A 57-year-old woman with a 2-year history of a left infra-auricular mass with no associated symptoms presented with a 6.0 cm ´ 4.0 cm ´ 3.0 cm firm, non-tender, movable mass. No imaging was done. Fine needle aspiration biopsy (FNAB) revealed sheets of epithelial cells that had abundant dense grayish-blue cytoplasm in a mucinous background with abundant lymphocytes (Figure 1), suggestive of salivary gland neoplasm with oncocytic or oncocytoid features (Category IVB, Salivary Gland Neoplasm of Uncertain Malignant Potential).Total parotidectomy revealed a 4.3 X 3.2 X 3.0 cm deep lobe lesion with a tan-grey to dark brown, smooth and dull external surface. Cut sections showed a cream-white to pink, lobulated, heterogenous cut surfaces. Microscopically, the lesion was unencapsulated with poorly demarcated borders. The neoplastic cells were arranged in haphazard sheets and surrounded by abundant lymphocytes. The tumor cells had abundant eosinophilic and granular cytoplasm compatible with oncocytes with mild to moderate nuclear atypia. There were occasional cystic spaces that contained mucin though mucocytes were not readily apparent. (Figure 2) Necrosis, perineural and lymphovascular space invasion or anaplasia were not evident.
Carcinoma, Mucoepidermoid ; Salivary Gland Neoplasms ; Parotid Gland

INTRODUCTION: The COVID-19 pandemic has significantly increased reliance on digital devices for education, leading to heightened concerns about digital eye strain (DES) among students. This study aimed to investigate the association between screen time and the degree of DES among first to third-year medical students at a private medical school from August to September 2023. METHODS: An analytical cross-sectional design was employed, involving 194 participants who completed a self administered questionnaire, including the Computer Vision Syndrome Questionnaire (CVS-Q). Data were analyzed using descriptive statistics and relative risk calculations. RESULTS: The mean daily screen time was 6.94 hours, with 79.38% of participants reporting symptoms of digital eye strain. A significant association was found between screen time and DES, with a positive risk ratio of 1.304 for those spending 4-8 hours on screens compared to those with less than 4 hours. CONCLUSION This study highlights the growing prevalence of DES among medical students during the pandemic, emphasizing the need for educational institutions to implement strategies that mitigate screenrelated health risks. Recommendations include awareness programs, ergonomic guidelines and regular eye check-ups to promote ocular health.
Human ; Students, medical ; online learning ; education, distance

Background: and Purpose Visual hallucinations (VH) and subjective cognitive complaints (SCC) are associated with cognitive impairment (CI) in Parkinson’s disease. Our aims were to determine the association between VH and SCC and the risk of CI development in a cohort of patients with Parkinson’s disease and normal cognition (PD-NC). Methods: Patients with PD-NC (total score of >80 on the Parkinson’s Disease Cognitive Rating Scale [PD-CRS]) recruited from the Spanish COPPADIS cohort from January 2016 to November 2017 were followed up after 2 years. Subjects with a score of ≥1 on domain 5 and item 13 of the Non-Motor Symptoms Scale at baseline (V0) were considered as “with SCC” and “with VH,” respectively. CI at the 2-year follow-up (plus or minus 1 month) (V2) was defined as a PD-CRS total score of <81. Results: At V0 (n=376, 58.2% males, age 61.14±8.73 years [mean±SD]), the frequencies of VH and SCC were 13.6% and 62.2%, respectively. VH were more frequent in patients with SCC than in those without: 18.8% (44/234) vs 4.9% (7/142), p<0.0001. At V2, 15.2% (57/376) of the patients had developed CI. VH presenting at V0 was associated with a higher risk of CI at V2 (odds ratio [OR]=2.68, 95% confidence interval=1.05–6.83, p=0.039) after controlling for the effects of age, disease duration, education, medication, motor and nonmotor status, mood, and PD-CRS total score at V0. Although SCC were not associated with CI at V2, presenting both VH and SCC at V0 increased the probability of having CI at V2 (OR=3.71, 95% confidence interval=1.36–10.17, p=0.011). Conclusions VH were associated with the development of SCC and CI at the 2-year follow-up in patients with PD-NC.

Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.

