Exploring nurse-led political activism in the Philippines: A conceptual framework

@#This paper examines nurse-led political activism in the context of contemporary socio-political issues in the Philippines. This paper integrates Martha Nussbaum's transitional anger as a factor that can help catalyze transformational change. It will be argued that while political activist movements may help counter income inequality and poor working conditions, the concept of moral inertia warrants critical analysis.

Nursing shortage in the Philippines: Dissecting an entanglement of issues

@#The banning of new nursing schools in the Philippines was imposed in 2010 to mitigate the failing compliance of schools with various competency standards set forth by the Professional Regulation Commission (PRC), in addition to the burden of students in paying their affiliations with hospitals. In the midst of the shortage of nurses in the country that was magnified by the COVID-19 pandemic, the Commission on Higher Education (CHED) decided to lift the moratorium. This paper draws on the narratives of nursing leaders and professionals on the phenomenon of nursing shortage and the issues that can arise with the reopening of nursing schools. The verbatims highlight the historical and contemporary entanglement of various issues that contributed to the problem of nursing shortage. In addressing these issues, this paper looks into some of the problems in Philippine nursing that may conform with the broad contemporary problems identified by philosopher Alain Badiou. Viable solutions may be found in the exploration of emerging research methodologies, consideration of systems thinking using technological advances, and incorporating political competency among Filipino nurses.

Analysis of dengue cases using geographic information systems: Evidence from Baguio City, Philippines

@#Dengue is a global health issue and is also regarded as one of the major public health concerns in the Philippines. Presented in this paper is the application of a geographic information system (GIS) in mapping dengue cases in Baguio City. A descriptive research design was utilized and mapped dengue cases were reconciled with environmental correlates such as land cover, housing information (independent, mixed, or interconnected), hydrology (water bodies and canals), urbanization level (urban or rural), elevation, soil, and land surface temperature. Moreover, demographic factors and practices were utilized for further analysis. Results show that interconnected housing, urbanization, land surface temperature, hydrology, and population density are predictors of dengue cases in Baguio City with the predictive power of 0.3810 (strong), 0.3426 (strong), 0.2509 (medium), 0.1675 (medium), and 0.1323 (medium), respectively. In the context of dengue, several data gaps in health information systems exist. Although the Manual of Procedures for the Philippine Integrated Disease Surveillance and Response (PIDSR) published by the Department of Health (DOH) of 2014 provides a detailed guide in the management and surveillance of communicable disease, the use of GIS was noted to be unspecified. Using GIS provides the possibility of harmonizing several data sets to better inform policymakers.

Central myelinolysis in a patient with hyponatraemia

We present a case of a 50-year old man who developed mutism and a flaccid quadriparesis within 48 hours of presentation to hospital with severe hyponatraemia. A diagnosis of central pontine myelinolysis was made based on the clinical features and typical appearances on magnetic resonance imaging.

Carcinoma gall bladder : an institutional experience.

This is a retrospective study of histologically proven cases of carcinoma of the gall bladder presenting to Bhaktapur Cancer Hospital and Om Hospital and Research center, Nepal, over a period of four years, from January 1999 to December 2003. The aim of this study was to review outcome of management and staging of cancer of gall bladder presenting to a specialist cancer centre. Sixty Eight patients presented over this time period; 57% presented with biliary tract symptoms and 49% had a history of chronic cholelithiasis. Twenty one patients presented with apparently resectable disease, but only those undergoing radical surgery demonstrated long term survival. Adjuvant therapies did not have any influence on outcomes. Palliative treatments, notably chemotherapy, showed some response. Besides radical surgery in truly operable cases, current treatments make little impact on this disease. Gall bladder cancer is one of the common biliary tract malignancy and demonstrates marked geographical variation. Its incidence appears to be reasonably common in Nepal. Treatment options have limited efficacy. Randomised data is urgently needed and a number of potential trials are suggested.

