BACKGROUND AND OBJECTIVE

Foreign body (FB) ingestion is a common pediatric concern in the Philippines, but local studies on flexible endoscopic management are lacking. This study aimed to describe the clinical profile and outcomes of children referred for flexible endoscopic management and identify factors associated with poor outcomes.

METHODS

This retrospective cohort study included 145 patients aged

RESULTS

Most FB ingestions (96.55%) were accidental, with coins as the most common FB (56.55%). Patients were admitted an average of 40.42 hours post-ingestion and referred for endoscopy within 9.28 hours. Flexible endoscopy was performed in 44.83% of cases, with a 98.46% success rate and an average procedure time of 32.25 minutes. Spontaneous passage occurred in 50.34% of cases. Poor outcomes were linked to age 48 hours; OR: 15.43, p = 0.0181), and prolonged procedures (>30 minutes; OR: 12, p = 0.0318). Good outcomes were associated with unremarkable physical exams (OR: 0.078; p = 0.0018), early admission (CONCLUSION

Flexible endoscopy is effective and safe for FB extraction in children. Early admission and timely intervention significantly improve outcomes, while delays and prolonged procedures increase the risk of complications.

Human ; Adolescent: 13-18 Yrs Old ; Child: 6-12 Yrs Old ; Foreign Bodies ; Endoscopy ; Child ; Retrospective Studies ; Aged ; Cohort Studies ; Eating ; Methods ; Numismatics ; Patients ; Philippines ; Physical Examination ; Time

BACKGROUND AND OBJECTIVES

The global pandemic caused by Coronavirus Disease 2019 (COVID-19) has affected millions, with growing evidence of the potential role of ocular tissues in viral transmission. At the time of writing, local data regarding the phenomenon was limited. This study investigated external ocular manifestations in patients with COVID-19 at a referral center in the Philippines, examined correlations between demographics, systemic manifestations, and laboratory results with ocular manifestations, and determined their timing relative to systemic symptoms.

METHODS

This single-center, descriptive cross-sectional study was carried out from December 8 to 18, 2020 at the adult COVID-19 wards of the Philippine General Hospital involving 72 participants. Data collection involved relevant clinical history taking and performing gross eye examination. The prevalence of ocular manifestations was described with 95% confidence intervals. Correlations between ocular manifestations and quantitative variables were analyzed with point-biserial correlation, and associations with qualitative variables were tested using chi-square or Fisher’s exact tests.

RESULTS

Among participants, 31.9% presented with ocular manifestations with foreign body sensation as the most prevalent ocular symptom (11.1%) and conjunctival hyperemia as the most prevalent ocular finding (19.4%). The median age of patients with ocular manifestations was 41 years old with a higher prevalence in the male population (73.9%, CI=95%, p=0.001). No significant correlation was observed between presence of external ocular manifestations and the different systemic and ocular co-morbidities as well as with COVID-19 clinical classification. Among those who experienced symptoms, majority (29.2%) of the patients experienced systemic symptoms prior to the onset of ocular symptoms. Ocular complaints may present as the sole manifestation (13.9%). Several laboratory parameters were measured and only temperature and AST levels showed a low positive correlation with the presence of ocular manifestations. 

CONCLUSION

Ocular manifestations occur in roughly one third of patients with COVID-19 based on this study population. With some individuals presenting with ocular signs or symptoms as the initial and sole manifestation, healthcare practitioners must exercise caution and remain vigilant in managing patients who present as such. At the time of writing, this is the first local study investigating the different external ocular manifestations in patients with COVID-19. There is a need to pursue more robust studies and conduct more local investigations which will guide both ophthalmologists and other practitioners in strengthening existing guidelines regarding precautionary practices, clinical diagnosis, and management of COVID-19 patients.

Human ; Sars-cov-2 ; Covid-19 ; Philippines ; Adult ; Association ; Classification ; Collection ; Confidence Intervals ; Coronavirus ; Cross-sectional Studies ; Data Collection ; Demography ; Diagnosis ; Disease ; Exercise ; Eye ; Foreign Bodies ; History ; Hospitals ; Hospitals, General ; Hyperemia ; Laboratories ; Male ; Morbidity ; Ophthalmologists ; Pandemics ; Patients ; Population ; Prevalence ; Referral And Consultation ; Role ; Sensation ; Temperature ; Time ; Tissues ; Volition ; World Health Organization ; Writing

BACKGROUND AND OBJECTIVE

In 2018, the Philippine Congress passed the Universal Healthcare (UHC) Law and its implementing rules which mandated the enrollment of all Filipinos to PhilHealth, the national social health insurance corporation. The Department of Health (DOH) and PhilHealth will leverage their strategic purchasing power by affiliating Health Care Provider Networks (HCPNs), established within the geopolitical boundaries of a province or a highly urbanized city, through service level agreements. This study aims to shed light on what is expected from providers, payers, and regulators to implement UHC successfully.

