Acta Medica Philippina最新文献

{"title":"Efficacy, Effectiveness, and Safety of Phenobarbital in the Treatment of Cholestasis and as a Premedication to Improve Diagnostic Accuracy of Hepatobiliary Scintigraphy: A Systematic Review.","authors":"Germana Emerita V Gregorio, Katrina Loren R Rey, Carol Stephanie C Tan-Lim","doi":"10.47895/amp.vi0.10948","DOIUrl":"10.47895/amp.vi0.10948","url":null,"abstract":"<p><strong>Objective: </strong>Phenobarbital is an inductor of microsomal hepatic enzyme and used as choleretic for cholestatic liver disease to enhance bile flow. It is also used as a premedication for hepatobiliary scintigraphy (HIDA) scan to improve diagnostic accuracy for an obstructive liver disease. We reviewed the available literature on the use of Phenobarbital for treatment of cholestasis and its utility as a premedication for HIDA scan.</p><p><strong>Methods: </strong>All published studies before June 30, 2023 that investigated the efficacy, effectiveness or safety of Phenobarbital in cholestatic jaundice and its effect on the accuracy of hepatobiliary scintigraphy in diagnosis of obstructive jaundice were included. Electronic databases were searched including MEDLINE via PubMed,Cochrane Library, medRxIV, BioRxIV, as well as the following registries for ongoing and completed trials: ClinicalTrials.gov (USA); ChiCTR.org. (China); and the WHO International Clinical Trials Registry Platform. We screened abstracts, reviewed full texts, and extracted relevant information on study design, settings, population, and outcomes. There was no age and language restriction. Two reviewers independently rated the quality of included studies using: Joanna Briggs Institute critical appraisal tool for case reports, case series, and diagnostic accuracy; Newcastle - Ottawa Quality Assessment Scale for cohort studies, and Cochrane Risk of Bias for Randomized Trials. Risk of bias was appraised and GRADE certainty of evidence was judged. Pooled analysis was done using Stata 14 and reported as sensitivity and specificity.</p><p><strong>Results: </strong>Included were nine reports on Phenobarbital as treatment for cholestasis (one case report, five case series, one cohort and two randomized studies) and seven studies (four diagnostics, two cohorts, one randomized trial) on its use as a premedication for HIDA scan. The quality of case report and case series were considered fair; cohort studies as good; and diagnostic studies were included based on overall assessment. The randomized studies had some or high risk for bias due to concerns in randomization process, measurement of outcome, and risk in the selection of reported results.There were 31 patients (16 adults and 15 children) from case reports and case series. Of the 16 adults, serum total bilirubin concentrations declined from 4 to 70% from baseline in 13 of 15 (87%) patients after Phenobarbital was given at 120 to 250 mg per day from 22 days to five months. Eleven of 14 with pruritus at onset also had improvement in intensity of itching. Of the 15 pediatric patients, ten (67%) showed a decrease from 10 to 60% of the baseline total bilirubin but not a normalization with Phenobarbital intake at a dose of 3 to 12 mg/kg/day from one to 21 months. Five of 14 children also had relief of itching after treatment.Phenobarbital compared to Ursodeoxycholic acid had limited efficacy in reducing the bilirubin levels in ","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 10","pages":"95-109"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938461","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":"Micronutrient Intake and Diet Quality of Overweight/Obese Filipino Adults in the National Capital Region, Philippines.","authors":"Jade Q Florento, Kim Leonard G Dela Luna, Charina A Javier, Eldridge B Ferrer","doi":"10.47895/amp.vi0.10804","DOIUrl":"10.47895/amp.vi0.10804","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to describe the micronutrient intake and diet quality of overweight and obese Filipino adults in the National Capital Region (NCR). Specifically, it seeks to assess micronutrient inadequacy among these individuals and analyze differences in food intake based on their sociodemographic profiles and lifestyle habits.</p><p><strong>Methods: </strong>This analytical cross-sectional study utilized data from the Expanded National Nutrition Survey (ENNS) conducted in 2018, 2019, and 2021 by the Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI). A total of 3,154 overweight and obese subjects were included. ANOVA and Kruskal-Wallis tests were employed to analyze the food groups consumed by these adults.</p><p><strong>Results: </strong>Majority of overweight and obese adults were found to be inadequate in vitamin A (81.7%), vitamin C (88.4%), thiamin (62.5%), riboflavin (70.7%), iron (69.8%), and calcium (88.7%). Significant differences were observed in the mean intake of various food groups across different age groups, sexes, civil statuses, wealth quintiles, educational attainments, employment statuses, and smoking and drinking statuses.</p><p><strong>Conclusion: </strong>Filipino adults who are overweight and obese, and residing in urban settings face significant challenges related to micronutrient inadequacy. When their food intake was assessed based on sociodemographic and lifestyle characteristics, it was found that their diets were more calorie-dense than nutrient-dense. To address this issue, it is recommended to encourage a wider variety of nutrient-dense foods among overweight and obese adults.