Acta Medica Philippina最新文献

Background: In the Philippines, the prevalence of food insecurity increased during the COVID-19 pandemic, affecting the nutritional status of communities nationwide. Urban areas in particular are vulnerable to the harmful effects of food insecurity, and the effects are extended and magnified when it comes to children.

Objectives: This study aims to evaluate the coping strategies of households with children aged 0-10 years old in an urban poor community in Quezon City. In particular, the study will determine Coping Strategies Index (CSI) scores and the frequency of specific coping strategies used.

Methods: A descriptive cross-sectional study was conducted to assess the coping strategies of 405 households with children in the community during the pandemic. Mothers or caregivers were given a survey inquiring about the sociodemographic data and CSI.

Results: Sociodemographic profiling showed that the households generally belonged to class D and E (PhP 15,000 and below) income households (73.8%). The majority of the household heads (52.6%) have their highest educational attainment at the high school level.The majority (77.5%) of the households were categorized as having low CSI classification (90%CI: 73.9, 80.8). This could indicate that relief operations conducted in the community may have helped ease their food insecurity. Coping strategies that were most frequently employed by the households were depending on less preferred or more affordable food (74.8%), rationing money for prepared food (69.1%), and purchasing food on credit (58.5%).

Conclusion: Low CSI classification was noted, which may be due to increased adaptation to persistent food insecurity and the utilization of coping strategies not indicated in the questionnaire. Common coping strategies used by households include reliance on less favored or less costly food items, rationing resources for prepared food, and food on credit. It is recommended that the results collected be used to target food availability and accessibility interventions in the community.

Objective: This study aimed to evaluate the nutritional adequacy and compliance with cardiovascular disease (CVD) guidelines in therapeutic diets implemented in four hospitals in General Santos City, Philippines.

Methods: The study employed a cross-sectional study and analyzed the one-day therapeutic menus of four hospitals using the Philippine Food Composition Table and the United States Department of Agriculture nutrient database. The nutrient contents calculated in this study were compared among hospitals and benchmarked against the Philippine Dietary Reference Intakes (PDRI) and CVD-specific guidelines, the Dietary Approaches to Stop Hypertension (DASH), and Therapeutic Lifestyle Changes (TLC). The nutrient adequacy ratios (NARs) and the corresponding mean (SD) values were used to interpret the data.

Results: Based on the PDRI, the mean (SD) NARs for proteins, simple sugars, vitamin B6, folate, and vitamin B12 were 116% (11%), 72% (16%), 139% (34%), 115% (7%), and 324% (156%), respectively, which were all interpreted as adequate. However, the mean (SD) NARs for energy, 88% (7%), and dietary fiber, 53% (33%), indicate non-compliance with the requirements for these components. As for the DASH guidelines, the hospitals failed to meet the recommendations for calcium, magnesium, and potassium, with mean (SD) NARs of 45% (14%), 49% (10%), and 51% (7%), respectively. The levels of saturated fatty acids, 195% (53%), and dietary cholesterol, 363% (177%), exceeded the limits set by the guidelines. For the TLC guidelines, the mean (SD) NARs of 70% (24%) and 40% (10%) for monounsaturated fatty acids and polyunsaturated fatty acids, respectively, were interpreted as suboptimal. Conclusive interpretations cannot be drawn for sodium, total carbohydrates, total fats due to large variations in their compositions among the hospitals.

Conclusion: At the menu analysis level, while the therapeutic diets adhered to the recommendations for proteins, simple sugars, and the vitamins, they fell short in their provision for energy, unsaturated fats, dietary fiber, and most minerals. They also exceeded the limits for most dietary lipid parameters set by DASH and TLC. The findings of this study highlight the need for improvements in nutritional adequacy and adherence to CVD guidelines in hospital therapeutic diets. Due to the limited number of observations, future research should aim to confirm and clarify these findings.