Introduction: A size of more than 10 cm suggests that a soft tissue tumor might be malignant. Pertinent ancillary diagnostic testing, such as immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), may be done to confirm the diagnosis. Several studies have shown that size may be a useful criterion in determining which tumors are candidates for further molecular testing. MDM2 and p16 are IHC markers for atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDLPS). Objectives: The primary objective of this study is to determine the proportion of tumors signed out as “lipomas” from 2017 to 2019, and measuring at least 10 cm, that express MDM2 and p16 on IHC and warrant revision as ALT/WDLPS. Methodology: This is a descriptive, retrospective cohort study in which all lipomas from 2017 to 2019 that measured at least 10 cm were included. The size, age of the patient, and location of each tumor were documented. The slides of all eligible cases were reviewed and immunohistochemically stained for MDM2 and p16. For each case, the intensity and immunoreactivity of each stain were assessed using a modified, four-tier scoring system. Fisher’s exact test was used to determine if a significant number of tumors expressed MDM2 or p16. Results: Thirty (30) cases satisfied the inclusion and exclusion criteria. The average size of these tumors is 15.10 cm. There is no sex predilection. The most common location of these tumors is the extremities. None of the tumors expressed MDM2, and only one case was p16-positive. The case positive for p16 also showed cytologic atypia and variability in cell size, resulting in the revision of its diagnosis from lipoma to atypical lipomatous tumor. The rate of diagnosis revision after slide review and IHC studies is 3.33%. Conclusion None of the adipocytic tumors that measured at least 10 cm in diameter and were signed out as lipomas was MDM2 positive, and only one case was p16-positive. Thus, morphology remains the cornerstone in the diagnosis of adipocytic tumors. Careful microscopic evaluation is necessary to establish the diagnosis of malignancy in these tumors. Ancillary tests should only be considered in cases where the pathologic features are equivocal.
Neoplasms ; Adipose Tissue ; Lipoma ; Extremities

INTRODUCTION: Metro Manila is at risk from “the big one”, a magnitude 7.2 earthquake caused by the movement of the West Valley Fault, thus awareness and preparedness of the people are very important. The study compared the levels of earthquake awareness and preparedness of households in a high-risk area and a low risk area. METHODS: This was a cross-sectional study among 376 households each from a high- and a low-risk barangay in Metro Manila using a self-administered household-based survey questionnaire consisting of questions on awareness and preparedness. The prevalence of households classified as aware and wellprepared was computed; the significance of differences between the high- and low risk barangays was determined through Fisher’s exact test. RESULTS: There were fewer households classified as aware in the high-risk barangay compared with the low risk barangay, but the difference was not significant (PR = 0.98, 95% CI 0.84, 1.01, p = 0.078, Fisher’s exact test). Less than half of households were classified as well-prepared in both high- and low risk barangays (49.7 vs 46.5%) and the difference was not significant (PR = 1.07, 95% CI 0.92, 1.24, p = 0.422, Fisher’s exact test). Television was the most common source of information in both barangays. Households in the high-risk barangay were more likely to be well-prepared when a member was at least a high school graduate (PR = 2.54, 95% CI 1.24, 5.22, p = 0.001, Fisher’s exact test). CONCLUSION There was no difference in the levels of awareness and preparedness between high and low risk barangays. Television was the most common source of information in both high and low risk barangays. The presence of at least one high school graduate in the household from a high-risk barangay was associated with preparedness but not awareness.
environment ; earthquake ;

Background: Cervical cancer is the most common gynecologic malignancy in the Philippines despite being a preventable disease. Radical hysterectomy with pelvic lymphadenectomy is considered the standard surgical treatment of choice for patients with cervical cancer confined to the cervix up to the upper vagina. However, recent studies show that a less radical approach can be offered to these patients with comparable outcomes to radical hysterectomy, but with lesser perioperative and post-operative morbidity. Objectives: The purpose of this study was to compare the outcomes in terms of recurrence and survival among cervical cancer patients who underwent simple hysterectomy and radical hysterectomy seen in a tertiary government hospital. Methods: The records of all cervical cancer patients who underwent radical hysterectomy and simple hysterectomy for the past ten years were reviewed. Results: The incidence of cervical cancer patients who underwent simple hysterectomy from 2009-2018 is 0.37 per 100 person years or 0.592:16, lower than 1:16 ratio from 1964-1974, as reported by Manalo and Sotto.1 Only 9 out of 42 patients who underwent simple hysterectomy had cervical cancer screening within 1 year prior to surgery. Conclusion The most common indication for surgery was myoma uteri. Those who underwent radical hysterectomy had better recurrence free survival and overall survival than those who had simple hysterectomy.
Female ; Uterine Cervical Neoplasms ; Hysterectomy