Acta Medica Philippina最新文献

{"title":"The Diameter of the Normal Extrahepatic Bile Duct among Patients Diagnosed with Cholecystolithiasis Managed at the Philippine General Hospital.","authors":"Dante G Ang, Teressa Mae D Bacaro, Juan Carlos R Abon, Jose Miguel P Verde","doi":"10.47895/amp.vi0.8887","DOIUrl":"10.47895/amp.vi0.8887","url":null,"abstract":"<p><strong>Background and objective: </strong>Understanding the normal anatomy and size of the extrahepatic biliary tree is vital for surgeons to make informed decisions regarding the necessity of additional procedures beyond cholecystectomy. The extrahepatic bile duct (EHBD) comprises the common hepatic duct (CHD) and the common bile duct (CBD), with the former formed by the convergence of the right and left hepatic ducts and the latter extending from the CHD to the duodenum. A normal diameter is indicative of the absence of any signs of obstruction in the EHBD, and the determination of the average range for these ducts are essential for identifying pathologies that may require further surgical intervention. Cholecystolithiasis is a common condition managed at the Philippine General Hospital (PGH). Trans-abdominal ultrasonography is frequently utilized to diagnose cholecystolithiasis, and it can also be used to determine the size of the common bile duct. Knowledge of the normal CBD diameter aids clinicians in distinguishing obstructed bile ducts from normal ones, prompting further diagnostic tests for improved patient management. However, there is limited data on the average diameter of the CBD among Filipino patients with this condition. The study aimed to determine the mean diameter of the common bile duct and common hepatic duct among patients diagnosed with cholecystolithiasis with no signs of obstruction in the EHBD managed at the PGH.</p><p><strong>Methods: </strong>This prospective cross-sectional study included 80 patients who underwent cholecystectomy with intraoperative cholangiography. The CBD and CHD diameters were measured using intraoperative ultrasonography, and the data were analyzed using descriptive statistics and independent t-test.</p><p><strong>Results: </strong>The mean diameter of the CBD was 5.17 mm, with a range of 2.7-10 mm (1.41) mm. The mean diameter of the CHD was 4.71 mm, with a range of 2.3- 10 mm (1.59) mm. There was no significant difference in the CBD and CHD diameters between male and female patients, and across different age groups.</p><p><strong>Conclusion: </strong>In patients with cholecystolithiasis managed at the PGH, the mean diameter of the CBD and the CHD was 5.17 mm and 4.71 mm, respectively, with no significant difference between genders and age groups. The mean diameter of the CBD among Filipino patients with cholecystolithiasis is similar to those reported in other countries. These findings may have clinical implications for the management of patients with cholecystolithiasis, particularly in the planning of endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy. Further studies with larger sample sizes and different populations are recommended to validate these results. These findings can aid clinicians in determining the need for pre-operative Magnetic Resonance Cholangiopancreatography (MRCP) or selective intraoperative cholangiography to detect extrahepatic bile ","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 2","pages":"50-54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Mindfulness-based Interventions versus Cognitive Behavioral Therapy on Social Anxiety of Adolescents: A Systematic Review and Meta-analysis.","authors":"Valentin C Dones, Kristel S Yamat, Krystin Elda P Santos, Abby Victoria M Concepcion, Margarita Anne R Lacson","doi":"10.47895/amp.vi0.8140","DOIUrl":"10.47895/amp.vi0.8140","url":null,"abstract":"<p><strong>Background and objective: </strong>Mindfulness-based interventions (MBI), a novel treatment, and cognitive behavioral therapy (CBT), the standard treatment, are both effective in treating anxiety in adolescents. This study determined the effectiveness of mindfulness-based interventions versus cognitive behavioral therapy in reducing symptoms of anxiety among adolescents experiencing social anxiety through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>A systematic approach was used to identify eligible studies. Electronic databases, reference lists of relevant articles, and gray literature were searched. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and subgroups. Heterogeneity was measured using visual assessment, the I² statistic, and chi-square test.