HLA antigens in Filipinos with Ankylosing Spondylitis

@#Ankylosing spondylitis has been shown to be highly associated with HLA-B27 in Caucasian patients. This is also present in other ethnic groups. This study was conducted to determine the frequency distribution of HLA antigens in Filipinos and determine the association of ankylosing spondylitis. Twenty patients satisfying the criteria for ankylosing spondylitis and 192 unrelated controls were HLA-A and B typed. Blood from these subjects were typed using NIH lymphocyte microcyto-toxicity method. Of the unrelated controls, the frequencies of HLA A9 (w24), B40, A1, B5, Bw22 were increased and B13, B18, Bw35 were decreased. B27 had a frequency of 5.2%. A very significant high frequency of B27 (90%) was found in patients with ankylosing spondylitis with a very high relative risk of 163. A11 had a frequency of 55% with a relative risk of 3.37 which was not significant while B18 had an 18% frequency and a relative risk of 10.5 which was significant. This study reaffirms the high degree of association of ankylosing spondylitis with HLA B27 and suggests than B18 may be an additional genetic marker for this disease.

A descriptive study of the nutritional and frailty status of working and retired employees within an academic community in the Philippines

Objectives@#This study aims to describe the sociodemographic and clinical profile of working and retired staff and faculty age 55 years and older in an academic community living in Laguna, Philippines; to determine the proportion of participants with Type 2 Diabetes Mellitus (T2DM); and to describe the nutritional and frailty status of working and retired participants with T2DM. @*Methods@#The study utilized a cross-sectional study design. The participants are current employees and retired faculty and staff of an academic community living in Bay and Los Baños, Laguna, Philippines. Stratified random sampling according to working status and gender was utilized. Participants with T2DM were determined and assessed based on their nutritional and frailty status using the comprehensive geriatric assessment (CGA), laboratory analysis, and mini nutritional assessment (MNA). Descriptive statistics were calculated for all continuous and categorical variables measured. @*Results@#A total of 109 participants agreed to participate and completed the CGA, with 93.6% undergone blood extraction for laboratory analysis. The mean age of the participants was 63.7 (±5.8) and 57.8% belonged to the young-old subgroup. There were more working (60.6%) than the retired (39.4%) and more females (61.5%) than males (38.5%). There was a low level of malnutrition (0.9%) in this cohort. However, many had abdominal obesity and elevated low-density lipoprotein (LDL). Low vitamin D was prevalent. Type 2 Diabetes Mellitus was present among 14.7% of participants of which 93.8% were pre-frail and 6.3% were at risk for malnutrition. @*Conclusion@#Although malnutrition and frailty were not prevalent among those with T2DM in this cohort, more participants were pre-frail and at risk for malnutrition. There are many opportunities to reduce the risk of malnutrition and frailty in the community. Early screening and interventions are recommended to improve the health and wellbeing of the working and retired participants.

Complementary and alternative medicine use and quality of life among Filipino Adult Psoriasis Vulgaris Patients seen in a tertiary center: A cross-sectional study

Objective@#To determine the prevalence of complementary and alternative medicine (CAM) use and its association with quality of life (QOL) among Filipino adult psoriasis vulgaris patients. @*Methods@#A cross-sectional study was conducted in an outpatient dermatology department of a tertiary hospital, using a semi-structured, interview-guided questionnaire, and a self-administered QOL questionnaire, the dermatology life quality index (DLQI). @*Results@#A total of 135 Filipino adult patients with psoriasis vulgaris were included. The prevalence of CAM use was 47%, with most CAM users being female and single. Completion of tertiary education was found significantly associated with CAM use (p < 0.05). A greater body surface area involvement and longer disease duration were more common among CAM users but these were not statistically significant. Special diet (56.3%) was the most commonly used type of CAM, followed by herbal medicine (46.9%), bath therapy (18.9%) and faith healing (12.5%). Major sources of CAM information were families (43.8%), internet/social media (28.1%) and health professionals (25%). Around 40% of the participants used CAM out of curiosity. The mean DLQI score of the respondents was 11.3 (±7.3) corresponding to poor quality of life. CAM use was significantly associated with negative impact on physical symptoms and feelings, daily activities, and work and school (P = 0.044; P = 0.019; P = 0.047). After adjusting for confounding variables, patients with poor QOL were twice more likely to use CAM but this was not statistically significant (odds ratio [OR], 1.76; 95% confidence interval [CI], 0.78-3.95; P = 0.17). @*Conclusions@#The use of CAM is prevalent among Filipino adult patients with psoriasis vulgaris. The significant association between CAM use and a poor quality of life may reflect the unmet physical and psychosocial needs of patients. A patient-perspective approach should acknowledge the reasons for CAM use, which could guide the physicians in imparting available scientific evidence, or the lack thereof, for the use of CAM to these patients.

