Covid-19 which was first documented in the Philippines in January 2020 had spread alarmingly. Severe acute respiratory symptoms were the most common presentation of this novel coronavirus infection. Reports have described neurologic manifestations of this disease involving the central nervous system as well as the peripheral nervous system. However, studies among the pediatric population are limited. In this paper, we present three pediatric patients who were diagnosed with COVID-19, via RT-PCR, presenting with seizures and behavioral changes. Two of these patients have no concomitant respiratory symptoms while the other one had Pediatric Community Acquired Pneumonia. These patients were managed as cases of acute viral meningoencephalitis and were given supportive care.

Human ; Male ; Female ; Aged 80 And Over ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Pulmonary, Seizures, Pneumonia

Objective: To determine the prevalence of hearing loss and otologic diseases among Filipinos living in the Southern Tagalog Region IV-A: CALABARZON (Cavite, Laguna, Batangas, Rizal and Quezon), Philippines.

Methods:

               Design: Retrospective Review of Community Survey Data

               Setting: Communities in Region IV-A provinces, Philippines

               Participants: 3267 residents of the five provinces aged 0 months and above

 Results: About 71.29% and 74.60% had at least mild hearing loss, in right and left ears, respectively. For disabling hearing impairment, overall prevalence was 26.33%, distributed into 11.87% among 4 to 18-year-olds; 8.97% for 19 to 64-year-olds; and 3.17% for 65-year-olds and above. Absence of prevalent and hearing loss-associated diseases: serous otitis media [OR 0.362, 95% CI 0.167 to 0.782, p = .010], CSOM [OR 0.407, 95% CI 0.236 to 0.703, p = .001] COM [OR 0.229, 95% CI 0.106 to 0.494, p < .001] can decrease the risk for hearing loss development in the region. Prevention of noise-induced hearing loss or delay in the manifestation of presbycusis can reduce the risk of having hearing loss by as much as 75% [OR 0.253, 95% CI (0.180 to 0.355), p < .001]. All pure tone audiometry measurements were obtained with surrounding median ambient noise of 55dB (IQR 46 to 60dB).

Conclusion: The prevalence of hearing loss among surveyed residents of the Southern Tagalog Region IV-A provinces was high compared to the previous nationwide study but low compared to other low- and middle-income countries. The top otologic conditions of this population (ear occlusion with ear wax, chronic suppurative otitis media, chronic otitis media, presbycusis, noise-induced hearing loss) were associated with hearing loss and their absence decreased the risks for hearing impairment.

Human ; Male ; Female ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Prevalence ; Hearing Loss ; Pediatrics ; Adult ; Presbycusis ; Otoscopy ; Otolaryngology

BACKGROUND: The dengue vaccine controversy in the Philippines caused significant public anxiety affecting childhood vaccines, as well as other healthcare programs. An assessment of parental perception and attitude on childhood immunization and other government healthcare programs after the dengue vaccine controversy is lacking

OBJECTIVE: To determine the perception and attitude of parents on childhood immunization and other government health care programs after the dengue vaccine controversy at a tertiary pediatric hospital.

METHODOLOGY: A hospital-based cross-sectional survey was done at a tertiary pediatric hospital. A total of 96 subjects participated in the study. Parents with children ages 9 to 18 years old whose child was either vaccinated or non-vaccinated with dengue vaccine seen in the dengue clinic, outpatient department and private clinics were invited to answer the structured questionnaire. Proportional stratified sampling was employed. Mann Whitney U-test compared the perception and attitude scores between parents of children who were recipients and non-recipients of dengue vaccine. A p-value of

RESULTS: The overall perception and attitude of parents on childhood immunization, deworming and vitamin A supplementation did not differ significantly between parents of non-dengue vaccinated children and dengue-vaccinated children. Sociodemographic factors such as gender, marital status, educational attainment, employment, and economic status did not differ significantly in their perception and attitude in terms of childhood immunization, deworming and vitamin A supplementation.

