A descriptive study on the sleeping habits and correlation of sleepiness with academic performance in a State University-run Medical School in the Philippines

Background and Significance@#Sleep is a vital facet of human existence that is vital to learning and memory; lack of sleep is associated with significant impairment in learning. Medical students are a special population because of the demands of medical school. They are very prone to sleep deprivation and poor quality of sleep, hence academic performance might be affected.@*Objectives@#We determined the different sleeping habits of medical students using a descriptive tool, with variables chosen specifically for this study. The level of sleepiness was then correlated with the academic performance (using the general weighted average) among students in a state university run-medical school in the Philippines.@*Methods@#The study is a prospective cross-sectional survey among medical students in a state university-run medical school enrolled for the academic year 2016-2017. The questionnaires used were the Epworth Sleepiness Score and specific questions about sleeping habits. The General Weighted Average (GWA) of those who participated were obtained from the student records section of the college. Descriptive statistics were used to describe the results on different sleeping habits, while the chi-squared test was used to determine any significant differences in the GWA versus level of sleepiness across all year levels.@*Results@#A total of 426 medical students (or 60% of the total student population of the college) participated. However, of the 426, only 326 had complete GWAs and were therefore included in the final analysis for correlation. The average medical student is “sleep-deprived”, sleeping two hours less (six hours) than the recommended daily minimum duration of sleep (eight to 10 hours). For the correlation of sleepiness and academic performance, we found out that there is no significant difference in academic performance among those who are excessively sleepy (ESS greater than 10) versus those who are not, p-value = 0.892.@*Conclusion@#Increased level of sleepiness does not correlate with poorer academic performance among these medical students, despite them sleeping less than the general recommendation for adults. The study is limited however by the use of the GWA as the sole tool to measure academic performance, which is affected by many other factors. We recommend the performance of this study in a broader population and use more validated tools to measure sleepiness and academic performance.

Blood eosinophilia as predictor for patient outcomes in chronic obstructive pulmonary disease (COPD) exacerbations

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> The eosinophilic phenotype of chronic obstructive pulmonary disease (COPD) has been demonstrated to respond better to corticosteroids and associated with better outcomes. This review aims to clarify the correlation of blood eosinophilia and outcomes patients with COPD exacerbations.</p><p style="text-align: justify;"><strong>METHODS:</strong> This is a review of cohorts and case-control studies that looked into eosinophilia and outcomes in exacerbations using the meta-analysis of observational studies in epidemiology (MOOSE) guidelines. The primary study outcome was length of hospitalization; other outcomes include readmission and mortality rate within one year, in-patient mortality, and need for mechanical ventilation.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Six studies were included in the review. Patients with blood eosinophilia had significantly shorter hospital stay compared to non-eosinophilic patients (mean difference 0.68 days [95% CI 1.09,0.27]). Eosinophilic patients had significantly less frequent readmissions (OR 0.69 [95% CI 0.55,0.87]) but there was no statistically significant difference in the one-year mortality rate (OR 0.88 [95% CI 0.73, .06]). Analysis showed a trend toward lower in-patient mortality among eosinophilic patients (OR 0.53 [95% CI 0.27,1.05]). Furthermore, COPD patients with eosinophilia had significantly less need for mechanical ventilation during an exacerbation (OR 0.56 [95% CI 0.35,0.89]).</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> COPD patients with blood eosinophilia had significantly shorter hospital stay, less frequent readmissions, and are less likely to require mechanical ventilation compared to the non-eosinophilic phenotype. </p>

Clinico-pathologic profile and clinical outcomes of patients with indolent lymphoma at the Cancer Institute of the Philippine General Hospital: A seven-year experience

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> Indolent lymphoma (IL) is a slowly growing lymphoma, generally refractory to conventional chemotherapy. There are several types of IL, which includes follicular lymphoma (FL), marginal zone lymphoma (MZL), small lymphocytic lymphoma (SLL), mantle cell lymphoma (MCL), and waldenstrom macroglobulinemia/ lymphoplasmacytic lymphoma (WM/LPL). Presently, there are no known data in the Philippines on IL. This study is done to determine the clinico-pathologic profile and outcomes of Filipino patients with IL.</p><p style="text-align: justify;"><strong>METHODS:</strong> This study is a retrospective chart review of outpatient department cases of IL seen at the Philippine General Hospital-Cancer Institute from January 2009 to January 2016. The following were documented: age; gender; primary location; presence or absence of B symptoms; type of IL; Ann-arbor stage; prognostic indices for FL and MCL; and staging with bone marrow aspiration and whole body CT scan. Treatment intervention and clinical outcomes were documented.</p><p style="text-align: justify;"><strong>RESULTS:</strong> This study showed that SLL was the most common IL. Most were elderly (>40 years old); male; lacked B symptoms; limited disease; and primary location at or near the orbital area. MCL were seen in all risk groups. Follicular lymphoma (FL) were mostly low risk and had grade one histology. Majority had disease control regardless of treatment intervention. Most patients with recurrence/progression after initial treatment had limited disease but were understaged. Most of the patients were not staged with bone marrow aspiration or whole body computed tomography.</p><p style="text-align: justify;"><strong>CONCLUSION: </strong>The results of this study are mostly consistent with known literature on IL. Absence of B symptoms and limited disease may indicate a low-grade histology. Observation was the most common option for asymptomatic patients.</p><p style="text-align: justify;"> </p>