Cardiometabolic risk factors leading to Diabetes Mellitus among the Young (YOD) from the 8th Philippine National Nutrition Survey / Journal of the ASEAN Federation of Endocrine Societies

Objectives@#This study looked into the prevalence of diabetes mellitus (DM) and risks for cardiovascular and metabolic diseases among young adults with diabetes (age 20-44 years old, YOD) and late-onset DM (≥45 years old, LOD) in Filipinos.@*Methodology@#Weighted data from 546,580 adults with DM from the 8th Philippine National Nutrition and Health Survey (NNHeS) were utilized. Differences in sociodemographic, anthropometric, clinical profiles and metabolic risks were compared between YOD and LOD.@*Results@#The aggregated prevalence of DM is 5.43% (95%CI, 5.10–5.79), YOD were 2.64% (95% CI, 2.32–3.00) and LOD 9.85% (95%CI, 9.18–10.56). Mean age of YOD was 37,6 years, LOD 59,9 years. The YOD were mostly males (56%), with higher BMI (26.24 kg/m2 vs 25 kg/m2, p=0.002), lower mean SBP (122.41±19.17 mmHg vs 135.45±22.47 mmHg, p<0.001), more daily smokers (23% vs 14%), and alcoholic beverage drinkers (39% vs 31%). Physical activity was similar between groups (44% vs 51%, p=0.078). However, average total caloric intake (1776.78±758.38 kcal vs 1596.88±639.16 kcal, p=0.023) and carbohydrate intake (306.13±142.16 grams vs 270.53±104.74 g, p=0.014) were higher in YOD. Dietary carbohydrate proportions were higher than recommended (69% vs 68%) for both groups. Young Filipinos had higher risk to develop diabetes when they are obese II (22% vs 12%), current drinker (56% vs 37%), and current smoker (28% vs 18%). Eighty percent of YOD and LOD had metabolic syndrome (MetS). With every unit increase in age and fat intake, the odds of having MetS were raised by 5.4% (95%CI 1%–10%, p=0.029) and 1.6% (95%CI 0.04%-3%, p=0.044), respectively.@*Conclusion@#Early-onset diabetes mellitus appears to be driven by obesity, MetS and social behaviors. Modifiable risk factors can be improved early to decrease hazards to develop cardiometabolic complications.

Primary Aldosteronism among adult Filipinos with resistant Hypertension: A pilot study

Background@#Primary aldosteronism (PA) was previously thought to be uncommon. With the utilization of plasma aldosterone concentration and plasma renin activity ratio (PAC/PRA) as a mode of screening, the frequency of its detection increased significantly. Among the population with an indication for PA screening, resistant hypertension has the highest prevalence. Detection of PA in this group is essential since it is associated with increased cardiovascular and cerebrovascular complications.@*Objective@#To determine the prevalence of PA among adult Filipinos at Capitol University Medical Center, Cagayan de Oro City, Misamis Oriental.@*Methods@#Adult Filipino patients with resistant hypertension underwent PA screening using the PAC/PRA. Patients with positive results were confirmed for PA either through IV saline infusion or using the following criteria: history of spontaneous hypokalemia or documented hypokalemia prior to screening, undetectable PRA (< 1 ng/ml/hour), and a PAC of > 15 ng/dl.@*Results@#Twenty-one patients were recruited, but only fourteen participated in the study. Thirty five percent of those who participated screened positive for PA. Among those who screened positive, three patients were confirmed of having PA.@*Conclusion@#The prevalence of PA in adult Filipinos with resistant hypertension in Capitol University Medical Center, Cagayan de Oro City, Misamis Oriental is estimated to be 21.43%.