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 10","pages":"85-94"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938396","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 Transarterial Chemoembolization on the Immediate Health-related Quality of Life of Patients with Hepatocellular Carcinoma in the Philippine Setting.","authors":"Scott Riley K Ong, Glenn Marc G Ignacio, Adovich S Rivera","doi":"10.47895/amp.vi0.11239","DOIUrl":"10.47895/amp.vi0.11239","url":null,"abstract":"<p><strong>Background and objective: </strong>Transarterial chemoembolization (TACE) is a locoregional therapy used in patients with unresectable intermediate-stage hepatocellular carcinoma (HCC). It has proven benefit on overall survival, but considerable side effects and potential complications may occur. Preservation of quality of life is a concern in many cancer-related therapies, and the same goal should apply in TACE. This study aimed to determine the effect of TACE on the immediate health-related quality of life (HRQoL) of Filipino patients with unresectable HCC.</p><p><strong>Methods: </strong>A prospective observational survey study of 18 HCC patients who underwent TACE was conducted. HRQoL scores were measured using the validated EORTC QLQ-C30 and QLQ-HCC18 questionnaires, 1-2 days before and two weeks after TACE. Baseline clinical data, which included tumor characteristics, Child-Pugh score, and performance status score, were also obtained. Changes in HRQoL scores before and after TACE, and any association of demographic and clinical variables with HRQoL outcomes were assessed.</p><p><strong>Results: </strong>Patients experienced overall decline in their global health status and functional scores with increase in their symptom scores after undergoing TACE. Statistically significant deterioration was observed in global health status (-13.9%), physical functioning (-23.0%), and role functioning (-31.4%). Alcohol users had lower global health status scores at baseline and follow-up, although there was no significant difference in the degree of decline in their post-TACE scores compared with non-alcohol users. Patients with BCLC stage C disease also had lower global health status scores at baseline, although scores were no longer significantly different from patients of other stages on post-TACE follow-up. Patients with BCLC stage B tumor experienced significant decline in their global health status scores. The presence of minimal ascites at baseline was associated with less deterioration in physical function scores after TACE. Largest and significant increases in symptomatology were seen for appetite loss (+41.1%), fever (+30.3%), fatigue (+28.5%), and general pain (+25.1%).</p><p><strong>Conclusion: </strong>TACE can negatively affect the HRQoL of Filipino patients in the early phase after treatment, with significant deteriorations in global health status, physical, and role functioning, and increased severity in symptoms, especially appetite loss, fever, fatigue and pain. Knowledge of these changes should be used to improve patient care, compliance, and expectations.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 10","pages":"30-36"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938407","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":"Optical Coherence Tomography of the Macular Ganglion Cell Complex Demonstrating Transsynaptic Retrograde Degeneration from a Temporal Lobe Tumor: A Case Report.","authors":"Jian Carlo R Narag, Franz Marie O Cruz","doi":"10.47895/amp.vi0.10696","DOIUrl":"10.47895/amp.vi0.10696","url":null,"abstract":"<p><p>We report a 39-year-old male who had generalized tonic-clonic seizure with loss of awareness. Investigations led to a diagnosis of a left temporal lobe tumor. He underwent resection of the mass with consequent loss of brain tissue in the temporal lobe and was found to have a complete right homonymous hemianopia in the immediate postoperative period. Macular ganglion cell analysis on optical coherence tomography (OCT) showed homonymous thinning affecting the inferonasal sector in the right eye and inferotemporal sector in the left eye. This case demonstrates transsynaptic retrograde degeneration through the interruption of the inferior optic radiation, and its corresponding effect on the structure and function of the affected retinal field. Temporal lobe lesions may cause not only a homonymous visual field defect contralateral to the side of the lesion but also result to homonymous sectoral thinning of the macular ganglion cell complexes in both eyes located ipsilateral to the side of the lesion.