BACKGROUND

LGBTQ+ populations worldwide bear a disproportionate burden of health disparities aggravated by stigma and discrimination in healthcare. This struggle is worsened in the Philippines due to systemic barriers, outdated medical curricula, and the pervasive stigma in society, making it harder for LGBTQ+ individuals to access healthcare.

METHODOLOGY

A community-based participatory research (CBPR) approach using the photovoice method was used to describe and co-construct perspectives from LGBTQ+ individuals related to healthcare access in the Philippine healthcare system. The LGBTQ+ participants who resided in Metro Manila were asked to capture photographs representing their healthcare experiences. Focused group discussions (FGD) were then utilized as a platform for collective discussions and interpretations of these photos, enabling the participants to voice their stories and views about healthcare access.

RESULTS

The results are represented in seven photographs, symbolizing seven key themes that are illustrative of the importance of narrating LGBTQ+ stories in healthcare, solidarity among the community for better access, the urgent need for a call to make healthcare spaces inclusive, navigation through intersecting identities, interaction between healthcare professionals and LGBTQ+ individuals, the call for systemic change to be fitted to the needs of LGBTQ+ people, and diverse healthcare challenges among transgender people.

CONCLUSION

The findings point to the strong call for systemic reforms in the Philippine healthcare system to better support the needs of LGBTQ+ people. This study highly recommends that lived experiences should be included in health practices and policies as a basis for inclusivity and equity.

Human ; Residence Characteristics

OBJECTIVE

The competence of health workers to attend to vulnerable and marginalized populations is critical to health equity. The study determines the competence of physicians in providing health care to LGBT adolescents in a national tertiary hospital.

METHODOLOGY

All physicians from the departments of Pediatrics and Family and Community Medicine were recruited. An electronic form collected demographic data and responses to the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBTDOCSS).Theresponsesweresummarizedandanalyzed.

RESULTS

Most respondents are male, with a mean age of 34.21 years. They are mainly staff of the Department of Pediatrics and post- residency fellows. Not all recall their participation in gender sensitivity training. They report scores towards the higher end of the scale: an overall score of 5.27 and mean subscale scores of 4.43 for clinical preparedness, 6.13 for attitudinal awareness, and 5.24 for basic knowledge. The heterogeneity and pertinacity of their experiences with LGBT individuals mediate their attitudinal awareness. Attaining the level of consultant suggests a better understanding of barriers and disparities against LGBT individuals. The tool has good internal reliability.

CONCLUSION

The demographic profile of the respondents suggests their involvement in healthcare, continuing education, and staff development. They report adequate competence in providing health care to LGBT adolescents.

Human ; Adolescent ; Competence ; Mental Competency ; Healthcare ; Delivery Of Health Care

BACKGROUND

Intimate partner violence (IPV) is a global public health issue with profound physical, psychological, and social consequences. Despite legislative measures in the Philippines, there is limited research on the profile of IPV survivors consulting specialized healthcare units.

OBJECTIVE

This study aimed to describe the profile of female survivors of IPV consulting at the Philippine General Hospital Women’s Desk (PGH-WD), focusing on sociodemographic, psychological, relationship, community, and partner factors as contributors to their risk of experiencing IPV.

METHODOLOGY

A cross-sectional study was conducted to analyze data from IPV survivors who consulted the PGH-WD between January 2022 and December 2023. Data collection involved a chart review of eligible cases, guided by predefined inclusion and exclusion criteria. Inclusion criteria required that participants be female survivors of IPV aged 19 years and above, with consultations specifically related to IPV. Exclusion criteria included male survivors, non-Filipino nationals, individuals not residing in the Philippines, and charts missing key components. Descriptive statistics were used to analyze sociodemographic, psychological, relationship, community, and partner-related factors. Survivors were categorized into low-, moderate-, or high-risk groups based on the number of identified risk factors.

RESULTS

A total of 518 charts were reviewed, of which 106 met the inclusion criteria and were analyzed. Survivors’ ages ranged from 19 to 74 years, with 46 (43.4%) aged 19–34. Most survivors belonged to lower socioeconomic strata, with 61 (57.5%) categorized as poor. Psychological distress was common, with 24 (22.6%) reporting depression and 22 (20.8%) having attempted suicide. Relationship factors included dissatisfaction in 91 cases (85.9%) and prior abuse by partners in 88 (83.0%). Community factors showed that 104 survivors (98.1%) were aware of the Anti-Violence Against Women and Children (Anti-VAWC) law, and 101 (95.5%) reported having social support networks. Partner-related factors were less frequently reported, with 3 survivors (2.8%) indicating perpetrator substance use and 2 (1.9%) reporting histories of childhood abuse. Risk profiling categorized survivors into low-risk (39/106, 36.8%), moderate-risk (39/106, 36.8%), and high-risk (28/106, 26.4%) groups based on the number of identified risk factors.

CONCLUSION

This study provided a detailed profile of female IPV survivors consulting at the PGH-WD. Survivors were predominantly younger women from lower socioeconomic backgrounds, with high rates of psychological distress, relationship dissatisfaction, and histories of prior partner abuse. Community factors, including strong social support networks and awareness of the Anti-VAWC law, were identified as potential protective mechanisms post-IPV.

