Superior ophthalmic vein thrombosis (SOVT) is a rare but potentially life-threatening condition associated with significant risk of vision loss. It may arise from infectious or inflammatory orbital diseases, trauma, neoplasms, or hypercoagulable states, with Staphylococcus aureus being a common pathogen in orbital cellulitis. We report the case of a 23-year-old male who presented with periorbital swelling, upper lip edema, and pustular lesions. During evaluation in the emergency department, he developed sudden-onset horizontal diplopia and left eye esotropia. Magnetic resonance imaging (MRI) of the brain revealed thrombosis of the left superior ophthalmic vein. Empiric therapy with ceftriaxone, vancomycin, metronidazole, and enoxaparin was initiated. Wound and blood cultures later demonstrated heavy growth of methicillin-resistant Staphylococcus aureus (MRSA), prompting adjustment of antimicrobial therapy to meropenem and vancomycin. The patient subsequently improved and was discharged in stable condition. This case highlights the aggressive nature of MRSA infection and its potential to rapidly progress to orbital and intracranial complications such as SOVT. Early diagnosis, prompt imaging, targeted antimicrobial therapy, and timely intervention are essential to preserve vision and improve clinical outcomes.
Simultaneous rapidly progressive dementia with parkinsonism is a rare initial presentation of dural arteriovenous fistula. Most cases of dural arteriovenous fistula present with either sudden-onset headache and cerebrovascular disease hemorrhage or other benign non-hemorrhagic symptoms. We present a unique case of a 60-year-old male who presented with progressive slowness of movement and forgetfulness. Physical examination was initially significant for bradykinetic movements, slowed gait, and reduced arm swing bilaterally, along with a MoCA score of 15/30, indicating moderate cognitive impairment. Cerebral catheter angiography revealed the presence of a complex tentorial-torcular-left transverse sinus-sigmoid sinus dural arteriovenous fistula. A month after the diagnosis, he eventually became stuporous and bedbound, with episodes of generalized tonic-clonic seizures, and was thus given Levetiracetam 500 mg twice daily. The patient underwent partial arterial feeder onyx embolization with a transverse approach. He was admitted to intensive care post-operatively, with gradual improvement of stupor and no seizure recurrence thereafter. Upon discharge, he was maintained on Memantine, slowly increased to 10 mg twice daily. Seven months after embolization, the patient ambulated without assistance. Although bradykinesia and dementia were still present, this represented a significant improvement from the condition pre-embolization. A high index of suspicion and awareness of this rare acquired cause of rapidly progressive dementia and parkinsonism is needed to avoid delays in the diagnosis and appropriate management.
Congenital cytomegalovirus (cCMV) infection is a leading cause of neurologic disability in infants, often presenting with microcephaly, seizures, and sensorineural hearing loss. However, atypical manifestations such as macrocephaly and intracranial abscess are extremely rare. We report a case of an infant presenting with progressive macrocephaly, with intracranial abscess and obstructive hydrocephalus. She had a history of prematurity and neonatal sepsis. Neuroimaging revealed a rim-enhancing lesion at the quadrigeminal cistern and aqueductal stenosis. Cerebrospinal fluid (CSF) analysis from ventricular tap showed signs of ventriculitis, and both serum and CSF tested positive for CMV IgG and IgM, associated with a high viral load. Antiviral and antibiotic therapy led to resolution of the abscess and ventriculitis. A ventriculoperitoneal shunt was subsequently placed. This case illustrates a rare neurological complication of cCMV presenting with an intracranial abscess and hydrocephalus in an immunocompetent infant. It highlights the wide spectrum of cCMV manifestations and the challenges of diagnosis in settings without routine CMV screening. Early recognition and timely intervention are critical in improving outcomes, especially in low- and middle-income countries where systematic CMV testing is lacking.
