The effect of fast food calorie labels on calories ordered by college students in Quezon City

Background@#There is an increasing trend of obesity in the Philippines with approximately 28.8% of adults considered overweight and 9.6% obese. This is presumably due to a shift in eating patterns towards dining out in restaurants and fast food chains for their convenience. Excess fast food consumption results in diets that are calorie dense yet nutritionally deficient due to their high levels of fat, sugar, and salt leading to increased prevalence of associated diseases such as Type 2 diabetes and cardiovascular diseases. @*Objective@#The researchers determined the effect of presenting the caloric information of fast food items on the total calories ordered among college students in private and public higher education institutions in Quezon City. @*Methodology@#A double-blind experimental research was performed with 179 students by convenience sampling. The participants were randomly assigned to a control group (without caloric labels) and an experimental group (with caloric labels). An online questionnaire was sent to each subject containing their menu and order form along with questions on their demographical data (age, sex, food allowance, BMI, physical activity). @*Results@#Using single linear regression, none of the demographic characteristics were found to be confounding variables. Using multiple linear regression analysis, it was found that the experimental group ordered significantly less calories (p-value = 0.013). @*Conclusion@#The results of the study conclude that those presented with calorie labels ordered less calories than the control.

A randomized, comparative study on the efficacy and safety of mangosteen 1% extract gel versus benzoyl peroxide 5% gel in the treatment of mild to moderate acne vulgaris

Introduction@#Acne vulgaris is a common dermatologic disorder caused by follicular epidermal hyperproliferation, excess se- bum production, inflammation, and Cutibacterium acnes (C. acnes). The mangosteen fruit rind contains large amount of xantho- nes, which has high antimicrobial activity against C. acnes.@*Objectives@#To compare the efficacy and safety of mangosteen 1% extract gel versus benzoyl peroxide (BPO) 5% gel in the treat- ment of mild to moderate acne vulgaris.@*Methods@#A total of 60 participants with mild to moderate acne or a rating of 2 or 3 in the Investigator’s Global Assessment (IGA) for acne were randomized to receive either mangosteen 1% extract gel or BPO 5% gel applied on the face twice daily over an 8-week period. Primary outcomes measured in the study were clinical remission graded as “clear” or “almost clear” (rating of 0 or 1) based on the IGA and any adverse reaction.

Pigmented extramammary Paget’s disease: A potential pitfall of misdiagnosis

Introduction@#Extramammary Paget’s disease (EMPD) is a rare cutaneous slow growing tumor seen in areas rich in apocrine glands such as the anogenital region while ectopic EMPD is defined as EMPD arising on non-apocrine areas. The pigmented variant of EMPD is a very rare finding, with only a few reported cases, and can be misdiagnosed as melanoma.@*Case report@#We report a case of a 74-year-old woman who presented with a four-year history of pruritic, non- healing erythematous plaques located on the right axilla and left lower abdomen. Histopathology revealed acanthotic epidermis with atypical keratinocytes that was negative for anti S-100 and Melan-A and was positive for carcinoembryonic antigen (CEA), cytokeratin (CK), CK 7 and epithelial membrane antigen (EMA). Patient was managed as pigmented and ectopic variant of extramammary Paget’s disease. Several tests and imaging were done to rule out malignancy. Wide excision with axillary node dissection, bilateral inguinal node dissection, frozen section biopsy and reconstruction using right pectoralis major musculocutaneous flap, split thickness skin graft with left inguinohypogastric drain were done by reconstructive surgery. Frozen section biopsy was negative for S-100, MELAN-A and HMB-45, ruling out malignant melanoma. Patient followed up every month for 6 months after the procedure with no recurrence and lymphadenopathy.@*Conclusion@#This case emphasizes that extramammary Paget’s disease is not a preventable disease and early diagnosis is the key to a favorable diagnosis. Any unilateral eczematous lesion that does not respond to an appropriate course of topical treatment warrants a skin biopsy.