Human ; Female ; Intimate Partner Violence ; Mental Health ; Gender-based Violence

INTRODUCTION

Adolescent pregnancy is enduringly perceived as posing a considerable social threat in the Philippines. Recent data from the Commission on Population and Development shows that over 40,000 births annually are from adolescent mothers aged 10 to 14 years, with many of these early pregnancies potentially linked to rape, forced sex, and abuse. Most studies in the past focus on causes and prevention. Limited research explores the lived experiences of early adolescent mothers, especially in the context of unwanted pregnancies.

OBJECTIVE

This study was conducted to determine the lived experiences of unwanted pregnancy among early adolescents age 12 to 15 years old in Zamboanga City.

METHODOLOGY

The study employed an Interpretative Phenomenological Study Design which involved understanding how the adolescents make sense of events, emotions, and interactions in their experiences. Ten (10) adolescent girls with experience of unwanted pregnancy were interviewed.

RESULTS

Analysis of transcripts generated three superordinate themes: (1) Living in the challenges of the present, (2) Facing the future with resilience, (3) Escaping the past. After identifying similarities across cases, two cross-case themes were generated: (1) Dysfunctional family background as a contributor to early pregnancy, and (2) The importance of relying on significant others for support.

CONCLUSION

The study revealed that unwanted pregnancies were influenced by dysfunctional family environments, socioeconomic challenges, and, in some cases, sexual exploitation. The participants faced emotional distress, financial instability, and social stigma, with support from family playing a critical role in the coping process. Despite the initial adversity, participants demonstrated resilience, finding ways to endure, adapt, and thrive.

Human ; Female ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Adolescent Pregnancy ; Pregnancy In Adolescence

BACKGROUND

In response to the need to provide for mental health services to address gender-related concerns in a higher education institute, the University of the Philippines (UP) Manila Center for Gender and Women Studies (CGWS) commissioned a project to formulate a framework for the increasing volume of referrals.

METHODOLOGY

A mixed methods study was done in order to gather data to create a responsive and practical mental health care service provision framework with and for service providers and service users in the university. An online survey (N=135), focus group discussion, key informant interviews, and a round table discussion were conducted, with constituents of the university recruited through purposive sampling.

RESULTS

A stepped-care model was proposed, consisting of: 1. Preventive Well-Being Resources, 2. Supportive Well-Being Interventions and Initial Screening Resources, 3. Structured Interventions, and 4. Interventions for Severe Mental Health Problems.

CONCLUSION

The framework formulated in collaboration with service providers and service users in the university addresses the goals of optimizing existing resources and enhancing service provision. Implementation and evaluation of this framework, as well as further information regarding the target population and their use of this model, are proposed avenues for further research.

Human ; Gender ; Gender Identity ; Sexual Harassment ; Mental Health ; Mental Health Services ; Lgbtq ; Sexual And Gender Minorities ; Psychiatry ; Psychology

Generally, this study explores the transformation of body image among former collegiate athletes in Metro Manila. Through qualitative hermeneutic phenomenology, the study found out diverse experiences of former female athletes with their body image. A salient theme that was elicited from the study was how changes in daily routines significantly impacted their perceptions. External factors like comments from family, peers, and society also played a major role. The cultural norms of both athletics and Philippine society influenced how these women internalized their body image. Many still associate ideal bodies with athletic terms like "muscular" or "visible abs." Coping mechanisms varied, but most leaned towards positive strategies like seeking support to counter the negative influences.

Human ; Female ; Hermeneutics ; Body Image ; Social Factors

Epithelioid sarcoma is an uncommon mesenchymal malignancy which represents less than 1% of all sarcomas. Rarer still are reports of this tumor initially presenting in the vulva. We report a case of vulvar proximal-type epithelioid sarcoma.

A 52-year-old had a 5-month history of slowly growing papule on the right labia majora. Excision of the mass revealed a tumor composed of large polygonal cells with abundant eosinophilic cytoplasm. An immunohistochemistry panel revealed cytokeratin AE1/AE3 positivity only. She underwent radical vulvectomy with bilateral groin node dissection. The specimen revealed a cream tan, firm, fairly defined mass at the right vulva. Microscopic examination showed a sheet-like growth pattern of large pleomorphic epithelioid cells with large vesicular nuclei and prominent nucleoli. The tumor showed loss of INI1 nuclear expression and absence of CD34 staining. EMA was positive. The case was signed out as proximal-type epithelioid sarcoma of the right vulva. Two months post-operatively, the patient was given concurrent chemotherapy with 5 cycles of cisplatin 40 mg/m2 and 6600 centigray vulvar intensity-modulated radiotherapy. She had no evidence of disease for five months until repeat workup showed tumor recurrence in the perineum. She was subsequently given 6 cycles of gemcitabine 900 mg/m2 and gemcitabine 900 mg/m2 with docetaxel 100 mg/m2. Two months after, repeat workup showed persistent progressive disease in the vulva. She was subsequently given 4 cycles of doxorubicin 60 mg/m2 and is for repeat workup.