Spiritual well-being of Filipino patients with cancer

@#Cancer is a serious disease that leads to physical, psychosocial, and spiritual difficulties. Filipinos' high reverence to God can affect their health-related behaviors and responses to illnesses like cancer. Though studies have shown the association of spirituality and quality of life, very few have been conducted in Filipino cancer patients. This study aimed to describe their spiritual well-being in terms of the personal, communal, environmental, and transcendental domains; and compare spiritual well-being across different patient characteristics (i.e. type of cancer, stage of cancer, type of treatment, and the period since first symptoms are felt) as input to determining patients at risk for spiritual distress. A descriptive cross-sectional design was utilized with 87 conveniently sampled respondents. A researcher-developed questionnaire and the Spiritual Health and Well-being Measure© (SHALOM) instrument were used to collect data. Data were analyzed using descriptive statistics and Kruskal Wallis H Test. Majority of the respondents were below 50 years old, female, married or with a common-law partner, had at least a high school education, unemployed, did not have enough income to support basic needs, Catholic, and an active member in the church. Most of them had colorectal cancer, were in Stage III, first felt symptoms 6 months to 1 year prior to the conduct of the study, and received a combination of treatments. In terms of personal state, the patients had the highest spiritual well-being in the Transcendental Domain which describes one’s relationship with God. The second-highest spiritual well-being level was found to be the communal domain followed by personal, and environmental domains. Significant differences were found in the spiritual well-being scores in the 4 domains across the types of cancer, with the lowest scores among those with head and neck cancer. Filipino patients in the study had high spiritual well-being despite the presence of cancer. Patient characteristics, especially their illness profile, should be considered in developing nursing interventions that may improve their spiritual well-being.

Active aging health determinants among working and retired Filipino older persons living in an urban academic campus

OBJECTIVES@#This study aims to describe the demographic profile and determine the proportion and Active Aging health determinants of staff, faculty, and retired employees who are 55 years of age and older.@*METHODS@#Mixed qualitative and quantitative methods, community-based, and participatory. Participants were working and retired faculty and staff, age 55 years and over, living within an urban campus of a University. The University Ethics Review Board approved the protocol. Focus group discussions (FGDs) led to the development of a pretested survey instrument. Additional health data were obtained using a validated Comprehensive Geriatric Assessment (CGA) tool. Trained and certified health professionals conducted the CGA. A Senior Geriatrician adjudicated the final diagnoses. Progress reports and validation workshops were conducted with study participants, content experts, and stakeholders. CSPRo, SPSS, and STATA were used to generate and analyze disaggregated data.@*RESULTS@#Two hundred thirty-one (n=231) agreed to participate. The matched dataset was used in data analysis, representing a total of n=192 completed both surveys and CGA interview. Of the top 10 Geriatrician diagnoses, the highest-ranking non-communicable disease was hypertension and the top sensory diagnosis was presbyopia. Three of the self-assessed conditions were vision-related. They had better oral health than the recent national report. Most were highly independent and functional. The majority rated their QOL as good. Most had access to health insurance and a University Health Service.@*CONCLUSION@#Non-communicable diseases and visual disorders were the most common medical problems among working and retired university workers 55 years and older, living within the campus. To reduce NCDs, maintain functional independence and achieve a better quality of life especially among the retired, programs for older persons are recommended. These include access to medication, improved health financing, and senior wellness programs during and after employment. The results of the study will help understand and create a Framework for Active Aging that is relevant to this academic community.

Prevalence and Factors Associated with Obesity at a Primary Preventive Cardiology Clinic: The Philippine Heart Center Experience

