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Background@#Retinoblastoma is the most common intraocular cancer in childhood in the Philippines. Most data though on demographics, clinical profile, treatment options, and outcomes in the country are from the National Capital Region. @*Objectives@#This study aimed to describe the demographics, clinical profile, treatment done, and outcomes of retinoblastoma patients seen in a public tertiary referral center in Davao from 2011-2020 to make available literature more representative of the status of retinoblastoma in the Philippines. @*Methods@#An analytical cross-sectional study was conducted using the records of retinoblastoma patients seen in a tertiary government hospital located in Davao Region from January 2011 to December 2020. @*Results@#There were 157 patients included in the analysis. Seventy-three (46%) were female with 44% coming from the Davao Region. One hundred seven (69%) patients had unilateral disease. Median age at initial consultation for patients with unilateral disease was significantly older than those with bilateral disease (p<0.003). Tumors were extraocular in 82 (40%) eyes. In the intraocular group, 36% of the eyes belonged to International Classification of Retinoblastoma (ICRB) Groups D and E. Enucleation was the most commonly performed treatment. Survival rate was 28%. This is the first report to provide epidemiologic and clinical data on retinoblastoma in the literature, including survival data, from Mindanao. Advanced stages and extraocular cases of retinoblastoma remain high. Delay of consultation contributed to the prognosis and clinical outcome of the disease.@*@#Conclusion. Advanced stages and extraocular cases of retinoblastoma remain significantly high in the country, even in Mindanao.
Assuntos
Retinoblastoma , Terapêutica , Taxa de SobrevidaRESUMO
The widespread and increasing resistance of Plasmodium falciparum to antimalarial drugs is one of several factors that contributed to the persistence and even worsening of the malaria problem. Resistance to Chloroquine is of utmost concern, considering that it had been the most reliable antimalarial until the emergence and spread of Chloroquineresistant P. falciparum. Until recently, Chloroquine and Sulfadoxine-Pyrimethamine were the first and second line antimalarials in use in the Philippines. However, this has been changed to a combination of Chloroquine and Sulfadoxine-Pyrimethamine, because of the high percentage of treatment failures in therapeutic efficacy studies done in northern and southern Philippines. The objective of this study is to apply PCR in determining the occurence of Chloroquine resistance in southeastern Mindanao using in-vitro test and polymerase chain reaction (PCR)In the first study, the in-vitro susceptibility of P. falciparum to Chloroquine was tested in 33 isolates using the World Health Organization (WHO) Semi-Microtest Method. These isolates were collected from patients who consulted or were admitted at the regional hospital of Davao del Norte. The results showed that 10 (30.3 percent) were susceptible with IC50 80 nM, 12 (36.4 percent) isolates had decreased sensitivity with 80 nM /- IC50 114 nM, and 11 (33.3 percent) were resistant with IC 114 nM. Ten of these 11 (91 percent) were from Davao del Norte. A closer look at the municipalities of this province showed that the geometric mean (SD) of IC50 of Asuncion was 133 (41) nM and was significantly higher (p=0.025) than nearby Kapalong at 82 (25) nMThe PCR, Apo1 restriction revealed that 30 (90.9 percent) of the isolates manifested the PfCRT (K76T) mutation. These findings are indicative of the presence of Chloroquine resistance among the isolates. Comparison with the results of the invitro test (33.3 percent resistance) showed that the frequency of the PfCRT gene (90.9 percent) was very high. This finding suggests that the mere presence of the PfCRT gene does not mean the expression of Chloroquine resistance. It is possible that other genes such as the Pfmdr and cg2 are also involved in the expression of Chloroquine resistance. The study also shows that PCR and Apo1 restriction may be limited in generating results that can be used to correlate with those of the in-vitro or even in-vivo tests
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Cataract remains the number one cause of blindness in third world countries. In the Philippines, it accounted for 77 percent of blindness in 1995 with a prevalence rate of 0.70 percent, and 62 percent in 2002 with a prevalence of 0.58 percent. Surgery is still the only treatment for cataract blindness. The two main kinds of cataract extraction are intracapsular and extracapsular. A third procedure, phakoemulsification, is being performed by highly trained ophthalmologists. Laser surgery as a primary procedure for cataract is still considered experimental and is not being performed on cataract patients in the Philippines. The main objective of this study was to determine the percentage of visual rehabilitation and prevention of blindness; and the percentage of complications after cataract surgery. Results were compared versus the different surgical procedures, and the health facility where the procedure was performed. Comparative studies on the different surgical procedures for cataract abound in the literature. However, this is the first report in the Philippines of a community-based study on the visual outcome after each kind of cataract surgery on Filipino patients. The results may also provide important information for the training of cataract surgeons as well as measures for the evaluation of facilities for cataract surgery in the country. This report is a retrospective study of the data gathered in 1999. After randomly sampling municipalities in each province in the 3 selected regions, all cases who had undergone cataract surgery were tracked down, interviewed, and examined especially for visual outcome. A total of 995 post-operative cases were included in this study: 95 in the National Capital Region, 330 in Western Visayas and 530 in Southern Mindanao. The study showed the following findings: Visual rehabilitation (pre-operative low vision that improved to 20/70 or better after surgery)=90.67 percentBlindness prevention (pre-op blindness that improved to Counting Fingers more than 3 meters or better)=92.82 percentOver-all complication rate = 2.20 percent. Some complications after surgery may be surgeon-related or technique-related. (Author)