Introduction: Peripheral Artery Disease (PAD) is a significant marker of cardiovascular disease and is prevalent but underdiagnosed. Ankle-Brachial Index (ABI) is the recommended screening test for PAD. However, not all clinics have a Doppler ultrasound. ABI by palpation offers a more feasible alternative. Objective: This study aims to determine the validity of ABI measurement by palpation method in the screening of PAD. Methodology: This prospective validation study utilized a cross-sectional analytic design. Three physicians performed the ABI by palpation method and their result was compared to the Doppler ABI. The accuracy indices for validation was computed per physician conducting the ABI by palpation and also as an average of all 3 palpation method readings. During the course of sampling, there were no patients with severe PAD found during the prospective period. Results: The accuracy of Ankle Brachial Index using Palpation method yielded the following ranges, sensitivity between 63.16 % - 73.68%, specificity of 94.06% - 98.02%, PPV within 85.37% - 95.45%, and NPV within 80.73% - 86.84% in predicting PAD. The accuracy indices were clinically acceptable. Meanwhile, the raters’ usage of Ankle Brachial Index using Palpation method demonstrated a substantial agreement with ABI by Doppler Method performed by the angiologist (Cohen Kappa >0.60). Conclusion The ABI by palpation is a good screening tool for PAD, but the person performing it must be adequately trained to do the procedure. The procedure is affordable and convenient, and should be done routinely during clinic visits in the physical examination of patients with known risk factors for PAD.
Diabetes Mellitus ; Ankle Brachial Index ; Palpation

Objective: This study aims to determine the prevalence of sexual dysfunction among premenopausal Filipino women with type 2 diabetes mellitus at the outpatient department of a tertiary hospital through the use of the Female Sexual Function Index (FSFI) and identify factors that could be associated with sexual dysfunction. Methodology: Seventy-five women with type 2 diabetes mellitus, aged 38 to 49 years old, received the FSFI questionnaire. Their age, history of hypertension, smoking habit, alcohol intake, body mass index, waist circumference, fasting blood sugar, HbA1c, creatinine, lipid profile, albuminuria or proteinuria, presence of microvascular complications such as diabetic retinopathy, neuropathy and nephropathy and their association with sexual dysfunction was determined. Results: Seventy-two percent of the participants have sexual dysfunction scoring lowest in the lubrication, orgasm and pain domains. Age (p=0.016), a high body mass index (p=0.001), a fasting blood sugar above 100 mg/dl (p=0.006) and the presence of microvascular complications of diabetes mellitus namely, retinopathy (p=0.046) nephropathy (p=0.004) and neuropathy (p=0.001) were associated with sexual dysfunction. Conclusion The prevalence of sexual dysfunction is high among premenopausal Filipino women with type 2 diabetes mellitus, and is associated with age, a high body mass index, an uncontrolled fasting blood sugar and the presence of microvascular complications of diabetes mellitus.
Diabetes Mellitus, Type 2 ; Premenopause ; Diabetic Neuropathies ; Diabetic retinopathy ; Diabetic Nephropathies

A 19-year-old Filipino male presents with recurrent respiratory tract symptoms every 4 to 5 months since childhood and sudden onset of diabetes type 1 with ketoacidosis. He had patchy hair loss which started at 7 years old, and was diagnosed with alopecia universalis. Thyroid antibodies and 21-hydroxylase antibody were normal. Common Variable Immunodeficiency with Polyglandular Autoimmune Syndrome IV was considered. The patient is on monthly intravenousimmunoglobulin therapy and basal bolus insulin regimen.
Common Variable Immunodeficiency ; Diabetes Mellitus

BACKGROUND

The Influenza Pandemic has made the world health authorities vigilant for the next pandemic. The First cases of the Novel Influenza A(H1N1) in Mexico infected 5,000 people in a span of 40 days. On May 22, 2009, the first case was reported in the Philippines. The rising incidence of people affected by this disease in several regions of the world prompted the WHO to declare a “pandemic”. The mounting number of affected people in the Philippines lead the Makati Medical Center to start a surveillance program.

To describe in an epidemiologic prespective the cases managed at the MMC.

This is a descriptive observational study of patients with suspected or confirmed influenza A (H1N1) infection treated at the Makati Medical Center. The study period was from May 3, 2009 to July 4, 2009. Patient consults were trended and analyzed. Confirmed cases were patients with nasopharyngeal throat swab specimens that tested positive for Influenza A (H1N1) by Real Time Reverse Transcription Polymerase Chain Reaction (PT-PCR). Demographics were presented.

There were 548 patients seen at the MMC who were suspected of being infected with Influenza A (H1N1). Two hundered sixty (47%) were confirmed to be positive for the Influenza A(H1N1) infection. The reported cases were distributed in Cities around Makati and near by provinces. Most patients seen were aged 19 to 49 years. One hundred seventy one (66%) of cases had no travel history or exposure to patients with known cases of Influenza A (H1N1). Most common presenting symptoms are fever, couh, nasal congestion and sore throat. Most of the cases were treated as outpatient (89%) and only 16% were treated with oseltamivir. Only 1 out of the 260 confirmed cases expired.

There is a heightened health-awareness among Filipino communities. The Makati Medical Center cohort shows the value and importance of multi-sectoral collaboration. The MMC data provided clinical evidence of a community level transmission. A great number of patients in the cohort was treated as out-patient without anti-viral therapy.