Harlequin Ichthyosis in a 4-year-old male: Case report

@#Harlequin ichthyosis (HI) is a rare type of congenital keratinization disorder that, when left untreated, usually leads to early neonatal demise. A clinical diagnosis of HI is considered when a patient presents with thick plate-like scaling of the skin together with eclabium, ectropion, and nasal hypoplasia. The diagnosis can be confirmed by genetic testing to determine mutation in the adenosine triphosphate-binding cassette A12 (ABCA12) gene. Early administration of systemic retinoids to promote desquamation and emollients to control excessive scaling and dryness of the skin lead to better prognosis in most cases of HI. We present the case of a 4-year-old male with HI who has been successfully managed with bland emollients and systemic acitretin therapy, which we started when he was 1 year old.

Harlequin Ichthyosis in a 4-year-old male: Case report

@#Harlequin ichthyosis (HI) is a rare type of congenital keratinization disorder that, when left untreated, usually leads to early neonatal demise. A clinical diagnosis of HI is considered when a patient presents with thick plate-like scaling of the skin together with eclabium, ectropion, and nasal hypoplasia. The diagnosis can be confirmed by genetic testing to determine mutation in the adenosine triphosphate-binding cassette A12 (ABCA12) gene. Early administration of systemic retinoids to promote desquamation and emollients to control excessive scaling and dryness of the skin lead to better prognosis in most cases of HI. We present the case of a 4-year-old male with HI who has been successfully managed with bland emollients and systemic acitretin therapy, which we started when he was 1 year old.

Demographic and clinical profiles of adult Filipino patients with psoriasis in Davao City: A cross sectional study

Background@#The Psoriasis Registry (PsorReg) was created by the Psoriasis Foundation of the Philippines with the goal of assessing the true magnitude of psoriasis in Davao City.@*Objectives@#To determine the demographic and clinical profiles of Filipino patients enrolled in PsorReg.@*Methods@#Cross-sectional study among adult patients enrolled in PsorReg.@*Results@#A total of 131 patients were included in the study. Mean age was 43.89 ± 15.8 years old. Chronic plaque psoriasis (96.2%) was the most common clinical pattern. 63.4% had nail involvement, while 35.1% had psoriatic arthritis. BMI was normal in 51.1% of patients. Common co-morbidities were hypertension (19.1%), diabetes (10.7%), and dyslipidemia (9.2%). Most common treatment were topical medications, while biologics were the least common. 42.7%, 49.6% and 37.4% had moderate psoriasis using BSA, PASI, and PGA, respectively. Majority (47.3%) reported a large effect of psoriasis on their quality of life.@*Conclusion@#This study determined the demographic and clinical profiles of adult Filipino patients registered in PsorReg in Davao City.

The association between new generation oral contraceptive pill and the development of inflammatory bowel diseases

BACKGROUND/AIMS: To examine the association between use of oral contraceptive pills (OCPs) and the risk of developing inflammatory bowel diseases (IBD), in a modern cohort. METHODS: A prospective nested case-control study across sites in the Asia-Pacific region was conducted; involving female IBD cases and asymptomatic controls. Subjects completed a questionnaire addressing questions related to OCP use. Primary outcome was the risk of development of IBD of those exposed to OCP versus non-exposure. Secondary outcomes were development of Crohn's disease (CD) versus ulcerative colitis (UC), and whether age of first use of OCP use may be associated with risk of IBD. RESULTS: Three hundred and forty-eight female IBD cases (41% CD, median age: 43 years) and 590 female age-matched controls were recruited. No significant association was found between OCP use and the risk of IBD (odds ratio [OR], 1.65; 95% confidence interval, 0.77–3.13; P=0.22), CD (OR, 1.55) or UC (OR, 1.01). The lack of association persisted when results were adjusted for age and smoking. IBD cases commenced OCP use at a younger age than controls (18 years vs. 20 years, P=0.049). CONCLUSIONS: In this large cohort of subjects from the Asia-Pacific region, we found a modest but not significantly increased risk of developing IBD amongst OCP users.

