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.

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.

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.

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.

Background: Workplace loneliness affects employees’ emotional distress and job performance yet validated measurement tools for Korean workers remain limited. This study aims to translate and validate the Loneliness at Work Scale (LAWS) into Korean. Methods: LAWS was translated according to international guidelines as follows: forward translation, reconciliation, back translation and review, and cognitive debriefing. For validation, 1,000 full-time Korean employees proportionally distributed across sex, age, and occupational type were surveyed in November 2024 with a four-week follow-up (N = 200). Internal consistency and test—retest reliability were examined. The validity of the measure was tested by correlational analyses and confirmatory factor analysis. Results: LAWS-K demonstrated excellent internal consistency (Cronbach α overall = 0.936, emotional deprivation = 0.933, social companionship = 0.902) and satisfactory test—retest reliability (r = 0.780).The confirmatory factor analysis revealed that the revised two-factor model provided the best fit (comparative fit index = 0.916, Tucker—Lewis index = 0.897, root mean square error of approximation = 0.126, standardized root mean square residual = 0.045). Correlations with the SingleItem Workplace Loneliness Question (r = 0.612) and the Three-Item Loneliness Scale at Work (r = 0.682) demonstrated strong criterion validity. Correlations with occupational stress (r = 0.531), psychological distress (r = 0.543), work performance (r = -0.337), engagement (r = -0.462), and wellbeing (r = -0.490) supported convergent validity. Conclusion LAWS-K adapted for the Republic of Korea demonstrated robust reliability and validity. It provides Korean researchers and practitioners with a validated tool for assessing workplace loneliness, enabling targeted interventions and research initiatives to address this occupational health concern.

Introduction: Gestational diabetes mellitus (GDM) is a common pregnancy complication associated with adverse maternal and neonatal outcomes, including hypertensive disorders, caesarean delivery, macrosomia, and increased lifetime risk of type 2 diabetes. Despite its clinical importance, considerable international variation exists in GDM screening and diagnostic criteria. Multiple frameworks are currently used, including those from the World Health Organization (WHO), International Association of Diabetes and Pregnancy Study Groups, Carpenter and Coustan, and the National Diabetes Data Group. Differences in glucose thresholds, testing protocols (one-step versus two-step), and universal versus risk-based screening contribute to heterogeneity in reported prevalence and healthcare burden. In multi-ethnic, middle-income settings such as Malaysia, identifying an evidence-informed and contextappropriate diagnostic approach is critical. Methodology: This scoping review follows the Joanna Briggs Institute methodology and will be reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed, Scopus, and ScienceDirect will be searched for English-language studies, reviews, guidelines, and consensus statements reporting GDM diagnostic criteria. Two reviewers will independently screen and select studies. Results: Data will be charted on country, study type, diagnostic criteria, gestational age at screening, and reported challenges. Findings will be synthesized descriptively and presented in tables and figures. No formal risk-of-bias assessment will be conducted. Conclusion This review will provide a comprehensive overview of global diagnostic practices, highlight variations and gaps, and support evidence-based selection of a suitable GDM screening and diagnostic strategy for Malaysia.
Diabetes, Gestational ; Malaysia ; Policy ; Review Literature as Topic

The emergence of novel pathogens poses significant challenges to public health systems worldwide, demanding rapid and coordinated outbreak response mechanisms. The case of “Pathogen X,” a hypothetical novel pathogen, highlights the complexity of such efforts, which require rapid identification, diagnostic readiness, and effective containment strategies. Leveraging recent advances in ultrastructural pathology and genomics is essential to ensure a timely and robust response. Within this diagnostic framework, transmission electron microscopy (TEM) serves as a powerful imaging modality at high magnification that enables direct visualization of pathogen particles and infection-induced ultrastructural cellular changes. Unlike molecular techniques that infer presence through nucleic acids, TEM offers same-day morphological triage, confirmation of pathogen presence, and identification of co-infections. Through techniques such as negative staining and ultrathin sectioning, TEM reveals hallmark structural features that not only support provisional taxonomic classification and biosafety risk assessment but also inform the design and quality control of downstream assays such as metagenomic next-generation sequencing (mNGS) and targeted PCR. As such, TEM significantly accelerates and reinforces the overall outbreak investigation workflow. Its high-resolution imaging capabilities make it particularly valuable in situations where speed, morphological clarity, and pathogen diversity necessitate a direct visualization approach.