Background. The World Health Organization (WHO) and the United Nations International Children’s Emergency Fund (UNICEF) recommend the use of complementary foods when children reach six months of age. Parents may opt for home-made or commercially available complementary foods. In recent years, there has been an increasing availability and utilization of commercially produced complementary foods (CPCF) in the Philippines. There is a growing concern that consumption of these food items among infants and young children may lead to poor nutritional outcomes. Objective. This study aimed to identify the available complementary foods in selected supermarkets in an urban poor community and examine the perceptions of caregivers of children 6–36 months of age on the use of CPCF. Methods. A community-based cross-sectional study was conducted in an urban poor village in the City of Manila. This study involved market research on the available CPCF in supermarket chains and a survey among primary caregivers of children on the use of CPCF. Data were gathered using a pre-tested questionnaire. Descriptive statistics were used in analyzing the data collected. For the qualitative responses of the participants, thematic analysis was employed. Results. A total of 30 CPCF were sold in the urban poor community of Manila and consisted mostly of dry, powdered, and instant cereal starchy food (50.0%). More than half of these CPCF (56.7%) met the general nutritional thresholds. All the products included nutrition and composition claims; 36.7% had marketing claims, whereas 66.7% did not contain health claims. Among the 30 caregivers interviewed, only 2 (6.7%) were aware of CPCF and its importance. The majority of the caregivers (93.3%) have tried giving CPCF to children. The use of CPCF was due to varying reasons, including perceived healthiness, child preference, cost, and convenience. Conclusion. Dry, powdered, and instant cereal or starchy foods were the most common CPCF in the urban poor community in Manila, Philippines. The available complementary foods in the supermarkets had inappropriate nutritional quality to be marketed as suitable for older infants and young children. Furthermore, the use of CPCF was prevalent among caregivers of children aged 6–36 months in the selected community. Key factors considered by caregivers in providing CPCF to the children were product healthiness, food preferences, affordability, and convenience. Continuous nutrition promotion and education on proper infant and young child feeding tailored for parents, relatives, and caregivers is put forward.
Background. YouTube contains simple and easily accessible home/health hacks, including self-exercises. However, the quality/reliability of health-related content cannot always be assured, potentially leading to unreliable and harmful information. With rising digital device use, musculoskeletal cervical pain has increased, and neck exercises on YouTube have not been previously evaluated. Objective. This study aimed to evaluate the quality/reliability of YouTube neck isometric exercise videos. Methods. A cross-sectional review of YouTube videos on cervical isometric exercises for neck pain was conducted on January 21, 2024. Videos demonstrating cervical isometric exercises, published within the past 10 years, and ≤20 minutes in duration were included. Non-English, duplicate, sponsored, or non-educational videos were excluded. Eligible videos were assessed using the Global Quality Scale and modified DISCERN scale. Results. 21/197 videos were included. Most videos had moderate quality (52.38%), uploaded by non-physician healthcare professionals (76.19%). Videos with generally poor quality (14.29%) were mostly uploaded by independent users (66.67%). Video quality varied according to the upload source. Conclusion. Quality and reliability of exercise videos vary based on sources. Videos produced by non-physician healthcare professionals were higher in quality/reliability than those produced by independent users. Medical professionals and institutions can be proactive in providing more quality/reliable public health-related resources.
Background. Despite established treatment guidelines, variations in the management of patients with gout in primary care settings are observed, leading to suboptimal patient outcomes. Objective. This study aimed to describe the quality of care among adult patients with gout who consulted in selected urban, rural, and remote primary care sites in the Philippines. Methods. This retrospective study involved review of electronic medical records (EMR) of adult patients diagnosed with gout between 2016 and 2022 in three primary care clinics in urban, rural, and remote settings in the Philippines. Quality of care was assessed based on adherence to predefined quality indicators from recommendations of the 2016 EULAR guidelines for gout management, including lifestyle counseling, comorbidity screening, prescription of recommended anti-inflammatory agents to patients with acute gout, and urate-lowering therapy (ULT) prescription. Results. A total of 557 patients were included in the study. The cohort was predominantly male (67.1%), with a mean age of 55.2 years. Young-onset gout (age <40 years) was present in 18.1% of patients. The remote site had the lowest rate of baseline SUA determination at only 7.7%, with no patient having follow-up SUA determination. The mean baseline SUA level was 8.8 mg/dL, with the highest baseline SUA seen at the remote site (9.6 mg/dL). Screening rates for comorbidities were also suboptimal at 2.5%. Appropriate anti-inflammatory treatment for acute gouty flares was provided in 45.6% of patients, with the lowest adherence at the rural site (17.6%). The majority (90%) of the 20 patients who were identified to have indications for ULT were prescribed ULTs. Prescription of allopurinol as firstline ULT was highest in the rural (69.1%) and remote sites (65.9%) and lowest in the urban site (36.7%). Overutilization of ULT was observed across the 3 sites (36.1%), with the highest overutilization observed in the remote (52.1%) and rural sites (34.6%). Conclusion. Health disparities were observed, with the remote site having the highest overutilization of nonrecommended analgesics, the least frequent serum uric acid determination, and the least frequent follow-up consults. Highest overutilization of ULT was observed in the urban and remote sites. The rural site had the highest percentage of patients with severe disease and the lowest adherence to the prescription of appropriate anti-inflammatory therapy for acute gouty arthritis and screening for comorbidities. These findings reflect the need to improve gout management in primary care and highlight the need for targeted strategies appropriate according to the setting, especially in underserved populations in rural and remote areas.