METHODS

The researchers conducted an inductive, content analytic qualitative study guided by the World Health Organization’s (WHO) Building Blocks Framework to determine the understanding and acceptance of the implementing rules of the UHC Law and the perceived barriers and enablers from the provider, payer, and regulator stakeholders in three provinces in the Philippines. Purposive sampling was utilized to provide the best representation across different economic and physical settings. A content analysis was done through an inductive process of coding concepts, which was the basis for categories grouped and matched deductively with the WHO framework. This formed the broader sub-themes and were used for the final data interpretation.

RESULTS

A total of 16 focus group discussions (FGDs) and nine in-depth interviews (IDIs) were performed with 84 participants. Inductive thematic analysis of categories and subcategories showed that the participants support the goals and objectives of the UHC Law. Still, perceived barriers refer to the lack of and improper use of funds, the need to clarify the implementing guidelines, and the role of politics. The participants indicated that solidarity and social connectedness with health system adaptability and resilience are enablers for the success of UHC reforms.

CONCLUSION

Proposals to mitigate the barriers include expanding the funding source, clarifying rules on the f inancial management system, and providing guidelines on health delivery integration to ensure access to patient care. Decentralization with autonomy will allow the stakeholders to align health programs with local needs. Proper representation in decision-making bodies is desirable to establish strong community involvement and solidarity. Resilience and adaptability based on a feedback loop are imperative.

Human ; Universal Health Care ; Health Financing ; Healthcare Financing ; Philippines

BACKGROUND AND OBJECTIVE

Randomized controlled trials (RCTs) are essential for advancing evidence-based healthcare by evaluating the effectiveness and safety of health interventions. Despite the increasing recognition of clinical research, the Philippines has had limited contributions to global RCT output. This bibliometric analysis aims to assess the trends, characteristics, and impact of RCTs conducted in the Philippines and published online.

METHODS

A systematic search of Medline (PubMed), and EMBASE, along with Acta Medica Philippina, was conducted to identify published RCTs from January 1990 to October 2022. Eligible studies were screened and analyzed based on publication trends, funding sources, study designs, research settings, and institutional contributions. Descriptive statistics were used to summarize key findings.

RESULTS

A total of 391 RCTs were identified, with a notable increase in number of RCTs published over time. Most studies (91.8%) were published in international journals, and funding was primarily sourced from pharmaceutical companies (47.1%). The predominant RCT design was two-arm parallel (64.7%), with hospitals being the most common research setting (54.2%). Research areas were led by infectious diseases, particularly vaccine-preventable illnesses (23.8%). While the University of the Philippines Manila (21.1%) and the Research Institute for Tropical Medicine (13.7%) were the leading institutions in terms of highest number of published RCTs, foreign authors accounted for nearly half (47.3%) of primary authorships. The most cited studies focused on cardiovascular diseases, infectious diseases, and oncology.

CONCLUSION

The increasing number of published RCTs in the Philippines reflects growth in research capacity and institutional engagement. Strengthening national research dissemination platforms and fostering regional collaborations will be essential in advancing the Philippines’ contribution to global clinical research.

Human ; Bibliometrics ; Bibliometric Analysis ; Philippines ; Publications

OBJECTIVES

Herbal plants can be an alternative source of therapy especially against hypertension, which is a prevalent burden in the Philippines. This study investigates the phytochemical composition and angiotensin-converting enzyme 1 (ACE-1) inhibitory activity of Mayana (Coleus scutellarioides Benth.) leaf extract, a plant ethnobotanically reported to be used for its potential antihypertensive properties and yet still lacking in in-vitro investigations.

METHODS

Employing a laboratory experimental research design and standard procedures for phytochemical screening and ACE-1 inhibitory assay, the study compares a crude ethanolic dehydrated leaf extract of Mayana with the positive control, Captopril.

RESULTS

Phytochemical screening revealed the presence of flavonoids and phenolic compounds. ACE-1 inhibitory activity of Mayana at 10 μg/mL, 25 μg/mL, 50μg/mL, 100 μg/mL, 500 μg/mL, 1000 μg/mL were 0.00% ± 0.0000, 12.40% ± 2.7094, 18.76% ± 0.7232, 27.31% ± 2.2159, 30.44% ± 1.6022, 40.12% ± 2.4385, respectively. Mayana exhibited an IC50 value of 55.9154 μg/mL compared to Captopril which was 7.7232 μg/mL, indicating potency disparities.

