Background: Pain impacts quality of life (QoL) in Parkinson's disease (PD) patients, yet it is often overlooked. This study aims to comprehensively evaluate pain in PD, particularly focusing on differences between neuropathic pain (NP) and other types. Methods: We conducted a cross-sectional study involving PD patients, assessing the prevalence and characteristics of pain. Various scales were employed to evaluate anxiety, depression, and QoL. We investigated associations between pain, demographic, and clinical variables to determine predictors and pain-related factors. Additionally, factors related to NP were explored. Results: During the study period, a total of 109 patients were examined. Sixteen patients were excluded due tovarious reasons. The final analysis included 93 patients (34 females and 59 males). Pain was reported by 80.6%of PD patients, with no significant demographic or clinical differences between those with and without pain.However, longer disease duration predicted NP, and musculoskeletal pain was more prevalent in females. Anxiety was common in patients with central parkinsonian pain (CPP). Patients taking amantadine reported less radicular/ neuropathic pain (RNP), suggesting a therapeutic role. Conclusions Our findings underscore the high prevalence of pain in PD and its impact on QoL. NP appears to be associated with disease progression, while sex-specific differences highlight the need for personalized pain management strategies. The association between anxiety and CPP emphasizes the importance of addressing psychological factors in PD pain management. Further research on amantadine's benefits in reducing RNP is warranted, emphasizing the importance of tailored pain management strategies for PD patients.

Background: Pain impacts quality of life (QoL) in Parkinson's disease (PD) patients, yet it is often overlooked. This study aims to comprehensively evaluate pain in PD, particularly focusing on differences between neuropathic pain (NP) and other types. Methods: We conducted a cross-sectional study involving PD patients, assessing the prevalence and characteristics of pain. Various scales were employed to evaluate anxiety, depression, and QoL. We investigated associations between pain, demographic, and clinical variables to determine predictors and pain-related factors. Additionally, factors related to NP were explored. Results: During the study period, a total of 109 patients were examined. Sixteen patients were excluded due tovarious reasons. The final analysis included 93 patients (34 females and 59 males). Pain was reported by 80.6%of PD patients, with no significant demographic or clinical differences between those with and without pain.However, longer disease duration predicted NP, and musculoskeletal pain was more prevalent in females. Anxiety was common in patients with central parkinsonian pain (CPP). Patients taking amantadine reported less radicular/ neuropathic pain (RNP), suggesting a therapeutic role. Conclusions Our findings underscore the high prevalence of pain in PD and its impact on QoL. NP appears to be associated with disease progression, while sex-specific differences highlight the need for personalized pain management strategies. The association between anxiety and CPP emphasizes the importance of addressing psychological factors in PD pain management. Further research on amantadine's benefits in reducing RNP is warranted, emphasizing the importance of tailored pain management strategies for PD patients.

Background: Pain impacts quality of life (QoL) in Parkinson's disease (PD) patients, yet it is often overlooked. This study aims to comprehensively evaluate pain in PD, particularly focusing on differences between neuropathic pain (NP) and other types. Methods: We conducted a cross-sectional study involving PD patients, assessing the prevalence and characteristics of pain. Various scales were employed to evaluate anxiety, depression, and QoL. We investigated associations between pain, demographic, and clinical variables to determine predictors and pain-related factors. Additionally, factors related to NP were explored. Results: During the study period, a total of 109 patients were examined. Sixteen patients were excluded due tovarious reasons. The final analysis included 93 patients (34 females and 59 males). Pain was reported by 80.6%of PD patients, with no significant demographic or clinical differences between those with and without pain.However, longer disease duration predicted NP, and musculoskeletal pain was more prevalent in females. Anxiety was common in patients with central parkinsonian pain (CPP). Patients taking amantadine reported less radicular/ neuropathic pain (RNP), suggesting a therapeutic role. Conclusions Our findings underscore the high prevalence of pain in PD and its impact on QoL. NP appears to be associated with disease progression, while sex-specific differences highlight the need for personalized pain management strategies. The association between anxiety and CPP emphasizes the importance of addressing psychological factors in PD pain management. Further research on amantadine's benefits in reducing RNP is warranted, emphasizing the importance of tailored pain management strategies for PD patients.

Background: Pain impacts quality of life (QoL) in Parkinson's disease (PD) patients, yet it is often overlooked. This study aims to comprehensively evaluate pain in PD, particularly focusing on differences between neuropathic pain (NP) and other types. Methods: We conducted a cross-sectional study involving PD patients, assessing the prevalence and characteristics of pain. Various scales were employed to evaluate anxiety, depression, and QoL. We investigated associations between pain, demographic, and clinical variables to determine predictors and pain-related factors. Additionally, factors related to NP were explored. Results: During the study period, a total of 109 patients were examined. Sixteen patients were excluded due tovarious reasons. The final analysis included 93 patients (34 females and 59 males). Pain was reported by 80.6%of PD patients, with no significant demographic or clinical differences between those with and without pain.However, longer disease duration predicted NP, and musculoskeletal pain was more prevalent in females. Anxiety was common in patients with central parkinsonian pain (CPP). Patients taking amantadine reported less radicular/ neuropathic pain (RNP), suggesting a therapeutic role. Conclusions Our findings underscore the high prevalence of pain in PD and its impact on QoL. NP appears to be associated with disease progression, while sex-specific differences highlight the need for personalized pain management strategies. The association between anxiety and CPP emphasizes the importance of addressing psychological factors in PD pain management. Further research on amantadine's benefits in reducing RNP is warranted, emphasizing the importance of tailored pain management strategies for PD patients.