Thymomas are rare tumours which generally account for only 0.2 - 1.5% of mediastinal tumours in adults. Around 40% of patients present with systemic symptoms such as motor weakness due to myasthenia gravis (MG), pure red cell aplasia, and hypogammaglobulinemia. Based on recent guidelines, management of advanced thymoma uses a multimodal approach, which is thymectomy followed by radiotherapy, but not all health care centers have radiotherapy facilities. A 52-year-old woman presented with nasal voice and had difficulty swallowing food. Patient was diagnosed with myasthenia gravis (MG). CT scan with contrast of the thorax showed a heterogenous solid mass in anterior mediastinum. Histopathological examination showed thymoma type B2. Thymectomy followed by seven cycles of platinum-based chemotherapy were done on the patient. Evaluation afterward showed complete remission of thymoma. The patient's motor weakness improved after the chemotherapy. Post-chemotherapy period was uneventful at six months on follow-up visit. The dosage of acetylcholinesterase inhibitor drug is reduced periodically due to improvement in motor weakness. The case emphasizes how to manage an advanced thymoma with MG with limited therapeutic options, and the importance of multidisciplinary management involving oncologists, surgeons, and neurologists.

Objective: This study aimed to determine the incidence of encephalopathy among hospitalized patients with COVID-19.

Methods: This was a retrospective observational study conducted in a tertiary hospital in Cebu City, Philippines. This study is a complete enumeration of all records of adult patients admitted for COVID-19 detected through polymerase chain reaction from March 1, 2020 to September 30, 2021. The cases were then classified as to the presence or absence of encephalopathy.

Results: The study determined that 6 in every 1000 admitted COVID-19 patients developed encephalopathy. The clinico-demographic profile of patients with encephalopathy were mostly elderly with a mean age of 67, males (55.7%), and obese stage I (61.1%). Encephalopathy was more likely to develop in patients with type 2 diabetes mellitus (80.1%) and coronary artery disease (40.0%). Most patients who did not have encephalopathy however had a history of CVD. Most patients (66.7%) who developed encephalopathy were dyspneic on presentation. Laboratory examination results showed an increase in fasting blood sugar and elevated levels of LDH, CRP, serum ferritin, procalcitonin, and D-dimer. Majority of patients (66.7%) with encephalopathy were intubated. Taking into consideration the stage of infection and the incidence of encephalopathy, most patients (66.6%) were in the hyperinflammatory stage. The number of hospitalization days and severity of illness did not have any association with developing encephalopathy. Dichotomous categorization of outcomes into deceased and discharged showed that clinical outcomes and the development of encephalopathy were significantly associated, with 66.7% of patients with encephalopathy expiring during their course of hospitalization.

Conclusion: The incidence of encephalopathy among admitted COVID-19 patients was 6 in every 1000 patients. Encephalopathy was more common in elderly males who were obese with type 2 diabetes mellitus and coronary artery disease. The most common presentation of patients who developed encephalopathy was dyspnea. Collated laboratory results showed an increase in fasting blood sugar and elevated levels of LDH, CRP, serum ferritin, procalcitonin, and D-dimer. Majority of patients with encephalopathy were intubated and were in the hyperinflammatory stage of COVID-19 infection. Dichotomous categorization of outcomes into deceased and discharged showed that clinical outcomes and the development of encephalopathy were significantly associated, with most patients with encephalopathy expiring during their course of hospitalization.

Objectives: The aim of this study is to establish a Reversed Phase - High Performance Liquid Chromatographic (RP-HPLC) method for the quantification of Rhein from Cassia fistula L. leaves.

Methods: A Shimadzu system equipped with a C18 Column (150 x 4.6 mm, 5 μm) with an isocratic elution of Acetonitrile (solvent A) and 0.1% trifluoroacetic acid aqueous solution (solvent B) (Merck, 1.08178.0050) with a 55:45 ratio, respectively and a flow rate of 1.0 mL/min and sample injection of 10 μL detection was done at 230 nm. Standard solution of Rhein (Chengdu Biopurify) was prepared for method development. This study was validated using the guidelines set under "ICH Topic Q2 R2 or the Validation of Analytical Procedures". Procedures for linearity, precision, accuracy, limit of detection, and limit of quantitation were performed.

Results: The retention time of Rhein standard was determined at 5.10 minutes. LOD and LOQ were determined to be 1.278 mcg/mL and 3.872 mcg/mL, respectively with good linearity (R2 ≥0.996) with a linear range of 2.5-20 ug/mL of the Rhein standard. The accuracy of the method was determined based on % recovery method and ranged from 94.75%-100.32% (intraday, n=3) with %RSD of 0.71. The intraday precision %RSD was 2.92 (n=6) while interday precision %RSD was 3.75 (n=3). The method was able to check the Rhein quantity among 10 samples of Cassia fistula L. leaves from different locations in the Philippines.