Cardiac disease in dialysis patients in a Jamaican hospital: echocardiographic findings that predict mortality / La enfermedad cardíaca en los pacientes de diálisis en un hospital de Jamaica: hallazgos ecocardiográficos que predicen la mortalidad

The aim of the study was to assess, by echocardiography, the cardiac abnormalities in a group of patients with chronic renal failure and to determine the cardiovascular predictors of mortality. The study comprised forty-five patients from the Renal Unit, University Hospital of the West Indies, Kingston, Jamaica, and was undertaken between October 1, 1998 and July 31, 2000. All echocardiography was done by a single operator. The parameters assessed were systolic dysfunction, diastolic dysfunction, ejection fraction, regional wall motion abnormalities and valvular disease. Left ventricular cavity size, septal and posterior wall thickness were measured and left ventricular mass calculated. Demographic data were obtained directly from each patient by interview. The patients were mainly of African/mixed-African origin. Their mean age was 43.2 +/- 16.0 years. The average body mass index was 23.7 +/- 6.9. Twenty-eight (60.9%) patients were male and seventeen (39.1%) female. Hypertension, chronic glomerulonephritis and diabetes mellitus were the leading causes of chronic renal failure. Blood pressure was controlled at a mean value of 145/90 mm Hg pre-dialysis and 140/90 mm Hg postdialysis. The mean duration of renal failure was 2.8 years. Echocardiographic M-mode and two dimensional apical, four chamber view measurements indicated that mean left ventricular internal diameter (LVID) diastole was 55.7 +/- 7.9 mm (normal 38-56 mm) and LVID systole was 38.9 +/- 9.8 mm (normal 24-45 mm); the mean thickness of the chamber walls was 10.3 +/- 2.8 mm and 10.6 +/- 2.4 mm for the interventricular septum (normal 6-11 mm) and left ventricular posterior wall (normal 6-11 mm) respectively. Diastolic dysfunction was seen in 15 (34%) patients and systolic dysfunction in 12 (23%) patients who had ejection fractions less than 50%. The mean left ventricular ejection fraction was 56.3% +/- 16% (normal 65-85%), mean stroke volume was 82.9 +/- 27.2 mls (normal 51-96 ml). After 21 months enrolment in the study, Kaplan Meier analysis revealed a two-year mortality of 28.3%. Cox regression analysis indicated that a history of smoking current or past, low haemoglobin level, high aorta flow velocities, severity of mitral regurgitation and a negative association with serum creatinine were independent predictors of mortality. The correction of anaemia and control of other factors that impact negatively on cardiac function in dialysis patients is vital to enhance survival.

Adult paratesticular malignant fibrous histiocytoma treated with surgery, systemic chemotherapy and postoperative adjuvant radiotherapy.

Paratesticular malignant fibrous histiocytoma is an extremely rare malignancy of the scrotum. This malignancy has rarely been described in the literature and scant information exists on the optimal management of this cancer. We present here a case of a 57-year-old man with a diagnosis of high-grade malignant fibrous histiocytoma of the left intrascrotal region who underwent radical orchiectomy, systemic chemotherapy and postoperative radiotherapy.

Benign and malignant breast disease presenting to Bhaktapur Cancer Hospital.

OBJECTIVE: In the absence of formal breast screening services in Nepal, patients must self present upon developing symptoms relating to the breast. Clinical examination and diagnostic tests are then used to differentiate benign and malignant conditions. Referral / presentation patterns are not well studied and this paper aims to investigate this. METHOD: Here we present the clinico-pathological diagnoses of patients presenting to Bhaktapur Cancer Hospital with breast related complaints within a six month period, and report upon their subsequent management. RESULTS: 727 patients presented with breast related complaints, of whom 34 were diagnosed with breast cancer. These tended to present at late stage and their subsequent management is discussed. CONCLUSION: As the incidence of breast cancer in Nepal is likely to be under-reported and more than likely rising, patient awareness campaigns are underway in order to facilitate the earlier diagnosis of malignant disease and thus beneficially influence treatment outcomes. To this end the need for the development of dedicated breast services is highlighted.

Pyoderma gangrenosum associated with osteomyelitis in a paediatric patient: a case report / Pioderma Gangrenoso Asociado con Osteomielitis en un Paciente Pediátrico Reporte de Caso

Pyoderma gangrenosum is a rare ulcerative skin disorder mainly occurring in adults. It is seen less frequently in children. The cause is unknown but it may occur in association with several disorders. Osteomyelitis is a very rare association. We report a case of pyoderma gangrenosum associated with osteomyelitis in a two-year-old girl

El pioderma gangrenoso es un raro trastorno cutáneo ulcerativo que se produce principalmente en adultos. Se observa con menos frecuencia en los niños. La causa es desconocida, pero puede ocurrir en asociación con varios desórdenes. Su asociación con la osteomielitis es rara. Reportamos un caso de pioderma gangrenoso asociado con osteomielitis en una niña de dos años de edad.