The immunohistomorphologic features of this tumor, in addition to its unusual location, present a diagnostic challenge. Clues to the diagnosis include an initial presentation as a soft tissue mass and microscopic features showing the presence of epithelioid to spindle cytomorphology with an infiltrative growth pattern. Immunohistochemistry studies revealing the loss of INI1 nuclear expression and expression of epithelial markers would ultimately establish the diagnosis of this rare clinical entity.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Female Urogenital Diseases ; Vulvar Neoplasms ; Epithelioid Sarcoma

Hyalinizing clear cell carcinoma of the salivary gland is a rare neoplasm, accounting for only less than 1% of malignancies arising from the salivary gland. It is molecularly defined by the expression of the EWSR-ATF1 fusion oncogene. To date, there has been no previous studies published yet in the Philippines regarding the existence of this tumor. In this paper, we present a case of a 70-year-old elderly female who had a 10-year history of a gradually enlarging left lateral neck mass. Histopathologic examination showed a tumor arranged of cords, nests, and trabeculae of monomorphic round cells with abundant clear to lightly eosinophilic cytoplasm surrounded by thick hyalinized collagen bundles. Immunohistochemistry and molecular studies were done which revealed a positive p63 staining, negative SMA and S100, and an EWSR1 rearrangement in Fluorescence in situ hybridization (FISH), thus, confirming the diagnosis.

Human ; Female ; Aged: 65-79 Yrs Old ; Carcinoma ; Immunohistochemistry

Schistosomiasis, a snail-borne disease caused by infection with a trematode parasite of the genus Schistosoma, is one of the most neglected tropical diseases in the world. One of its rare complications is hepatosplenic schistosomiasis which ultimately leads to fibrosis and presinusoidal portal hypertension.

We report a case of a 13-year-old Filipino male from Quezon City with previous one year residence in the endemic island of Leyte, presenting with melena. Diagnostic work-up revealed hepatosplenomegaly and periportal fibrosis with multiple hepatic nodules on ultrasound, positive Schistosoma japonicum eggs on Kato-Katz stool examination technique, and findings of esophageal varices on upper endoscopy. The patient was managed with praziquantel, propranolol, and endoscopic rubber band ligation of the esophageal varices, with note of resolution of bleeding, and improvement on sonographic liver findings.

The degree of liver fibrosis from schistosomiasis is affected by poorly understood mechanisms which affect its severity, progression, and complications, regardless of biosocial factors including egg burden and duration of parasite exposure. This is the first case report on a Filipino adolescent to document significant interval improvement, within four weeks of treatment, of the characteristic fibrotic pattern in hepatosplenic schistosomiasis. Hepatosplenic schistosomiasis is still often missed out as the diagnosis in patients who consult with common symptoms, and high index of suspicion is recommended for those with history of residence in endemic areas. Likewise, treatment focusing on parasite eradication can aid in promptly addressing the resulting fibrosis and its complications.

Human ; Male ; Adolescent: 13-18 Yrs Old ; Fibrosis ; Hypertension, Portal

BACKGROUND

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL). Classification of DLBCL is often based on the cell of origin (COO), distinguishing between germinal center B-cell (GCB) and non-GCB subtypes. Although not yet recognized as a distinct entity by the World Health Organization (WHO), double expressor lymphoma (DEL), characterized by the co-expression of c-MYC and BCL2, carries an unfavorable prognosis for a subgroup of DLBCL patients. Another entity is the so-called high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements (double-hit/triple-hit lymphomas) diagnosed through fluorescent in-situ hybridization (FISH) analysis.

OBJECTIVE

This study aimed to determine the clinicopathologic profile and survival outcomes of Filipino DLBCL patients at the Philippine General Hospital (2016-2021), comparing double-hit versus non-double-hit and doubleexpressor versus non-double-expressor lymphomas, and assessing concordance between FISH-measured double-hit and IHC-measured double-expressor statuses.

METHODS

This is a single-arm, retrospective cohort study involving all surgical pathology cases signed out, with the aid of immunohistochemistry (IHC) studies, as NHL DLBCL, GCB, or non-GCB subtype, from 2016 to 2021. A second panel of IHC studies and FISH analysis using tissue microarray was subsequently done. Most cases exhibited a nonGCB subtype and were classified as DEL on second IHC panel. Five out of eleven DEL cases were reclassified as double hit lymphoma (DHL).

RESULTS

Clinically, most patients with these lymphomas present at age 60 years and below, exhibit B symptoms, with elevated serum lactate dehydrogenase (LDH) levels, at least stage III-IV disease at diagnosis, and possess a high International Prognostic Index (IPI) score, collectively indicating a poor prognosis.

CONCLUSION

Survival outcomes for patients with DLBCL ranges from three to 37 months. All cases of mortality were associated with DEL, contrasting with DHL cases which had variable outcomes. Due to limited sampling, statistical significance of the results cannot be determined. A comprehensive evaluation is essential to the diagnosis of DLBCL and DHL to include a complete immunohistochemistry panel and molecular testing, notably with FISH studies.

Human ; Lymphoma ; Lymphoma, Large B-cell, Diffuse ; Immunohistochemistry ; Cytogenetics