CONCLUSIONS: The overall perception and attitude of parents in both groups showed no significant difference toward childhood immunization, deworming and vitamin A supplementation. There is no association with the overall perception and attitude of parents on childhood immunization, deworming and vitamin A supplementation and their sociodemographic factors. RECOMMENDATIONS: Future similar studies may be conducted in other regions to determine parental perception and attitude towards the government's immunization program and other health care programs.

Human ; Male ; Female ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Dengue Vaccines ; Immunization

OBJECTIVE: To determine the prognostic value of surgical interventions done among patients with anaplastic thyroid carcinoma (ATC)

METHODS: A five-year retrospective chart review of 25 patients was done and baseline characteristics determined. Patients discharged alive as of the time of last chart entry were followed up by phone interview or personal visit. Overall survival was the main outcome measure which was plotted as Kaplan-Meier estimates and compared via log-rank test. The incidence of complications surrounding tracheostomy and thyroidectomy were also noted.

Methods:

Design: Ambispective Cohort Study

Setting: Tertiary National University Hospital

Participants: All private and public (charity) patients seen at the wards or clinics diagnosed with ATC via fine needle cytology or tissue histopathology.

RESULTS: All patients presented with either stage IV-B or stage IV-C disease. A significant difference in survival curves was noted when comparing between the two stages (p<.05). Subgroup analysis per stage revealed no significant difference in overall survival when comparing patients who did not undergo surgery, those who underwent tracheostomy or those who underwent thyroidectomy for both IV-B (p=.244) or IV-C (p=.165) disease. The incidence of complications for tracheostomy was 60%, the most common being mucus plugging. For thyroidectomy, the incidence of complications was 80% with hypocalcemia being the most common.

CONCLUSION: The current available data fails to demonstrate any significant survival advantage of tracheostomy or thyroidectomy when performed among similarly staged patients.

Human ; Animal ; Male ; Female ; Aged 80 And Over ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Anaplastic Thyroid Cancer ; thyroidectomy ; tracheostomy ; survival

Background and Objective: Cadavers are the main teaching and learning tools utilized by faculty and students of Gross Anatomy. The conventional procedure of using formalin to preserve cadavers has its limited benefit due to its obnoxious odor, darkened color, indistinguishable small structures, rigid joints, with friable organs and tissues. Using the Thiel Method, cadavers are known to have: life-like presentation, a high degree of suppleness, natural mobilization of various body parts with tolerable odor, natural color, and antimicrobial and antifungal efficacy. The aim of this study was to compare the Thiel soft-embalmed cadaver and the formalin-preserved cadaver for use in Gross Anatomy dissection.

Materials and Method: Six formalin-preserved cadavers were compared with six Thiel soft-embalmed ones and were evaluated by 160 first year medical students and 10 faculty members of Gross Anatomy from the University of the Philippines College of Medicine using a visual analogue scale that evaluated the cadaver's presenting color. A Likert scale was utilized to assess the skin and muscle texture, blood vessel integrity, odor, joint flexibility, and state of cadaver preservation. Their perceptions on the ease of the dissection process, distensibility, and differentiation of structures were also elicited through a questionnaire checklist.

Results: Results show that the Thiel Method-preserved cadavers were rated higher compared to the formalinpreserved cadavers in terms of: 1) presenting color; 2) tolerable odor; 3) skin and muscle texture; 4) blood vessel integrity; 5) joint flexibility; and 6) state of cadaver preservation after 1 year. However, the ease of the dissection process, the distensibility of structures, and the differentiation of the various structures were easily managed in the formalin-preserved cadavers while the feasibility of practicing laparoscopy, endoscopy, and intubation were seen in the Thiel soft-embalmed cadavers. Results validate the claims of previous studies on the advantages presented in using the Thiel Method.

Conclusion: Cadavers preserved utilizing the Thiel Method are life-like and can be used for Gross Anatomy dissection. The data gathered support the feasibility of using them also in research and training.