BACKGROUND

The COVID-19 pandemic caused by SARS-CoV-2 significantly strained healthcare systems in the Philippines, highlighting the critical importance of reliable molecular diagnostics and genomic surveillance. Although vaccination efforts and public health measures mitigated disease impact, the continued emergence of viral variants underscores the need for sustainable local surveillance strategies. Strengthening in-country capacity through the development of in silico–designed primers and cost-effective sequencing approaches can enhance rapid variant detection and improve preparedness for future emerging infectious diseases.

This paper offers a method in detecting the SARS-CoV-2 virus and its variants. A direct PCR product sequencing surveillance or DPPSS offers a new possibility of detecting emerging disease by using PCR products and using it as templates in determining the base sequence.

A total of 20 random positive samples for SARS-COV-2 from March 2022 sample pool in Metro Manila, Philippines was used in this study. The RNA was extracted using Purelink™ RNA Mini Kit, quantified with NanoDrop, and subjected to one-step RT-PCR. An in-house designed in silico primers were used in this study by using thermodynamic parameters to optimize specificity and amplification efficiency, considering GC contents, balanced Tm, minimal secondary structures and cross-dimers and in silico validation via Basic Local Alignment Search Tool (BLAST) against reference databases.

Amplicons were analyzed through gel electrophoresis, sequenced, and analyzed using BioEdit software. A nucleotide BLAST search identified COVID-19 variants, confirmed using Cov-Lineages website.

In silico designed primers (S1, S2, E/M, Orf1ab) collectively exhibited 100% sensitivity in detecting SARS-CoV2 in nasopharyngeal swab samples. Individual primer sensitivities varied, with Orf1ab at 58.82% and E/M at 90.91%. Our analysis revealed the prevalence of Omicron sublineage BA.2 in the Philippines, aligning with local data showing more BA.2 cases than the global predominance of BA.1.

Combined in silico primers (S1, S2, E/M, ORF1ab) accurately detect SARS-COV-2 and its variants. This method provides a valuable diagnostic and surveillance tool for public health management.

Introduction: Polycystic ovarian syndrome (PCOS) is a complex endocrine disorder that significantly affects adolescent girls, particularly those with overweight or obesity. However, data examining the determinants and metabolic profiles of PCOS among adolescents with overweight and obesity remain limited, especially in Malaysia. This protocol describes a case-control study investigating the cardiometabolic, dietary, and psychosocial determinants of PCOS among adolescents with overweight and obesity. Methodology: This study is designed as a case-control study involving adolescent girls aged 13–16 years with a body mass index z-score >+1 standard deviation. Cases are defined as adolescent girls with a confirmed diagnosis of PCOS based on the recommendations of the 2017 International Consortium of Paediatric Endocrinology (ICPE), while controls are those who do not meet the diagnostic criteria for PCOS. A total sample size of 440 participants is required. Participants will be recruited from 22 secondary schools selected from a list of schools in Kuala Lumpur. Data on sociodemographic characteristics, psychosocial health, physical activity, and dietary intake will be collected using structured questionnaires. Blood samples will be obtained and analyzed for diagnostic testing (free testosterone), exclusion tests (thyroid-stimulating hormone, folliclestimulating hormone, luteinizing hormone, estradiol, prolactin, and dehydroepiandrosterone sulfate), and biochemical parameters (liver function tests, lipid profile, hemoglobin A1c, fasting glucose, fasting insulin, and inflammatory markers). Results: The study is expected to generate comprehensive data on the cardiometabolic, dietary, and psychosocial determinants of PCOS among adolescents with overweight and obesity. The findings will inform early screening strategies and targeted interventions aimed at reducing long-term reproductive and cardiometabolic complications. Conclusion This protocol outlines a structured approach to investigating PCOS in adolescence and addresses current gaps in early identification and risk stratification among highrisk populations.
Adolescent ; Humans ; Case-Control Studies ; Overweight ; Polycystic Ovary Syndrome ; Obesity

