Association of internet gaming disorder to depression, anxiety and stress among Filipino adolescents in selected public high schools in Pasay City / The Health Sciences Journal

Introduction@#This study determined the relationship of personal factors and gaming factors with Internet Gaming Disorder (IGD). It aimed to provide information on the association of IGD with depression, anxiety, stress and both depression and anxiety among adolescent gamers.@*Methods@#This was an analytic cross-sectional study among 560 14-18-year-old adolescents from two public high schools in Pasay City that used the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF), Depression, Anxiety and Stress Scale-21 items (DASS-21) and gamer profile questionnaires.@*Results@#The prevalence of Internet Gaming Disorder (IGD) was low at 1.1%, while moderate depression was observed in 67%, stress in 46.8%, both depression and anxiety in 64.8%, and high anxiety in 89.3% among adolescents. Using multiple logistic regression to control the effects of possible confounders, the association of IGD with depression (OR 0.971, 95% CI 0.085-11.084, p-value .981), anxiety (OR 6.0x107, p-value .999), stress (OR 6.135, 95% CI 0.373-100.991, p-value .204) and both depression and anxiety (OR 1.027, 95% CI 0.089-11.846, p-value .983) were not statistically significant. @*Conclusion@#The odds of depression, anxiety, stress and both depression and anxiety were higher among those with IGD as compared to those without IGD. However, it is not statistically significant. This study recommended further validation of the new IGD definition in the local setting and longitudinal studies with a larger population to determine other factors associated with mental disorders.

Effectiveness of ultrasound guided platelet rich plasma injection in comparison with standard conservative treatment on improving pain and function among the athletes with partial anterior cruciate ligament injury of knee: a randomized controlled trial

Background: Anterior cruciate ligament (ACL) injuries are one of the most common ligamentous injuries of knee. Treatment options for partial ACL tear range from conservative treatment up to partial reconstruction. PRP may have enhancing effect on ACL cell viability and promotion of cell proliferation in partial tear of ACL. Thus, the purpose of this study is to determine the role of PRP on partial ACL tear.Methods:A RCT was done among athletes with partial ACL injury who visited department of Sports Medicine, RIMS, Imphal during June 2019-December 2020. Patients with MRI diagnosed grade 1 and 2 ACL injury (n=48) randomized into PRP injection plus rehabilitation, (n=24) and rehabilitation alone, (n=24) groups. The outcomes were compared using International Knee Documentation Committee (IKDC) score, Lysholm score and VAS at baseline, 1stmonth, 4thmonth, 8thmonth and 12thmonth respectively.Results: Baseline characteristics were not statistically significant.At the end of 1stmonth, there were statistically significant improvement in both mean difference of IKDC score (.001), Lysholm score (0.001) and VAS (0.007). At the end of 4thmonth, there were statistically significant improvement in both mean difference of IKDC score (0.001), Lysholm score (0.026) and VAS (0.001). At the end of 8thand 12thmonth, improvement in mean difference of IKDC score, Lysholm score, VAS were observed however not statistically significant.Conclusions: Ultrasound guidedPRP injection along with conservative rehabilitation program might be a treatment choice for ACL partial tear.

Vaginoplasty tips and tricks

ABSTRACT Vaginoplasty is a commonly performed surgery for the transfeminine patient. In this review, we discuss how to achieve satisfactory surgical outcomes, and highlight solutions to common complications involved with the surgery, including: wound separation, vaginal stenosis, hematoma, and rectovaginal fistula. Pre-operative evaluation and standard technique are outlined. Goal outcomes regarding aesthetics, creation of a neocavity, urethral management, labial appearance, vaginal packing and clitoral sizing are all described. Peritoneal vaginoplasty technique and visceral interposition technique are detailed as alternatives to the penile inversion technique in case they are needed to be used. Post-operative patient satisfaction, patient care plans, and solutions to common complications are reviewed.

