included sinus tachycardia, atrial fibrillation, and ischemic changes, all of which may have clinical implications.p>
Human ; Coronavirus Disease 19 ; Covid-19 ; Electrocardiography ; Atrial Fibrillation

BACKGROUND<p style="text-align: justify;" data-mce-style="text-align: justify;">The Philippines has been significantly affected by the HIV epidemic in the Asia-Pacific region, with a notable increase in new cases over the past decade. Despite efforts to promote HIV testing, access to treatment, and awareness campaigns, progress has been slow, particularly among youths. Tangere, a market research application, conducted surveys during and after the COVID-19 pandemic to assess HIV knowledge among Filipinos.p>OBJECTIVES<p style="text-align: justify;" data-mce-style="text-align: justify;">This study aimed to evaluate changes in HIV awareness among young Filipinos during and after the COVID-19 pandemic using data collected via Tangere’s surveys. Specifically, it sought to analyze demographic characteristics, sources of HIV information, and knowledge regarding HIV transmission, prevention, and stigma.p>METHODS<p style="text-align: justify;" data-mce-style="text-align: justify;">Tangere collaborated with the investigators to develop a questionnaire assessing HIV knowledge among young Filipinos. Surveys were conducted during and after the COVID-19 pandemic, targeting subscribers aged 18-35 years, primarily from the National Capital Region and Luzon area. Data analysis involved calculating frequencies and percentages to summarize demographic characteristics and HIV knowledge. An Independent-Samples Proportions procedure was used to compare HIV knowledge during and after the pandemic.p>RESULTS<p style="text-align: justify;" data-mce-style="text-align: justify;">The survey revealed that while respondents generally possessed reasonable knowledge about HIV, there were notable changes in the awareness during and after the pandemic. Social media and television were identified as primary sources of HIV information. Knowledge regarding HIV transmission and prevention increased postpandemic, particularly concerning preventive measures such as pre-exposure prophylaxis (PREP) and motherto-child transmission (MTCT). However, persistent misconceptions and stigma surrounding HIV remained, indicating the need for continued education and advocacy efforts.p>CONCLUSION<p style="text-align: justify;" data-mce-style="text-align: justify;">The study underscores the importance of utilizing social media platforms for HIV awareness campaigns, especially among youths who are disproportionately affected by the epidemic. Despite improvements in knowledge, the Philippines has yet to achieve global HIV prevention goals. Continued efforts to enhance awareness, particularly regarding recent advancements in HIV prevention and treatment, are essential for curbing the epidemic and improving public health outcomes nationwide.p>
Human ; Knowledge ; Attitude ; Hiv ; Covid-19 ; Pandemics