Introduction: ISPAD guidelines recommend continuous glucose monitoring (CGM) as the standard of care for paediatric type 1 diabetes (T1DM). However, a “real-world” adoption gap persists, particularly in resource-limited settings. The Introductions of the study were to evaluate CGM adoption prevalence, identify documented barriers, and compare glycemic outcomes between active and non-active users. Methodology: This retrospective review analyzed electronic medical records (EMR) of 125 paediatric T1DM patients at Hospital Putrajaya (2025). Data included CGM status, insulin delivery method, and documented barriers. Independent T-tests compared mean hemoglobin A1c (HbA1c) between groups, and multivariable logistic regression identified independent predictors of adoption. Results: Cohort mean age was 11.8 ± 3.8 years. Active CGM users were 32.8% (n = 41), of whom 29.3% (n = 12) utilized predominantly automated insulin delivery (AID) systems. The remaining 67.2% (n = 84) were classified as non-active users, comprising both never-users and ex-users (discontinued use). Active users achieved significantly lower mean HbA1c than non-active users (8.73% vs 9.86%; p <0.001), with no significant difference in rates of DKA (p = 0.564) or severe hypoglycemia (p = 0.250). Among never-users, 42.9% lacked documented technology counselling (p = 0.001). Multivariable analysis identified funding source as the sole independent predictor of CGM adoption (adjusted OR = 7.76, p <0.001). While the primary documented barrier was financial (31.0%), a lack of documented barriers was noted in 61.9% of non-active users. Conclusion A substantial technology gap exists, primarily driven by financial access rather than clinical demographics. The difference of 1.13% in HbA1c between groups underscores the need to address financial setbacks to improve technology access in Malaysia and prevent diabetes complications.
Child ; Blood Glucose ; Blood Glucose Self-Monitoring ; Continuous Glucose Monitoring ; Diabetes Mellitus, Type 1

Introduction: Arginine vasopressin deficiency (AVP‑D), previously termed central diabetes insipidus, is a rare paediatric endocrine disorder that may present as an early manifestation of diverse hypothalamic–pituitary conditions. Identifying the underlying etiology is crucial for guiding management and surveillance; however, in some children, the cause remains unresolved, leading to primarily symptomatic treatment. In Malaysia, published literature on paediatric AVP‑D has been limited to isolated case reports, with no cohort‑level data available. This study aims to describe the clinical features, etiological spectrum, and treatment patterns of paediatric AVP-D in a single-centre Malaysian cohort, emphasizing diagnostic yield, unresolved causes, and the central role of neuroimaging. Methodology: A retrospective review was conducted of children diagnosed with AVP-D. Data collected included age at symptom onset, age at presentation, clinical features, etiological classification, neuroimaging findings, comorbidities, treatment modalities, and follow-up outcomes. Descriptive statistics were used for analysis. Results: Twelve children were included, with a median age of 9.8 years; two-thirds were male. Children were referred at a median age of 3.4 years, with presentation ranging from the neonatal period to 10.4 years. Diagnostic delay was minimal overall, although 25% experienced delays exceeding 1 year. The water deprivation test was performed in 33.3% of patients. Magnetic resonance imaging (MRI) was completed in all children and served as the principal determinant of etiology. Structural abnormalities were identified in 50% of the cohort, including semilobar holoprosencephaly (33.3%), Arnold– Chiari I malformation (8.3%), and pituitary stalk interruption syndrome (8.3%). The posterior pituitary bright spot was absent in most patients, and 50% required repeat MRI to clarify evolving neurohypophyseal features. Tumor-related AVP-D accounted for 8.3%, while one-third had no definitive etiology despite imaging. Initial therapy included desmopressin (58.3%), hydrochlorothiazide (25%), and diluted sublingual desmopressin (8.3%), with most requiring dose escalation. Growth impairment occurred in 66.7% of patients, and delayed puberty in 16.7%. Conclusion MRI played a central role in defining etiology, with half of the cohort demonstrating congenital structural abnormalities. Persistent unresolved cases highlight the diagnostic challenges of AVP-D and underscore the importance of early MRI and longitudinal endocrine follow-up.
Child ; Cohort Studies ; Diabetes Insipidus, Neurogenic ; Arginine

