BACKGROUND AND OBJECTIVE

Residency satisfaction is an important indicator of training quality and may influence physician well-being and performance. Surgical trainees are generally reported to have lower satisfaction compared to other specialties. This study assessed satisfaction among urology residents in the Philippines and evaluated a structured questionnaire for measuring training experience.

A cross-sectional survey was conducted among residents in accredited urology programs (2024-2024-5). A 12-domain Likert-scale questionnaire was developed and validated. Internal consistency and test-retest reliability were assessed. Satisfaction scores were analyzed overall and across subgroups.

A total of 106 residents participated. The instrument demonstrated good internal consistency (Cronbach's α = 0.870) and strong test-retest reliability (r = 0.896). Overall satisfaction was high (52.41 5.4/60). Clinical exposure was the highest-rated domain, while work-life balance was the lowest. No significant differences were observed by gender, training year, or institution type. Key areas for improvement were case exposure and academic learning.

Urology residents in the Philippines report high overall satisfaction. The validated questionnaire is reliable and useful for assessing multidimensional aspects of residency training. Improvements in case exposure, academic support, and work-life balance may further enhance training quality.

OBJECTIVE

This study aimed to identify the different risk factors for developing sepsis in patients undergoing percutaneous nephrolithotomy

This is a case-control study of all patients who underwent percutaneous nephrolithotomy in the National Kidney and Transplant Institute from 2017 to 2021. Demographic, stone characteristics, perioperative data and post-operative parameters were recorded. The association of clinical variables and sepsis was determined using logistic regression analysis.

A total of 536 patients who underwent percutaneous nephrolithotomy were included in the study with 58 of them suffering from sepsis with a prevalence rate of 9.9%. The majority [392 (67.82%)] of the patients were 31-59 years old. Majority of patients suffering from sepsis also belonged to the same age group were predominantly male [33 (56.9%)], mostly diabetic [15 (26.32%)] and hypertensive [14 (24.56%)] and underwent previous PCNL [49 (8.45%)]. Imaging of patients who had sepsis showed staghorn calculi [30 (51.72%)] with mild [20 (34.48%)] and moderate [23 (39.66%)] seen on imaging. Patients who were requiring transfusion post operatively (Grade II Clavien-Dindo Classification) were seen to have sepsis.

The following factors are contributory to the development of sepsis: a high Guy's stone score, high degree of obstruction or hydronephrosis, previous stone surgery and a higher volume of blood loss.

BACKGROUND

The benefits of preimplantation genetic testing for aneuploidy (PGT-A) in the advanced maternal age group are unclear.

This study aims to determine whether PGT-A improves pregnancy outcomes.

This is a retrospective cohort study of PGT-A outcomes using next generation sequencing for advanced maternal age women undergoing IVF at CARMI from May 2017 to May 2021. Women were grouped by age: those 35-39 and those 40 and above. Pregnancy rate (PR), live birth rate (LBR), and miscarriage rate (MR) were computed per transfer and per cycle and compared with women who underwent single day-5 frozen transfer of a morphologically chosen embryo.

Overall euploid blastocyst rate was 38.5%: 16.9% for 40 and above and 47.6% for 35- 39 group. There were no transfers in 41.4% due to absence of a euploid embryo. PR and LBR per embryo transfer were higher in the PGT-A versus the non-PGT-A group (61.9% vs 24.1% p = < 0.001 and 42.9% vs 19% p = < 0.001). By age, the findings were similar: higher PR and LBR per-embryo transfer in PGT-A versus non-PGT-A in the 35-39 group (58.4% and 29%, p = 0.006 and 42.9% vs 22.6%, p < 0.001 respectively) and 40 and above (71.4% vs 18.5%, p < 0.001 and 53.6% vs 14.8%, p < 0.001 respectively). MR was increased in the PGT-A versus non-PGT-A group, but this may be due to the small number of events in the population.