Human ; Male ; Female ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age)

This study was conducted to: (1) determine the profile of nurses in various work settings based on available databases; (2) describe the current nursing education and programs in the Philippines; and (3) identify national key issues affecting the nursing workforce. The study utilized descriptive, cross-sectional research design; and employed institutional survey, Delphi survey, and round table discussions. Results showed that the Department of Health has the current number of nurses working in hospitals and communities in the different regions, including information on age and sex distribution, employment characteristics, and type of hospital affiliations. The Professional Regulations Commission Board of Nursing has the results of the national licensure examinations. Commission on Higher Education has information on BSN curriculum and schools. Priority key issues identified are: (1) nursing leadership and nursing role clarity, (2) workplace safety and violence, and (3) shortage of nurses, (4) unjust compensation, and (5) skills mix and geographic maldistribution. PNA is thought to have a big role in helping address these key issues. 

Human ; Male ; Female ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Canada

Diabetic ulcer is a dangerous complication of diabetes mellitus associated with adverse consequences and high costs. Diabetic ulcers have a significant impact on quality of life. It is related to activity restriction, disabilities and the loss of mobility. Diabetic foot ulcers also lead to body image impairment and limitation of interaction with others. The purpose of this study was to identify the quality of life of patients with diabetic foot ulcer. This study used a descriptive method among 35 patients who had foot diabetic ulcer graded 2, 3, and 4. Findings of the study revealed that diabetic ulcer affects physical health, psychological health, social relationship and environment of 54.3%, 54.3%, 85.7% and 60%, respectively. Therefore, it is suggested that healthcare providers, their families, and the community give motivation, support, and education on patients with diabetic foot ulcer to achieve higher levels of quality of life.

Human ; Male ; Female ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Quality Of Life ; Diabetes Mellitus ; Foot Ulcer

OBJECTIVE: To develop a locally adapted patient decision aid (PtDA) on treatment intensification among Filipino patients with Type 2 Diabetes Mellitus and to test the feasibility of using PtDAs in a low middle-income country.

METHODOLOGY: A qualitative approach and an iterative process of development of a PtDA were employed for this study. We describe the process of developing a Filipino version of the Diabetes Medication Decision Aid. This PtDA was designed to help the patient choose the appropriate treatment intensification based on his own values and preferences, in consultation with his physician. The process involved decisional needs assessment through focus group discussions and key informant interviews, systematic literature review, iterative process of the development of a PtDA with clinical encounters (pilot testing), and preliminary field testing.

RESULTS: Decisional needs assessment revealed that Filipino patients are open to participate in shared decision-making if given the opportunity, including those with low socioeconomic status who likely have low health literacy. Physicians prefer to have visual aid tools to help them support their patient's decision-making. A PtDA prototype of a set of flash cards in Filipino was created and revised in an iterative method. We developed a more visually appealing tool after inputs from the expert panel and patient advisory group. Its use during clinical encounters provided additional insights from patients and clinicians on how to improve the PtDA. Preliminary field testing showed that its use is feasible in the target patient population.

CONCLUSION: Filipino patients, clinicians, and diabetes nurse educators have contributed to the creation of the first Filipino PtDA for diabetes treatment intensification.

Human ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Decision Making

"Those with access to these resources -- students, librarians, scientists --

you have been given a privilege. You get to feed at this banquet of knowledge

while the rest of the world is locked out. But you need not -- indeed, morally,

you cannot -- keep this privilege for yourselves. You have a duty to share it

with the world."

Aaron Swartz1 (who killed himself at the age of 26,

facing a felony conviction and prison sentence

for downloading millions of academic journal articles)

 

The Philippine Journal of Otolaryngology Head and Neck Surgery was accepted into the Directory of Open Access Journals (DOAJ) on October 9, 2019. The DOAJ is "a community-curated online directory that indexes and provides access to high quality, open access, peer-reviewed journals"2 and is often cited as a source of quality open access journals in research and scholarly publishing circles that has been considered a sort of "whitelist" as opposed to the now-defunct Beall's (black) Lists.3

As of this writing, the DOAJ includes 13,912 journals with 10,983 searchable at article level, from 130 countries with a total of 4,410,788 articles.2 Our article metadata is automatically supplied to, and all our articles are searchable on DOAJ. Because it is OpenURL compliant, once an article is on DOAJ, it is automatically harvestable. This is important for increasing the visibility of our journal, as there are more than 900,000 page views and 300,000 unique visitors a month to DOAJ from all over the world.2 Moreover, many aggregators, databases, libraries, publishers and search portals (e.g. Scopus, Serial Solutions and EBSCO) collect DOAJ free metadata and include it in their products. The DOAJ is also Open Archives Initiative (OAI) compliant, and once an article is in DOAJ, it is automatically linkable.4

