Introduction: The COVID-19 pandemic accelerated the adoption of alternative instructional approaches, including distance and online learning. This study aimed to determine factors associated with preference for online learning modality among medical students at a private medical school in the National Capital Region (NCR). Methods: An analytical cross-sectional study was conducted among 367 medical students using convenience sampling. Participants completed an online survey assessing preferred learning modality, general anxiety, self-efficacy, and satisfaction with online learning. Factors associated with preference for online learning were identified using logistic regression analysis. Results: Most respondents (79.3%) preferred traditional face-to-face learning, whereas 20.7% preferred online learning. Male students were more likely to prefer online learning than female students (OR = 2.19, p = 0.003). Married students were more likely to prefer online learning than unmarried students (OR = 9.71, p = 0.021). Students who reported greater satisfaction with their online learning experience were more likely to prefer online learning (OR = 2.28, p = 0.024). Self-efficacy demonstrated a borderline association with preference for online learning (OR = 0.42, p = 0.053). Conclusion Sex, civil status, and satisfaction with online learning were significantly associated with preference for online learning modality. Self-efficacy demonstrated a borderline association. Despite the increased use of online learning during the COVID-19 pandemic, most respondents continued to prefer traditional face-to-face instruction.
Education ; Anxiety ; Self-efficacy

Introduction: Autoimmune polyendocrine syndrome (APS) type 4 is a clustering of at least 2 or more organ-specific autoimmune diseases in a single patient, which do not fall into other categories of APS, in combination with at least one more endocrine or non-endocrine organs. The multitude of autoimmune comorbidities and their associated treatment may contribute to osteoporosis and fracture. Case Description: A 35-year-old female with bilateral distal femoral pathologic fracture from an inch fall underwent bilateral, minimally invasive plate osteosynthesis. Pathologic fracture from secondary osteoporosis resulted from rheumatoid arthritis, chronic steroid use from rheumatoid arthritis (prednisone 10 mg for 24 months), premature ovarian failure since 20 years old without hormone replacement therapy, and possible Turner syndrome. She had persistently elevated thyroid-stimulating hormone in spite of high levothyroxine (4.25 μg/kg/day) dose; hence, gastric malabsorption from possible atrophic gastritis was likewise considered. Benefits and risks associated with treatment were reviewed to manage the patient holistically. Conclusion APS is a rare complex syndrome which may lead to various complications. Presence of hypogonadism, rheumatoid arthritis, and chronic steroid use further predisposes the development of secondary osteoporosis. Early screening and treatment of osteoporosis would have decreased the risk of development of fracture.
Fractures, Spontaneous ; Primary Ovarian Insufficiency ; Arthritis, Rheumatoid

BACKGROUND: The objective of this study was to determine the efficacy of liraglutide in reducing cardiovascular complications. METHODOLOGY: Literature searches of electronic databases (PubMed and ScienceDirect) were performed to identify relevant studies. Relevant journals included were electronically searched for randomized controlled trials (RCTs) regarding the use of liraglutide versus placebo in reducing the rate of cardiovascular complications. Data extraction and quality assess- ment were done by independent reviewers. Statistical analysis of the study was accomplished using Cochrane Systematic Review Software Review Manager. Mean difference was used to analyze a data set which used mean and standard deviation from the studies. A p-value of less than 0.05 for the observed effect size was considered statistically significant. RESULTS: A total of two RCTs with 16,977 patients were included in this meta-analysis. The results showed that in the lirag- lutide group, there is a statistically lower rate of the major adverse cardiovascular events (risk ratio [RR] 0.86 [0.78, 0.95]), cardiovascular events (RR 0.75 [0.63, 0.89]), and all-cause mortality (RR 0.81 [0.70, 0.93), but it is not statistically significant when compared to the placebo group in terms of non-fatal myocardial infarction and non-fatal stroke. There is no significant difference in rates of severe adverse events in general (p > 0.05). However, liraglutide caused significant reduction in rates of severe hypoglycemia as an independent secondary outcome (p < 0.05). CONCLUSION Compared with placebo, liraglutide provided a significant reduction in MACE, cardiovascular events, all-cause mortality and severe hypoglycemia as an adverse event.
Human ; Liraglutide ; Diabetes Mellitus, Type 2