@#INTRODUCTION: Obesity has been linked to the development of type 2 diabetes mellitus (T2DM) and cardiovascular diseases. This study primarily aims to determine the prevalence of obesity among the Filipino patients in our institution since there have been no previous studies on this subset of patients. METHODS: A cross-sectional analytical study of 2,078 patients at the Primary Preventive Cardiology Out-Patient Clinic of the Philippine Heart Center (PHC) was done from January 1, 2002 to December 31, 2017. The prevalence of obesity was determined using the World Health Organization (WHO) and Asian classification. Factors associated with obesity were determined using binary logistic regression analysis. RESULTS: A majority of the patients were females (1499, 71.14%) with a higher mean age compared to the male patients (57.67±10.5 vs 55.66±11.8, p<0.001). Hypertension (68.5%), coronary artery disease (37.1%) and T2DM (20.3%) were the most common co-morbid illnesses in both genders. The mean body mass index (BMI) was 25.8±4.3 kg/m2 for the female patients while it was 25.2±4.1 kg/m2 for the male patients (p<0.001). The prevalence of obesity using the WHO and Asian classifications was 15% (n=312). Compared to the Asian criteria, there were significantly more patients classified as having normal weight (44.09% vs 24.95%, p<0.001) and overweight (37.98% vs 19.13%, p<0.001) using the WHO classification. Pre-obesity, an additional criterion of the Asian classification which was not adopted by WHO was seen in 37.98% of the patients. On multivariate analysis, female gender (OR 1.31, 95% CI [1.08-1.59)] p=0.006) and T2DM (OR 1.25, 95% CI [1.01-1.56], p=0.42) were significant factors associated with obesity while age (OR 0.98, 95% CI [0.98-0.99], p<0.001) was protective of obesity. CONCLUSION: The prevalence of obesity in our cohort was consistent with the worldwide prevalence reported by the WHO which underscores the need for effective weight management programs and primary preventive strategies 7to lower the prevalence and obviate the development of complications related to obesity. Female gender and T2DM were significant factors associated with obesity, while age was a significant protective factor of obesity.

Fibrodysplasia Ossificans Progressiva in three Filipino children

@#Fibrodysplasia ossificans progressiva (FOP) is a debilitating, rare, autosomal dominant disorder of connective tissue characterized by malformed great toes and by progressive endochondral ossification of extra-skeletal sites (e.g., muscles, tendons, fascia) triggered by trauma, soft tissue injury, muscle fatigue, or viral infections. We present three children affected with FOP with this classic clinical presentation, the first reported cases in the Philippines, thus extending the range of classic FOP to new geographic and ethnic locations. Two of the affected children are siblings who have the common ACVR1 R206H mutation associated with classic FOP; this mutation was not found in their parents who are phenotypically unaffected, providing evidence of germline mosaicism in FOP. To our knowledge, this is the first family with genetic testing done showing presence of the classic mutation in affected siblings not seen in the unaffected parents.

Upper eyelid and eyebrow dimensions in adult Filipinos

Objectives@# To determine the normative values for upper eyelid and eyebrow dimensions among adult Filipinos and the effects of age and sex on these parameters.@*Methods@#This was a prospective, descriptive study involving 75 Filipino adults who were recruited from a single tertiary government hospital in the Philippines. Profile data collected included age and sex, while clinical data included measurements of the pretarsal skin height (PSH), eyelid crease height (ECH) and eyebrow height (EBH) by a single observer, with the average of an individual’s eyes used as the representative measurement. An intereye correlation coefficient was calculated. The subjects were categorized into 4 age groups (i.e. early, early middle, late middle, and late adulthood) and according to gender for statistical analyses. All measurements were compared across age groups using Analysis of Variance (ANOVA) and between sexes using t-test.@*Results@#This study included 43 males and 32 females. Overall, mean PSH measured was 4.5 ± 1.5 mm; mean ECH was 5.9 ± 1.7 mm, while mean EBH was 10.4 ± 2.7 mm. Means of PSH and EBH showed similar measurements between sexes. The mean ECH of females in early adulthood was significantly higher than the mean ECH of males belonging to the same age group (p=0.01). Among the female group, mean EBH was also observed to increase with age (p=0.02). A high degree of inter-eye correlation was observed (r = 0.94 to 1.00).@*Conclusion@#Filipinos have unique upper eyelid and brow features compared to other races. Sex-related differences were not identified in PSH and EBH. While EBH increased with age among female subjects.