Diffuse cutaneous systemic sclerosis: A case report

@#<p style="text-align: justify;"><strong>BACKGROUND: </strong>Systemic sclerosis (SSc) is a rare, connective tissue  disease  with  multisystem involvement.This is due to immunological processes,vascular endothelial cell injury  and extensive activation of fibrolast that commonly affects the skin and other internal organs such as the esophagus, lungs, heart, and kidneys. SSc has one of the highest mortality among  the  autoimmune  rheumatic  diseases,  hence  the  emphasis  on  the  early  recognition  and  management  to  prevent significant progression of the disease. <br /><strong>CASE:</strong> A 22-year-old  female  presented  with  a  one-year history of multiple hard and hypopigmented patches on the face, neck, trunk and upper extremities. Further examination revealed mask-like facies, microstomia, frenulum sclerosis, Raynaud's phenomenon, pitted scars on the digital pulp of hands  and  sclerodactyly.Baseline  blood  chemistry,chest radiograph and electrocardiography  were  all  negative  for systemic involvement. Autoantibodies were positive for dsDNA, SS-A/Ro and Scl-70. Skin biopsy revealed sclerosing dermatitis, which was consistent with SSc. <br /><strong>OUTCOME:</strong> The  patient  was  initially  started  with  oral prednisone 0.5 mg/kg/day and was increased to 0.75 mg/kg/day for eight weeks. Prednisone was slowly tapered to 5.0 mg/day and methotrexate 15.0 mg/week was included in  the  management for eight weeks which resulted in decreased joint pains, halted the progression of skin induration, decreased in pruritus and palmar edema. <br /><strong>CONCLUSION:</strong> The characteristic dermatological findings of SSc are not only important signs to dermatologists, but these serves as diagnostic clues for clinicians from other disciplines as well. In our case, the presence of the autoantibody Scl-70 indicated the potential risk of pulmonary fibrosis and pulmonary arterial hypertension that accounts with high mortality.Hence,physicians should be aware of the possible risk of organ damage,even when asymptomatic because there is a high risk of disease progression. The importance of early recognition and a multidisciplinary approach lead to the good outcome in this case.</p>

Diffuse cutaneous systemic sclerosis: A case report

BACKGROUND: Systemic sclerosis (SSc) is a rare, connective tissue  disease  with  multisystem involvement.This is due to immunological processes,vascular endothelial cell injury  and extensive activation of fibrolast that commonly affects the skin and other internal organs such as the esophagus, lungs, heart, and kidneys. SSc has one of the highest mortality among  the  autoimmune  rheumatic  diseases,  hence  the  emphasis  on  the  early  recognition  and  management  to  prevent significant progression of the disease. CASE: A 22-year-old  female  presented  with  a  one-year history of multiple hard and hypopigmented patches on the face, neck, trunk and upper extremities. Further examination revealed mask-like facies, microstomia, frenulum sclerosis, Raynaud's phenomenon, pitted scars on the digital pulp of hands  and  sclerodactyly.Baseline  blood  chemistry,chest radiograph and electrocardiography  were  all  negative  for systemic involvement. Autoantibodies were positive for dsDNA, SS-A/Ro and Scl-70. Skin biopsy revealed sclerosing dermatitis, which was consistent with SSc. OUTCOME: The  patient  was  initially  started  with  oral prednisone 0.5 mg/kg/day and was increased to 0.75 mg/kg/day for eight weeks. Prednisone was slowly tapered to 5.0 mg/day and methotrexate 15.0 mg/week was included in  the  management for eight weeks which resulted in decreased joint pains, halted the progression of skin induration, decreased in pruritus and palmar edema. CONCLUSION: The characteristic dermatological findings of SSc are not only important signs to dermatologists, but these serves as diagnostic clues for clinicians from other disciplines as well. In our case, the presence of the autoantibody Scl-70 indicated the potential risk of pulmonary fibrosis and pulmonary arterial hypertension that accounts with high mortality.Hence,physicians should be aware of the possible risk of organ damage,even when asymptomatic because there is a high risk of disease progression. The importance of early recognition and a multidisciplinary approach lead to the good outcome in this case.