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 10","pages":"119-124"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938436","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":"Reflecting on the Occupational Safety and Health Landscape in the Philippines: A Data-driven Imperative.","authors":"Vivien Fe F Fadrilan-Camacho","doi":"10.47895/amp.v59i10.13651","DOIUrl":"10.47895/amp.v59i10.13651","url":null,"abstract":"","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 10","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938398","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":"Honor and Excellence from Within: Enhancing University Mental Health Systems in Developing Resilient Medical Professionals.","authors":"Paul Michael R Hernandez","doi":"10.47895/amp.v59i9.13594","DOIUrl":"10.47895/amp.v59i9.13594","url":null,"abstract":"","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 9","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844029","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":"Important but Neglected: A Qualitative Study on the Lived Experiences of Barangay Health Workers in the Philippines.","authors":"Kenneth Y Hartigan-Go, Melissa Louise M Prieto, Sheena A Valenzuela","doi":"10.47895/amp.vi0.9589","DOIUrl":"10.47895/amp.vi0.9589","url":null,"abstract":"<p><strong>Background and objective: </strong>Within a decentralized health system, barangay health workers (BHWs) are often the first point of contact for Filipinos seeking care. Despite their importance, BHWs are neglected in the health value chain. The study seeks to examine the lived experiences of BHWs, particularly their journey in navigating their roles within the community and the health system that encompasses their day-to-day realities, challenges, motivations, and the meanings they derive from their work.</p><p><strong>Methods: </strong>The study draws on seven focus group discussions (FGDs) with BHWs (n=50), residents (n=7), and local government officials and health workers (n=7) of San Miguel, Bulacan. The qualitative data collected were analyzed using thematic analysis.</p><p><strong>Results: </strong>Findings show that BHWs perform many roles, which are not limited to health and are dependent on orders from their superiors. Guidelines are vague in appointing BHWs, with personal connections valued more than technical qualifications. Their accreditation is hardly conferred any significance. There is also a lack of formal and structured training. The informality of these processes leads to an absence of quality assurance on rendered health services. The non-provision of incentives and benefits stipulated in RA 7883 also places their health and lives at risk. Furthermore, BHW's commitment to serve is used to excuse the inadequacy of their compensation and excessive workload.</p><p><strong>Conclusion: </strong>BHWs take on diverse roles, from community organizers to healthcare providers, and are confronted with significant challenges encompassing politicization, inadequate training, and insufficient compensation. The study concludes with policy recommendations to improve the conditions of the neglected BHWs, with particular attention to coordinating, capacitating, compensating, career pathing, and connecting them to the health system.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 9","pages":"19-31"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844030","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":"Factors Associated with Stunting among Infants and Young Children in the Fourth District of Camarines Sur, Philippines.","authors":"Jeena Sandra R Manrique-de Hitta, Kim Leonard G Dela Luna, Anna Paulina S Rodriguez, Mildred O Guirindola","doi":"10.47895/amp.vi0.10849","DOIUrl":"10.47895/amp.vi0.10849","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the determinants linked to stunting among infants and young children aged 0-23 months in the Fourth District of Camarines Sur.</p><p><strong>Methods: </strong>An analytical cross-sectional study was conducted among 628 primary caregivers with infants and young children aged 0-23 months in four municipalities of the Fourth District of Camarines Sur, Philippines, using a twostage stratified random sampling design. Data on sociodemographic and economic factors were collected through face-to-face interviews. Infant and young child feeding (IYCF) indicators were assessed using a list-based approach, while weight and length were evaluated using the World Health Organization Anthro Plus software. Descriptive statistics and multiple logistic regression were done using R statistical software version 4.3.1.</p><p><strong>Results: </strong>The study revealed that the prevalence of stunting was of significant public health concern, reaching 42.8%. Holding other variables constant, age of the child (OR=0.77; 95% CI: 0.63-0.94), having college undergraduate mothers (OR=0.26; 95% CI: 0.05-1.28), and belonging to a poor income household (OR=0.40; 95% CI: 0.14-0.88) were associated with stunting among infants aged 0.01-6.00 months. Moreover, after controlling for the confounding effects of other variables, age (OR=1.09; 95% CI: 1.05-1.14) and sex of the child (OR=1.55; 95% CI: 1.05-2.28) were associated with stunting among older children aged 6.00-23.99 months.</p><p><strong>Conclusion: </strong>This study emphasizes the challenge of stunting in the Fourth District of Camarines Sur. None of the IYCF indicators were associated with stunting; however, maternal education, the child's age, sex, and socioeconomic status were identified as significant factors influencing stunting. Addressing these determinants through targeted interventions focusing on improving maternal education and enhancing socio-economic conditions were crucial to reducing stunting in the study areas.