BACKGROUND

Intraoperative transfusion for gynecologic surgery, when appropriately used, can improve patient outcomes. However, when utilized incorrectly, blood transfusion can worsen patient outcomes and increase patient cost. This study aimed to evaluate the blood transfusion practices of tertiary hospitals in the Philippines.

The study utilized a cross-sectional design wherein prospective data were gathered through multiple sources across seven tertiary-level hospitals. Women admitted to undergo gynecologic surgery were recruited based on a set of criteria. A chart review was conducted, and blood utilization indices were calculated. Outcomes were compared between public versus private facilities and transfused versus nontransfused patients.

Among 514 patients, 79.7% underwent cross-matching and 75.1% received transfusions. Adverse events were rare, with no transfusion-related deaths. The overall crossmatch-to-transfusion ratio (C/T ratio) was 2.8, exceeding the 2.5 optimal benchmark; all public hospitals recorded a C/T ratio >2.5, whereas private centers had more efficient usage. Six hospitals met acceptable benchmarks for transfusion probability and transfusion index. Open abdominal procedures, particularly hysterectomy, accounted for the most blood used. Transfused patients had longer operative times, greater blood loss, lower preoperative hemoglobin, and more frequently involved resident physicians in training. Public hospitals recorded higher cross-match and transfusion rates, greater resident physician participation, and broader use of general anesthesia.

Results of the study highlight the importance of monitoring blood transfusion parameters to optimize blood utilization. The observed differences between public and private institutions in the country highlight the urgent need for standardized and evidence-based practice to ensure efficient transfusion protocols nationwide.

The present study aimed to evaluate the influence of serum vitamin D levels on semen quality and testosterone levels. This is a cross-sectional study conducted at Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Andrology Laboratory in Sao Paulo, Brazil, with 508 male patients, aged 18-60 years, from 2007 to 2017. Seminal parameters and serum sexual hormones were correlated with serum vitamin D concentrations in 260 men selected by strict selection criteria. Patients were divided into normozoospermic group (NZG, n = 124) and a group with seminal abnormalities (SAG, n = 136). Evaluation included complete physical examination, past medical history, habits and lifestyle factors, two complete seminal analysis with sperm functional tests, serum levels of 25-hydroxy-vitamin D

The prevalence of obesity in Asia is of epidemic proportions, with an estimated 1 billion overweight/obese individuals in the region. The majority of patients with type 2 diabetes mellitus (T2DM) are overweight/obese, which increases the risk of cardiorenal outcomes in these patients; hence, sustained reductions in body weight and visceral adiposity are important management goals. However, most of the glucose-lowering therapies such as insulin, sulfonylureas, glinides, and thiazolidinediones induce weight gain, which makes the management of overweight/obese T2DM patients challenging. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are the only oral glucose-lowering agents that have been shown to reduce body weight and visceral adiposity. In addition, SGLT-2 inhibitors therapy reduces ectopic fat deposition and improves adipose tissue function and weight-related quality of life. In this article, we aim to consolidate the existing literature on the effects of SGLT-2 inhibitors in Asian patients with T2DM and to produce clinical recommendations on their use in overweight or obese patients with T2DM. Recommendations from international and regional guidelines, as well as published data from clinical trials in Asian populations and cardiovascular outcomes trials are reviewed. Based on the available data, SGLT-2 inhibitors represent an evidence-based therapeutic option for the management of overweight/obese patients with T2DM.