Changing epidemiological trends of inflammatory bowel disease in Asia

Inflammatory bowel disease (IBD) has become more common in Asia over the past few decades. The rate of increase in prevalence of the disease varies greatly in Asia, with several countries in East Asia experiencing a more than doubled increase in IBD prevalence over the past decade. Historically, ulcerative colitis (UC) is more common than Crohn's disease (CD) in Asia. However, a reverse trend is beginning to appear in more developed countries in Asia such as Japan, Korea, and Hong Kong. While Asian IBD patients share many similarities with their Western counterparts, there are important differences with significant clinical implications. In Asia, there are more men with CD, more ileo-colonic involvement in CD, less familial aggregation, fewer extra-intestinal manifestations and worse clinical outcomes for older-onset patients with UC. These differences are likely related to the different genetic makeup and environmental exposures in different regions. Evaluation of the differences and rates in epidemiologic trends may help researchers and clinicians estimate disease burden and understand the reasons behind these differences, which may hold the key to unravel the etiology of IBD.

Changing Epidemiology and Future Challenges of Inflammatory Bowel Disease in Asia

In the past decade, many countries in Asia, in particularly in East Asia, are experiencing a progressive rise in the incidence and prevalence of inflammatory bowel disease (IBD). Improved physician awareness and diagnostic methods are unlikely to fully account for this rapid increase. This epidemiological shift is likely to relate to industralization, westernization of lifestyles and changes in eating habits, as part of the socioeconomic development in Asia, although many of these putative environmental factors have not been formally investigated in Asian cohorts. Genetic factors for IBD differ between Asia and the West. NOD2/CARD15 mutation, repeatedly observed in the Caucasian populations, is not associated with Crohn's disease in Asian populations. Familial clustering is generally uncommon in Asia but it is expected to increase as the IBD prevalence in this region rises. Ethnic-racial differences of IBD have been described and Indians appear to be most affected in South-East Asia. Clinical manifestation of IBD in Asia resemble the Western population in general, but with some differences, including higher prevalence of males and ileocolonic disease, lower disease severity, surgical rates and extraintestinal manifestations. These differences may relate to time factor, genetic background and environmental factors. This review summarises recent epidemiological data of IBD including environmental factors associated with the development of IBD in Asia. Future research focusing on studying the epidemiology of IBD in an area of rapidly increasing prevalence such as Asia will allow the opportunity to identify potential risk factors and provide a better understanding of the aetiology of disease in the Asian population.

Changing Epidemiology and Future Challenges of Inflammatory Bowel Disease in Asia

In the past decade, many countries in Asia, in particularly in East Asia, are experiencing a progressive rise in the incidence and prevalence of inflammatory bowel disease (IBD). Improved physician awareness and diagnostic methods are unlikely to fully account for this rapid increase. This epidemiological shift is likely to relate to industralization, westernization of lifestyles and changes in eating habits, as part of the socioeconomic development in Asia, although many of these putative environmental factors have not been formally investigated in Asian cohorts. Genetic factors for IBD differ between Asia and the West. NOD2/CARD15 mutation, repeatedly observed in the Caucasian populations, is not associated with Crohn's disease in Asian populations. Familial clustering is generally uncommon in Asia but it is expected to increase as the IBD prevalence in this region rises. Ethnic-racial differences of IBD have been described and Indians appear to be most affected in South-East Asia. Clinical manifestation of IBD in Asia resemble the Western population in general, but with some differences, including higher prevalence of males and ileocolonic disease, lower disease severity, surgical rates and extraintestinal manifestations. These differences may relate to time factor, genetic background and environmental factors. This review summarises recent epidemiological data of IBD including environmental factors associated with the development of IBD in Asia. Future research focusing on studying the epidemiology of IBD in an area of rapidly increasing prevalence such as Asia will allow the opportunity to identify potential risk factors and provide a better understanding of the aetiology of disease in the Asian population.