Background. The manuscript describes the initial reactions, concerns, and coping responses of Filipino mothers upon the birth of a child with cleft lip and/or palate. It highlights that mothers experience predominantly negative emotions (e g., shock, anxiety) alongside hope, with major concerns focused on feeding, speech, cost of surgical intervention, and social stigma. Mothers commonly respond by seeking professional help, information, social support, and engaging in religious coping behaviors. Objective. The study explored the initial reactions, concerns, and responses of Filipino mothers to the birth of their child with a cleft lip and/or palate. It aimed to identify which of the cleft types (i.e., cleft lip, cleft palate, and cleft lip and palate) showed the highest number of identified reactions, concerns, and responses. Methods. The study employed a quantitative research design using descriptive statistics to present the data. Purposive sampling was utilized to recruit the participants. 201 Filipino mothers of children with cleft lip and palate were recruited from a local cleft center and through an online support group of mothers with children with cleft. Data were obtained using a self-administered questionnaire that was developed based on existing tools and modified by the researchers to suit the study objectives. The instrument was subjected to a two-level validation process conducted by a team of professional speech pathologists. Results were presented using tables and graphs depicting the frequency of the participants' responses on the specifics of the study. The questionnaire was written in English and was also translated into Tagalog, the predominant local language in the Philippines. Results. The initial reactions expressed by the mothers included shock (63.68%), anxiety (49.75%), worry (76.61%), and sadness (54.22%). However, a notable positive reaction was also reported, as many mothers felt hopeful (78.10%) that something could be done to improve their child’s condition. The concerns raised by the mothers ranged from the costs of intervention and potential effects on the psycho-emotional development of the children due to bullying in school, as well as the impact of the condition on feeding (70.64%), speech (74.12%), and social relationships (37.31%). Many mothers sought consultations with medical and health professionals (91.54%), while others looked for existing parent support groups (50.74%) or consulted with family members (29.85%). The internet (78.10%) played a crucial role in helping these mothers by providing information about cleft lip and/or palate, guidance on where to seek help, and advice on what steps to take. Additionally, many mothers relied on their religious and cultural backgrounds (83.85%) as a means to cope with the situation. Conclusion. The reactions, concerns, and responses of parents upon the birth of a child with a cleft lip and/ or palate were congruent with other studies reported. The results showed that mothers of children with cleft lip and palate showed the highest number of reactions, concerns, and responses, while mothers of children with cleft palate exhibited the least reactions, concerns, and responses.
Background. Respiratory infections, including COVID-19, continue to pose a major global health burden, highlighting the need for effective community-based healthcare strategies. Community health workers (CHWs), particularly Thailand’s village health volunteers, play a critical role in surveillance, prevention, and primary care delivery; however, evidence-based respiratory triage tools and continuing training programs for CHWs remain limited. Addressing these gaps may strengthen community health systems and improve preparedness for future public health emergencies. Objective. This research aimed to evaluate Community Health Worker (CHW) readiness in respiratory infection triage and implemented an innovative, theoretically grounded training program in Khon Kaen, Thailand. Methods. A two-phase action research was conducted. Phase 1 assessed CHW knowledge and skill gaps using Priority Needs Index analysis. Phase 2 designed, developed, and implemented an innovative training program with workshops, field training, and a 4-color triage card. Multi-stage sampling selected 215 CHWs and 111 providers for assessment; 50 CHWs and 14 providers participated in workshops and practical training. Three expert-validated instruments ensured reliability. We collected the data from October 2022 to September 2023. Results. In Phase 1, significant gaps were identified, with 89.3% of CHWs indicating low-moderate knowledge and 70.23% triage skill. PNI (modify) discovered significant differences between CHW capabilities and provider expectations (p = 0.026). Most CHWs positively expanded the triage role. In Phase 2, researchers found that CHW knowledge significantly improved from 10.56 to 11.38 (p = 0.018), along with an increase in triage skill, which had a mean score of 4.48. Both CHWs (4.51) and providers (4.82) achieved high levels of satisfaction. Success factors were stakeholder participation, contextbased design, and simple tools. Conclusion. The innovative training program effectively bridged critical competency gaps, significantly enhancing CHWs' knowledge and practical skills in respiratory triage while garnering high stakeholder satisfaction. By empowering the community workforce with user-friendly tools such as a 4-color triage card, this evidence-based model offers a scalable solution to reduce the disease burden. Consequently, this adaptable framework serves as a vital mechanism for strengthening global health security and community resilience in resource-limited settings post-COVID.
