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.

Carotid web was described more than 50 years ago as an atypical fibromuscular dysplasia (FMD) subtype with highly supporting pathological evidence as intimal FMD. In the following decades, the transition from catheter angiography or digital subtraction angiography (DSA) to non-invasive imaging techniques and the dramatic decrease in pathological procedures contributed to the gradual loss of this information. Currently, attention on the carotid web has increased due to its association with cryptogenic ischemic stroke. In fact, the underlying hypothesis is that the morphological features of the carotid web may determine a thrombogenic potential with artery-to-artery embolism. The pathology of the carotid web allowed identification of small thrombi embedded in the web pouch, and the features of thrombi endovascularly retrieved from intracranial arteries are very similar. The diagnosis of carotid web is usually made by non-invasive techniques, such as computed tomography angiography, ultrasound, and magnetic resonance imaging, requiring the concordance of two different techniques for confirming the diagnosis. DSA is usually considered in cases of diagnostic uncertainty and when interventional treatment of ischemic stroke or carotid web is considered. Treatment options in symptomatic cases include medical therapy (single or dual antiplatelets) or interventional approach (surgery or stenting), but there are no randomized controlled trials about therapy. The main aim of this review is to present the current knowledge on carotid web, retrieving historical data and angiographic classifications of FMD, as well as to discuss the biological plausibility of the association with stroke in symptomatic cases and the need for an updated classification of FMD, together with prospective data.

BACKGROUND

Pediatric dermatoses are multifactorial and diverse. Environmental factors play a significant role in skin disease. This study described the prevalence of common dermatoses among pediatric population seen at a tertiary referral center in Pangasinan.

This was a 4-year retrospective, single center, chart review study in a tertiary referral hospital in Pangasinan. The researchers reviewed both electronic and medical charts of all pediatric outpatient and inpatient referrals with dermatoses from January 1, 2019 to December 31, 2022 by utilizing Proportion sampling technique.

This study reviewed a total of 501 (Males, 49.5% and Females, 50.5%) outpatient and inpatient pediatric patients who consulted due to skin related concerns. The majority of the patients were school-age children and adolescents followed by newborns, infants and toddlers respectively. Scabies infestation (n=76, 15.2%), Acne vulgaris (n=53, 10.6%) and Atopic dermatitis (n=48, 9.6%) were the top 3 common dermatoses among pediatric age groups. Scabies was the top diagnosis for both male (n=37, 14.9%) and female (n=39, 15.4%). Acne vulgaris (n=50, 31.6%) was the most common diagnosis in the adolescent age group.

There was wide variation in the most common dermatosis according to age, sex, and year. Poor sanitation, overcrowding and low socioeconomic status are important factors for the increased prevalence of parasitic infestations. Acne vulgaris was seen almost exclusively in adolescents. This study served as a preliminary epidemiological report on pediatric dermatoses in Region 1 Medical Center that may pave the way for well-controlled and better designed researches in the future.

BACKGROUND

Scabies, recognized as one of the neglected tropical diseases (NTDs) by the WHO continues to persist in our locality today. Health education emerges as an indispensable tool, aimed at enhancing the knowledge, attitudes, and practices (KAP) of Barangay Health Workers (BHWs). As the primary frontliners in our community, they encounter a wide array of skin conditions, but often lack the resources to manage them effectively.

The primary objective of this study is to assess the impact of health education on the KAP of BHWs concerning Scabies infestation.

A quasi-experimental, one-group pre-test-post-test design assessed the effectiveness of a 30-minute face-to-face lecture on BHWs’ KAP regarding Scabies infestation in the community. The study was conducted on April 25, 2023 at the Dagupan City Health office utilizing random population sampling.

The study included 45 BHW participants, 71.11% of whom had prior Scabies knowledge mainly from seminars/training (42.22%). Initially, most had poor baseline knowledge. Less than half (46.67%) identified skin manifestations and treatment accurately. Most displayed positive attitudes toward environmental management (91.11%) and fomite infection control (77.78%). After the lecture, the participants' total scores increased.

BHWs bridge the gap between healthcare and underserved populations. Equipping them with knowledge of diseases such as Scabies is imperative. This underscores the effectiveness of health education in enhancing their KAP towards Scabies. By empowering them, we can reduce the impact of NTDs in vulnerable communities. These findings have potential implications for future training programs, awareness campaigns, and further studies involving healthcare workers.

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by extreme immune activation, resulting in pathologic inflammation that may be life-threatening. Early recognition is crucial since survival largely depends on early initiation of treatment which utilizes a combination of chemotherapy, immunotherapy and in some cases even bone marrow transplantation.

OBJECTIVES: This study aims to describe the clinical characteristics, treatment received and outcome of patients diagnosed with HLH at the Philippine Children’s Medical Center from 2004 to 2017.

METHODS: A retrospective analysis of records of children 0 -18 years of age diagnosed with HLH from January 2004 to December 2017 was done.

