Patient profiles and cost of otolaryngologic surgeries in an LMIC Country

Objectives@#This study aims to analyze the cost of patient care among ORL-HNS patients admitted in a tertiary, teaching government hospital in a low- to middle-income country.@*Methods@#This is a prevalence-based, prospective, bottom-up, cost-of-illness analysis among patients of the Department of Otorhinolaryngology-Head and Neck Surgery in a tertiary training government hospital admitted from July 2021 to March 2022. The value assessment method used is the human capital approach. The societal perspective is used for analysis to estimate and reflect payer (insurance providers) and patient perspectives.@*Results@#A total of one hundred fifty seven (157) patients were admitted for elective surgery under the service of ORL-HNS consisting of 75 females and 82 males. The average total overall cost was $3,851.10 (Php 199, 870.50 ± 164, 725.60). The total direct health care cost for all patients within the study period amounted to $3,712.18 (Php 192, 662.22 ± 159, 548.60) while the direct non-health care cost was $58.60. The workforce cost (58.5%) and medication cost (18.8%) comprised the majority of in-patient expenses with a mean cost of $2,221.36 (Php 37,083.66) and $714.51 (Php 44,363.14), respectively. In this study, an average of $80.29 was lost due to illness and hospitalization (± $81.74). The total PHIC coverage pays a range from zero to 67.5% with an average coverage of only 17%.@*Conclusion@#Our analysis has shown that workforce and medication expenses are the main cost drivers for the direct healthcare costs among Otolaryngology patients admitted for elective procedures. Stakeholders, such as the otolaryngologists and hospitals should coordinate closely to create a more encompassing coverage of Philhealth to prevent patients from suffering from financial crises due to their illness.

Characteristics of Polyps in Lebanese population

Background: The objectiv e of this study is to describe the characteristics of the polyps in the Lebanese population and evaluate dysplasia and its relation to the polyps’ locations. Methods: A retrospectiv e descriptiv e study was conducted at the Department of the National Institute of Pathology in Lebanon and comprised a biopsy of colonic polyps or resected polyps from patients from 2007 to 2009. We collected demogr aphic data and polyps’ characteristics. Then, we divided patients according to age sex, location, and histology . Results: With 2298 polyps in 1470 patients, the mean age was 57.45 with 68% aged more than 50yo. 75.6% have one polyp and multiple polyps are more commonly found in older patients (> 50 years). More than 20 % of polyps are found in the recto-sig moid area. In the right colon, people older than 50 years were more likely to have polyps (19%) compared to those < 30 years (8.3%) (p < 0.05). In the rectum, people < 30 years were more likely to have polyps compared to those > 50 years (p < 0.01). Concerning histology , tubular adenoma is the most common type and is more prevalent in the left colon. Hyperplastic polyps are mainly found in the recto-sigmoid area and mainly in the age group 30-50 in contrast to adenomatous polyps found over 50yo. Adenocarcinomas and/or degener ative polyps were founded in 5.9% of our population. Conclusion: This study gives valuable information on colorectal polyps in the Lebanese population regarding age, sex, dominant histology and anatomic location. We noted a male predominance and mainly above 50 years old. The majority had single polyps, and>50% of polyps were localized in the rectosigmoid. Adenomatous polyps were the most common type.

Exploring factors influencing Essential Intrapartum and Newborn Care (EINC) practice amongst Covid-19 suspected mothers: a qualitative study

BACKGROUND@#The practice of Unang Yakap or Essential Intrapartum and Newborn Care (EINC) during the COVID-19 pandemic poses a safety concern with regards to a newborn’s exposure to their COVID-19 suspected mother. @*OBJECTIVES@#This study aims to describe the experiences of COVID-19-suspected mothers and explore the factors influencing their decision to allow healthcare professionals to practice full EINC. Specifically, it aims to: 1) describe the experiences of mothers prior to, during, and immediately after delivery, and during postpartum care leading to their decision; and 2) explore the factors that influence the participant’s decision to practice EINC amidst the pandemic.@*METHODOLOGY@#For this phenomenological case study, online interviews with nine (9) participants were conducted using a 13-item questionnaire describing their experience. Thematic analysis using the inductive and semantic approach was conducted to identify the common themes or factors. @*RESULTS@#Of the nine (9) participants, five (5) experienced EINC, while four (4) did not. The COVID-19 status and the choice to undergo Unang Yakap were not a causal relationship. Two main influences, mother-related factors, and hospital-related factors, were identified and were found to have weight in decision-making. The mother-related factors include prior knowledge and perception towards EINC, COVID-19 status, personal beliefs, and information from social media; while the hospital-related factors are hospital facilities, hospital protocols, and HCW-patient relationship. @*CONCLUSION@#By delineating the different factors that influence mothers’ decisions, this study allows for the identification of possible bottlenecks in the practice of EINC, as well as effective and efficient means to encourage its practice.