Prevalence, epidemiology and clinical characteristics of melasma in Philippine dermatology patients: A multicenter, cross-sectional study

BACKGROUND@#Melasma is an acquired hyperpigmentary disorder occurring in the sun-exposed areas of the face and neck. There is little information on its prevalence, epidemiology and clinical characteristics in the Philippines.@*OBJECTIVE@#To determine the prevalence, epidemiology and clinical characteristics of melasma in Philippine dermatology patients@*METHODS@#This was a multicenter, cross-sectional study conducted from July to December 2013. The investigators determined the prevalence of melasma in 12,068 dermatology patients from 6 government hospitals and private centers in Metro Manila, Philippines. The melasma patients, aged 18 years and above were examined and given self-administered questionnaires to determine the epidemiological and clinical characteristics of their melasma.@*RESULTS@#Of the 12,068 dermatology patients who were seen at the selected hospitals and private centers, 153 (1.26%) were clinically diagnosed with melasma. Majority of the melasma patients were Filipinos (73.20%), aged 41-50 years old (37.91%), with an average age of 42.40 + 9.68 years, and Fitzpatrick skin types III and IV (29.41% and 57.52%, respectively). Melasma was more prevalent in females (81.70%), wherein majority had a prior history of pregnancy (76.8% of the females). Oral contraceptive use was also reported in 37.6% of the female patients and 63.83% of those who have used OCP, have used it for only 1 year or less. Majority had no thyroid disease (75.16%) and daily sun exposure was limited to 1 hr or less for most patients (43.14%). Their melasma was mostly malar in distribution (60.13%), epidermal (61.44%), and mild (51.63%) to moderate (27.45%) in severity. The average mMASI score was 4.63 + 3.32.@*CONCLUSION@#Prevalence of melasma was low among the Philippine dermatology patients sampled. Majority of the melasma patients were Filipinos, aged 41-50 years old, with Fitzpatrick skin type IV, limited sun exposure and no thyroid disease. They were mostly females, with a prior history of pregnancy. Their melasma was mostly malar, epidermal, and mild in severity. These descriptive data can serve as baseline information for further studies on melasma in the Philippines.

Lupus among Filipinos: Unmet needs

@#Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide range of manifestations and potential to affect several organ systems. Complications arise from the disease itself as well as the medications especially glucocorticoids, significantly contributing to overall morbidity and mortality. SLE predominantly affects patients during prime productive years resulting in a substantial economic burden on the patient, caregivers, and society due to direct, indirect and intangible costs. The University of Santo Tomas (UST) lupus database established in 2008 and supported by Lupus Inspired Advocacy (LUISA), aims to bring recognition of SLE as an important disease among Filipinos, serving as the impetus to drive policy makers to include SLE in the national health agenda.

Comparison of the prevalence of Hypertension using three proposed classifications in a single center primary prevention setting

Introduction@#The American College of Cardiology/American Heart Association (ACC/AHA) revised the thresholds for the definition and treatment of hypertension that was recommended by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) while the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) Guidelines for the Prevention, Detection, Evaluation, and Management of High Blood Pressure retained their previous classification but revised the recommendations for diagnosis and treatment. The impact of these changes in our setting is uncertain. This study aims to compare the prevalence of hypertension using the three proposed criteria in a primary preventive setting.@*Methods@#This is a cross-sectional analytical study using data at the Primary Preventive Cardiology Clinic of the Philippine Heart Center from January 1, 2002 to December 31, 2017.@*Results@#There were 2,082 patients in this study. The mean age is 57.1±10.9 years with a female predominance (72.5%). Most of the patients were married (67.3%, 1,401) and unemployed (67.1%, 1,398). Comorbid illnesses include dyslipidemia (48.2%) and type 2 diabetes mellitus (20.3%). The prevalence of hypertension using the JNC 7 and the 2018 ESC/ESH blood pressure (BP) classification was 56% (n=1,167). When the 2017 ACC/AHA BP classification was applied, there was a significant increase in the prevalence of hypertension to 80.3% (n=1671) (p<0.001) demonstrating an absolute increase of +24.2%.@*Conclusion@#The study shows a high prevalence of hypertension which further increased when the 2017 ACC/AHA BP classification was applied This can impose a significant public health burden that needs to be addressed to prevent or decrease hypertension-related complications. Use of the new guidelines may affect diagnosis and treatment of hypertension with potential cost implications.