The Philippine Coronavirus Disease 2019 (COVID-19) profile study: Clinical profile and factors associated with mortality of hospitalized patients

Introduction@#The coronavirus disease 2019 (COVID-19) have spread globally and reached the Philippines in late January 2020. This study is the first local and nationwide research on admitted COVID-19 adult patients: their clinic-demographic profiles, managements, and clinical outcomes. We aim to determine the associated factors with mortality among COVID-19 patients.@*Methods@#This was a retrospective, multicenter, observational cohort study of rt-PCR confirmed and admitted COVID-19 adult patients in 89 hospitals in the Philippines from February to July, 2020. The data on admission of patient’s demographic, clinical, laboratory, pre-hospital and during hospital treatment management and in-hospital clinical outcomes were gathered. The data were described and analyzed using multiple logistic regression analysis.@*Results@#There were 2884 rt-PCR confirmed and admitted COVID-19 adult patients included in the study. Majority were Filipinos (99·4%), with slightly more males (54.4%) than females. 21% were healthcare workers (HCWs). Mortality was higher among non-HCWs at 16% versus 2% among HCWs. 63% of the patients had a co-morbidity, which included hypertension (69%), diabetes mellitus (48%) and chronic kidney disease (26%). The significantly associated factors with mortality in this Philippine cohort were: age >60 years, hypertension as co-morbidity, tachypnea (> 22/minute), WBC count > 10 x 109 /L, and elevated serum lactate dehydrogenase (LDH) (all p<0.05). Elevated serum LDH was the strongest factor associated with mortality (OR of 8.74, p=0.004).@*Conclusion@#This study identified that age, hypertension, tachypnea, elevated WBC count, and elevated serum LDH were associated with mortality among COVID-19 adult patients and results were consistent with results from studies done in other countries. We recommend that early detection and awareness of exposures and symptoms will improve the management and clinical outcomes of COVID-19 adult patients. Also, a long follow-up of the outcomes of COVID-19 to determine the effectiveness of treatment is recommended for further study.

Non-surgical diagnosis and management of chronic ectopic: A case report / The Health Sciences Journal

@#Chronic ectopic pregnancy is a rare form of ectopic gestation that contributes to the increased maternal morbidity and mortality in the frst trimester of pregnancy. Diagnosis is often challenging as it presents with subtle clinical signs and symptoms, imposing the need for surgical exploration and management. This is a case of a 27-year-old gravida 3 para 2 (2002) who presented with vaginal bleeding of three weeks duration, was hemodynamically stable with unremarkable physical examination fndings. The diagnosis of a chronic ectopic pregnancy was established with a conservative, non-surgical approach through the combination of clinical symptoms, transvaginal sonography, and b-hCG monitoring. Management was likewise conservative with multiple dose methotrexate chemotherapy, eventually yielding a decrease in b-hCG from 80.0 mIU/mL to 1.0 mIU/mL.

Factors Associated with Treatment Outcome of Patients with Pulmonary Tuberculosis in the Philippines, 2015 to 2016

Objective@#The study aims to determine the factors associated with unsuccessful treatment outcome among patients who have undergone tuberculosis treatment.@*Methods@#An analytic cross-sectional study was employed through secondary data analysis of administrative data collected by the National Tuberculosis Control Program from October 2015 to September 2016. Using multiple logistic regression analysis, factors associated with unsuccessful treatment outcome were determined. @*Results@#Multiple logistic regression analysis revealed that belonging to age groups 25 to 34 (aOR=0.73; 95%CI 0.54-0.99) or 35 to 44 (aOR=0.75; 95%CI 0.56-0.99), being male (aOR=1.30; 95%CI 1.03-1.64), doing crafts and related trades work (aOR=0.66; 95%CI 0.46-0.94), living in either a 4th class city (aOR=0.46; 95%CI 0.26-0.82), 1st class municipality (aOR=0.75; 95%CI 0.57-0.98), 4th class municipality (aOR=0.59; 95%CI 0.38-0.93), having a positive sputum smear result (aOR=1.60; 95%CI 1.29-2.00), having rifampicin-resistant/ multidrug-resistant tuberculosis (aOR=9.32; 95%CI 7.28-11.93), being a treatment after lost to follow-up case (aOR=1.84; 95%CI 1.37-2.47) or a case with previously unknown treatment outcome (aOR=1.42; 95%CI 1.00-2.01) were significant correlates of unsuccessful treatment outcome. @*Conclusion@#The study found that age, sex, occupation, residence, sputum smear results, drug resistance, and history of previous treatment were associated with unsuccessful treatment outcome.