Purpose: This study aims to examine the prevalence of overweight and obesity in children with type 1 diabetes mellitus (T1DM) in Hong Kong and to evaluate the association between obesity, glycemic control, and metabolic comorbidities. Methods: A retrospective cross-sectional study was conducted from 2022–2023 at the Hong Kong Children’s Hospital, enrolling all children with T1DM. Anthropometric measurements and biochemical data were extracted from medical records, and prevalence rates of metabolic complications were compared. Results: One hundred twenty-six children (41% male, 89% Asian) with a median age of 12.8 years were included. Of these, 17.5% were either overweight or obese. There were no significant differences in hemoglobin A1c values between the normal-weight and overweight/obesity groups, though the latter group required higher total daily insulin doses. Children with overweight/obesity had higher prevalence rates of hypertension (28.6% vs. 2.9%) and dyslipidemia (90.5% vs. 71.9%). They were also more likely to have hypertension (adjusted odds ratio [aOR], 18.48; 95% confidence interval [CI], 3.42–99.94) and hypertriglyceridemia (aOR, 7.71; 95% CI, 1.66–35.76). The overweight/obese group also exhibited significantly higher alanine aminotransferase levels (median, 18 IU/L vs. 14 IU/L), non–high-density lipoprotein cholesterol (HDL-C) levels (median, 3.3 mmol/L vs. 2.9 mmol/L), and triglyceride/HDL-C ratios (median, 1.09 vs. 0.52) and lower HDL-C levels (median, 1.4 mmol/L vs. 1.6 mmol/L). Among those with dyslipidemia, only 8% were started on lipid-lowering agents, while none of those with hypertension were started on antihypertensive agents. Conclusion Despite a lower prevalence of overweight/obesity in Asian children with T1DM compared to Western populations, metabolic comorbidities occur at an exceptionally high rate. Early interventions to tackle these modifiable cardiovascular risk factors are crucial to prevent long-term complications.

Background/Aims: Esophagogastric junction contractile integral (EGJ-CI) is a metric of EGJ barrier function assessed on high-resolution manometry (HRM). However, its clinical utility may be limited by measurement discrepancies and wide variability. Mean basal EGJ pressure (MBEP) is a novel, simple HRM metric assessing barrier function. We compared their performance to predict conclusive gastroesophageal reflux disease (GERD). Methods: Consecutive patients undergoing esophageal function testing for known or suspected GERD were retrospectively evaluated. MBEP and EGJ-CI were manually calculated. Conclusive GERD was defined as acid exposure time > 6% or histologically confirmed Barrett’s esophagus. Statistical analyses including Mann-Whitney and Kruskal-Wallis tests, receiver operating characteristic (ROC) curves, univariable and multivariable logistic regression were performed. Results: Two hundred and twenty-six patients (mean age 52.8 ± 14.6 years, 58% males) were included. Applying Lyon 2.0 consensus criteria, 41% had conclusive GERD, 8% had borderline GERD, 8% had reflux hypersensitivity, and 43% had no GERD evidence. Patients with conclusive GERD had significantly lower MBEP compared to those without (11.8 mmHg vs 18.5 mmHg; P < 0.001). MBEP showed greater predictive performance for conclusive GERD (area under the ROC curve [AUROC]: 0.71; 95% CI, 0.65-0.78) than EGJ-CI (AUROC: 0.66; 95% CI, 0.59-0.74), also discriminating Lyon 2.0 subgroups (P < 0.001) and EGJ morphology types (P < 0.001). On multivariable analysis, MBEP independently predicted conclusive GERD (per 1-mmHg increase OR, 1.11; P = 0.022), while EGJ-CI did not (OR, 0.99; P = 0.207). Conclusions MBEP is a simple HRM metric to evaluate anti-reflux barrier function, predicting conclusive GERD and differentiating reflux phenotypes with better performance than EGJ-CI. This metric could serve as a valuable adjunctive tool in GERD diagnosis.