Aeroallergen sensitization and associated comorbid diseases of an adult Filipino population with allergic rhinitis

BACKGROUND: There is a large global variation in sensitization patterns to aeroallergens due to differences in climate, urbanization, and lifestyle. Knowledge of the most common inhalant allergens is important for appropriate prevention and management of allergic rhinitis (AR). OBJECTIVE: This study aims to provide data on aeroallergen sensitization patterns and associated comorbid diseases of adult Filipinos with AR. METHODS: Medical records of adult Filipinos seen in an Otolaryngology-Allergy Clinic from January 2011 to 2016 were reviewed. Inclusion criteria used was presence of clinically defined AR and positive skin test to at least one aeroallergen in the test panel. Demographics, comorbid conditions, and results of skin prick test were determined. Standard descriptive statistics were used for analysis. RESULTS: One hundred ninety-one adult patients were included in this study. Mean age was 38.8 years, and majority lived in an urban area (71.2%). Most patients exhibited polysensitization (97.4%). All exhibited sensitization to indoor and 86.9% to outdoor allergens. The most common indoor allergens were Dermatophagoides pteronyssinus (97.4%), Dermatophagoides farinae, (95.8%), cockroach (80.1%), and molds (72.8%). Bermuda (67%), Johnson grass (58.7%), and Acacia (58.2%) were the most common outdoor allergens. Urticaria (18.8%), dermatitis (16.8%), and asthma (11.5%) were the most common associated comorbid disease. Twelve percent of patients had more than one associated comorbid disease. Asthma + urticaria followed by asthma + dermatitis were the most common co-morbid combinations. One patient had three comorbid diseases: asthma + urticaria + rhinosinusitis. CONCLUSION: Compared to earlier studies, aeroallergen sensitization patterns of Filipinos remain unchanged. This study also identifies for the first time, the associated comorbid diseases of AR in this population. Understanding these factors can guide treatment strategies to reduce disease burden.

Prevalence and correlates of depression, anxiety, and distress among Filipinos from low-income communities in the Philippines

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> More than one billion people worldwide are affected by mental health disorders, making up 16% of the world's population. However, psychological morbidity has been understudied and disparately estimated among Filipinos living in low-income<br />communities in the Philippines.</p><p style="text-align: justify;"><strong>PURPOSE:</strong> The specific aims of this descriptive, cross-sectional study were to 1) describe depression, anxiety, distress, and quality of life in a large sample of Filipinos from low-income communities in the Philippines; and 2) determine the prevalence and correlates of<br />depression, anxiety, and distress in this sample.</p><p style="text-align: justify;"><strong>METHODS:</strong> A convenient sample of Filipinos (?18 years old) were recruited to participate in the study and asked to complete a general health survey. Only one person per household was eligible to participate in the study to avoid biases based on the prevalence of mental health disorders.</p><p style="text-align: justify;"><strong>RESULTS:</strong> One thousand two hundred three participants, mean age, 49.5 ± 17.6 years, primarily women (64.6%) and married (58.4%) reported the following cardiometabolic disorders: overweight/obesity (29%), hypertension (43%), hyperlipidemia (21%), type 2<br />diabetes (14%), and current smoker (19%). The mean physical and mental quality of life was 46.2 ± 8.1 and 48.6 ± 7.7, respectively. Depression (21%), anxiety (39%) and distress (82%) were prevalent in the sample. Depression was associated with older age, higher distress and anxiety, and lower quality of life. Anxiety and distress were associated with younger age, female gender, higher depression, and lower quality of life.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Mental health disorders are prevalent in Filipinos from low-income communities. Findings provide empirical support for the provision of mental health services consistent with the World Health Organization's action plan in this understudied population. The high association between psychological morbidity and perceived physical and mental quality of life signifies the need to screen for depression in older adults and anxiety and distress in younger adults and women.</p>