Comparison of the clinical effect of intra-articular injection of platelet-rich plasma and methylprednisolone in primary osteoarthritis of knee: a randomized controlled trial

Background: Osteoarthritis of knee is one of the commonest musculoskeletal disorder causing mobility impairment affecting 3.3% in urban areas and 5.5% in rural areas. Intra-articular injection of Platelet-Rich Plasma (PRP) delivers activated platelets that may reduce inflammation, provide pain relief, improve function and stimulate possible cartilage regeneration at the site of worn cartilage area of the knee.Methods: Eighty patients with primary osteoarthritis of the knee fulfilling inclusion and exclusion criteria were recruited in the study conducted in the Department of Physical Medicine and Rehabilitation, RIMS, Imphal from October 2014 to September 2017. Six ml of PRP prepared by conventional bench top centrifugation system was injected intra-articularly, two weeks apart in the PRP group. Steroid group received 80mg of methylprednisolone, two weeks apart by the same technique. The outcome variables (VAS and WOMAC score) were measured before starting intervention (baseline) and at 8 and 24-weeks post-intervention follow up.Results: Significant improvement seen in VAS, WOMAC-pain, stiffness and physical function and total scores in both the groups at 8- and 24-weeks follow-ups (p˂0.001). Steroid group showed better result than the PRP group in VAS (2.78±0.76 vs 3.58±1.03) and WOMAC-total (30.42±6.85 vs 36.25±10.87) scores at 8 weeks respectively (p˂0.001). But at 24 weeks follow-up, PRP showed significantly more effective than the steroid group in reducing pain (2.0±.0.87 vs 2.45±0.78) and disability (22.95±3.78 vs 25.25±6.67) respectively (p˂0.001).Conclusions: Intra-articular injection of methylprednisolone was found to be more effective in reducing pain and disability in primary knee osteoarthritis of KL grade 2 and 3 at the end of 8 weeks whereas 2 doses of PRP intra-articular injection 2 weeks apart was significantly more effective than methylprednisolone at the end of 24 weeks. However, the long-term benefit of PRP is to be determined by studies with a larger sample size and longer duration of follow-up.

A comparative study of acetated isotonic electrolyte solution, normal saline solution, and lactated ringer’s solution in the initial fluid resuscitation of children 1 month to 18 years old with severe dengue at the Philippine Children’s Medical Center

BACKGROUND@#At PCMC, acetated isotonic electrolyte solution is used in the initial resuscitation in severe dengue patients. However, no local study has comparedacetated isotonic electrolyte solution against normal saline and lactated Ringer’s solutions.@*OBJECTIVE@#This study aims to determine the comparative recovery time to achieve initial and sustained cardiovascular stability in severe dengue patients using acetated isotonic electrolyte solution, normal saline solution, and lactated Ringer’s solution.@*METHODOLOGY@#This is a retrospective cohort study involving 166 severe dengue patients 1 month to 18 years old admitted at the PICU from 2014 to 2016. They were divided into 3 groups based on the initial fluid used: 58 in the AIES group, 58 in the NSS group, and 50 in the LRS group.@*RESULTS@#AIES group had the shortest time to achieve initial and sustained stability among patients without re-shock. Also, AIES group needed less fluid to establish stability and had less re-shock, less use of colloid and inotropes, less blood transfusion,and less need for mechanical ventilation and dialysis. NSS had the most fluid shift to AIES and/or colloid while LRS had the most colloid used. Hyperchloremic metabolic acidosis was mostly seen in the NSS group. The length of ICU stay was almost the same in all groups. There was zero mortality in AIES group as compared to 3 on NSS group and 2 in LRS group.@*CONCLUSION AND RECOMMENDATION@#Acetated isotonic electrolyte solution is more effectivethan normal saline and lactated Ringer’s solutions in initial fluid resuscitation among severe dengue patients. It should be the fluid of choice in the initial resuscitation among severe dengue patients. It is recommended that a randomized control study with more patients be conducted.

