Pub Date : 2022-12-07DOI: 10.35460/2546-1621.2022-sp05
L. Mercado-Asis, Ma. Lourdes D Maglinao
Research integrity is manifested thru the use of honest and verifiable research methods with adherence to accepted professional codes. Recently, trustworthiness in research has been challenged by various forms of research misconduct, such as analytical flexibility, data dredging, HARKing (hypothesis after research knowledge), plagiarism, and selective and distorted reporting. Drivers of research misconduct have been identified as institutional--publication incentives to pursue a career, researcher--metric of success is publication volume, and the journal-- more likely to accept papers with positive. The open-access mode propelling the proliferation of predatory journals is causing a dilemma to sound research reporting. Measures were established to curtail research integrity challenges, such as study registration, open data, common reporting standards, a team of rivals, and blind analysis. This report will elaborate and provide insight into what influenced research misconduct, how it can be mitigated, and how to maintain a credible research environment.
{"title":"Improving Systems to Promote Research Integrity","authors":"L. Mercado-Asis, Ma. Lourdes D Maglinao","doi":"10.35460/2546-1621.2022-sp05","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp05","url":null,"abstract":"Research integrity is manifested thru the use of honest and verifiable research methods with adherence to accepted professional codes. Recently, trustworthiness in research has been challenged by various forms of research misconduct, such as analytical flexibility, data dredging, HARKing (hypothesis after research knowledge), plagiarism, and selective and distorted reporting. Drivers of research misconduct have been identified as institutional--publication incentives to pursue a career, researcher--metric of success is publication volume, and the journal-- more likely to accept papers with positive. The open-access mode propelling the proliferation of predatory journals is causing a dilemma to sound research reporting. Measures were established to curtail research integrity challenges, such as study registration, open data, common reporting standards, a team of rivals, and blind analysis. This report will elaborate and provide insight into what influenced research misconduct, how it can be mitigated, and how to maintain a credible research environment.","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129838836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-07DOI: 10.35460/2546-1621.2022-sp16
Joseph Niño A Espino, A. M. C. Navarroza, Alvin Brian C Velasco, R. Romano, Carmelita C Dalupang, Frederick T Dy, Stephen N. Wong
Background: Weight loss, though difficult to attain and sustain over time, remains the cornerstone of non-alcoholic fatty liver disease (NAFLD) treatment. We aimed to describe weight changes among NAFLD patients. Methods: This was a retrospective, cohort study of consecutively-identified NAFLD patients with >2 clinic visits from March2007–April2018. Weight changes from baseline were categorized into weight gain, weight loss, and no change. Baseline liver and metabolic biochemistries and non-invasive liver fibrosis tests were correlated with the final weight changes. Succeeding weight changes after the initial follow-up visits were used to determine sustainability of weight loss. Results: Of the 240 patients included, 123 (51.2%), 93 (38.8%), and 24 (10%) had weight gain, weight loss, and no change, respectively. Only 12.5% had >5% weight loss. Duration of follow-up was significantly longer for patients with weight loss (p<0.001). None of the baseline demographic and laboratory data were associated with weight loss. Patients with weight loss also did not have significant changes to their biochemistries and non-invasive liver fibrosis tests compared to patients with weight gain/no change. Compared to patients with weight gain after the initial follow-up, where only 11.8% were able to lose weight on the final visit, 73.1% of patients who lost weight after the initial follow-up were able to sustain their weight loss on the final visit. Conclusions: Weight loss is achieved in only a third of NAFLD patients. Although 73% of patients who lost weight initially were able to sustain it, patients who gained weight after the 1st follow-up were unlikely to lose weight on further follow-up. Key words: Non-alcoholic fatty liver disease, weight loss, sustainability