BACKGROUND AND OBJECTIVE

COVID-19 has been associated with cardiac injury, often detectable through electrocardiographic (ECG) changes. This study seeks to characterize the cardiovascular and electrocardiographic profiles of adult patients diagnosed with COVID-19.

This study included adult patients with confirmed COVID-19 from June 2021 to June 2022. Clinical profiles and 12-lead ECG tracings were obtained from electronic medical records and reviewed independently by three cardiologists. Descriptive analysis was performed to summarize the cardiovascular and electrocardiographic findings in this population.

The study included 998 COVID-19 patients (mean age: 50 years; 53.7% male). The most common comorbidities were hypertension, diabetes, and dyslipidemia. A majority (31.36%) presented with severe COVID-19 infection. The most frequent significant ECG abnormalities observed at admission were sinus tachycardia (22.8%), and atrial fibrillation (11.02%). Additional ischemic findings included ST segment depression (2.91%), T-wave inversion (1.70%), and ST segment elevation (2.71%).

The baseline ECG findings among COVID-19 patients were predominantly normal; however, significant abnormalities were also identified. The most frequent abnormalities included sinus tachycardia, atrial fibrillation, and ischemic changes, all of which may have clinical implications.

Background: Pain impacts quality of life (QoL) in Parkinson's disease (PD) patients, yet it is often overlooked. This study aims to comprehensively evaluate pain in PD, particularly focusing on differences between neuropathic pain (NP) and other types. Methods: We conducted a cross-sectional study involving PD patients, assessing the prevalence and characteristics of pain. Various scales were employed to evaluate anxiety, depression, and QoL. We investigated associations between pain, demographic, and clinical variables to determine predictors and pain-related factors. Additionally, factors related to NP were explored. Results: During the study period, a total of 109 patients were examined. Sixteen patients were excluded due tovarious reasons. The final analysis included 93 patients (34 females and 59 males). Pain was reported by 80.6%of PD patients, with no significant demographic or clinical differences between those with and without pain.However, longer disease duration predicted NP, and musculoskeletal pain was more prevalent in females. Anxiety was common in patients with central parkinsonian pain (CPP). Patients taking amantadine reported less radicular/ neuropathic pain (RNP), suggesting a therapeutic role. Conclusions Our findings underscore the high prevalence of pain in PD and its impact on QoL. NP appears to be associated with disease progression, while sex-specific differences highlight the need for personalized pain management strategies. The association between anxiety and CPP emphasizes the importance of addressing psychological factors in PD pain management. Further research on amantadine's benefits in reducing RNP is warranted, emphasizing the importance of tailored pain management strategies for PD patients.

BACKGROUND AND OBJECTIVE

Physician adherence to the recommended management of patients with heart failure with reduced ejection fraction (HFrEF) at the outpatient setting is crucial to reduce the burden of subsequent rehospitalization, morbidity, and mortality. Recently updated guidelines recommend early and rapid titration to optimal doses of medications in the first 2 to 6 weeks of discharge. In the absence of local data, our study evaluates physician adherence to guideline-recommended treatment in this setting.

This is a retrospective cross-sectional study among post-discharge HFrEF patients at the outpatient department from December 2022 to May 2023 with a follow-up within three months. Clinical profile and treatment were extracted from medical records. Adherence to the 2021 ESC Guidelines Class I recommendations, among eligible patients, is measured as quality indicators. Data are presented using descriptive statistics.

A total of 99 patients were included in the study. Overall, adherence to prescription of beta-blockers (94.8%), ACEI/ARNI/ARBs (88.5%), and diuretics (100%) were high. Prescription of mineralocorticoid receptor antagonists (MRA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) were 67% and 57.3%, respectively. Over three months of follow-up, improvement in the quality of care was demonstrated with ACEI/ARNI/ARBs (81.8% to 90.9%), MRA (68.7 to 81.2%), and SGLT2i (58% to 67.7%). Beta-blocker use is consistently high at 97%. In the 3rd month post-discharge, titration to optimal doses was achieved in only 26.4%, 15%, and 6.25% for those on beta-blockers, ACEI/ARNI/ARB, and MRA, respectively. For non-pharmacologic management, referral to HF specialty was made in 30% and cardiac rehabilitation in 22.2%.

Among patients with HFrEF seen at the outpatient, there is good physician adherence to betablockers, ACEI/ARNI/ARBs, and diuretics. MRA and SGLT2i prescription, referral to HF specialty and cardiac rehabilitation, and up-titration to optimal doses of oral medications for HF need improvement. Hospital pathway development and regular performance evaluation will improve initiation, maintenance, and up-titration of appropriate treatment.