The intra-articular use of hyaluronic acid (HA) for the treatment of synovitis and osteoarthritis is still controversial. As a consequence, corticosteroids remain the most frequently employed therapeutic agents, despite their potential systemic and local deleterious effects. This study examined the anti-inflammatory, antioxidant, and chondroprotective activities of low and high molecular weight hyaluronic acid (LMW-HA and HMW-HA) on lipopolysaccharide (LPS)-induced synovitis in horses compared to triamcinolone acetonide (TA). LPS was injected in the metacarpophalangeal joints, which were treated intra-articularly with either TA (as control) or LMW-HA or HMW-HA. Joint clinical evaluation and synovial fluid (SF) analysis were performed at 0, 8, 24, and 48 h. The white blood cell counts (WBC), prostaglandin E2 (PGE2), interleukin (IL)-1, IL-6, IL-10, tumor necrosis factor-α, chondroitin sulfate (CS) and HA concentrations, oxidative burst, and HA molecular weights were measured. TA reduced the lameness, swelling, and PGE2 release but increased the SF CS concentrations enormously at 24h and 48h, and decreased the SF HA modal molecular weight. These results indicate the breakdown of articular cartilage aggrecan and SF HA. In contrast, LMW-HA and HMW-HA were less effective in reducing the inflammation symptoms, but preserved the joints because only a modest increase in CS occurred at 24 h, decreasing at 48 h, and the SF HA was maintained. The HA-treatment also had anti-inflammatory actions, and LMW-HA was the most effective in reducing the release of cytokine. In summary, the HA treatment inhibited efficiently the digestion of cartilage proteoglycans and SF HA breakdown.
Adrenal Cortex Hormones ; Aggrecans ; Cartilage ; Cartilage, Articular ; Chondroitin Sulfates ; Digestion ; Dinoprostone ; Horses ; Hyaluronic Acid ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Interleukins ; Joints ; Leukocyte Count ; Metacarpophalangeal Joint ; Molecular Weight ; Necrosis ; Osteoarthritis ; Proteoglycans ; Respiratory Burst ; Synovial Fluid ; Synovitis ; Triamcinolone ; Triamcinolone Acetonide

Tendon transfers for radial nerve palsy is a common operation with good results. We did a retrospective study on twenty patients with radial nerve palsy who underwent tendon transfer surgery and recovered between January 2008 and December 2012. Outcomes measured were motor power of wrist extension, finger extension, grip strength and DASH scores. There was significant improvement of motor power of wrist and finger extension between the preoperative period and three months post-operatively, between the pre operative period and six months post operatively and between three and six months postoperatively (p = 0.0005). Grip strength improved significantly as well between preoperative, three and six months postoperatively (p = 0.0005). DASH scores reflecting patient satisfaction at six months postoperatively showed only mild or moderate difficulty of function.

Background: Benzene is primarily routed by inhalation which highly sensitive to blood parameters as bone marrow is their target organ. The ability of benzene even in low exposure levels may induce human bone marrow suppression resulting in blood diseases such as leukopenia, anemia, thrombocytopenia, aplastic anemia, and pancytopenia. In the occupational setting, the most common benzene-exposed workers are from the petrochemical industries and petrol distribution such as gasoline pumps. Benzene also generated primarily by mobile exhaust and some from various of anthropogenic sources at environmental atmosphere and occupationally exposed in the policemen traffic, taxi and bus drivers, and street vendors in long-length time with low concentration exposure. Methodology: This paper reviewed published articles on biomarkers exposure, effects and susceptibility as the useful tools for benzene exposure assessment in the occupational and environmental setting. Data from previous epidemiological studies relevant to benzene exposure in various occupational and environmental setting is also summarized. Results: Based on these analyses, the findings agreed that these biomarkers are could suggest in linking the benzene exposure with possible adverse health effects. The biological monitoring used in epidemiological studies is useful in providing an understanding of activation and detoxification of benzene in both the occupational and general population as they are exposed to wide range of benzene concentration. Conclusion. The biomarkers of exposure, effects, and susceptibility utilized for benzene exposure assessment are valid tools in determining the greatest potential risk as well as an early biological effect which then caused a related specific disease.
benzene exposure ; biomarkers ; genetic polymorphisms and environmental and occupational population

Indoor air quality (IAQ) has become a major concern nowadays because of the universality of exposure and its potential negative impact on human health especially on children. This study is intended to explore the association between IAQ and the respiratory health among preschool children in urban and suburban area. A cross-sectional comparative study was carried out among Malay preschool children in urban (N= 60, Puchong) and suburban (N=60, Hulu Langat) areas. An indoor air quality assessment was conducted in 12 preschools and 60 houses which include parameters of PM2.5, PM10, VOCs, mold, bacteria, Gram-negative bacteria and physical parameters. A set of standardized questionnaire was distributed to obtain respondents’ background information, exposure history and respiratory health symptoms. Spirometry test was carried out and the data obtained were analyzed to determine the lung function of the respondents. There was a significant difference between IAQ in urban and suburban preschools for all parameters measured (p<0.05). Most of the pollutants were significantly associated with respiratory health symptoms. There was a significant association between the level of indoor pollutants with the lung function abnormalities among the respondents. Even though this study is the first to take Gram-negative bacteria as an indoor air pollutant, the finding also shows that there is a significant association between exposure of Gram-negative bacteria with lung function impairment and higher reported respiratory symptoms among the respondents. The finding concluded that exposures to indoor air pollutants, especially PM2.5 increases the risk of getting lung function abnormality and respiratory health symptoms among respondents.
Indoor air quality ; mold ; bacteria ; lung function ; respiratory health symptoms