{"title":"Low Sustainability of Weight Loss Among Patients with Non-alcoholic Fatty Liver Disease","authors":"Joseph Niño A Espino, A. M. C. Navarroza, Alvin Brian C Velasco, R. Romano, Carmelita C Dalupang, Frederick T Dy, Stephen N. Wong","doi":"10.35460/2546-1621.2022-sp16","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp16","url":null,"abstract":"Background: Weight loss, though difficult to attain and sustain over time, remains the cornerstone of non-alcoholic fatty liver disease (NAFLD) treatment. We aimed to describe weight changes among NAFLD patients. Methods: This was a retrospective, cohort study of consecutively-identified NAFLD patients with >2 clinic visits from March2007–April2018. Weight changes from baseline were categorized into weight gain, weight loss, and no change. Baseline liver and metabolic biochemistries and non-invasive liver fibrosis tests were correlated with the final weight changes. Succeeding weight changes after the initial follow-up visits were used to determine sustainability of weight loss. Results: Of the 240 patients included, 123 (51.2%), 93 (38.8%), and 24 (10%) had weight gain, weight loss, and no change, respectively. Only 12.5% had >5% weight loss. Duration of follow-up was significantly longer for patients with weight loss (p<0.001). None of the baseline demographic and laboratory data were associated with weight loss. Patients with weight loss also did not have significant changes to their biochemistries and non-invasive liver fibrosis tests compared to patients with weight gain/no change. Compared to patients with weight gain after the initial follow-up, where only 11.8% were able to lose weight on the final visit, 73.1% of patients who lost weight after the initial follow-up were able to sustain their weight loss on the final visit. Conclusions: Weight loss is achieved in only a third of NAFLD patients. Although 73% of patients who lost weight initially were able to sustain it, patients who gained weight after the 1st follow-up were unlikely to lose weight on further follow-up. Key words: Non-alcoholic fatty liver disease, weight loss, sustainability","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125095156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-07DOI: 10.35460/2546-1621.2022-sp01
P. Caguioa, M. Ramirez
{"title":"DESCRIPTION OF THE THEME FOR THE 95TH ANNIVERSARY OF THE DEPARTMENT OF MEDICINE - Internal Medicine at 95: An Illustrious Past, A Dynamic and Vibrant Present and A Revolutionary Future","authors":"P. Caguioa, M. Ramirez","doi":"10.35460/2546-1621.2022-sp01","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp01","url":null,"abstract":"","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129493480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-07DOI: 10.35460/2546-1621.2022-sp02
A. T. Alora
The Coronavirus-19 (Covid-19) pandemic disrupts our medical world. There are substantial demands on our overstretched, understaffed, and under-resourced health systems. Physicians continuously adjust to “crisis standard of care” and new skills for on-line or face to face restricted practice. Physician health and well-being suffer stress, burn-out and moral injury. Many get sick and some die. They ask: “How should I behave as a medical professional in a time of the Covid-19 Pandemic and Beyond?” This article explores medical professionalism: its meaning, its core values and challenges in the time of Covid-19. Its aim is to help doctors and medical students improve their professionalism, and mature into more dedicated physicians who derive joy and pride in what they do.
{"title":"Medical Professionalism in a Time of the Covid 19 Pandemic and Beyond","authors":"A. T. Alora","doi":"10.35460/2546-1621.2022-sp02","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp02","url":null,"abstract":"The Coronavirus-19 (Covid-19) pandemic disrupts our medical world. There are substantial demands on our overstretched, understaffed, and under-resourced health systems. Physicians continuously adjust to “crisis standard of care” and new skills for on-line or face to face restricted practice. Physician health and well-being suffer stress, burn-out and moral injury. Many get sick and some die. They ask: “How should I behave as a medical professional in a time of the Covid-19 Pandemic and Beyond?” This article explores medical professionalism: its meaning, its core values and challenges in the time of Covid-19. Its aim is to help doctors and medical students improve their professionalism, and mature into more dedicated physicians who derive joy and pride in what they do.","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128380716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-07DOI: 10.35460/2546-1621.2022-sp08
Clarissa M Mendoza
Background: Corona Virus 2019 (COVID-19) challenged the delivery of medical education and training, especially to the 4th year medical students. Medicine's signature pedagogy, the ward rounds in the hospital, was put on hold in compliance with safety precautions during this pandemic and the Commission on Higher Education’s (CHED) suspension of face-to-face classes in all levels. How the University of Santo Tomas Faculty of Medicine & Surgery (UST FMS) Cardiology Rotation was delivered despite these restrictions is described. Using Google Classroom, Blackboard Collaborate, and Zoom, a 7-day online Cardiology Clerkship rotation was delivered to UST FMS 4th year students (clerks) using the synchronous and asynchronous mode of delivery. It consisted of the following: 1) Cardiovascular (CV) Ward Rotation with 3 cases using Google Classroom's adaptive release to create a vicarious experience of taking care of a patient and doing all the tasks that a clerk is supposed to do; 2) Virtual Ward Rounds by a consultant; 3) Outpatient Department (OPD) / Ambulatory Care Services (ACS) case discussions with a consultant and a 4) Heart Station Rotation for training in electrocardiogram (ECG) interpretation. Conclusion: The advances in technology and software provided just-in-time resources that made possible the creative delivery of Medicine's signature pedagogy. Key words: virtual cardiology rotation, clerkship, signature pedagogy