Conclusion: The method was found to be sensitive and accurate for the quantification of Rhein. The method was found to be useful for the quantification of the amount of Rhein and can be used as a Quality Control tool for the assessment of Cassia fistula.

Background and objectives: Intraperitoneal injection (i.p.) of D-galactose (D-gal) accelerates aging and develops aging models. A low dose of long-term use and a high dose of short-term use of D-gal can induce natural aging in mice, like brain, cardiac, liver, renal, and skin aging, and erectile dysfunction. Our research aims to determine whether a high dose of short-term use of D-gal. i.p. in rats can induce natural aging and affect the following parameters: body weight (BW), Superoxide Dismutase (SOD), Vascular endothelial growth factor (VEGF), C-reactive protein (CRP), and myostatin.

Methods: A daily D-gal i.p. dose of 300 mg/ml/kg for seven days was carried out to induce aging parameters in the rats. After seven days, the body and gastrocnemius circumference of the rats were weighed, and biochemical analysis for SOD, VEGF, CRP, and myostatin in the blood plasma was done.

Results: The data obtained were analyzed using nonparametric statistics Friedman test and Mann-Whitney test. After the seven day-intervention, both the control (NaCl 0.9% i.p.) and the high dose of short-term use of D-gal i.p. groups showed no significant difference in the body weight and gastrocnemius circumference. However, D-gal administration could increase the blood plasma level of SOD, VEGF, CRP, and myostatin.

Conclusion: We conclude that a high dose of short-term intraperitoneal D-galactose can be administrated to induce aging in rat models. The SOD, VEGF, CRP and myostatin can be used as aging parameters.

Objectives: This study sought to investigate citizens' awareness, availment, satisfaction, and perceived need for action with health services offered by a rural municipality in Samar, Philippines.

Methods: This study utilized an explanatory-sequential research design, involving 150 participants selected through the Kish Grid Method via a multi-stage sampling approach within the community. The Citizen Satisfaction Index System was employed to assess the levels of awareness, utilization, and satisfaction with health services in the municipality.

Results: Among the assessed health services, the cohort had low awareness and low availment on services for communicable diseases, basic dental/oral hygiene, and reproductive health. While high awareness was observed for childbirth services, there was low availment on these. The participants showed high awareness and availment for only two services namely, free general consultation and the free medicine program. While high satisfaction was seen among all services that were assessed, the participants also expressed a high perceived need for action to improve their delivery.

Conclusion: This study presents a comprehensive view of rural healthcare in Samar, Philippines. Despite high satisfaction rates, gaps persist in the citizen's awareness and availment due to accessibility, costs, fear, misinformation, and cultural differences. The findings of this study can guide policymakers in identifying gaps in healthcare in rural areas.

Background: Medicinal plants are widely used for healthcare needs, including oral health. In the Philippines, garlic, guava, tsaang-gubat, and hierba buena, although primarily recognized as plants used for the treatment of systemic diseases, are indicated as analgesics for dental pain, treatment of gingival inflammation, and oral health maintenance. Despite studies focusing on the effectiveness of these plants for oral health, there is little to no research on the populace's knowledge, attitude, and practices on these medicinal plants.

Objectives: The study aimed to determine the knowledge, attitude, and practices of Oral Medicine patients from a dental college in Manila on four medicinal plants (garlic, guava, tsaang-gubat, and hierba buena) for oral health.

Methods: A descriptive study design was used. Oral Medicine patients (694) were invited to participate in the study through daily text messages containing brief research details. The link to the three-part online questionnaire (Google Forms) was sent via text and Facebook messages, and was answerable within 15-20 minutes.

Results: Two hundred fourteen (214) Oral Medicine patients participated, with 147 (68.69%) having knowledge on using medicinal plants for oral health which they mostly knew through friends and acquaintances. Most participants had a generally positive attitude toward medicinal plants for oral health and believed they were beneficial (177, 82.71%), safe, effective, and cheaper than conventional medicine (175, 81.78%), and accessible (171, 79.91%). Only 64 (29.91%) personally used medicinal plants to address their oral health conditions. Garlic (144, 97.96%) was the most widely known and used, followed by guava (52, 35.37%), hierba buena (12, 8.16%), and tsaang-gubat (4, 2.72%).

Conclusion: Most participants were knowledgeable with a generally positive attitude toward the four medicinal plants for oral health but did not use these to address their oral health problems.