Mycological profile of fungal sinusitis: An audit of specimens over a 7-year period in a tertiary care hospital in Tamil Nadu.

BACKGROUND: Fungi are being increasingly implicated in the etiopathology of rhinosinusitis. Fungal sinusitis is frequently seen in diabetic or immunocompromised patients, although it has also been reported in immunocompetent individuals. Invasive fungal sinusitis, unless diagnosed early and treated aggressively, has a high mortality rate. AIM: Our aim was to look at the mycological and clinical aspects of fungal sinusitis in a tertiary referral center in Tamil Nadu. DESIGN: This is a retrospective audit conducted on fungal culture positive sinus samples submitted to the Microbiology department from January 2000 to August 2007. Relevant clinical and histopathological details were analysed. RESULTS: A total of 211 culture-positive fungal sinusitis samples were analysed. Of these, 63% had allergic fungal sinusitis and 34% had invasive fungal sinusitis. Aspergillus flavus was the most common causative agent of allergic fungal sinusitis and Rhizopus arrhizus was the most common causative agent of acute invasive sinusitis. A significant proportion of these patients did not have any known predisposing factors. CONCLUSION: In our study, the etiology of fungal sinusitis was different than that of western countries. Allergic fungal sinusitis was the most common type of fungal sinusitis in our community. Aspergillus sp was the most common causative agent in both allergic and chronic invasive forms of the disease.

Antiinflammatory and antipyretic activity of Michelia champaca Linn., (white variety), Ixora brachiata Roxb. and Rhynchosia cana (Willd.) D.C. flower extract.

Methanolic extracts of the flowers of M. champaca, I. Brachiata and R. cana were found to possess antiinflammatory activity against cotton pellet granuloma in rats at a dose level of 100 mg/kg body weight, sc. The latter two drugs showed higher activity (AIA) as compared to that of M. champaca. They reduced the protein content, acid phosphatase, glutamate pyruvate transaminase and glutamate oxalo-acetate transaminase activities in liver and serum. A significant reduction in the ascorbic acid content in adrenals was also observed in drug-treated animals. R. cana was recorded to possess significant antipyretic activity from the first hour of administration. These pharmacological properties may be traced to the presence of flavonoids in the flowers of these plants.

Antiinflammatory and antipyretic activity of vicolides of Vicoa indica DC.

Vicolides A,B, C and D, the sesquiterpene lactones isolated from V. indica exhibited antiinflammatory activity against cotton pellet granuloma in rats at dose level of 10 mg/kg body weight, sc. Highly significant activity was observed with vicolides C and D. They reduced the protein content, acid and alkaline phosphatase, glutamate-pyruvate transaminase and glutamate oxaloacetate transaminase activities in liver and serum. Significant reduction in ascorbic acid content in adrenals was also observed in treated animals. The highly significant antiinflammatory activity of vicolides C and D can be attributed to their chemical structures. Vicolide D has an epoxy angeloyl group while vicolide C has 3,4 epoxy group and an ester moiety in the molecule. Vicolide D possesses antipyretic activity at 250 mg/kg body weight, po dose. It may be due to the presence of epoxy angeloyl group in the molecule.