{"title":"The Virtual Cardiology Rotation: Situated Cognition and the Signature Pedagogy in Medicine","authors":"Clarissa M Mendoza","doi":"10.35460/2546-1621.2022-sp08","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp08","url":null,"abstract":"Background: Corona Virus 2019 (COVID-19) challenged the delivery of medical education and training, especially to the 4th year medical students. Medicine's signature pedagogy, the ward rounds in the hospital, was put on hold in compliance with safety precautions during this pandemic and the Commission on Higher Education’s (CHED) suspension of face-to-face classes in all levels. How the University of Santo Tomas Faculty of Medicine & Surgery (UST FMS) Cardiology Rotation was delivered despite these restrictions is described. Using Google Classroom, Blackboard Collaborate, and Zoom, a 7-day online Cardiology Clerkship rotation was delivered to UST FMS 4th year students (clerks) using the synchronous and asynchronous mode of delivery. It consisted of the following: 1) Cardiovascular (CV) Ward Rotation with 3 cases using Google Classroom's adaptive release to create a vicarious experience of taking care of a patient and doing all the tasks that a clerk is supposed to do; 2) Virtual Ward Rounds by a consultant; 3) Outpatient Department (OPD) / Ambulatory Care Services (ACS) case discussions with a consultant and a 4) Heart Station Rotation for training in electrocardiogram (ECG) interpretation. Conclusion: The advances in technology and software provided just-in-time resources that made possible the creative delivery of Medicine's signature pedagogy. Key words: virtual cardiology rotation, clerkship, signature pedagogy","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126212628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-07DOI: 10.35460/2546-1621.2022-sp17
M. Ramirez
{"title":"Images in Medicine: The Tales of William, Willem, and Waller, and the Birth of the Electrocardiogram","authors":"M. Ramirez","doi":"10.35460/2546-1621.2022-sp17","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp17","url":null,"abstract":"","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123750356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-07DOI: 10.35460/2546-1621.2022-sp00
M. Ramirez
{"title":"AN OPEN LETTER TO DR. WILLIAM BURKE (and the Pillars of Medicine that followed)","authors":"M. Ramirez","doi":"10.35460/2546-1621.2022-sp00","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp00","url":null,"abstract":"","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115064487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-07DOI: 10.35460/2546-1621.2022-sp13
Maria Piedad Rosales-Natividad
The World Health Organization declared Covid 19 a pandemic in March 2020, disrupting medical education and creating a significant void in the hospital rotation of the clinical clerks. Alternative methods of teaching and learning had to be instituted, and since face-to-face encounters were still not allowed, all these activities had to be online. While the various activities were able to challenge critical analysis and thinking, the Section on Pulmonary Medicine felt that the clerks would benefit most from activities that would most closely simulate an actual patient encounter. And so, the PulmoSerye was born: a miniseries that followed the patient from initial consultation in the emergency room resulting in admission, events that happened in the ward, formulation of the Master Problem List, progress notes, giving discharge orders, writing the discharge summary, and finally a follow up via Telemedicine. This is what the clerks would have experienced if they had been in hospital. Activities such as the Pulmoserye should be highly considered as a viable option should clerkship hospital rotations once again be put on hold. Key words: Covid 19, online learning, medical education, innovation, clinical clerkship
{"title":"TWO THUMBS UP! A Review of the “PULMOSERYE: Pulmonary Patient Miniseries… Dead or Alive: The Saga of Mang Jose”- a Clerkship Learning Activity During the Pandemic","authors":"Maria Piedad Rosales-Natividad","doi":"10.35460/2546-1621.2022-sp13","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp13","url":null,"abstract":"The World Health Organization declared Covid 19 a pandemic in March 2020, disrupting medical education and creating a significant void in the hospital rotation of the clinical clerks. Alternative methods of teaching and learning had to be instituted, and since face-to-face encounters were still not allowed, all these activities had to be online. While the various activities were able to challenge critical analysis and thinking, the Section on Pulmonary Medicine felt that the clerks would benefit most from activities that would most closely simulate an actual patient encounter. And so, the PulmoSerye was born: a miniseries that followed the patient from initial consultation in the emergency room resulting in admission, events that happened in the ward, formulation of the Master Problem List, progress notes, giving discharge orders, writing the discharge summary, and finally a follow up via Telemedicine. This is what the clerks would have experienced if they had been in hospital. Activities such as the Pulmoserye should be highly considered as a viable option should clerkship hospital rotations once again be put on hold. Key words: Covid 19, online learning, medical education, innovation, clinical clerkship","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129963296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-07DOI: 10.35460/2546-1621.2022-sp06
