OBJECTIVES

A growing body of evidence points to a positive association between periodontitis and
various systemic diseases, including cardiovascular diseases (CVD), hypertension, and rheumatoid arthritis. However,
there is limited data on the prevalence and odds of having systemic conditions among Filipino periodontal patients.
Thus, this study aimed to determine the association of periodontal disease with systemic conditions among Filipino
patients at a university dental clinic.

METHODS

The periodontal and medical charts of all patients who underwent periodontal consult at a university
dental clinic within two academic years were reviewed. Periodontal diagnoses which had originally been assigned
using the 1999 classification of periodontal diseases were reclassified based on the 2018 European Federation
of Periodontology-American Academy of Periodontology classification. Listed medical conditions in the patients’
charts were self-reported. The prevalence of various systemic conditions in 715 periodontitis cases was compared
to that of 834 control patients without periodontitis. Fisher’s exact test was performed to evaluate the difference
in the prevalence of comorbidities between groups, while adjusted odds ratios (AOR) were computed using logistic
regression analysis, accounting for age, sex, educational attainment, and smoking status.

RESULTS

The prevalence of having at least one systemic condition was significantly higher among periodontitis patients
(44.5%) compared to non-periodontitis patients (36.3%). Compared to controls, a significantly higher number of
periodontitis cases had two systemic comorbidities (P=0.001). The prevalence of hypertension (18.6% versus 5.04%),
CVD including hypertension (20.42% versus 6.95%), arthritis (9.37% versus 3.0%), and diabetes mellitus (5.73% versus
0.84%) were all significantly higher in patients with periodontitis compared to non-periodontitis controls.
The odds of having CVD (AOR=1.81), hypertension (AOR=2.14) and diabetes (AOR=3.05) were higher in periodontitis cases. Meanwhile, the prevalence of asthma (9.23% versus 5.31%), respiratory diseases including asthma (12.95% versus 8.25%), and allergies (18.82% versus 13.71%) were significantly higher in non- periodontitis patients compared to periodontitis cases.

CONCLUSION

Periodontitis patients were more likely to present with CVD, hypertension, and diabetes mellitus. On the other hand, no association was found between periodontitis and respiratory diseases, as well as between periodontitis and asthma.

Human ; Male ; Female ; Adolescent: 13-18 Yrs Old ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Regression (psychology) ; Respiratory Tract Diseases ; Regression Analysis ; Periodontal Diseases ; Cardiovascular Diseases

OBJECTIVES

his quantitative cross-sectional study aimed to determine the level of knowledge, attitude, and practices
regarding COVID-19 vaccination of unvaccinated adult patients admitted at Region II Trauma and Medical Center
(R2TMC). This may help determine the knowledge gap regarding COVID-19 vaccination, address it, and to achieve
the goal to vaccinate all eligible Filipinos. Furthermore, this may also be a springboard for future researches and
management regarding novel infections needing new vaccinations.

METHODS

Collected data from the sample size of 197 using the formula for finite population with 95% confidence
level, population proportion of 50%, population size of 400, allowing 5% margin of error were summarized in a
Microsoft excel database and tables, then were analyzed using Jamovi version 2.6.22 software. Frequency, mean,
and standard deviation were calculated to measure the knowledge, attitude, and practices; Pearson correlation and
Kendall’s Tau b correlation for its relationship.

RESULTS

There is moderate level of knowledge (MS: 9.80-11.8), a positive attitude (MR: 2.35-2.60), and good preventive
practices (MS: 12.00-13.00) regarding SARS-CoV-2 (COVID-19) vaccination among the unvaccinated adult in-patients
of R2TMC post-pandemic. Knowledge, attitudes, and practices statistically differed (pCONCLUSION

There is a significant correlation among the knowledge of the respondents about COVID-19 vaccination,
their attitude towards it, and their practices, implying that promoting preventive behaviors toward COVID-19 would
require promoting both knowledge and efficacy beliefs among the public.

Human ; Bacteria ; Male ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Wounds And Injuries ; Population Density ; Cross-sectional Studies ; Forecasting ; Sars-cov-2 ; Sars Virus ; Covid-19

BACKGROUND

Otomycosis, or fungal infection of the ear, is most commonly caused by Aspergillus, particularly of the Aspergillus niger species. On the other hand, pulmonary aspergilloma is a late manifestation of chronic cavitary pulmonary aspergillosis. Development of invasive aspergillosis is a possibility in immunocompromised patient but very rarely seen in immunocompetent persons. There have been no published reports in patients who initially presented as otomycosis and later development of pulmonary aspergilloma.