Background. Psoriatic arthritis (PsA) is a complex musculoskeletal disorder that is associated with psoriasis. Its estimated prevalence among patients with psoriasis ranges widely from 6% to 42% in Europe, North America, and South Africa. However, there is a paucity of data in Asia. To date, there is no local study done in the Philippines. Objective. This study aimed to determine the prevalence of psoriatic arthritis (PsA) among patients with psoriasis in a tertiary institution. Methods. This is a descriptive cross-sectional study that included 150 patients with psoriasis in the Dermatology Clinic. Demographic and clinical data were collected. Psoriatic Arthritis Screening Tool (PEST) was applied to all participants. Those who scored ≥3 on the PEST were seen at the Rheumatology Clinic and confirmed with the Classification of Psoriatic Arthritis (CASPAR) Criteria. Descriptive statistics were used to describe the demographic and clinical characteristics. The prevalence of psoriatic arthritis among patients with psoriasis was calculated as the percentage of the population who scored ≥3 on the CASPAR Criteria. Results. Out of the 150 patients with psoriasis, a total of 50 scored ≥3 on PEST. Of these, 47 patients (31.3%) qualified for the diagnosis of PsA using the CASPAR criteria. Thirty-seven out of the forty-seven patients (79%) are known PsA patients, while the remaining 10 patients (21%) were newly diagnosed with PsA. A total of 34 patients (72%) were female, with a mean age of 33 and 39 years at the onset of psoriasis and PsA, respectively. Family history of psoriasis was present in 22 patients (47%). The most common pattern of arthritis was polyarticular (51%) followed by oligoarticular (38%) and axial (11%). Morning stiffness was present in 83% of the patients. Dactylitis was recorded in 16 patients (34%), while 19 patients (40%) had enthesopathy. Onycholysis was the most common nail abnormality seen in 20 patients (43%). Only 13 patients had rheumatoid factor at baseline, and all were negative. Most of the patients did not have imaging studies at baseline. Conclusion. In this single center study, the diagnosis of psoriatic arthritis among patients who were previously diagnosed with psoriasis increased from 24.5% to 31.3% using PEST as a screening tool, showing its usefulness in improving clinical detection of psoriatic arthritis among these patients.
Background. Despite the critical role of the private sector in identifying the missing cases of TB, little is known about the perceptions of private physicians on mandatory TB notification. Although Republic Act 10767 has been in place for over a decade, evidence on its acceptability among private doctors remains limited. Objective. This study explored the acceptability of mandatory TB notification among private physicians in the Second District of the National Capital Region, Philippines. Methods. The study employed a descriptive qualitative case study approach. Data were collected through semistructured interviews with eight private physicians in the Second District of NCR, Philippines. A purposive sampling technique was used in selecting participants. Thematic analysis was conducted using a deductive approach guided by the Theoretical Framework for Acceptability, with manual coding performed using Microsoft Excel. Results. Private physicians demonstrated varying levels of acceptability of mandatory TB notification, shaped by multiple interrelated factors. Overall acceptability reflected differences in physicians’ understanding of the policy, perceived burden, and perceived value of participation. These findings suggest the need for tailored strategies to improve policy acceptability among private practitioners. Conclusion. The findings provide preliminary evidence on the acceptability of mandatory TB notification among private physicians. The results underscore the importance of understanding private sector perceptions to enhance their engagement and strengthen the country’s efforts to end tuberculosis.