F. Mesina, M. Collante
Background: The field of medicine is constantly changing. Notable changes occur in the patterns of clinical practice, business of medicine, shift in demographics/generation of the health care workforce, emergence of sub-specialization; and advances in research and technology. These changes can affect the way young physicians establish their practice and this is an area not addressed by the medical education and training. Purpose: There is little data in the literature regarding the experience of young physicians in establishing clinical practice. This study was undertaken to answer the central question: Among physicians in the field of Internal Medicine with or without subspecialty who graduated from training in 2013 to 2018, what were the issues and challenges that they faced as they established their clinical practice in the urban or mixed setting? Methodology: Qualitative research-case study; Key informant interview was conducted among junior Internal Medicine consultants who satisfied the inclusion criteria. Data analysis used thematic analysis consisting of reading, writing notes, describing, and classifying transcripts according to categories and themes. Results: After a comprehensive analysis of narratives, five emergent themes surfaced: “Tough Days” (Period of figuring out the system; Need for Self-introduction; Few patients and Feelings of frustration and depression); “Torn and Divided” (Unpredictable work schedule and workload; Lack of time for issues outside career); “Temporary Debt” (Large start-up cost; Expensive maintenance); “Difficult but Tolerable” (Family support; Call-a-colleague; Debt of gratitude to mentors) and lastly “Dreams and To-do’s”. Conclusions: Our respondents have experienced substantial challenges in starting clinical practice. Learning the ways of the healthcare business, effectively promoting oneself to the community, dealing with the emotional turmoil of having few patients, coming up with a strategic schedule and area of practice, and looking for funds and paying it back, were the challenges and experiences of these young medical specialists as they establish their careers in the urban and/or rural setting. Key words: clinical practice, challenges, start-up, establishing practice
{"title":"Challenges and Experiences of Young Medical Specialists in Establishing Private Clinical Practice","authors":"F. Mesina, M. Collante","doi":"10.35460/2546-1621.2022-sp06","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp06","url":null,"abstract":"Background: The field of medicine is constantly changing. Notable changes occur in the patterns of clinical practice, business of medicine, shift in demographics/generation of the health care workforce, emergence of sub-specialization; and advances in research and technology. These changes can affect the way young physicians establish their practice and this is an area not addressed by the medical education and training. Purpose: There is little data in the literature regarding the experience of young physicians in establishing clinical practice. This study was undertaken to answer the central question: Among physicians in the field of Internal Medicine with or without subspecialty who graduated from training in 2013 to 2018, what were the issues and challenges that they faced as they established their clinical practice in the urban or mixed setting? Methodology: Qualitative research-case study; Key informant interview was conducted among junior Internal Medicine consultants who satisfied the inclusion criteria. Data analysis used thematic analysis consisting of reading, writing notes, describing, and classifying transcripts according to categories and themes. Results: After a comprehensive analysis of narratives, five emergent themes surfaced: “Tough Days” (Period of figuring out the system; Need for Self-introduction; Few patients and Feelings of frustration and depression); “Torn and Divided” (Unpredictable work schedule and workload; Lack of time for issues outside career); “Temporary Debt” (Large start-up cost; Expensive maintenance); “Difficult but Tolerable” (Family support; Call-a-colleague; Debt of gratitude to mentors) and lastly “Dreams and To-do’s”. Conclusions: Our respondents have experienced substantial challenges in starting clinical practice. Learning the ways of the healthcare business, effectively promoting oneself to the community, dealing with the emotional turmoil of having few patients, coming up with a strategic schedule and area of practice, and looking for funds and paying it back, were the challenges and experiences of these young medical specialists as they establish their careers in the urban and/or rural setting. Key words: clinical practice, challenges, start-up, establishing practice","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"38 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120884088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-07DOI: 10.35460/2546-1621.2022-sp10