Initial outcomes of endoscopic CO2 laser posterior cordectomy and partial arytenoidectomy among patients with bilateral vocal cord paralysis: A Case series

Objective@#To describe the initial outcomes of endoscopic CO2 laser posterior cordectomy and partial arytenoidectomy among patients with bilateral vocal cord paralysis in our institution.@*Methods@# Design: Case Series Setting: Tertiary National University Hospital Participants: 17 Patients @*Results@#Seventeen (17) patients who underwent transoral posterior cordectomy and partial arytenoidectomy using carbon dioxide laser were included in the study consisting of 14 females and 3 males. Iatrogenic injury was the most common cause of bilateral vocal cord paralysis in this subset of patients. Five patients who tolerated decannulation and another six who had no preoperative tracheostomy all reported subjective improvement in breathing. All of them were also observed to have resolution of stridor and increased respiratory comfort compared to their preoperative condition. The most common postoperative complication was granuloma formation at the medial arytenoidectomy site occurring only in 4 patients. None of the patients complained of aspiration episodes or dysphagia during the postoperative period. @*Conclusion@#Our initial experience with transoral endoscopic posterior cordectomy and partial arytenoidectomy using carbon dioxide laser has good postoperative outcomes among patients with bilateral vocal cord paralysis.

Anurans of Sete Cidades National Park, Piauí state, northeastern Brazil / Anuros do Parque Nacional de Sete Cidades, estado do Piauí, nordeste do Brasil

The Sete Cidades National Park is located in the Brazilian municipalities of Piracuruca and Brasileira, Piauí state, in a transitional zone between the Caatinga and Cerrado biomes. Studies on its herpetofauna were limited to anuran distribution notes and a snake checklist. Thus, here we present an unpublished species list of anurans from Sete Cidades National Park, Piauí state, northeastern Brazil. We recorded one of the two highest species richness for all northeastern National Parks, and also increased the geographic distribution of one species in the state of Piauí. Most species observed are common of both Caatinga and Cerrado biomes or have wide distribution in Brazil. The anuran assemblage of Sete Cidades National Park is more similar to those registered at the Delta do Parnaíba Environmental Protection Area, Ceará, Piauí and Maranhão states, and Ubajara National Park, Ceará state. These results increase our knowledge on anuran diversity in northeastern Brazil, providing basic information for management and conservation actions of an important Brazilian National Park.

O Parque Nacional de Sete Cidades está localizado nos municípios de Piracuruca e Brasileira, Estado do Piauí, em uma zona de transição entre os biomas Caatinga e Cerrado. Os estudos sobre sua herpetofauna estão limitados a notas de distribuição de anfíbios e um inventário de serpentes. Portanto, aqui apresentamos uma lista inédita de espécies de anuros do Parque Nacional de Sete Cidades, Estado do Piauí, Nordeste do Brasil. Nós registramos uma das duas maiores riquezas de espécies dentre todos os Parques Nacionais do Nordeste, além de aumentar a distribuição geográfica de uma espécie para o estado. A maioria das espécies observadas são comuns em ambos os biomas da Caatinga e Cerrado ou têm ampla distribuição no Brasil. A assembleia de anuros do Parque Nacional de Sete Cidades é mais similar àquela registrada na Área de Proteção Ambiental do Delta do Parnaíba, estados do Ceará, Piauí e Maranhão, e no Parque Nacional de Ubajara, estado do Ceará. Estes resultados aumentam nosso conhecimento sobre a diversidade de anuros no Nordeste do Brasil, fornecendo subsídios para ações de gestão e conservação de um importante Parque Nacional do Brasil.

