ABSTRACT
BACKGROUND: Hemifacial spasm (HFS) is a chronic, potentially disabling disorder that often requires long-term management with botulinum toxin (BoNT). In a country where healthcare costs limit compliance to medical follow-up and treatment, the study aims to provide a real-world experience on the use of BoNT for HFS among Filipinos. METHODS: We retrospectively collected data from 162 HFS patients who received 1138 botulinum toxin (BoNT) injections from 2006 to 2019 in our movement disorders center in the Philippines. We described their clinical profile and treatment response. RESULTS: The mean age at onset of disease was 47.7 ± 10.72 years. Majority of the patients reported a baseline moderate disease severity and disease frequency of >75% of waking time (59.8% and 46.9%, respectively). Most patients (61.73%) received 5 or less injections during the follow-up period. The mean duration of follow-up was 2.96 ± 4.28 years. The overall duration of treatment effect per injection was 3.6 ± 1.3 months while the mean interval between injections was 6 ± 5 months. There was no difference in the symptom improvement and duration between onabotulinumtoxinA and abobotulinumtoxinA. Side effects were infrequent. CONCLUSION: This study supports existing evidence on the efficacy and safety of BoNT for the symptomatic relief of HFS. In the Philippines, long-term treatment with BoNT may be limited by the cost of the procedure as majority of our patients had a few injections with long treatment intervals.
ABSTRACT
OBJECTIVES: This study aimed to a) evaluate the knowledge of water refilling station (WRS) owners and operators regarding the proper techniques and procedures applicable to WRS based on the Certification Course for Water Refilling Station and Plant Operators (CCWRSPO); b) assess compliance to regular physical-chemical and microbiological testing of product water and sanitary permit acquisition and c) determine the quality of product water of selected water refilling stations (WRS) in a municipality in Cavite. METHODS: The study includes WRS owners and operators who participated in the CCWRSPO from 2005 to 2009. A 50-item objective examination administered by the researchers was used to evaluate the knowledge of the respondents. This was formulated based on the objectives of the CCWRSPO. The compliance to legal requirements for WRS was assessed according to the results of the physical-chemical and microbiological tests (Multiple Tube Fermentation Technique and Pour Plate Method) and the presence of an updated sanitary permit. Results of product water analyses were compared to the 2007 Philippine National Standards for Drinking Water. Water refilling stations that failed to meet at least one of the three legal requirements were considered as "non-compliant". RESULTS AND CONCLUSION: Results showed that 71.8% of the respondents passed the written examination whereas 28.2% obtained scores less than 50.0%. Chi-square analysis indicated that there was no significant difference between the knowledge of the trainees in 2005 to 2008 and the trainees in 2009. Similarly, majority (78.9%) of the WRS included in the study were found to be non-complaint with the provisions of P.D. 856 and the prescribed standards for water quality. The quality of product water served as an important determinant of the compliance of WRS. Although majority of the water samples tested had acceptable microbiological examination results, 16.9% of the samples exceeded the standards for microbiological water quality. Aside from this, the non-compliance of WRS was attributed to the absence of an updated sanitary permit, which was one of the important indicators of product water quality. Chi-square analysis showed that the trainees who have been operating WRS for only a year after the certification course were less compliant as compared to those operating for two to five years.
