Rationale/Objective: The competency of surgical trainees is measured by, among other things, summative examinations and operative experience. There is little literature on general surgery training in the Philippines. This study examines the trends in operative case load and variety in training institutions accredited by the Philippine Society of General Surgeons (PSGS) from 2009-2018. Methods: This is an observational cross-sectional study of the surgical outputs of PSGS accredited training institutions as reflected in their annual reports. The study determined the trends in general surgical case load and variety and their distribution across the different training institution types from 2009 to 2018. Results: In the study period, there is a trend to an increasing number of operations across all categories/procedures except for trauma surgeries. Overall, the average number of cases credited to residents meets the requirements set by the PSGS. The distribution of cases, however, is not equal among residents of the different institutiontypes. Changes in scope and differences in interpretation of index operations contributed to significant changes in trends. Conclusion Recommendations include a review of definitions of index operations and strict compliance to changes, the utilization of an annual computerized database and the addition of patient outcome measures in the assessment of resident competencies.

Background: Health literacy is important in the self-management of hypertension. It is, thus, necessary to assess the health literacy of hypertensive patients to identify health literacy gaps and make appropriate interventions. A prerequisite to health literacy assessment is an accurate and efficient measurement of health literacy. Objective: This study examined the psychometric properties of the Filipino version of Health Literacy Short-Form 12 (HLS-SF12) among adult patients with hypertension. Methodology: A cross-sectional study was conducted among 47 hypertensive patients from a selected barangay who were registered in the local health center. Data were analyzed using correlation analysis, Cronbach's alpha test, and Mann-Whitney U test. Results: The acceptability was demonstrated by the absence of missing data, lack of significant floor and ceiling effects, and adequate distribution of scores. Cronbach's alpha was 0.78, and most corrected item-total correlations ranged from .31 to .58, which suggested satisfactory reliability. The pattern of interdomain correlations (r = .38-.69) and domain score-total score correlations (r = .76-.91) supported the construct validity of the instrument. Known-groups validity was also exhibited by the lower health literacy scores among those with primary education than those with secondary or tertiary education (median: 22.22 vs 29.17, p = 0.04). Conclusion Satisfying the set criteria, the Filipino version of HLS-SF12 is an acceptable, reliable, and valid instrument to measure the health literacy of adult hypertensive patients in a selected barangay in Manila.
Health Literacy ; Hypertension

Background & Objectives: Stroke mimics are conditions that simulate the signs and symptoms of a stroke. These conditions pose a clinical challenge as they need to be distinguished from actual strokes based on neurologic findings, laboratory tests, and imaging studies in order to minimize the adverse effects of acute stroke therapies as well as hospital costs. The study aims to determine the rate and the most common etiologies of stroke mimics in a private tertiary care hospital in the Philippines and calculate the average cost incurred for diagnostics. Methods: We conducted a retrospective review of medical records of adult patients assessed by the hospital’s Brain Attack Team from 1 January 2014 to 31 December 2017. The diagnosis of stroke mimic was based on negative neuroimaging findings and laboratory results that showed an alternate diagnosis, in consultation with the stroke neurologist on call. Results: A total of 1,485 patient records were analyzed; 448 patients (30.2%) were diagnosed as stroke mimics. The most common etiologies were encephalopathy (83 cases, 18.5%), seizures (77 cases, 17.2%), headache (31 cases, 6.9%), hypertensive emergency (31 cases, 6.9%), and radiculopathy (27 cases, 6.0%). The average cost for diagnostics for each patient diagnosed as a stroke mimic was PHP 24,629.53 (approximately US$500). Conclusion: Stroke mimics are often encountered in the emergency setting. Due to the wide range of medical conditions that mimic stroke, early recognition is important in order to avoid the potential adverse effects of acute stroke therapies and minimize diagnostic costs, particularly in countries with limited resources.

OBJECTIVE: This study assessed the species composition of mosquitoes collected from ovitraps in selected public schools of Metro Manila, Philippines.

MATERIALS AND METHODS: Ovitraps were installed from November 2013 to February 2014, in purposively selected public elementary and high schools of Metro Manila. Ovitraps were installed inside classrooms and collected weekly and examined for mosquito eggs and larvae. Speciation was done once a month from November 2013 to February 2014. All positive paddles were immersed in water for larval emergence, reared to fourth instars and were identified using taxonomic keys.

RESULTS: A total of 1,482 ovitraps were installed in the selected public schools, and 18,325 larvae were collected from elementary schools, while 16,670 larvae were collected from high schools. The mean ovitrap index or infestation rate was 49.69% during the period of data collection. Mosquito larvae were identified as Aedes aegypti (88.94%) and Aedes albopictus (11.06%). Aedes aegypti and Aedes albopictus coexisted in some of the examined paddles. No significant differences were observed between the type of school and the presence of Aedes larvae. Significant differences were observed between total number of mosquito larvae and months of collection.

CONCLUSION: The presence of Aedes mosquitoes in schools evidently shows that continuous vector surveillance in schools is necessary as this information will help in the formulation of proactive vector control activities, thereby preventing the occurrence of mosquito-borne diseases.

In the last two decades gastroesophageal reflux disease (GERD), initially thought to be a disease only common  in the West, is described  increasingly in Asia, including the Philippines. A recent local report indicated that the prevalence of erosive esophagitis (EE), a common complication of GERD, has more than doubled, i.e., 2.9% to  6.3%,  between the two time periods of 1994-1997 and 2000-2003, respectively. GERD causes recurrent annoying symptoms which are common  reasons  for  clinic  visits  and consultations thus, it is the objective of these guidelines to provide both primary care physicians  (PCPs) and specialists a current, evidence-based, country-specific recommendations for the optimal management  of  GERD.  These  guidelines  are  intended   to   empower   PCPs   to   make   a   clinic-based diagnosis of GERD, to start an empiric acid-suppressive therapy in the appropriate patient,and direct them to select which GERD patient may need to undergo investigations to ascertain further the diagnosis of GERD or to assess outcomes of therapy. We acknowledge that studies published in the future may influence the impact on our confidence on the recommendations enumerated in  these guidelines thus, we commit to update this document when it is deemed appropriate.

Necrosis

Injury inflicted to the body by an external force ; inhibition, physical ; Freezing ; Colchicine ; Ciliary Body

4-methoxyamphetamine ; Research

Endothelium, Corneal