The study suggests an increase in PR and LBR per embryo transfer in advanced maternal age women undergoing PGT-A. A larger sample size is needed to validate the results.

Genetic Counseling ; Ophthalmology ; Philippines

OBJECTIVE

This paper reports a rare presentation of diffuse intraocular inflammation following reversed vaulted multipiece intraocular lens (IOL) implanted in the sulcus of a 7-year-old child.

This is a case report.

A 7-year-old child presented with persistent posterior pole inflammation and optic disc swelling after an improperly placed multipiece intraocular lens in the sulcus. Comprehensive eye and wholebody evaluations were performed with the aid of optical coherence tomography (OCT), magnetic resonance imaging (MRI) and systemic work-up to rule out other causes of uveitis to definitively diagnose the case. The reverse-vaulted lens was eventually explanted. After 1 week post-explantation, the visual acuity improved markedly to 20/100 with the appropriate spectacle prescription. The patient recovered from the ocular inflammation 8 months postoperatively.

This paper reports significant posterior pole inflammation as an uncommon yet potentially visually-disabling consequence of a reverse-vaulted sulcus placement of a multipiece intraocular lens in a child. Careful attention is warranted to ensure proper IOL orientation during implantation, especially in pediatric cataract surgery. Visual rehabilitation is important postoperatively

Introduction: Surgical site infection (SSI) surveillance is resource-intensive, particularly in low-resource settings. This study evaluated whether selective surveillance of high-risk patients can accurately identify postoperative SSI compared with traditional surveillance of all surgical patients. Methods: A cross-sectional study was conducted among 587 patients who underwent selected general surgical procedures from January 2022 to June 2023 in a tertiary university hospital. Patients were classified as high-risk or low-risk for SSI using eight perioperative variables. Logistic regression analysis identified factors independently associated with SSI. The accuracy and agreement of selective surveillance versus traditional surveillance were assessed using sensitivity, specificity, predictive values, and Cohen’s kappa. Results: The overall SSI rate was 12% (71/587). Independent predictors of SSI included resident service cases (OR 2.57, 95% CI 1.37–4.83), ASA score 3–5 (OR 6.28, 95% CI 3.30–11.93), clean-contaminated to dirty wounds (OR 21.73, 95% CI 6.26–75.48), operative duration beyond the 75th percentile (OR 2.33, 95% CI 1.24–4.38), and failure to maintain perioperative normothermia (OR 39.49, 95% CI 3.35–465.06). Selective surveillance demonstrated 100% sensitivity, specificity, positive predictive value, and negative predictive value, with perfect agreement with traditional surveillance (Cohen’s kappa = 1.00). Conclusion Selective surveillance focused on high-risk patients demonstrated excellent agreement with traditional surveillance and may serve as a cost-effective alternative for SSI monitoring in resource-limited settings.
Surgical Wound Infection ; Cross Infection ;

The current kidney care model - focused on late -stage disease and in -centre haemodialysis - is unsustainable, because of costs, environmental burden, poor outcomes, and reduced quality of life. The 78th World Health Assembly ’s recognition of kidney disease as a serious health threat presents a critical opportunity to reshape kidney care. Aligned with this, the 2026 World Kidney Day theme, “Kidney Health for All: Caring for People, Protecting the Planet ”, calls for a systematic change. A sustainable model must prioritise early detection and prevention, reducing the need for kidney replacement therapy. Transplantation and home dialysis benefit people with kidney failure, environment and society. Dialysis itself must become more eco -friendly without compromising care quality, recognising that planetary perturbations in turn affect kidney health. Conservative care should also be considered, particularly for elderly and frail patients, if the quality -of-life benefits outweigh the perspectives offered by dialysis. Achieving this shift requires coordinated action across all stakeholders; education and engagement of the public, policymakers and health professionals to raise awareness about the threat of kidney disease; and an urgent move toward patient -centered care