Background. Health inequity is a prevailing issue in the Philippines. Universal health care (UHC) aims to provide equitable access to healthcare services and protection from financial risk for all Filipinos. The Philippine Primary Care Studies (PPCS) evaluated the impact of interventions to improve primary care in an urban, rural, and remote area in the country, which represented communities with higher, lower, and least baseline resources for health care, respectively. We previously measured healthcare utilization and change in out-of-pocket (OOP) expenses for outpatient services from baseline to one year after implementation of interventions. Objective. This is a follow-up study that measured the same outcomes until funding for the interventions was depleted. Methods. The interventions to strengthen the primary care system included equal per capita health financing in all three areas, establishment of an electronic health record system, healthcare worker training, and early community engagement. Other context-specific interventions were also implemented in the rural and remote sites. We evaluated healthcare utilization (measured as the total number of ambulatory consultations per month) and OOP expenses (estimated through community surveys performed at baseline and yearly thereafter). These outcomes were measured at baseline prior to implementation of interventions, during the first year of implementation when full funding was available, in the second year of implementation when partial funding was available, and at the third or fourth year of implementation when funding ended. Results. Improvements in primary care had the most impact on the rural site, having the highest number of cumulative ambulatory consults and the lowest out-of-pocket expenses per study year. It had the least impact on the urban site, while the remote site generally had modest improvements. Conclusion. Policies and interventions to improve primary care may inadvertently aggravate existing inequities, especially in remote areas. Rather than equal distribution, funding must be allocated according to need, and interventions must be contextualized to local settings, if UHC is to successfully reduce inequities in healthcare access in the country.
The are no lessons yet to be learned from the passing of former Cambridge professor Jason Arday. This is not because there aren’t any but because many stakeholders are only beginning to unpack the complex scenario that accompanied his story. Among the issues are concerns about academic integrity, but equally important are the inquiries into the processes that accompanied the investigation of the alleged wrongdoing. This incident, though extreme, offers a sobering illustration of how questions of integrity can threaten the credibility and trust within the academia and in the world of scientific research. Integrity is a virtue not only of individuals but of institutions. One may have a smattering of elements that promote integrity, an ethical review board here, an office of research integrity there. But without the whole infrastructure aligned to a moral standard, all these small tokens are merely performative. In a paper on academic integrity, it was stated that: “Institutions must protect the practices they house, and therefore they have a duty to do something about those behaviours of its members that may corrupt or in some way harm the integrity of that practice. “ This however is not an easy task. The pressures of academia challenge this undertaking day in and day out. Many believe such an environment promotes misconduct. The challenge is how to create a culture promoting integrity in a setting that relies heavily on punishing misconduct. The approach is multi-prong. Focusing on supporting faculty and students in an educative framework is a worthwhile undertaking that prevents alongside punishing offenses. This strategy is explicitly described in a recent paper: “As publication pressure seems to encourage competition and gamification practices, more support is needed for academics, especially for those in resource-scarce contexts. Support can be provided in the form of relief from other duties for dedicated writing time, access to writing support and technology, and ethical use of writing professionals.” To contribute to the preventative aspect, the Acta Medica Philippina has undertaken editorial policy clarifications, specifically on authorship, on AI use, and on disclosures. An overhaul of the submission system was implemented, adopting the Contributor Role Taxonomy (CRediT) system, requiring declarations of conflicts of interests and use of assistive technology. Structural reforms are needed as well. It was suggested in a recent paper that “institutionally, evaluation systems (can) shift from quantity-based to quality-focused metrics, incorporating measures of research impact and reproducibility.” The punitive aspect in the control of misconduct should likewise be constructive. The use of restorative practices (RP), the understanding and building social connections to integrate appropriate behavior and to construct healthy communities, are seen to be “fair, fostering empathy, compassion and accountability; through experiential learning opportunities.” Beyond the legalistic framework, this approach espouses restorative justice, which aims ”to involve, to the extent possible, those who have a stake in a specific offense and to collectively identify and address harms, needs, and obligations, in order to heal and put things as right as possible’.” It is hoped that these measures promote academic integrity and minimize ethically discordant behavior. Calamities such as the Wakefield debacle and the tragedy at Cambridge will not recur. In this environment, we can all strive to conduct honest research, stand on the stable bedrock of integrity, and pursue scientific discovery with plain and simple truthfulness.