RESULTS: A total of 39 patients were included in the study which gave an incidence of 1.22 per 3000 patients admitted under 18 years of age. There were 29 males (74.4%) and 10 females (25.6%) with a male to female ratio of 2.9:1 Mean age was 6.12 ± 3.89 years. The average time from initial presentation to diagnosis was 6 weeks and 2 days. The most commonly seen clinical and laboratory features observed in these patients were fever (100%), splenomegaly (71.8%), anemia (87.17%), thrombocytopenia (79.48%) and hypertriglyceridemia (69.23%). Only 5 patients were confirmed to be familial HLH with 3 having XLP gene mutation, and one each having syntaxin and perforin gene mutations. Majority of patients received a combination of treatment based on the HLH 2004 regimen while almost one third only received antibiotics. Only 23% of patients survived during the study period and all but one of these patients received drug combinations based on the HLH 2004 protocol.

CONCLUSION: HLH is a rare but important condition that must be recognized early and treated appropriately to optimize survival. The mortality rate of 39 patients seen in this institution is high. There is a need to better utilize the diagnostic criteria of the disease and to employ a more uniform treatment strategy. Increasing awareness among health care personnel can also improve case finding, characterization and treatment.

BACKGROUND

Gestational diabetes mellitus (GDM) may increase fetal abdominal fat mass, but its correlation with fetal abdominal circumference (AC) is inconsistent. This study compares third trimester fetal AC between adult pregnant patients with and without GDM, and between those managed with diet modification alone versus insulin therapy.

This retrospective cohort study involved 354 Filipino adult pregnant patients at The Medical City admitted for delivery from January 2016 to May 2022. This included 180 patients with GDM, and 174 patients without GDM. One hundred sixteen (116) of the GDM patients were diet-managed, and 64 were insulin-requiring. Participants underwent third trimester fetal AC ultrasound and 75-gram oral glucose tolerance test (OGTT) between 24 to 28 weeks of gestation. The third trimester fetal AC, fetal outcomes and maternal outcomes between patient groups were analyzed using Stata 15.0.

The GDM group had higher rates of cesarean section delivery (70% vs 46.55%, pCONCLUSION

Third trimester fetal AC is significantly larger in women with GDM compared to non-GDM women, regardless of management method. Monitoring fetal AC during the third trimester is important for prenatal care in GDM pregnancies.

Overlap syndrome is a rare condition involving the coexistence of at least two distinct autoimmune diseases, such as systemic lupus erythematosus and systemic sclerosis. This condition has limited studies on epidemiology probably because it is often under-recognized. We present a 22-year-old Filipino female with a 10-month history of hyperpigmented patches on the malar surface and extremities, with associated photosensitivity, fatigue, pallor, arthralgia, and oral ulcers, and positive antinuclear antibody titer. She was treated with oral Prednisone in tapering doses, leading to clinical improvement. Eight months later, there was a recurrence of hyperpigmented patches on the face and extremities with skin tightening and diffuse hair loss, development of shiny skin with facial fold loss, a beak-like nasal appearance, and episodes of dyspnea and malaise. Consistent with scleroderma, the patient was started on mycophenolate mofetil (MMF) 500 mg daily, with close monitoring for disease progression and systemic involvement. Overlap syndrome remains under-recognized due to its variable presentation and rarity. Treatment is individualized based on the specific connective tissue diseases involved and the patient’s symptoms. Multidisciplinary care is crucial for timely management and to adjust treatment as needed, given the potential for life-threatening complications involving cutaneous and internal organs.

Carotid web was described more than 50 years ago as an atypical fibromuscular dysplasia (FMD) subtype with highly supporting pathological evidence as intimal FMD. In the following decades, the transition from catheter angiography or digital subtraction angiography (DSA) to non-invasive imaging techniques and the dramatic decrease in pathological procedures contributed to the gradual loss of this information. Currently, attention on the carotid web has increased due to its association with cryptogenic ischemic stroke. In fact, the underlying hypothesis is that the morphological features of the carotid web may determine a thrombogenic potential with artery-to-artery embolism. The pathology of the carotid web allowed identification of small thrombi embedded in the web pouch, and the features of thrombi endovascularly retrieved from intracranial arteries are very similar. The diagnosis of carotid web is usually made by non-invasive techniques, such as computed tomography angiography, ultrasound, and magnetic resonance imaging, requiring the concordance of two different techniques for confirming the diagnosis. DSA is usually considered in cases of diagnostic uncertainty and when interventional treatment of ischemic stroke or carotid web is considered. Treatment options in symptomatic cases include medical therapy (single or dual antiplatelets) or interventional approach (surgery or stenting), but there are no randomized controlled trials about therapy. The main aim of this review is to present the current knowledge on carotid web, retrieving historical data and angiographic classifications of FMD, as well as to discuss the biological plausibility of the association with stroke in symptomatic cases and the need for an updated classification of FMD, together with prospective data.