BACKGROUND

Waiting time of patients from a consult with a primary care physician to a specialist is poorly understood. It is one indicator of health service delivery and patient satisfaction. Patients consider waiting for a specialist consult for more than three months too long and unacceptable.

To describe the sociodemographic and clinical factors associated with length of referral waiting time.

Cross-sectional retrospective chart review of patient records in a tertiary government hospital from 2015 to 2019.

A total of 366 charts were reviewed. Many of the patients referred to other specialty clinics were middle-aged adults and females. Median wait times for medical and surgical specialties were 11 (IQR: 0-29) and 18 (IQR: 6-35) days, respectively (p=0.003). Nutrition, rehabilitative medicine, and family health unit received the most number of referrals among non-surgical fields. Ophthalmology, otorhinolaryngology, and general surgery received the highest number of referrals among the surgical fields. Referral waiting times were longest for cardiology (median: 125, IQR: 91-275 days) and shortest for nutrition (median: 0, IQR: 0-6 days).

Waiting times from a primary care clinic to a specialty clinic at a tertiary government hospital vary based on urgency, specialty clinic, purpose of referral, presence of comorbidities, and chronicity of condition. Clinical factors found to be significantly associated with referral waiting time include urgency, type of clinic, and purpose of referral.

BACKGROUND

Length of stay is one of the metrics of crowding in the emergency department. Identification of the factors associated with prolonged length of stay is vital for staffing and policy making to prevent overcrowding at the ambulatory care unit.

This study aimed to determine the association of sociodemographic, clinical, and temporal factors with length of stay among patients seen at the ambulatory care unit of a tertiary government training hospital.

A retrospective case-control study was conducted between January to December 2019 at the ambulatory care unit of a tertiary government hospital. Charts of patients who stayed for more than six (6) hours were classified as cases, while those who stayed for more than two (2) hours up to six (6) hours were classified as controls. Charts were reviewed to obtain the clinicodemographic profile of patients who satisfied the inclusion criteria.

The case group consisted of 86 patients, while the control group consisted of 172 patients. Eight factors had an effect on the probability of prolonged length of stay at the ambulatory care unit: age 40-59 years old (OR = 2.29, 95% CI: 1.16-4.49), ESI 3 at triage level (OR = 3.35, 95% CI: 1.50-8.38), psychiatric complaint (OR = 6.97, 95% CI: 2.53-19.21), medications given and diagnostics done (OR = 2.16, 95% CI: 1.16-3.99), medications given/diagnostics/ referral to other services done (OR = 7.67, 95% CI: 2.70-21.80), psychiatric/substance-related case (OR = 6.97, 95% CI: 2.63-18.49), transferred to other services (OR = 3.25, 95% CI: 1.33-7.94), and endorsed to next shift (OR = 6.94, 95% CI = 3.90-12.35).

The factors associated with prolonged length of stay were middle-aged adults, conditions with severe presentation, psychiatric/substance-use-related cases, need for more diagnostic test and treatment intervention, and decision to transfer care to other services.

Background and Objective: Physician adherence to the recommended management of patients with heart failure with reduced ejection fraction (HFrEF) at the outpatient setting is crucial to reduce the burden of subsequent rehospitalization, morbidity, and mortality. Recently updated guidelines recommend early and rapid titration to optimal doses of medications in the first 2 to 6 weeks of discharge. In the absence of local data, our study evaluates physician adherence to guideline-recommended treatment in this setting. Methods: This is a retrospective cross-sectional study among post-discharge HFrEF patients at the outpatient department from December 2022 to May 2023 with a follow-up within three months. Clinical profile and treatment were extracted from medical records. Adherence to the 2021 ESC Guidelines Class I recommendations, among eligible patients, is measured as quality indicators. Data are presented using descriptive statistics. Results: A total of 99 patients were included in the study. Overall, adherence to prescription of beta-blockers (94.8%), ACEI/ARNI/ARBs (88.5%), and diuretics (100%) were high. Prescription of mineralocorticoid receptor antagonists (MRA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) were 67% and 57.3%, respectively. Over three months of follow-up, improvement in the quality of care was demonstrated with ACEI/ARNI/ARBs (81.8% to 90.9%), MRA (68.7 to 81.2%), and SGLT2i (58% to 67.7%). Beta-blocker use is consistently high at 97%. In the 3rd month post-discharge, titration to optimal doses was achieved in only 26.4%, 15%, and 6.25% for those on beta-blockers, ACEI/ARNI/ARB, and MRA, respectively. For non-pharmacologic management, referral to HF specialty was made in 30% and cardiac rehabilitation in 22.2%. Conclusion Among patients with HFrEF seen at the outpatient, there is good physician adherence to betablockers, ACEI/ARNI/ARBs, and diuretics. MRA and SGLT2i prescription, referral to HF specialty and cardiac rehabilitation, and up-titration to optimal doses of oral medications for HF need improvement. Hospital pathway development and regular performance evaluation will improve initiation, maintenance, and up-titration of appropriate treatment.
Human ; outpatients