Background:The role of prescription errors (PE) in mental healthcare environments is not well understood. There are few studies that have examined PE in psychiatric hospitals. Although the occurrence of PE in mental health facilities is less frequent than in general hospitals, the specifics of PE remain unclear. Objective:The study aims to shed light on both the circumstances of each PE in a regional psychiatric hospital in Germany and the factors that shape the nature of PE. Methods:This qualitative narrative investigation was part of a large-scale one-year observational study (January 2023 - 2024) conducted at St. Josef psychiatric hospital AMEOS Oberhausen in Germany. The therapeutic protocols of the patients were anonymized, and PE were identified according to a modified EQUIP method. For each PE, a double-blind interview was conducted and recorded. Through the interviews, we extracted the keywords based on their frequency and by using NVivo 13 software we build up a codebook followed by a Delphi consensus to clarify the nature of the PE. The observers also recorded the prescriber's behavioral patterns. An analysis of the thematic patterns, semantic groups, and principal factors was executed. Results:In total, 6020 therapeutic plans were compiled, and 150 PE were detected, leading to an error rate of 2.5%. The predominant PE were associated with medications for musculoskeletal and joint disorders, followed by gastrointestinal drugs and central nervous system (CNS) medications, including psychotropics. The mean duration of the interviews was 2.6 ± 0.8 minutes. The average age of the prescribers was 35.5 ± 4.9 years, with 52.1% being male. Through the interviews, we extracted the following keywords: minimum - shortest time, time - under pressure, unrecognizable - unidentifiable script, vision loss - lack of lighting, lack of knowledge, stress - work stress. There were few cases reported where prescribers failed to pay attention, experienced communication breakdowns, suffered from lack of sleep, had concentration issues, issued unnecessary prescriptions, responded to patient requests, and made misspellings. The average meeting duration was 20 ± 4.2 minutes. The Delphi consensus indicated that there are four primary semantic groups: features of time, reading - spelling challenges, poor lighting, and communication difficulties. These are identified as key factors contributing to PE in mental health contexts, and a hypothesis regarding the nature of writing PE is discussed. Conclusions:Although nearly all PE were classified as minor in severity, the qualitative research indicated variability in the responses from prescribers regarding each PE. Nonetheless, there are prominent semantic categories, such as temporal aspects, the act of writing, and environmental conditions, that could clarify the characteristics of PE. We suggest that the process of documenting PE is a complex undertaking with checkpoints that should be adhered to. More research is needed to clarify the risks and factors associated with the nature of PE, in a way to develop interventions to address them.
Background and Objective:Considering the vital roles of the aging workforce in the Philippine development as well as the unavailability of health data, there is a need to address gaps in the current state of employment and their quality of life, which may likewise improve their performance. This study aimed to assess the relationship of individual and workplace factors with the subjective well-being (SWB) of older employees in the academe in line with the University of the Philippines Wellness Initiatives for Seniors and Elders (UPWISE) Program. Methods:The 69 randomly selected respondents were employees ages 50 years and above as of June 30, 2020, representing the faculty, administrative staff, including the research extension and professional staff (REPS) of the leading university in the Philippines. SWB was measured through the WHO-5, and its association with the identified individual and workplace factors was tested through Fisher's exact test. The resulting p-values were tested at a five percent level of significance. Results:Almost ninety percent of the respondents had better SWB. When tested at a five percent level of significance, the SWB had no significant associations with 1) individual factors: perceived health condition (p-value = 0.34); diagnosed health condition (p-value = 0.97); individuals as care recipients (p-value = 0.85); as well as 2) workplace factors: new knowledge and skills (p-value = 0.37); overall growth and development (p-value = 0.11); value of work (p-value = 0.2); and work environment (p-value = 0.28). Conclusion:With the lack of statistically significant associations, further research should be done with regard to other aspects of individuals and workplaces. This includes the relationship between individuals and their caregivers, including the support provided, the presence of existing health programs, personal growth efforts, working hours, and salaries. Qualitative studies may provide an in-depth understanding of the cultural factors associated with SWB in a developing country such as the Philippines.