</p><p><strong>Results: </strong>Randomized controlled trials comparing MBI to CBT for adolescents diagnosed with social anxiety or social phobia disorder were analyzed, with non-randomized studies being excluded. Structured searches in electronic databases, reference lists, and gray literature were conducted by four independent reviewers who initially identified potential articles through title and abstract screening. After a comprehensive review of full-text articles and a consensus-building process, the selection of included articles was finalized. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and to examine subgroups, with heterogeneity being assessed through visual evaluation, the I² statistic, and chi-square tests. Total number of participants was 255; 101 were male and 158 were women. Mean age was 27.5 years old, and diagnosed with Social Anxiety Disorder, Social Phobia, or DSM-IV-Defined-Anxiety-Disorder. They were divided into two groups: 125 participated in 8- to 12-week MBI sessions lasting 2 hours each, while 130 underwent 2-hour CBT sessions spanning 8, 12, or 14 weeks. There is moderate quality of evidence reporting non-significant difference on MBI vs CBT's effectiveness in alleviating symptoms of social anxiety [mean (95% CI) = -0.04 (-0.58, 0.51)].</p><p><strong>Conclusion: </strong>Study found that there were no significant differences between Mindfulness-Based Interventions and Cognitive Behavioral Therapy in reducing social anxiety in adolescents. Mindfulness interventions have advantages in terms of cost-effectiveness for reducing symptoms of anxiety. Future research should include larger sample sizes and longer follow-up periods to further assess long-term effects of these interventions.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 2","pages":"15-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile and Prescribing Patterns of Therapy in Children with Bronchial Asthma in a Rural Site in the Philippines: A Retrospective Cohort Study.","authors":"Gayle Therese K Gonzales-Javier, Leonila F Dans, Kristine Tanega-Aliling, Carol Stephanie C Tan-Lim, Cara Lois T Galingana, Mia P Rey, Maria Rhodora D Aquino, Josephine T Sanchez, Antonio L Dans","doi":"10.47895/amp.vi0.8536","DOIUrl":"10.47895/amp.vi0.8536","url":null,"abstract":"<p><strong>Background: </strong>Bronchial asthma is one of the most common chronic childhood diseases encountered in the primary care setting. Adherence to recommendations from clinical practice guidelines on asthma can be utilized as an indicator of quality of care when evaluating the implementation of the universal health care in the Philippines.</p><p><strong>Objectives: </strong>To determine the clinical profile of pediatric patients with bronchial asthma; and to evaluate the prescription patterns for asthma treatment in a primary care setting.</p><p><strong>Methods: </strong>This was a retrospective cohort study that involved review of the electronic medical records in a rural site of the Philippine Primary Care Studies (PPCS). All patients less than 19 years old who were diagnosed with asthma from April 2019 to March 2021 were included. Quality indicators for asthma care were based on adherence to recommendations from the 2019 Global Initiative for Asthma (GINA) Guidelines.</p><p><strong>Results: </strong>This study included 240 asthmatic children with mean age of 6 years (SD ± 4.9) and a slight male preponderance (55.4%). Majority (138 children or 57.5%) were less than 6 years old. Out of the 240 children, 224 (93.3%) were prescribed inhaled short-acting beta-agonists (SABA) and 66 (27.5%) were prescribed oral SABA. Only 14 children (5.8%) were prescribed inhaled corticosteroids (ICS), with 13 children (5.4%) given ICS with long-acting beta-agonists (LABA) preparations, and one child (0.4%) given ICS alone. Quality indicators used in this study revealed underutilization of ICS treatment across all age groups, and an overuse of SABA-only treatment in children 6 years old and above. Moreover, 71.3% of the total patients were prescribed antibiotics despite the current GINA recommendation of prescribing antibiotics only for patients with strong evidence of lung infection, such as fever or radiographic evidence of pneumonia.</p><p><strong>Conclusion: </strong>There were 240 children diagnosed with asthma over a 2-year period in a rural community, with a mean age of 6 years old and a slight male predominance. This quality-of-care study noted suboptimal adherence of rural health physicians to the treatment recommendations of the GINA guidelines, with overuse of SABA and underuse of ICS for asthma control.