The current kidney care model - focused on late -stage disease and in -centre haemodialysis - is unsustainable, because of costs, environmental burden, poor outcomes, and reduced quality of life. The 78th World Health Assembly ’s recognition of kidney disease as a serious health threat presents a critical opportunity to reshape kidney care. Aligned with this, the 2026 World Kidney Day theme, “Kidney Health for All: Caring for People, Protecting the Planet ”, calls for a systematic change. A sustainable model must prioritise early detection and prevention, reducing the need for kidney replacement therapy. Transplantation and home dialysis benefit people with kidney failure, environment and society. Dialysis itself must become more eco -friendly without compromising care quality, recognising that planetary perturbations in turn affect kidney health. Conservative care should also be considered, particularly for elderly and frail patients, if the quality -of-life benefits outweigh the perspectives offered by dialysis. Achieving this shift requires coordinated action across all stakeholders; education and engagement of the public, policymakers and health professionals to raise awareness about the threat of kidney disease; and an urgent move toward patient -centered care

Vascularized composite allotransplantation (VCA) has transformed reconstructive surgery for patients with severe tissue defects. Nonetheless, donor shortages remain a major limitation. Cross-sex VCA (CS-VCA) has been proposed as a means of expanding the donor pool, but concerns persist regarding potentially heightened rejection risks in sex-mismatched transplants. This review examines published adult CS-VCA cases up to May 2025. The primary outcomes analyzed were acute rejection episodes, allograft survival, immunological complications, and sequelae affecting form and function.Nine CS-VCA cases were identified (six upper extremity, one lower extremity, and two abdominal wall transplants). Eight involved female donors (median age, 47 years) and male recipients (median age, 30 years). Acute rejection occurred in five of nine cases;however, 11 of 13 allografts remained viable at follow-up (6–41 months) under immunosuppressive therapy. Two cases developed vascular complications, resulting in technical failure and partial amputation, respectively. Higher human leukocyte antigen (HLA) mismatches (mean, 5) were associated with complications, while fewer mismatches (mean, 3) correlated with better outcomes. In contrast to trends in solid organ transplantation, female-to-male CS-VCA demonstrated relatively favorable outcomes in the limited cases reported. These findings suggest that CS-VCA may be a feasible strategy to expand the VCA donor pool, provided that patient selection is careful, ABO/Rh and HLA compatibility are prioritized, and rigorous immunological monitoring is maintained.Further studies should investigate sex-specific immune mechanisms to optimize longterm success rates.

Objective: This study aimed to demonstrate the benefits of using SaTScan (Boston, MA, USA), a cluster-detection software programme, and whole genome sequencing to investigate a suspected outbreak of Serratia marcescens infections in a tertiary government hospital in the southern Philippines. The hospital is part of the national Antimicrobial Resistance Surveillance Program’s network of sentinel sites. Methods: The investigation followed national outbreak investigation protocols. In May 2022, when evaluation of daily hospital laboratory census data revealed an increase in the number of Serratia species in the hospital, an alert was triggered. A concurrent, routine SaTScan analysis of the hospital’s surveillance data by the Antimicrobial Resistance Surveillance Reference Laboratory confirmed a cluster of cases. The Reference Laboratory requested isolates from clinical specimens from the hospital for confirmation of bacterial identification, antimicrobial susceptibility testing and whole genome sequencing. Results: Six isolates were submitted for genomic analysis, two of which were from the identified cluster. Although originally identified as S. marcescens, five of the isolates were subsequently confirmed as S. sarumanii. Phylogenetic analysis showed that the two isolates from the cluster were closely related and belonged to the same clade, which may suggest a common source. Three antimicrobial resistance genes were identified, but their phenotypic expression was limited, with one isolate exhibiting resistance mechanisms. Discussion: This study highlighted the utility of SaTScan for the early detection of potential disease outbreaks. The use of whole genome sequencing enhanced the investigation by enabling the analysis of potential transmission pathways at the genetic level, identification of the outbreak source and the detection of novel species.