Background:Vestibular stimulation, particularly through rhythmic swinging, has been associated with relaxation, stress reduction, and improved psychological well-being by modulating physiological and emotional responses. Academic stress is highly prevalent among nursing students due to demanding workloads, clinical placements, and examinations, negatively affecting their physical health, mental well-being, and academic performance. Despite existing coping strategies, the potential of vestibular stimulation as a stress management intervention among student nurses remains underexplored. Objective:This study aimed to determine the effect of vestibular stimulation, specifically swinging, in reducing academic stress among student nurses, evaluating its effectiveness across year levels and assessing variations in duration and position. Grounded in Ulrich's Stress Reduction Theory, it investigated the physiological and psychological mechanisms through which vestibular stimulation may alleviate stress. Methods:A quasi-experimental design was used with 78 student nurses from School X in Baguio City, stratified by year level. Participants were 18 years and above and physically capable of performing the intervention. Those with medical conditions, musculoskeletal issues, orthostatic intolerance, mental health treatment, recent stress interventions, and weighing over 100 kg were excluded. Participants were randomly assigned to intervention and control groups. The intervention group received vestibular stimulation in lying and sitting positions for five and ten minutes, while the control group followed their usual routines. Stress levels were measured using the Perceived Academic Stress Scale (PASS). A two-way ANOVA tested the effects of position and duration on stress levels, with Bonferroni post hoc tests at p <0.05. Results:The intervention group showed a significant reduction in academic stress compared with the control group. Differences in stress reduction were noted based on duration and body position. Conclusion:Vestibular stimulation effectively reduces academic stress among student nurses by triggering physiological responses linked to relaxation. Integrating this intervention into nursing education is recommended, including creating campus spaces that support its use.
Background:This study explores the highlights of the crucial role of male midwives in MCH programs amidst societal perceptions and preferences for female providers. Despite their growing presence, a significant gap exists in understanding their unique experiences, challenges, and facilitating factors within a female-dominated, culturally sensitive field in Central Luzon, Philippines. This gap obstructs efforts to optimize MCH implementation and foster an inclusive workforce. Objective:This research aims to investigate the challenges and coping strategies of male midwives in Region 3 Philippines, offering insights that can inform both policy and practice. Methods:This narrative inquiry qualitatively explored the work experiences of male midwives in Central Luzon, Philippines. In-depth interviews were conducted with participants to gather rich, personal accounts from August to October 2025. Data analysis employed thematic analysis to identify recurring patterns and insights, with NVivo software utilized solely as a tool to facilitate the organization and management of the qualitative data. Participant narratives provided a detailed understanding of their roles in Maternal and Child Health programs. Results:The study revealed five themes highlighting the complexities encountered by male midwives in the workplace: 1) Gender Stereotypes and Professional Identity; 2) Workplace Discrimination and Limited Support; 3) Cultural Barriers and Community Acceptance; 4) Emotional Labor and Work-Life Balance; and 5) Coping Strategies and Professional Development. Conclusion:This study reveals that male midwives face significant challenges due to gender stereotypes, discrimination, and cultural barriers, leading to isolation and professional identity uncertainty. Effective coping strategies and self-care are vital. Recommendations include fostering inclusive environments, establishing strong support networks, promoting continuous education, and advocating for policies that ensure equitable resources and support for all midwives, ultimately benefiting community health.
Background:This study looks at pediatric research in the Zamboanga Peninsula and nearby provinces (Basilan, Sulu, and Tawi-Tawi), focusing on what pediatricians are doing and the challenges they face with research after completing their training. Objective:The goal was to understand past and present research efforts and to identify what helps or hinders pediatricians in pursuing research. Methods:A cross-sectional mixed-methods design was employed utilizing results of the survey completed by 47 pediatricians-some members and some non-members of the Philippine Pediatric Society - Southwestern Mindanao Chapter (PPS-SWM), alongside qualitative focus group discussions. Results:The findings indicate a low level of research engagement among pediatricians in this region, with only 6.7% of respondents actively participating in research activities. While many pediatricians had done research during their training, few continue to do so during clinical practice. Key enablers for research involvement include peer support and training in research methods and statistics, and financial assistance. On the other hand, barriers include a lack of skills in technical writing, limited funding, and a general disinterest in research. Discussions revealed that many pediatricians find research to be an added burden, often prioritizing their clinical work instead due to financial concerns. The study suggests that to boost pediatric research in the region, it is essential to spark more interest in research and provide targeted training opportunities and wholistic support for individuals who exhibit a genuine interest in research instead of targeting pediatricians in general. Conclusion:This research underscores the need for a supportive environment that encourages pediatricians to engage in research, leading to better healthcare delivery and informed decision-making for children.