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 9","pages":"62-71"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844026","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":"Evaluation of Medication Errors among Inpatients in a Tertiary Government Hospital's Pulmonary Medicine Service: A Cross-sectional Retrospective Study.","authors":"Judith L Abunales, Jan Redmond V OrdoñEz, Saandra Beattina B Salandanan, Charles Mandy G Ayran, Rubina Reyes-Abaya","doi":"10.47895/amp.vi0.10684","DOIUrl":"10.47895/amp.vi0.10684","url":null,"abstract":"<p><strong>Background and objective: </strong>Medication errors pose substantial risks in hospitals, particularly concerning patient safety. These errors, occurring throughout the medication use process, are one of the most common causes of morbidity and mortality in clinical practice. In the Philippines, there is a lack of evidence on the prevalence and effects of medication errors, emphasizing the need for further investigation. This study evaluated the prescribing, transcribing, and monitoring errors among inpatients under the Pulmonary Medicine Service of the Department of Medicine in the Philippine General Hospital.</p><p><strong>Methods: </strong>This cross-sectional retrospective records review used the total population purposive sampling technique to examine eligible charts of inpatients with asthma and/or COPD from August 1 to December 31, 2022. The frequency, type, and severity of medication errors were determined. Linear regression and Cox proportional hazards models were used to examine the relationship between patient-related factors and medication errors, and length of hospital stay and mortality.</p><p><strong>Results: </strong>Fifty (50) out of 226 medical records were processed and analyzed. Included patients were predominantly older male adults. More than twothirds of the patients were diagnosed with COPD while approximately one-fourth suffered from asthma. All patients were practicing polypharmacy and the vast majority presented with comorbidities. A total of 6,517 medication errors, predominantly prescribing errors (99.1%), were identified. Despite the high prevalence of medication errors, the majority were classified as \"error, no harm\" (98.8%), while only 1.17% were deemed as \"error, harm.\" As the frequency of prescribing errors increases in the power of three (rough approximation of e), from 1 to 3 to 9 to 27, etc., the expected hospital stay increases by 2.078 days (p <0.001) (e.g., 3² = 9 errors with LOS of around 4 days); meanwhile, more severe transcribing errors increase the length of stay by 4.609 days (p = 0.034) All independent variables were noted to have a lack of significance and thus no meaningful patterns in the data related to patient mortality were identified, primarily due to the insufficient amount of observed mortality in the included sample.</p><p><strong>Conclusion: </strong>All eligible patient charts had at least one medication error, with the majority being prescribing errors. Among the variables, prescribing errors significantly affected the length of stay, while severity of transcribing errors had a marginally significant effect. It is essential to develop comprehensive education and training initiatives and adopt a systematic approach to mitigate medication errors and promote patient safety.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 9","pages":"40-61"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844025","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":"Anxiety, Depression and Resilience among Primary Care Nurses Working in the Rural Health Units of Samar Province during the COVID-19 Pandemic.","authors":"Oscar B de Paz, Charlie C Falguera, Abigail L Brillantes, Kiara F Balo, Veigner V Cabugayan, Rosemarie T Del Monte, Beberly T Pimentel, Ethel C Valones","doi":"10.47895/amp.vi0.9325","DOIUrl":"10.47895/amp.vi0.9325","url":null,"abstract":"<p><strong>Background and objective: </strong>Primary care nurses serve as the gatekeeper of the health system. They could be psychologically affected in times of health crisis such as the COVID-19 pandemic. This study aimed to assess their perceived anxiety, depression, and resilience while working in the rural health units in Samar Province.</p><p><strong>Methods: </strong>A cross-sectional design was employed involving 188 primary care nurses who were working in rural health units (RHUs) in Samar province. They were selected through stratified random sampling technique. Anxiety and depression levels were assessed using the 21-item Depression Anxiety Stress Scale (DASS-21). Resilience level was assessed using 18-item Resilience Scale. Pearson's r moment correlation and logistic regression analysis were used to determine associated factors with mental health.</p><p><strong>Results: </strong>Twenty (20) nurses experienced anxiety and five of them reported depression. Work experience is associated with depression [Exp(B) = 3.753; 95% CI (1.121 - 12.563)]. Overall, nurses reported high resilience level. Anxiety and depression are significantly and negatively associated with resilience.</p><p><strong>Conclusions: </strong>Primary care nurses experience depression and anxiety during COVID-19 pandemic. Work experience is associated to their levels of depression. Moreover, nurses reported high levels of resilience. The higher the levels of anxiety and depression, the lower is their resilience.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 9","pages":"98-106"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844010","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}