CONCLUSION

Mayana has been shown to contain flavonoids and phenolic compounds that exhibit preliminary anti- hypertensive potential through the inhibition of ACE-1. However, the bioactivity of Mayana is lower when compared with a positive control. As such, more research is needed. Despite that, this research contributes to our under- standing of Mayana as a medicinal plant and its potential contribution to complementary and alternative healthcare, with implications for patient care, community awareness, farmer livelihood, education, and future research.

Plants ; Antihypertensive Agents ; Antihypertensive ; Coleus ; Phytochemicals ; Philippines

OBJECTIVES

To describe the clinical profile and outcomes of a series of adult patients diagnosed with ocular myasthenia gravis and to evaluate the potential factors affecting the risk of generalization.

METHODS

This retrospective cohort study involved a medical chart review of adult patients seen from 2012 to 2019 at the neuro-ophthalmology clinic of a tertiary Philippine hospital with a clinical diagnosis of ocular myasthenia gravis supported by serologic, electrophysiologic, or pharmacologic test results. Outcomes of interest were complete stable remission, pharmacologic remission, minimal manifestations, and generalization. Kaplan-Meier method and log-rank test were used to analyze the probability of generalization.

RESULTS

The study sample consisted of 16 patients. The female to male ratio was 3:1. Mean age at symptom onset was 39 years. All patients received pharmacologic treatment, while two patients underwent thymectomy. No patient had remission as of last follow-up. Three patients had conversion of ocular myasthenia gravis to generalized myasthenia gravis. Mean time from symptom onset to generalization was 10.7 months. The generalization curves of patients who were symptomatic for less than two years and those who were symptomatic for at least two years prior to consult were significantly different (p = 0.049).

CONCLUSION

In this single-center study, there was female predominance among adult patients diagnosed with ocular myasthenia gravis. The incidence of generalization was 4 per 100 person-years while the 2-year probability of generalization was 30%. Further study is needed in order to determine the factors affecting the risk of generalization.

Human ; Myasthenia Gravis ; Pyridostigmine ; Pyridostigmine Bromide ; Philippines

BACKGROUND

This first clinical practice guideline (CPG) on osteoporosis prevention and management in the Philippines is the output of a shared undertaking by a multidisciplinary CPG development team spearheaded by the Osteoporosis Society of the Philippines Foundation, Inc. and joined by the Philippine Academy of Family Physicians; the Philippine College of Endocrinology, Diabetes, and Metabolism; the Philippine Orthopedic Association; the Philippine Obstetrics and Gynecological Society and the Philippine Rheumatology Association. This guideline seeks to augment and update the "Consensus statements on osteoporosis diagnosis, prevention and management in the Philippines," initially published in 2011, incorporating evidence-based practices developed in the last decade.

METHODOLOGY

The steering committee formulated and prioritized clinical questions based on meetings and stakeholder consultations. A PICO (population, intervention, comparator, outcome) format was used to develop clinical questions and guide the systematic search for evidence. The development of guidelines followed the ADAPTE process. Once completed, panel discussions were done using the Evidence to Decision Framework. After the panel discussions, the final recommendations were revised.

RESULTS

Thirty-four recommendations were formulated to address 27 clinical questions related to screening, prevention, diagnosis, pharmacologic and nonpharmacologic treatment, surgical management, follow-up, and continuity of care. With these recommendations, the developers aim to establish a standard of care in the prevention, diagnosis and management of osteoporosis and fragility fractures in both in-patient and out-patient cases that are appropriate to the Philippine context. Specifically, the CPG development group aims to use these recommendations to define the standard of care for osteoporosis as part of universal healthcare services once the program is implemented nationally. Relevant stakeholders may also use the recommendations to inform public and private payor policies for patients with fragility fractures, as well as by local government units or private companies looking to establish orthogeriatric centers with fracture liaison services.

CONCLUSION

This guideline is helpful for physicians and other allied health personnel in screening, diagnosis, management and prevention of primary osteoporosis and fragility fractures among postmenopausal women and older men.

Human ; Philippines ; Guideline ; Osteoporosis

BACKGROUND

Pituitary adenomas comprise approximately 20% of surgically resected intracranial tumors. This study aimed to collect local data on the post-operative neurologic, visual and endocrine outcomes of patients with pituitary macroadenoma.