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"84-90"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Ectasia versus Pseudoectasia using the Ectasia Risk Factor Score System.","authors":"Karen B Reyes, Emerson M Cruz, Melody Ana T Daclan, Robert Edward T Ang","doi":"10.47895/amp.vi0.6313","DOIUrl":"10.47895/amp.vi0.6313","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate and compare ectasia and pseudoectasia in post-myopic LASIK patients presenting with corneal topographic changes indicative of ectasia using the Ectasia Risk Factor Score System (ERFSS).</p><p><strong>Methods: </strong>Single-center retrospective comparative case series of a consecutive chart review of cases in 18 years who underwent bilateral myopic-LASIK and showed topographic changes indicative of ectasia.</p><p><strong>Results: </strong>Four patients were included. Group 1: pseudoectasia eyes, consisting of two patients with bilateral pseudoectasia, and Group 2: ectasia eyes, consisting of two patients with unilateral ectasia. The clinical course of the cases was discussed and compared based on the ERFSS parameters: topography pattern, residual stromal bed thickness, age, preop thinnest cornea, and pre-operative spherical equivalent (SE) manifest refraction (MR). Group 1 scored zero to low risk for developing ectasia while Group 2-eyes with ectasia scored moderate risk. The predictive value of the ERFSS was 1 in this study.</p><p><strong>Conclusion: </strong>The ERFSS is a good measure in deciding the suited treatment plan for patient undergoing refractive procedure. Knowing the clinical course of ectasia and pseudoectasia is helpful in the therapeutic approach since pseudoectasia is reversible when identified and managed early as seen in this study.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"73-83"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Rate Variability Analysis to Investigate Autonomic Nervous System Activity among the Three Premature Ventricular Complex Circadian Types: An Observational Study.","authors":"Novita G Liman, Sunu B Raharjo, Ina Susianti Timan, Franciscus D Suyatna, Salim Harris, Joedo Prihartono, Kristiana Siste, Mohammad Saifur Rohman, Bambang Budi Siswanto","doi":"10.47895/amp.vi0.8356","DOIUrl":"10.47895/amp.vi0.8356","url":null,"abstract":"<p><strong>Background and objective: </strong>Premature ventricular complex (PVC) burden exhibits one of three circadian types, classified as fast-type, slow-type, and independent-type PVC. It is unknown whether PVC circadian types have different heart rate variability (HRV) parameter values. Therefore, this study aimed to evaluate differences in HRV circadian rhythm among fast-, slow-, and independent-type PVC.</p><p><strong>Methods: </strong>This cross-sectional observational study consecutively recruited 65 idiopathic PVC subjects (23 fast-, 20 slow-, and 22 independent-type) as well as five control subjects. Each subject underwent a 24-hour Holter to examine PVC burden and HRV. HRV analysis included components that primarily reflect global, parasympathetic, and sympathetic activities. Repeated measures analysis of variance was used to compare differences in HRV circadian rhythm by PVC type.</p><p><strong>Results: </strong>The average PVC burden was 15.7%, 8.4%, and 13.6% in fast-, slow-, and independent-type idiopathic PVC subjects, respectively. Global, parasympathetic nervous system, and sympathetic nervous system HRV parameters were significantly lower in independent-type PVC versus fast- and slow-type PVC throughout the day and night. Furthermore, we unexpectedly found that tendency towards sympathetic activity dominance during nighttime was only in independent-type PVC.</p><p><strong>Conclusion: </strong>The HRV parameters are reduced in patients with independent-type PVC compared to fast- and slow-type PVC. Future research is warranted to determine possible differences in the prognosis between the three PVC types.