CASE PRESENTATION

This case report presents 53-year-old Filipino immunocompetent female who was initially presented with ear discharges with diagnosed with otomycosis. She underwent modified radical mastoidectomy of the right ear with tympanoplasty type II. The patient then developed right facial nerve palsy due to erosion of the facial nerve canal. She was discharged with a final diagnosis of chronic suppurative otitis media with cholesteatoma; however, patient was not started on any anti-fungal medications. After fourteen months, the patient presented with episodes of hemoptysis and dyspnea and eventually re-admitted. Diagnostic work up was done with chest CT scan and serum galactomannan antigen test. She was diagnosed to have pulmonary aspergilloma. Patient was then started on long term anti-fungal therapy, instead of invasive surgical procedure. Repeat chest CT scan after six months showed a decrease in the size of the fungal ball.

CONCLUSION

This study illustrates the lung aspergilloma may happen with preceding history of invasive otic fungal infection even if there is no immunocompromised condition. It also emphasizes the importance of proper identification of infection etiology to ensure adequate control and prevent further opportunistic infection.

Human ; Fungi ; Female ; Middle Aged: 45-64 Yrs Old ; Aspergillus Infection ; Aspergillosis ; Otomycosis

Symplastic leiomyoma is a rare type of leiomyoma diagnosed histologically by the presence of bizarre cells and nuclear atypia. It is difficult to diagnose preoperatively due to its overlapping clinical presentation and ultrasound features with typical leiomyomas. This paper presents a case of a 52-year-old woman who consulted due to right lower quadrant pain and abdominal enlargement. On transvaginal ultrasound and computed tomography scan, she was diagnosed with right ovarian new growth measuring 9 cm × 8 cm × 10 cm with features suggestive of an endometriotic cyst and a 16.2% risk of malignancy by the International Ovarian Tumor Analysis ADNEX model. Tumor markers CA-125 and the premenopausal ROMA were elevated. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Intraoperatively, the right ovary appeared normal and a 10 cm retroperitoneal cystic mass was seen adherent to the right posterolateral aspect of the uterus and extending towards the right broad ligament, which exuded yellow to brown serous fluid on cut section. Histopathology revealed an intraligamentary symplastic leiomyoma with cystic degeneration. The patient was discharged stable after 3 days.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Hysterectomy

Mammary Paget’s disease (MPD) is a rare form of intraepithelial adenocarcinoma occurring in the apocrine gland-bearing areas in patients older than 50 years old. This clinical disease presents as erythematous, scaly plaque that usually affects the unilateral nipple or areola and is frequently misdiagnosed as inflammatory or infectious dermatitis. In this report, we are presented with a 54-year-old Filipino female who came in with a 3-year history of persistent pruritic erythematous moist plaque on the right nipple gradually spreading to the surrounding areola previously treated as a case of fungal infection. Mammography revealed BI-RADS 4C. Skin punch biopsy showed nuclear atypia with pale staining cytoplasm and were consistent with MPD. Immunohistochemical stains showed positive for epithelial membrane antigen and carcinoembryonic antigen. We reiterate the importance of early diagnosis for appropriate treatment to prevent unwanted sequelae.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Paget' ; s Disease, Mammary ; Mpd

Leukocytoclastic vasculitis (LCV) is a histopathologic descriptor for a prevalent type of small-vessel vasculitis (SVV) that affects arterioles, capillaries, and postcapillary venules. Although the association between vasculitis and malignancy only accounts for <5% of vasculitis cases, it has been recognized as a true paraneoplastic syndrome in several studies. A 57-year-old Filipino male presented with erythematous, nonblanching macules on his lower extremities, which rapidly progressed to violaceous lesions on his trunk, buttocks, and lower extremities. He also reported significant weight loss, decreased appetite, and vomiting. A skin biopsy confirmed LCV. Initially treated for meningococcemia, his condition did not improve. Abdominal imaging revealed an enlarged heterogeneous liver with retroperitoneal lymphadenopathy and a parenchymal nodule. He was eventually diagnosed with vasculitis secondary to an underlying hepatic malignancy and expired later from multiorgan failure.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Leukocytoclastic Vasculitis ; Erythema Elevatum Diutinum ; Malignancy ; Neoplasms ; Paraneoplastic Syndromes