Paddy cultivation is one of the widely planted crop in Malaysia. The growth of agricultural activity leads to the use of Organophosphate pesticide to protect the crop. This study is to determine the relationship between the levels of blood cholinesterase with the performance of motor coordination of children living in paddy farming area in Tanjung Karang, Selangor. This cross sectional study was conducted among 683 children from four schools in an agricultural area. Majority of the children have at a family member worked as farmer and was involved with pesticides. A set of questionnaire on the was given to the children to be filled by their parents. To measure their exposure to pesticide, blood cholinesterase levels were measured. Blood samples were taken through finger prick technique and were then analysed using LOVIBOND 412870 AF287. The children were administered with motor-coordination performance test using WHO Neurobehavioral Core Test Battery and McCarthy Learning Ability Scale. Young group children (6-85 years) showed a mean score of 56.66 in motor-coordination test while older group children (10-11)= years) scored a mean of 45.37. There was a significant relationship between blood cholinesterase level and motor coordination performance among the young-group children (r=0.215, p<0.001) and the older-group children (r=0.106, p=0.049). Based on the Linear Regression test results, total household income of family, and mode of transport used were found to have significant relationship with blood cholinesterase level of children in both groups. In addition, blood cholinesterase level and mothers’ occupation were found to have significant relationship with the motor-coordination performance of all children.
Organophosphate ; children ; blood cholinesterase ; motor-coordination

Background: Benzene is primarily routed by inhalation which highly sensitive to blood parameters as bone marrow is their target organ. The ability of benzene even in low exposure levels may induce human bone marrow suppression resulting in blood diseases such as leukopenia, anemia, thrombocytopenia, aplastic anemia, and pancytopenia. In the occupational setting, the most common benzene-exposed workers are from the petrochemical industries and petrol distribution such as gasoline pumps. Benzene also generated primarily by mobile exhaust and some from various of anthropogenic sources at environmental atmosphere and occupationally exposed in the policemen traffic, taxi and bus drivers, and street vendors in long-length time with low concentration exposure. Methodology: This paper reviewed published articles on biomarkers exposure, effects and susceptibility as the useful tools for benzene exposure assessment in the occupational and environ-mental setting. Data from previous epidemiological studies relevant to benzene exposure in various occupational and en-vironmental setting is also summarized. Results: Based on these analyses, the findings agreed that these biomarkers are could suggest in linking the benzene exposure with possible adverse health effects. The biological monitoring used in epi-demiological studies is useful in providing an understanding of activation and detoxification of benzene in both the occu-pational and general population as they are exposed to wide range of benzene concentration. Conclusion. The biomarkers of exposure, effects, and susceptibility utilized for benzene exposure assessment are valid tools in determining the greatest potential risk as well as an early biological effect which then caused a related specific disease.

Indoor air quality (IAQ) has become a major concern nowadays because of the universality of exposure and its potential negative impact on human health especially on children. This study is intended to explore the association between IAQ and the respiratory health among preschool children in urban and suburban area. A cross-sectional comparative study was carried out among Malay preschool children in urban (N= 60, Puchong) and suburban (N=60, Hulu Langat) areas. An indoor air quality assessment was conducted in 12 preschools and 60 houses which include parameters of PM2.5, PM10, VOCs, mold, bacteria, Gram-negative bacteria and physical parameters. A set of standardized questionnaire was distributed to obtain respondents’ background information, exposure history and respiratory health symptoms. Spirometry test was carried out and the data obtained were analyzed to determine the lung function of the respondents. There was a significant difference between IAQ in urban and suburban preschools for all parameters measured (p<0.05). Most of the pollutants were significantly associated with respiratory health symptoms. There was a significant association between the level of indoor pollutants with the lung function abnormalities among the respondents. Even though this study is the first to take Gram-negative bacteria as an indoor air pollutant, the finding also shows that there is a significant association between exposure of Gram-negative bacteria with lung function impairment and higher reported respiratory symptoms among the respondents. The finding concluded that exposures to indoor air pollutants, especially PM2.5 increases the risk of getting lung function abnormality and respiratory health symptoms among respondents.