Avaliação do controle higienicossanitário da produção de alimentos em unidades de alimentação e nutrição hospitalar / Evaluation of the hygienicosanitary control of food production in food and hospital nutrition units

As Unidades de Alimentação e Nutrição (UAN) são todos os estabelecimentos onde ocorre a manipulação e processamento de alimentos e deverá fornecer uma alimentação, nutricionalmente equilibrada e segura do ponto de vista higienicossanitário. Uma das ferramentas utilizadas para avaliar a aplicação das Boas Práticas de Fabricação em áreas de produção de alimentos, é a ficha de inspeção ou checklist. Esta ferramenta é empregada para verificar as porcentagens de não conformidades referentes à legislação em vigor, Portaria CVS 5/2013. O objetivo do presente trabalho foi realizar um diagnóstico das condições higienicossanitárias em duas Unidades de Alimentação e Nutrição Hospitalar (UANH), por meio da aplicação de checklist, para verificação da conformidade aos itens avaliados. As duas UANs foram classificadas como satisfatórias, após aplicação do checklist, por meio do qual foram encontrados 81% de adequação na Unidade A e 74% na Unidade B, sendo possível verificar que há o controle na produção de alimentos nos locais estudados e que os pontos críticos citados são falhas pontuais na adoção e controle das boas práticas e infraestrutura dos locais.

The Food and Nutrition Units (FNU) are all the establishments where food manipulation and processing occurs and should provide a nutritionally balanced and safe nutrition from the hygienic and sanitary point of view. One of the tools used to achieve good Practices in food productions areas is the Inspection or check list. This tool is used to verify the percentages of non-conformities referring to the current legislation CVS 5 of 2013.The objective of the present study was to perform the diagnosis of the hygienic-sanitary conditions of a. Hospital. Food and Nutrition Unit (UANH) a A check list based on the country's legislation is used countrywide to detect non-conformities by the Unit. The two FNU were classified as satisfactory after application of the checklist where 81% of suitability was found in unit A and 74% in unit B, being possible to verify that there is hygienic-sanitary control, and the critical points are Punctual failures in the adoption and control of the good practices and infrastructure of the sites.

Rheumatoid arthritis associated interstitial lung disease: a review / La artritis reumatoide asociada a la enfermedad intersticial pulmonar: una revisión

Rheumatoid arthritis is a common inflammatory disease affecting about 1% of the population. Interstitial lung disease is a serious and frequent complication of rheumatoid arthritis. Rheumatoid arthritis associated interstitial lung disease (RA-ILD) is characterized by several histopathologic subtypes. This article reviews the proposed pathogenesis and risk factors for RA-ILD. We also outline the important steps involved in the work-up of RA-ILD and review the evidence for treatment and prognosis.

La artritis reumatoide es una enfermedad inflamatoria común, que afecta cerca del 1% de la población. La enfermedad pulmonar intersticial es una complicación frecuente y seria de la artritis reumatoide y esta asociación está caracterizada por diferentes subtipos histológicos. Este artículo analiza la patogénesis y los factores de riesgo de esta asociación. Además señala los esfuerzos realizados y las evidencias para el diagnóstico y tratamiento.

Squamous cell carcinoma and Bowen's disease of the skin in Singapore

<p><b>INTRODUCTION</b>Non-melanoma skin cancer is one of the commonest cancers in Singapore and worldwide. The aim of our study was to evaluate the demographic and clinicopathological patterns of squamous cell carcinoma (SCC) and Bowen's disease (BD) of the skin, in order to better understand the characteristics of these tumours in our population.</p><p><b>MATERIALS AND METHODS</b>Histologically proven cases of SCC and BD seen at our centre between 2002 and 2003 were retrospectively analysed according to age, sex, race, predisposing factors such as immunosuppression and ultraviolet therapy, site and size of tumour, histological differentiation and subtype, and treatment method.</p><p><b>RESULTS</b>A total of 161 patients were studied--81 with SCC, 68 with BD, and 12 with both tumours. There were 199 tumours in total--105 SCC and 94 BD. For both SCC and BD, males outnumbered females (ratio of 2.4:1 and 1.5:1 respectively); patient age averaged 72.9 years and 66.8 years respectively; and Chinese were the majority race. The mean duration to presentation was 21.2 months for SCC compared with 39.9 months for BD, and common symptoms were itch, pain and bleeding for both. The mean tumour size was 19.0 mm and 18.5 mm, and the commonest site was the head and neck for both.</p><p><b>CONCLUSIONS</b>SCC and BD show rather similar patient characteristics, with a predominance among males, having a predilection for the head and neck region, and with a tendency towards slow growth. As incidences increase worldwide, it is important for healthcare providers to be adept at recognising and managing nonmelanoma skin cancers.</p>