Multifocal acquired demyelinating sensory and motor neuropathy (MADSAM) is a variant of chronic inflammatory demyelinating polyneuropathy (CIDP). It presents as a chronic, asymmetrical sensory-motor polyneuropathy with features of demyelination on nerve conduction studies. Management options include intravenous immunoglobulin and corticosteroid infusions. Prognosis is generally favorable but there have been reports of variable response to treatment. This condition is rare and local data on CIDP and its variants is limited, hence we report a case of a 64-year-old male presenting with 3 year history of progressive asymmetric numbness and weakness of all limbs. Sensory deficits began on the left hand and had progressed to involve the distal portions of all limbs, eventually developing weakness as well. The patient underwent multiple nerve-conduction studies, all of which showed findings congruent with MADSAM. He was given intravenous high dose methylprednisolone and was maintained on mycophenolate mofetil.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Methylprednisolone ; Mycophenolate Mofetil ; Mycophenolic Acid

OBJECTIVE

This is a case report of a 60-year-old woman with a juxtapapillary choroidal melanoma who underwent globe-sparing treatment using linear-accelerator (LINAC)-based hypofractionated stereotactic radiotherapy (FSRT).

METHODS

Clinical data, ophthalmologic findings, and imaging results were obtained through retrospective chart review.

RESULTS

At three months and nine months post-treatment, tumor thickness decreased by 20.5% (from 13.00 mm to 10.34 mm) and 33.2% (to 8.69 mm), respectively. Partial resolution of subretinal fluid and vitreous hemorrhage was confirmed clinically and by B-scan. No metastatic spread was detected on liver ultrasound and chest radiography. Best-corrected visual acuity in the treated eye remained stable at hand motion. Radiation-induced dry eye was managed effectively with preservative-free sodium hyaluronate eye drops.

CONCLUSION

LINAC-based hypofractionated FSRT achieved marked local control and tumor regression in this case of a medium-large, juxtapapillary choroidal melanoma, while preserving the globe and the baseline vision. In regions without access to plaque brachytherapy, this technique offers a practical, cost-efficient, and multidisciplinary approach to eye-conserving therapy.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Radiotherapy ; Melanoma

Objective: To report a case of lingual thyroglossal duct cyst in an elderly man, excised via combined Trotter procedure and hyoid osteotomy.

Methods:
Design: Case Report
Setting: Tertiary Government Training Hospital
Participant: An elderly retired male office worker with dysphagia

Results: The cyst was completely excised via median labiomandibular glossotomy, with hyoid osteotomy providing additional exposure. Our patient was discharged in two weeks after decannulation and remains asymptomatic.

Conclusion: The Trotter procedure with hyoid osteotomy may be a viable alternative to the Sistrunk procedure for large lingual TGDCs.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Thyroglossal Duct Cyst ; Thyroglossal Duct Remnants

A 52-year-oldintellectually disabled man who had previously undergone a left canal wall down mastoidectomy with cartilage graft tympanoplasty for cholesteatoma 20 years ago presented with new-onset discharge in the contralateral ear. He did not have any symptoms, particularly recurrent discharge, in the post-operative ear, despite infrequent and irregular clinic follow-up for periodic cleaning of the cavity. Clinical examination of the post-operative ear revealed the presence of retained cerumen which was easily removed. The mastoid cavity was noted to have a healthy skin lining, an intact neotympanum, and a smooth bowl-like appearance with no areas that could not be adequately visualized through the surgically widened external auditory meatus. He underwent computerized tomographic imaging of the temporal bone to evaluate the nature and cause of the new-onset discharge in the contralateral ear. This imaging study provided the opportunity to present and describe key post-operative radiologic features of a symptom-free canal-wall down mastoidectomy with tympanoplasty.

A canal-wall down mastoidectomy is a more extensive type of mastoidectomy which, in addition to the resection of the mastoid cortex, all mastoid air cells and Körner septum, is characterized by the resection of the posterior wall of the external auditory canal and scutum. Among the most common causes of failure following this type of surgery are incomplete removal of tegmental air cells and incomplete lowering of the facial ridge.1These two factors can and should be purposefully assessed in a post-operative imaging study.

Adequacy of bone removal in the epitympanum to address the issue of tegmental air cell disease is evaluated on axial CT images at the level of the malleus head-incus body complex and the proximal portion of the tympanic segment of the facial nerve. (Figure 1) All of the bone lateral to the ossicles, especially that overlying the malleus head and anterior epitympanic recess, should have been surgically removed.

On coronal CT images, this same adequacy is demonstrated by the surgical removal of all bone lateral to the epitympanum, from the scutum to the outer cortex, such that there is a clear line of sight from the external auditory meatus to the epitympanum. This helps ensure that there are no pockets of soft tissue medial to any bony ridges; soft tissue that may represent residual or recurrent disease. (Figure 2)

Human ; Male ; Middle Aged: 45-64 Yrs Old