Prevalence of chronic renal failure in the diabetic population at the University Hospital of the West Indies

The prevalence of chronic renal failure (CRF) in 460 patients with diabetes mellitus attending the diabetic outpatient clinic at the University Hospital of the West Indies in Jamaica was determined from a review of medical records. The prevalence of CRF was 10 (39/386) in the diabetic clinic population. Significant positive associations with CRF were found with male gender (20/98, 20 vs 19/287, 7; odds ratio (OR), 3.24; p = 0.001); age 60 years and older (22/162; 14 vs 17/221, 8; OR, 2.01; p = 0.04); fasting blood glucose concentrations exceeding 8.0 mmol/L (22/162, 13 vs 12/182, 7; OR, 2.08; p = 0.05); the presence of significant proteinuria as a marker for outcome (13/39, 33 vs 48/346, 14; OR, 3.60; p = 0.02) and peripheral vascular disease (6/20, 30 vs 139/386, 10; OR, 4.75; p = 0.005). The prevalence of CRF did not differ significantly between patients with Type 1 and Type 2 diabetes mellitus. Also, the presence of CRF was not significantly associated with duration of diabetes mellitus, type of hypoglycaemic agents used, or history of hypertension. However, the presence of persistent proteinuria was significantly associated with duration of diabetes mellitus exceeding five years (46/255, 17 vs 11/149, 7; OR, 2.52; p = 0.005) and a history of hypertension (41/235, 17 vs 20/198, 10; OR, 1.88; p = 0.03) but not with age or gender. This study emphasizes the need to evaluate patients with diabetes mellitus for renal impairment so that intervention strategies may be adopted early to delay progression to endstage renal disease

A survey of chronic renal failure in Jamaica

The prevalence of chronic renal failure (CRF)/end stage renal disease and the accessibility of long term renal replacement therapy in Jamaica were evaluated. The study was conducted at six Jamaican healthcare facilities between July 1998 and December 1999 and included 605 patients with CRF. Men with CRF (57 of patients, mean age of 56.7 years) were significantly older than women (mean age 53.2 years). Hypertension was the most commonly associated medical condition (60.8 of patients) followed by diabetes mellitus (31.4 of patients). The estimated crude point prevalence of CRF in persons 20 years and over at the end of 1999 was 327 per million population. More than one-third of patients with CRF (39) were receiving renal replacement therapy, the most common modality being haemodialysis, and only 1.8 of patients had received kidney transplantation. The prevalence of chronic renal failure was not increased in areas known to have high soil cadmium levels. Chronic renal failure is a significant public health problem in Jamaica and is placing an increasing financial burden on the healthcare sector

Autoantibodies, human T lymphotropic virus type 1 and type 1 diabetes mellitus in Jamaicans

The clinical characteristics, autoantibody profiles and seroprevalence of human T lymphotropic virus Type 1 (HTLV-1) were assessed in 30 Jamaican patients with Type 1 diabetes mellitus. Two hundred and fifty-two blood donors and 108 patients with Graves' disease were included as controls for the HTLV-1 component of the study. The mean age of onset of diabetes mellitus was 20.5 +/- 9.2 years and the mean duration of diabetes mellitus was 10.5 +/- 6.1 years. The remarkable clinical data included an absence of other associated organ-specific autoimmune diseases, and clinical evidence and history of congenital rubella in one patient. Islet cell cytoplasmic antibodies (ICA) were absent but 17 (5/30) of the diabetic patients tested positive for glutamic acid decarboxylase (GAD) antibodies. No other organ-specific autoantibodies were detected but non-organ-specific autoantibodies were present in 9 (30) of the sera of diabetic patients. The seroprevalence of HTLV-1 in the patients with diabetes mellitus was significantly higher than that in the healthy controls (17 (5/30) versus 4 (11/252), p = 0.05). Autoantibodies were found in the sera of 4/5 (80) of the diabetic patients who were positive for HTLV-1. None of the patients with onset of diabetes mellitus below age 15 years was HTLV-1 positive. The likely polyaetiological nature of Type 1 diabetes mellitus in Jamaicans is being further investigated at the molecular level.

Arsenic: the forgotten poison?

Chronic arsenic poisoning is an uncommon cause of peripheral neuropathy in Jamaica. A patient with this disorder is described. The insidious nature of chronic arsenic poisoning, with its disabling complications, is emphasised.