Acute Myocardial Infarction in very young Filipino adults

Introduction@#Acute myocardial infarction (AMI) is rare in “very young” patients and studies among Filipinos are scarce. The objective of this study is to determine the prevalence, clinical, echocardiographic and angiographic features, and outcome of this population.@*Methods@#A retrospective study of patients aged 19 to 30 years old who were diagnosed with AMI at the Philippine Heart Center from 2012 to 2016 was done.@*Results@#The prevalence of AMI in very young Filipino adults at our institution was 0.93% (11/1182). The mean age was 26.5±3.4 years with a male predominance (82%). Chest pain was the most common symptom (91%). More than half of the patients did not have heredofamilial diseases. Eight patients were smokers (72%). There was one case of illegal drug use (methamphetamine) (9%). There were only two cases of non-ST elevation myocardial infarction (NSTEMI) (18%). ST elevation myocardial infarction (STEMI) of the anterior wall was seen in four cases (36%), inferior wall in three cases (27%) and anterolateral wall in two cases (18%). Six patients (45%) had left anterior descending artery (LAD) involvement. Two patients (18%) had right coronary artery (RCA) involvement. Two patients (18%) had both LAD and RCA involvement. The youngest patient, a 19-year-old female with Takayasu arteritis, had three-vessel involvement. Five patients (45%) underwent percutaneous coronary involvement (PCI) of the LAD while two had PCI of the RCA (18%). All patients were discharged improved.@*Discussion@#Acute myocardial infarction (AMI) in the young has not been extensively studied among Asians. Chest pain is the most common clinical presentation with STEMI being more frequent than NSTEMI in this age group. Male gender and smoking were the most common risk factors.@*Conclusion@#Early recognition and prompt management of AMI, particularly revascularization (if indicated), are of paramount importance to optimize outcomes.

Attitudes, practices on allergic rhinitis of three socioeconomic classes of Filipinos in the National Capital Region

BACKGROUND: Healthcare access and usage may vary according to socioeconomic class (SEC). Knowing this variable's effect on patient attitudes, practices, and health seeking behavior allows better understanding of compliance, adherence to treatment, and educational needs on allergic rhinitis (AR). OBJECTIVE: This study seeks to assess the attitudes and practices on AR of Filipinos in the National Capital Region. METHODS: A cross sectional survey of 301 Filipinos, stratified into socioeconomic groups ABC1, C2, and DE, was conducted from December 2014 to February 2015. A previously validated and pilot tested questionnaire on AR was administered via structured face to face interviews. RESULTS: Most respondents attributed their symptoms to "colds" (ABC1 77%, C2 79%, DE 78%); most did not consult a physician for their symptoms. Only 26% of all respondents were aware of AR. Only the ABC1 group had respondents who specifically used the term AR. Most respondents' symptoms fulfilled criteria for moderate to severe disease. Sleep was the activity most affected by AR (62%). For symptom relief, over the counter antihistamine-decongestants were the most preferred drug preparations (ABC1 30%, C2 38%, DE 34%). Groups ABC1 and C2 cited family, television, and Internet as the top primary sources of health information; DE cited family, television, and friends. CONCLUSION: Regardless of SEC, Filipinos are not aware of AR. Lack of awareness and gaps in knowledge can result to an underestimation of the condition, decrease in health seeking behavior, unmet patient needs, and undertreatment of disease.

The meanings of diabetes, healthy lifestyle and barriers to healthy lifestyle among Filipino immigrants in the United States

@#The purpose of this study was to explore the knowledge, perception, and beliefs of newly arrived Filipino immigrants regarding Type 2 Diabetes Mellitus (T2DM), healthy lifestyle, and perceived barriers to healthy lifestyle. This is a qualitative study. A sample (n=40) of newly-arrived (less than six years in United States) first generation Filipino immigrants, not diagnosed with T2DM, living in southeastern part of United States were the focus of the study. Face to face interviews were conducted using an interview guide. No further interviews were conducted after data were saturated. The data sources were field notes and audio-recorded interviews, which were transcribed verbatim by the researcher. This study complied with the protocol for human subjects’ protection as obtained from the institutional review board. Prior to analyses of the transcripts, each transcript was read at least twice and compared to the recordings to ensure accuracy and completeness. To ensure trustworthiness, selected transcripts were reviewed and coded by two experience qualitative researchers to ensure inter-coder reliability. A significant number of the participants had little knowledge and few beliefs about T2DM. The perceptions of T2DM were varied, but several beliefs were widely held: (a) T2DM is a “sugar disease” that is based on sweet food intake, (b) participants were aiming to achieved healthy lifestyles through diet, exercise and prayers and (c) T2DM can result from several factors, including barriers to healthy lifestyle that includes stress, possible discrimination, and not enough information to navigate health resources. Although immigration brings opportunities, there are also numerous risks. Some of the diabetes beliefs that this study delineates provide anchors for future culturally appropriate intervention programs for recent Filipino immigrants. One of the major findings in this study was the low diabetes literacy among the participants. Immigrants with low diabetes literacy may have lower awareness of the disease condition, which may have a negative impact on their disease prevention behaviors. Migratory background is also an important factor influencing beliefs about disease prevention. These results provide information for the design of health programs for the prevention of T2DM in the Philippines and United States.

