Background. Non-adherence to treatment in epilepsy is considered as a worldwide problem ranging from 30-50% of patients. Despite its striking magnitude, only a few studies tried to explain the factors affecting it. Moreover, a standard method to measure adherence to treatment among patients is still lacking. An in-depth analysis on adherence to treatment of patients with epilepsy, taking into factor their values, beliefs, and culture, is deemed necessary. Objectives. The purpose of this qualitative study is to investigate the contributory factors and issues on treatment adherence faced by Filipino patients with epilepsy and their caregivers. This study also aimed to serve as a catalyst to further stimulate local researches on treatment adherence in epilepsy. Methods. Four focus group discussions were conducted with patients and caregivers who voluntarily agreed to participate and share their experiences on dealing with epilepsy. A total of 39 participants were included. The focus group discussions, facilitated by skilled moderators, were composed of an ice breaker and a discussion on the experiences and issues faced by the participants. The discussions were transcribed and analyzed using thematic coding. Results. Three main content categories were identified from the focus group discussions, namely, 1) accepting a life with epilepsy, 2) dealing with the disease, and 3) ensuring freedom from seizure attacks, which were further sub-categorized. From these, a number of factors affecting treatment adherence were identified and a conceptual framework was developed by the investigators. Conclusion. This study was able to demonstrate that conducting a focus group discussion was an effective means of eliciting the experiences and issues in patients and their caregivers. Several factors affecting treatment adherence such as patient-doctor relationship, financial resources, government support, adverse medication effects, religious belief, trigger avoidance, frequent reminders, and safety precautions were elucidated in this study.

Background and Significance of the StudyBrain tumors is a large group of benign and malignant neoplasms arising from the brain parenchyma and its adjacent structures [1].Though considered to be uncommon, with less incidence compared to neoplastic processes of the prostate, lungs, breast and colon, it is among the significant causes of cancer-related deaths [2,3].It is associated with a high level of physical, neurological, cognitive and psychosocial changes [4].The worldwide incidence of brain tumors is 3.4 to 18.6 per 100,000 and is reported to have an increasing trend in the last decades Background: Brain tumors, although affecting only a small percentage of the population, poses a large impact worldwide with its high incidence of morbidity and mortality.In the turn of the century, we have witnessed major breakthroughs in the diagnosis and management of patients with brain tumors that is largely becoming molecular-based and personalized.In developing countries like the Philippines, major efforts are yet to be made in order to deliver the ideal treatment modalities to patients with brain tumor, yet certain socio-cultural factors and the lack of standardized protocol limit and even hinder this goal.Hence, it is important to be able to describe our patient population and to determine if they were able to receive adequate treatment in order to pave the way to further identification of ways to clinical improvement in the future.Objectives: This study aims to describe the clinical characteristics of patients diagnosed with brain tumors and to identify the different treatment modalities utilized to treat them in the Philippine General Hospital from January 2010 to December 2015.Methodology: Between 2010 and 2015, a total of 262 medical records of adult patients with brain tumors were successfully retrieved.The demographic data, clinical presentation, performance status, histopathologic diagnosis and treatment of all patients were recorded.The descriptive statistics using the STATA 13.0 software was used to summarize the data obtained.Results: Majority of the patients were females (59.2%) with a mean age of 41.7 years and a mean duration of symptoms of 13.2 months.The majority of the patients (66.8%) had a KPS of 80-100.Headache, focal deficits, seizures and visual disturbances were the most common symptoms reported.Meningioma, Astrocytoma and glioblastoma were the most common histopathologic diagnosis.More than half of the patients received surgery alone (56.5%) but this is still lower than the expected number of patients who were advised to have surgery (60.7%).The use of combination therapy was found to be increasingly utilized within the duration of the study but a lower proportion of patients completed the planned treatment (13.1%).Around 10.5% of the patients only had regular follow-up to see if any progression in the tumor takes place.No intervention was done in 17.6% of patients who were noted to be either with poor prognosis, those who were lost to follow-up or those who had no consent to any intervention.Conclusion: In summary, there are multiple treatment modalities available to improve the outcome of patients with brain tumors.Although surgery alone remains to be the treatment of choice in majority of the patients, combination therapy was shown to have an increasing popularity.A lower proportion of patients received these treatment modalities than what was expected.Giving minimal or no intervention to the patient was already of decreasing trend in the institution.Further studies to determine the outcome after these treatment modalities on the patients diagnosed with brain tumors are deemed necessary in the future.

Introduction. Coenzyme Q10, also known as Ubiquinone, is a substance now being used as a dietary supplement in many countries including the Philippines. It has also been the focus of several researches as treatment for several diseases including Parkinson’s Disease. Several studies have shown that Coenzyme Q10 inhibits mitochondrial dysfunction in Parkinson’s Disease, hence delaying its progression. Objectives. The objective of this study is to assess and summarize the available evidence on the efficacy and safety of Coenzyme Q10 administration in the prevention of the progression of early Parkinson’s Disease. Methods. This is meta-analysis of randomized controlled trials on the use of Coenzyme Q10 in Parkinson’s Disease. A literature search in several databases was conducted for relevant studies. Three randomized controlled trials met the inclusion criteria. The efficacy of Coenzyme Q10 were measured using the total and the component scores of the Unified Parkinson Disease Rating Scale on follow-up. On the other hand, safety were measured using the withdrawal rate and the associated adverse reactions during the therapy of CoQ10. The Review Manager Software was utilized for the meta-analysis. Results. Compared to Placebo, treatment of CoQ10 did not show any significant difference in the mean scores of the UPDRS mental and ADL scores. Interestingly, the UPDRS motor score showed a significant difference between Coenzyme Q10 and placebo, but no significant difference when a subgroup analysis between high-dose (-4.03 [-15.07-7.01], p-value 0.47, I2 67%, P for heterogeneity 0.08) and low-dose Coenzyme Q10 (0.53 [-0.891.94], p-value 0.47, I2 34%, P for heterogeneity 0.22) was done. Overall, there was no significant difference in the total UPDRS score (0.68 [-0.61-1.97], p-value 0.30, I2 0%, P for heterogeneity 0.70). The most common side effects of the use of Coenzyme Q10 are anxiety, back pain, headache, sore throat, nausea, dizziness and constipation. Conclusion. Contrary to some animal and human studies, this meta-analysis showed that the use of CoQ10 results to nonsignificant improvement in all components of the UPDRS scores as opposed to placebo. However, the use of CoQ10 is tolerated and seems to be safe but further studies are needed to validate this finding.