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"91-98"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"R-CHOP and Consolidation Radiotherapy for Limited-stage and Low-IPI High-Grade B-Cell Lymphoma with <i>MYC</i> and <i>BCL2</i> and/or <i>BCL6</i> rearrangements: a Single-center Case Series and Review of Literature.","authors":"Joseff Karl U Fernandez, Michael D San Juan, Edilberto Joaquin V Fragante, Billionario Januario Antonio D Veloso, Timothy Carl F Uy, Michelle Regina L Castillo, Benedict Mihangel P Crisostomo","doi":"10.47895/amp.vi0.8611","DOIUrl":"10.47895/amp.vi0.8611","url":null,"abstract":"<p><p>High-Grade B-Cell Lymphoma (HGBCL) with gene rearrangements in <i>MYC</i> and <i>BCL2</i> and/or <i>BCL6</i> is an aggressive malignancy usually presenting in advanced stages. Current recommendations suggest the use of regimens more intensive than R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, prednisone), which are based on retrospective studies and single-arm prospective trials that included patients who are mostly in the advanced stage, and did not receive consolidation radiotherapy. The optimal approach and treatment of HGBCL, whether limited-stage (LS) or advanced-stage, remains to be determined. Here we describe the promising outcomes of three patients with LS and low IPI HGBCL with the use of R-CHOP as induction chemotherapy regimen, which was followed by consolidation radiotherapy. Three women, 54-, 60-, and 64-years of age diagnosed to have HGBCL with <i>MYC,</i> and <i>BCL2</i> and/or <i>BCL6</i> rearrangements, with Ann Arbor stages I-IIE were included in this case series. All three patients had complete metabolic response to 6 cycles of R-CHOP and was subsequently treated with consolidation involved site radiotherapy (ISRT; total dose 30-36 Gy). Chemotherapy and radiotherapy were tolerated very well. All patients remain to be in remission, with the longest being at 23 months. Outcomes of patients with HGBCL generally remain to be poor, but this may not be the case for patients with limited-stage disease and favorable clinicopathologic risk profile. Nevertheless, the treatment of HGBCL is currently evolving and more studies are needed to determine the ideal approach and preferred chemotherapy regimen. Also, more studies are needed to elucidate the potential role of consolidation radiotherapy in patients with limited-stage HGBCL to improve survival outcomes. Findings of this case series suggest that patients with LS HGBCL may still derive benefit from R-CHOP followed by consolidation ISRT, but prospective trials are needed to confirm this.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"99-109"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile and Outcomes of COVID-19 Positive Patients with Chronic Obstructive Pulmonary Disease (COPD) in a Tertiary Government COVID-19 Referral Center.","authors":"Mary Bianca Doreen F Ditching, Joel M Santiaguel","doi":"10.47895/amp.vi0.8578","DOIUrl":"10.47895/amp.vi0.8578","url":null,"abstract":"<p><strong>Introduction: </strong>It is anticipated that Chronic Obstructive Pulmonary Disease (COPD) has greater risk in acquiring COVID-19 infection and poorer outcome. However, current worldwide data are conflicting.</p><p><strong>Objectives: </strong>This study primarily aims to compare the outcomes of COVID-19 patients with COPD and those without COPD in terms of length of hospital stay (LOS), recovery or mortality, treatment received, and predictors of mortality.</p><p><strong>Methods: </strong>This is a retrospective cohort chart review of 1,017 admitted adult COVID-19 patients from July to December 2020. Age, gender, smoking status, current control and medications for COPD, COVID-19 severity, symptoms, treatment, and outcomes of the two study groups were compared.</p><p><strong>Results: </strong>Prevalence rate of COPD was 3.8%. COVID-19 patients with COPD were older (median age of 69 vs 54, p<0.001), male (87% vs 50%, p<0.001), hypertensive (72% vs 48%, p=0.004), and with tuberculosis (31% vs 11%, p=0.002). COVID-19 patients with COPD more commonly needed oxygen therapy, High Flow Nasal Cannula, Mechanical Ventilation, Tocilizumab, Convalescent Plasma Therapy and Dexamethasone, and had longer LOS. Significant risk factors for mortality are malignancy, investigational therapies, smoking, and older age. There was no difference in survival rates between the two groups.</p><p><strong>Conclusion: </strong>COPD increases the risk for severe COVID-19 and lengthens LOS.