METHODOLOGY

This is a retrospective study of patients with pituitary macroadenoma who underwent neurosurgery at the Philippine General Hospital between 2017 to 2022. Data on demographics, clinical signs and symptoms, neuro-ophthalmologic examination findings, hormonal and radiologic studies, type of surgery, and post-operative outcomes were collected. Statistical analyses were done to compare the neurologic, ophthalmologic and endocrine status pre- and post-operatively.

RESULTS

A total of 122 patients were included. The mean age was 44.18 years, and majority (50.82%) were female. The most common presentation was blurring of vision. Most tumors were non-functioning (77.87%). Among the functioning adenomas, the most common was acromegaly. The median tumor size was 3.5 cm, and the median time to surgery was 18 months. Microscopic transsphenoidal surgery was the most common approach (60.83%) followed by endoscopic resection (24.17%). There was significant improvement in visual acuity post-operatively (p >0.05), by approximately one line in the Snellen chart. There was also some improvement in post-operative endocrine function, manifested as a significant decrease in the use of hormone replacement therapy. Factors such as age, sex, type of adenoma, tumor size, timing of surgery, surgical approach, post-operative complications and adjuvant radiation were not significantly associated with the visual and endocrine outcomes (p >0.005).

CONCLUSION

This is the first local study to comprehensively assess the entirety of post-operative outcomes among pituitary macroadenoma patients. Our results showed that even patients with longstanding visual and endocrine deficits may still improve with surgery.

Philippines

Artificial Intelligence (AI) is transforming the landscape of pathology, particularly in resource-constrained settings like the Philippines. This narrative review explores the applications, challenges, and future potential of AI in digital image analysis for pathology practices. By synthesizing peer-reviewed literature from 2019 to 2024, the review highlights the role of machine learning (ML) and deep learning (DL) algorithms in enhancing diagnostic accuracy, workflow efficiency, and clinical decision-making. AI-driven tools such as convolutional neural networks (CNNs) and transfer learning models have demonstrated significant success in tumor detection, biomarker evaluation, and predictive analytics, paving the way for personalized medicine. However, barriers such as limited annotated datasets, privacy concerns, and model interpretability hinder widespread adoption. The review emphasizes the need for ethical frameworks, workforce training, and infrastructure development to ensure equitable and effective integration of AI into pathology practices. By addressing these challenges, AI has the potential to improve diagnostic precision, expand access to healthcare, and modernize pathology services in the Philippines.

Human ; Artificial Intelligence ; Pathology ; Philippines ; Deep Learning ; Machine Learning

BACKGROUND

The impact of the COVID-19 pandemic on respiratory virus activity in children has been studied globally, but no published study in the Philippines has provided viral profiling and epidemiological data on children during and after the pandemic’s peak.

OBJECTIVES

To identify respiratory pathogens detected using a multiplex RT-PCR assay (BioFire® Respiratory 2.1 Panel) among pediatric patients with respiratory symptoms admitted to St. Luke’s Medical Center–Global City during (March 2020–February 2022) and after (March 2022–March 2023) the peak of the COVID-19 pandemic; to compare the prevalence of these pathogens between the two periods; and to assess the clinico-demographic characteristics, diagnostic test results, and clinical outcomes of patients with single-pathogen infections versus co-infections.

METHODS

A single-center, cross-sectional study was conducted through a retrospective chart review of pediatric patients with respiratory symptoms tested using a multiplex RT-PCR assay (BioFire® Respiratory 2.1 Panel) at St. Luke’s Medical Center–Global City from March 2020 to March 2023.

RESULTS

Of 739 children, 92.02% were positive for at least one respiratory pathogen, mostly viruses. Rhinovirus/enterovirus (50.59%), RSV (19.71%), and COVID-19 (12.50%) were the most common. COVID-19 and Influenza A were more prevalent during the peak, while rhinovirus/enterovirus and adenovirus were higher post-peak. Most patients were male, aged 1–5 years, and cough (89.99%) was the most common symptom. Normal leukocyte, CRP, and procalcitonin levels were observed in 70.09%, 47.31%, and 68.25%, respectively. No significant differences were noted in diagnostic test results based on pathogen detection. Antibiotics were given to 53.31% of patients, and 99.86% were discharged. The average length of stay was 3.69 days

CONCLUSION

The prevalence of respiratory pathogens among children admitted to our institution during and after the peak of the COVID-19 pandemic predominantly consisted of viruses, showing statistically significant differences. Rhinovirus/enterovirus and RSV were the leading respiratory pathogens in both periods. The peak group showed a higher prevalence of COVID-19 and Influenza A whereas the post-peak group exhibited a higher prevalence of rhinovirus/enterovirus and adenovirus. Single viral infections were more prevalent compared to co-infections

Human ; Pandemics ; Prevalence ; Philippines