The meanings of diabetes, healthy lifestyle and barriers to healthy lifestyle among Filipino immigrants in the United States

The purpose of this study was to explore the knowledge, perception, and beliefs of newly arrived Filipino immigrants regarding Type 2 Diabetes Mellitus (T2DM), healthy lifestyle, and perceived barriers to healthy lifestyle.This is a qualitative study. A sample (n=40) of newly-arrived (less than six years in United States) first generation Filipino immigrants, not diagnosed with T2DM, living in southeastern part of United States were the focus of the study. Face to face interviews were conducted using an interview guide. No further interviews were conducted after data were saturated. The data sources were field notes and audio-recorded interviews, which were transcribed verbatim by the researcher. This study complied with the protocol for human subjects' protection as obtained from the institutional review board. Prior to analyses of the transcripts, each transcript was read at least twice and compared to the recordings to ensure accuracy and completeness. To ensure trustworthiness, selected transcripts were reviewed and coded by two experience qualitative researchers to ensure inter-coder reliability. A significant number of the participants had little knowledge and few beliefs about T2DM. The perceptions of T2DM were varied, but several beliefs were widely held: (a) T2DM is a "sugar disease" that is based on sweet food intake, (b) participants were aiming to achieved healthy lifestyles through diet, exercise and prayers and (c) T2DM can result from several factors, including barriers to healthy lifestyle that includes stress, possible discrimination, and not enough information to navigate health resources. Although immigration brings opportunities, there are also numerous risks. Some of the diabetes beliefs that this study delineates provide anchors for future culturally appropriate intervention programs for recent Filipino immigrants. One of the major findings in this study was the low diabetes literacy among the participants. Immigrants with low diabetes literacy may have lower awareness of the disease condition, which may have a negative impact on their disease prevention behaviors. Migratory background is also an important factor influencing beliefs about disease prevention. These results provido information for the design of health programs for the prevention of T2DM in the Philippines and U nited States.

Clinical and Histopathological Profile Of BRAF V600E Mutation In Conventional Papillary Thyroid Carcinoma in A Filipino Population

BRAF V600E is a possible biomarker for risk stratification and prognostication in papillary thyroid carcinoma. Studies on its association with aggressive clinicopathological features among East Asian populations are limited. This study examines the clinical and histopathological features of this mutation in Filipinos with conventional papillary thyroid carcinoma. Methods: Formalin-fixed, paraffin embedded thyroid tissue blocks of papillary carcinoma for the study period January 2010 to December 2012 were retrieved. Slides were reviewed and described according to tumour size, variant type, sclerosis, multifocality, subcapsular location, extra-thyroidal extension, nodal metastasis, and nodal extracapsular spread. Medical records were reviewed for patient demographics and characteristics. Mutation status was determined using realtime polymerase chain reaction and sequencing. Results: Sixty-five patients were included in this study. BRAF V600E mutation prevalence was 38.46%. The mutation positive group was predominantly female, young (mean age 36 years), with tumour size less than 4 cm, and late-stage disease. Extra-thyroidal extension (60%), significant sclerosis (96%), and subcapsular tumour location (72%) were the most frequent findings. Eighty-three percent of patients with nodal metastasis had extracapsular spread. Conclusions: Compared to some Asian populations, this study of Filipino patients shows a lower prevalence of BRAF V600E mutation. The clinical and histopathological features of mutation positive patients raise important issues regarding extent of surgical excision and appropriate management of neck metastasis for this group.