Virgilio S Lo Jr, Carmelita D Dado-Dalupang
Significance: Accurate detection of Helicobacter pylori (HP) is essential for the diagnosis of HP infection. The use of antibiotics and proton pump inhibitors (PPI) may result in false-negative rapid urease test (RUT) results. We aimed to determine the sensitivity and specificity of RUT compared with histology and assess the detection rate of combined RUT and histology for HP infection. Methodology: Retrospective data collection was performed on 192 patients who were tested for both RUT and histology at the time of upper endoscopy from 2017 to 2018. At least two gastric biopsies (1 from corpus, 1 from antrum) were taken each for RUT and histology. The endoscopy was performed by a single gastroenterologist and a single pathologist was responsible for interpreting the histology with hematoxylin and eosin (H&E) and Giemsa stain. The gold standard test for the diagnosis of HP infection was histology. Demographic profile, RUT and histology results were reviewed. Tests for diagnostic accuracy were computed using SPSSv23. Results: 192 patients were tested for RUT and histology. 52(27.1%) were males and 140(72.9%) were females with a mean age of 54±17 years. Epigastric pain was the most common indication (42.7%). 24(12.5%) patients tested positive for HP infection. Among these; 16(8.3%) tested positive for both RUT and histology(true-positive), while 8(4.2%) tested negative for RUT but had positive histology(false-negative). 6 out of 8(75%) patients with false negative results had PPI use. The sensitivity and specificity of RUT for the diagnosis of HP infection were 66.7 and 98.2%, respectively. While the positive and negative likelihood ratio were 37.3 and 0.34, respectively with a diagnostic odds ratio of 110. Conclusion: The HP detection rate of RUT combined with histology increased by 33% compared with RUT alone. RUT is a highly specific test for diagnosing HP infection. Given its modest sensitivity, histology plays an important role in the diagnosis of HP infection, especially in patients taking PPIs. We recommend doing histology when RUT is negative to increase the HP detection rate. Key words: retrospective, helicobacter pylori, rapid urease test, histology, RUT, giemsa stain
{"title":"Combined Rapid Urease Test and Histology For The Diagnosis of Helicobacter Pylori Infection","authors":"Virgilio S Lo Jr, Carmelita D Dado-Dalupang","doi":"10.35460/2546-1621.2022-sp10","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp10","url":null,"abstract":"Significance: Accurate detection of Helicobacter pylori (HP) is essential for the diagnosis of HP infection. The use of antibiotics and proton pump inhibitors (PPI) may result in false-negative rapid urease test (RUT) results. We aimed to determine the sensitivity and specificity of RUT compared with histology and assess the detection rate of combined RUT and histology for HP infection. Methodology: Retrospective data collection was performed on 192 patients who were tested for both RUT and histology at the time of upper endoscopy from 2017 to 2018. At least two gastric biopsies (1 from corpus, 1 from antrum) were taken each for RUT and histology. The endoscopy was performed by a single gastroenterologist and a single pathologist was responsible for interpreting the histology with hematoxylin and eosin (H&E) and Giemsa stain. The gold standard test for the diagnosis of HP infection was histology. Demographic profile, RUT and histology results were reviewed. Tests for diagnostic accuracy were computed using SPSSv23. Results: 192 patients were tested for RUT and histology. 52(27.1%) were males and 140(72.9%) were females with a mean age of 54±17 years. Epigastric pain was the most common indication (42.7%). 24(12.5%) patients tested positive for HP infection. Among these; 16(8.3%) tested positive for both RUT and histology(true-positive), while 8(4.2%) tested negative for RUT but had positive histology(false-negative). 6 out of 8(75%) patients with false negative results had PPI use. The sensitivity and specificity of RUT for the diagnosis of HP infection were 66.7 and 98.2%, respectively. While the positive and negative likelihood ratio were 37.3 and 0.34, respectively with a diagnostic odds ratio of 110. Conclusion: The HP detection rate of RUT combined with histology increased by 33% compared with RUT alone. RUT is a highly specific test for diagnosing HP infection. Given its modest sensitivity, histology plays an important role in the diagnosis of HP infection, especially in patients taking PPIs. We recommend doing histology when RUT is negative to increase the HP detection rate. Key words: retrospective, helicobacter pylori, rapid urease test, histology, RUT, giemsa stain","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123214851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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