Being indexed in DOAJ affirms that we are a legitimate open access journal, and enhances our compliance with Plan S.5 The Plan S initiative for Open Access publishing launched in September 2018 requires that from 2021, "all scholarly publications on the results from research funded by public or private grants provided by national, regional, and international research councils and funding bodies, must be published in Open Access Journals, on Open Access Platforms, or made immediately available through Open Access Repositories without embargo."5 Such open access journals must be listed in DOAJ and identified as Plan S compliant.

There are mixed reactions to Plan S. A recent editorial observes that subscription and hybrid journals (including such major highly-reputable journals as the New England Journal of Medicine, JAMA, Science and Nature) will be excluded,6 quoting the COAlition S argument that "there is no valid reason to maintain any kind of subscription-based business model for scientific publishing in the digital world."5 As Gee and Talley put it, "will the rise of open access journals spell the end of the subscription model?"6

If full open access will be unsustainable for such a leading hybrid medical journal as the Medical Journal of Australia,6 what will happen to the many smaller, low- and middle-income country (southern) journals that cannot sustain a fully open-access model? For instance, challenges facing Philippine journals have been previously described.7

According to Tecson-Mendoza, "these challenges relate to (1) the proliferation of journals and related problems, such as competition for papers and sub-par journals; (2) journal funding and operation; (3) getting listed or accredited in major citation databases; (4) competition for papers; (5) reaching a wider and bigger readership and paper contribution from outside the country; and (6) meeting international standards for academic journal publications."7  Her 2015 study listed 777 Philippine scholarly journals, of which eight were listed in both the (then) Thomson Reuters (TR) and Scopus master lists, while an additional eight were listed in TR alone and a further twelve were listed in Scopus alone.7 To date, there are 11,207 confirmed Philippine periodicals listed on the International Standard Serial Number (ISSN) Portal,8 but these include non-scientific and non-scholarly publications like magazines, newsletters, song hits, and annual reports. What does the future have in store for small scientific publications from the global south?

I previously shared my insights from the Asia Pacific Association of Medical Journal Editors (APAME) 2019 Convention (http://apame2019.whocc.org.cn) on the World Association of Medical Editors (WAME) Newsletter, a private Listserve for WAME members only.9 These reflections on transformation pressures journals are experiencing were the subject of long and meaningful conversations with the editor of the Philippine Journal of Pathology, Dr. Amado Tandoc III during the APAME 2019 Convention in Xi'an China from September 3-5, 2019. Here are three main points:

the real need for and possibility of joining forces- for instance, the Journal of the ASEAN Federation of Endocrinology Societies (JAFES) currently based in the Philippines has fully absorbed previous national endocrinology journals of Malaysia and the Philippines, which have ceased to exist.  While this merger has resulted in a much stronger regional journal, it would be worthwhile to consider featuring the logos and linking the archives of the discontinued journals on the JAFES website. Should the Philippine Journal of Otolaryngology Head and Neck Surgery consider exploring a similar model for the ASEAN Otorhinolaryngological - Head and Neck Federation? Or should individual specialty journals in the Philippines merge under a unified Philippine Medical Association Journal or the National Health Science Journal Acta Medica Philippina? Such mergers would dramatically increase the pool of authors, reviewers and editors and provide a sufficient number of higher-quality articles to publish monthly (or even fortnightly) and ensure indexing in MEDLINE (PubMed).the migration from cover-to-cover traditional journals (contents, editorial, sections, etc.) to publishing platforms (e.g. should learned Philippine societies and institutions consider establishing a single platform instead of trying to sustain their individual journals)? Although many scholarly Philippine journals have a long and respectable history, a majority were established after 2000,7 possibly reflecting compliance with requirements of the Commission on Higher Education (CHED) for increased research publications. Many universities, constituent colleges, hospitals, and even academic and clinical departments strove to start their own journals. The resulting journal population explosion could hardly be sustained by the same pool of contributors and reviewers.