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Brief Training Program on the Knowledge of Filipino Primary Care Providers in a Rural and a Remote Setting: a Before and After Study.","authors":"Julianne Keane M Pascual, Arianna Maever Loreche, Regine Ynez H De Mesa, Noleen Marie C Fabian, Josephine T Sanchez, Janelle Micaela S Panganiban, Mia P Rey, Carol Stephanie C Tan-Lim, Mark Anthony U Javelosa, Ramon Pedro P Paterno, Ray U Casile, Leonila F Dans, Antonio L Dans","doi":"10.47895/amp.vi0.8869","DOIUrl":"10.47895/amp.vi0.8869","url":null,"abstract":"<p><strong>Background and objective: </strong>Primary care providers are key players in providing quality care to patients and advancing Universal Health Care (UHC). However, effective and quality healthcare delivery may be affected by inadequate knowledge and failure to adhere to evidence-based guidelines among providers. The Philippine Primary Care Studies (PPCS) is a five-year program that pilot tested interventions aimed at strengthening the primary care system in the country. Evidence-based training modules for healthcare providers were administered in Sorsogon and Bataan from the years 2018 to 2021. Module topics were selected based on common health conditions encountered by providers in rural and remote settings. This program aimed to evaluate the effectiveness of training in increasing provider knowledge.</p><p><strong>Methods: </strong>A series of training workshops were conducted among 184 remote- and 210 rural-based primary care providers [nurses, midwives, barangay or village health workers (BHWs)]. They covered four modules: essential intrapartum and newborn care (EINC), integrated management of childhood illness (IMCI), non-communicable diseases (NCD), and geriatrics. A decision support system (UpToDate) was provided as a supplementary resource for all participants. We administered pre-tests and post-tests consisting of multiple-choice questions on common health conditions. Data was analyzed using paired one-tailed t-test, with an alpha of 0.05.</p><p><strong>Results: </strong>The knowledge of nurses, midwives, and BHWs improved after the training workshops were conducted. The largest increase from pre-test to post-test scores were observed among the midwives, with a mean difference (MD) of 32.9% (95% CI 23.9 to 41.9) on the EINC module, MD of 25.0% (95% CI 16.6 to 33.4) in the geriatrics module, and MD of 13.5% (95% CI 6.9 to 20.1) in the NCDs module. The nurses had the greatest improvement in the IMCI module (MD 10.8%, 95% CI 2.5 to 19.1). The knowledge of BHWs improved in all participated modules, with greatest improvement in the NCD module (MD 9.0%, 95% CI 5.77 to 12.14).</p><p><strong>Conclusions: </strong>Primary care workshops, even if conducted as single-sessions and on a short-term basis, are effective in improving short-term knowledge of providers. However, this may not translate to long-term knowledge and application in practice. Furthermore, comparisons across provider categories cannot be made as participant composition for each training workshop varied. Ultimately, this study shows enhancing provider knowledge and competence in primary care will therefore require regular and diverse learning interventions and access to clinical decision support tools.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"66-72"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Evaluation of Oral Ivermectin, Alone or in Combination with Permethrin, versus Permethrin, in the Treatment of Classic Scabies in the Philippine Setting.","authors":"Rowena F Genuino, Mac Ardy J Gloria, Clarence Pio Rey S Yacapin, Maria Christina Filomena R Batac, Fernando B Garcia, Francis R Capule, Mary Ann J Ladia, Malaya P Santos, Ailyn M Yabes, Ma Stephanie Fay S Cagayan","doi":"10.47895/amp.vi0.8650","DOIUrl":"10.47895/amp.vi0.8650","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Oral ivermectin is recommended as an alternative to topical permethrin in Japanese, European, and CDC-STI guidelines for treating classic scabies. The combination of oral ivermectin and topical permethrin is also used in some settings. Partial economic evaluations conducted in India and Egypt have conflicting results, and no cost-effectiveness analysis in the Philippines has compared ivermectin-based regimens to permethrin for scabies treatment. We aimed to determine the cost-effectiveness of oral ivermectin, alone or in combination with permethrin, compared to permethrin, in the treatment of Filipino adult patients with classic scabies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used a decision tree model to estimate the cost-effectiveness of two regimens, oral ivermectin alone or in combination with permethrin, compared with permethrin to treat adults and children aged five years and older with classic scabies in the outpatient setting from the household perspective in the Philippines. We estimated total costs and disability-adjusted life years (DALYs) over a