Background:Hearing screening for school-aged children is crucial to identify cases missed by newborn screening, detect delayed-onset hearing loss, and address middle ear conditions that can cause hearing impairment. This is particularly important for children with special educational needs, who may present atypical developmental patterns, increasing their risk for undetected hearing issues. Objective:This study aimed to determine the prevalence of hearing problems among students enrolled in inclusive classes at selected public special education (SPED) schools in Ilocos Norte, Philippines, during the 2023-2024 academic year. Methods:Fifty-six (56) children aged 6 to18 years old with various disabilities, with or without medical diagnoses, were screened using a protocol that included visual inspection, otoscopy, tympanometry, screening pure tone audiometry (PTA), and transient evoked otoacoustic emissions (TEOAE). Children unable to complete the tests were classified as "unable to test" (UTT) and included in the analysis. Results:Out of 56 participants, 15 (26.79%) had otologic problems, with impacted cerumen being the most common issue (19.61%). Sensorineural hearing loss (93.33%) was more prevalent than conductive hearing loss (6.66%), with severity ranging from mild (33.33%) to moderate (6.66%) to profound (60%). Children with autism spectrum disorder (ASD) showed the highest UTT rates. Compliance was higher for TEOAE (72.72%) compared to screening PTA (52.72%). There was an overall 78% average compliance with all procedures. Conclusion:The study highlights a significant prevalence of hearing problems among children with disabilities, emphasizing the importance of early detection. Prioritizing otoscopy, tympanometry with ipsilateral acoustic reflex testing, and TEOAE may improve screening efficiency and compliance in this population.
Background:Hypertension is one of the leading causes of morbidity in the Philippines owing to urbanization, population growth, and individual lifestyles. Upon the advent of COVID-19 in the Philippines, Enhanced Community Quarantine (ECQ) was imposed from March to May 2020, resulting in mobility restrictions and changing the overall focus of the health system. Objective:This paper aims to understand and describe daily experiences, self-care practices (SCPs), and barriers and facilitators involved in the management of hypertension of selected female hypertensive patients in Marikina City during ECQ. Methods:A descriptive phenomenological design complemented with purposeful sampling was employed to gather in-depth information regarding lived experiences and SCPs of female hypertensive patients aged 40-59 in the City of Marikina during ECQ. Results:Inductive thematic analysis using NVivo12 Qualitative Data Analysis software following 13 in-depth inter-views revealed five themes: 'pagkakulong' or imposition, 'pagpapahalaga' or preservation, 'pakikibagay' or adaptation, 'palakasan' or inclination, and 'panawagan' or petition. Discontinuation and acquisition of SCPs were influenced by factors external to participants, while retention of practices was influenced mainly by individual factors, implying that a patient-centered approach is important in drafting interventions and creating policies for long periods of lockdown. Conclusion:The imposed ECQ affected environmental and macro-level factors surrounding discontinuation, retention, and acquisition of SCPs related to hypertension. Inequities in resource distribution affected patient perception of health services and willingness to seek care. Recommendations include establishing an association between barriers, facilitators, and outcomes and broadening the study's coverage to wider demographics.
Background. Pterygium is a common benign fibrovascular growth of the conjunctiva extending onto the cornea that induces corneal distortion and astigmatism as it progresses. Following excision, transient keratometric instability may occur, making the timing of refractive procedures dependent on the restoration of corneal stability. Objectives. The study aimed to identify the time to achieve keratometric stability after pterygium excision surgery and associated factors. Methods. This was an observational retrospective cohort study of patients who underwent pterygium excision within a period of 6 months. Data were abstracted from electronic medical records. The Kaplan-Meier method and log-rank test were used to analyze the time to keratometric stability. Cox proportional hazards regression analysis was used to identify the associated factors. Results. A total of 58 eyes that underwent pterygium excision from January 2022 to December 2023 were included in the analysis. There was no statistically significant difference in terms of age, sex, laterality, polarity, and surgical technique. Ninety-one percent (n=53) demonstrated keratometric stability three months after pterygium excision. All eyes (100%) reached keratometric stability at the post-operative six-month period. The median time to reach keratometric stability was 4 weeks (1 month), and the maximum time is six months. Conclusion. Higher-grade pterygia required longer to achieve postoperative keratometric stability, informing optimal timing of subsequent procedures. Biometry for cataract surgery is best performed ≥3 months after excision (≈6 months for Grade 3) to ensure accurate IOL calculation, with further studies needed to evaluate varied cases and long-term outcomes.