In our field for example, faculty members of departments of otorhinolaryngology who submitted papers to their departmental journals were unaware that simultaneously submitting these manuscripts to their hospital and/or university journals was a form of misconduct. Moreover, they were not happy when our specialty journal refused to publish their papers as this would constitute duplicate publication. The problem stemmed from their being required to submit papers for publication in department, hospital and/or university journals instead of crediting their submissions to our pre-existing specialty journal. This escalated the tension on all sides, to the detriment of the new journals (some department journals ceased publication after one or two issues) and authors (whose articles in these defunct journals are effectively lost).

The older specialty journals are also suffering from the increased number of players with many failing to publish their usual number of issues or to publish them on time. But how many (if any at all) of these journals (especially specialty journals) would agree to yield to a merger with others (necessitating the end of their individual journal)? Would a common platform (rather than a common journal) provide a solution?

more radically, the individual journal as we know it today (including the big northern journals) will cease to exist- as individual OA articles (including preprints) and open (including post-publication) review become freely available and accessible to all. However proud editors may be of the journals they design and develop from cover to cover, with all the special sections and touches that make their "babies" unique, readers access and download individual articles rather than entire journals. A similar fate befell the music industry a decade ago. From the heyday of vinyl (33 and 78 rpm long-playing albums and 45 rpm singles) and 8-tracks, to cassettes, then compact disks (CD's) and videos, the US recorded music industry was down 63% in 2009 from its peak in the late 70's, and down 45% from where it was in 1973.10 In 2011, DeGusta observed that "somewhat unsurprisingly, the recording industry makes almost all their money from full-length albums" but "equally unsurprising, no one is buying full albums anymore," concluding that "digital really does appear to have brought about the era of the single.10 As McDowell opines, "In the end, the digital transforms not only the ability to disrupt standard publishing practices but instead it has already disrupted and continues to break these practices open for consideration and transformation."11

Where to then, scientific journals? Without endorsing either, will Sci-Hub (https://sci-hub.se) be to scholarly publishing what Spotify (https://www.spotify.com) is to the music industry? A sobering thought that behooves action.

Human ; Male ; Female ; Aged 80 And Over ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Adult (a Perso ; Open Access Publishing ; Open Access Publishing ; Journalism

OBJECTIVE:? This study aimed to determine the prevalence of nasopharyngeal tuberculosis among patients who were initially assessed to have a nasopharyngeal mass and subsequently underwent biopsy in a Philippine Tertiary General Hospital from 2013 to 2015.

 

METHODS:?

Design:           Case Series

Setting:           Tertiary National University Hospital

Participants: All patients with nasopharyngeal mass identified from January 2013 to December 2015 from a hospital wide census who underwent biopsy were investigated using chart and histopathology review. The prevalence of tuberculosis, malignancies and other findings were determined.

 

RESULTS:? Among 285 nasopharyngeal biopsies done between 2013 and 2015, 33 (11.6%) were histologically compatible with nasopharyngeal tuberculosis, 177 (62.1%) were different types of nasopharyngeal carcinoma, 59 (20.7%) were chronic inflammation, 4 (1.4%) were lymphoma, 5 (1.8%) were normal, and 7 (2.5 %) had diagnoses other than those above.

 

CONCLUSION: This study suggests a relatively high prevalence rate (11.6%) of nasopharyngeal tuberculosis in patients who have a nasopharyngeal mass. This indicates that nasopharyngeal tuberculosis should always be a differential when confronted with a mass in the nasopharynx especially in tuberculosis endemic areas.

 

KEYWORDS: nasopharyngeal tuberculosis; prevalence; censuses; tertiary care centers; Philippines; carcinoma; nasopharynx; biopsy; tuberculosis; lymphoma

 

Human ; Male ; Female ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Prevalence ; Censuses ; Tertiary Care Centers ; Philippines ; Nasopharynx ; Biopsy ; Tuberculosis ; Lymphoma ; Carcinoma