one-month follow-up. Input parameters were obtained from secondary data, such as effect estimates for probabilities of clinical outcomes from a network meta-analysis, DALYs from the Global Burden of Disease 2019, and prevailing market cost in the Philippines (DPRI 2022 with recommended markup by DOH, and leading drugstores) as of August 2022. We computed for incremental cost-effectiveness ratio (ICER) and net monetary benefit (NMB) to determine which of the interventions are cost-effective. Univariate and probabilistic sensitivity analyses, and scenario analyses were conducted to assess the impact of parameter and structural uncertainty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Ivermectin-based regimens are suggested to be likely cost-saving compared to permethrin in the Philippine outpatient setting. Base case analysis showed that oral ivermectin had higher cost-savings (change in cost, -1,039.31; change in DALYS, 0.00027), while combination oral ivermectin/permethrin had higher DALYs averted (change in cost, PhP -1,019.78; change in DALYs, 0.00045), compared to permethrin. Combination oral ivermectin/permethrin (56%) was the most cost-effective, followed by oral ivermectin (44%) compared to permethrin (0%) through probabilistic sensitivity analysis. Estimates for ivermectin were sensitive to risk of cure for ivermectin vs permethrin using 1-way deterministic sensitivity analysis. Oral ivermectin was favored over combination oral ivermectin/permethrin at all thresholds based on the cost-effectiveness acceptability curve.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Both ivermectin-based regimens seem to be cost-saving compared to permethrin in the treatment of classic scabies in the Philippine outpatient setting. Clinicians may consider oral ivermectin, alone or in combination with permethrin as an alternative first-line or second-line treatment depending on patient pre","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"18-40"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Job-related Factors Associated with Depression, Anxiety, and Stress among Healthcare Workers in a Tertiary Government Hospital in Metro Manila during the COVID-19 Pandemic.","authors":"Ana Melissa Hilvano-Cabungcal, Sheila R Bonito","doi":"10.47895/amp.vi0.8590","DOIUrl":"10.47895/amp.vi0.8590","url":null,"abstract":"<p><strong>Background and objectives: </strong>Ensuring the total well-being of healthcare workers (HCWs), including their mental health and psychological well-being, is an essential aspect in the delivery of patient care and the preservation of the health workforce. This study aimed to determine the level of mental well-being and emotional state of HCWs in terms of depression, anxiety, and stress using the DASS-21 scale in a tertiary government hospital during the COVID-19 pandemic in the Philippines and to identify the job-related factors that may be associated with these outcomes.</p><p><strong>Methods: </strong>This is an analytical, cross-sectional study among HCWs involved in direct patient care in a tertiary government hospital in the Philippines during the COVID-19 pandemic. Data collection was conducted from February to March 2022 through an online self-administered questionnaire, which included the Demand-Control-Support Questionnaire (DCSQ), and the 21-item Depression Anxiety Stress Scale (DASS-21). This was sent to doctors, nurses, and allied medical workers actively working in the clinical areas. All responses were collected and analyzed.</p><p><strong>Results: </strong>Three hundred sixty-four healthcare workers were included in the study. Majority were single (62.62%), living with immediate family (50.82%), and working in a COVID-designated area (62.09%). High prevalence of depression (49.18%), anxiety (61.54%), and stress (30.22%) was found among the HCWs. Work in high infection/COVID-designated areas was significantly associated with anxiety and stress, and high-job demand was significantly associated with all three mental health states compared to low job-demand.</p><p><strong>Conclusion: </strong>Focus should be placed on modifying the condition of high job demand among healthcare workers working in hospitals. This includes ensuring optimum staffing levels and patient to HCW ratio which avoids HCWs from being subjected to high workloads and time pressures that subsequently increase risk for stress, anxiety, and depression.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"57-65"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}