JMUST Vol 1 Issue 1

Journal for Medicine, UST

Editor: Dr. Raymond Rosales

ISSN: 2546-1621

Volume 1  Issue 1

The maiden issue of the reinvented scholarly publication of the UST Faculty of Medicine and Surgery brings “light” to the generation of promising young Thomasian researchers who again have been blessed with the “voice” to be heard and a “venue” to be read. Rising from the trail blazing record of its predecessor, “The Santo Tomas Journal of Medicine”, this new tool for timely dissemination and assimilation of research-based discoveries shall continue the tradition of excellence in medical education and research our beloved Alma Mater has been long regarded for.

The Social and Cultural Dimensions of Health as a Research Agenda: Establishing the Need for a Research Interest Group (RIG)in Social Medicine

"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.")

-Constitution of the World Health Organization

The terms "health inequities," "health disparities," and "health inequalities" reflect the magnitude of differences in health outcomes existing in populations unless we address the underlying causes of disease and I'll health. In the Philippines, Kalusugang Pangkalahatan (KP) or Universal Health Care (UHC) is the health reform agenda of the Aquino administration which has been implemented by the Department of Health (DOH) since 2011.

Evolving Clinical Presentation and Assessment of Pheochromocytoma: A Review

Pheochromocytoma (PHEO) is a neuroendocrine lesion in the adrenal medulla composed of chromaffin cells producing excess amount of catecholamines. These tumoral cells have the property to synthesize, metabolize, store, and secrete catecholamines and their metabolites. The clinical symptomatology is derived from the peripheral tissue effect of norepinephrine, epinephrine, and their by-products. Morbidity and mortality is increased due to the delay in the diagnosis and treatment. A high index of suspicion leads to testing for PHEO through biochemical, imaging, and genetic studies. Dilemma in its assessment comes about when the clinical picture is beset by too much catecholamine secretory periodicity, too little catecholamine secretion, in lesions less than 1 cm, in exclusively dopamine-secreting tumors, and in the unavailability of biochemical tests and imaging.

Keywords: pheochromocytoma, catecholamine, metanephrines, methoxytyramine

The Effects of Spirulina (Arthrospira Platensis) Dietary Supplement As An Adjunct Therapy For Children Aged 7–14 Years Old With Asthma: A Randomized – Double Blind Placebo Controlled Clinical Trial

Asthma is the most prevalent chronic disease in children. It is estimated to affect more than 20% of the population in industrialized countries. (1) Establishing asthma control is a cornerstone of therapy. Standard treatment for asthma includes inhaled β2 agonists and inhaled corticosteroids. (2) Newer classes of medications have been developed that target mediator release and modify biologic response. Although current therapies are effective in controlling daily asthma symptoms, continuous and long term treatment with corticosteroids may pose significant adverse effects, especially in children.

Detection of Hearing Impairment in Patients with Subjective Complaints of Hearing Loss using the Whispered Voice Test and Standard Pure Tone Audiometry: A Prospective Non-Randomized Trial

Background:  Standard tools for the detection of hearing impairment have limitations because access to specialists and audiometric evaluation is not always possible.  These require time, training, and technology that are not available in the primary care setting.  The WVT is a simple screening tool that has been tested in adults and children however, it lacks standardization, compromising its application.

Objectives: To determine the accuracy of the WVT compared to standard PTA in detecting hearing impairment in patients with subjective complaints of hearing loss and to determine the association of PTA and WVT to age as well as to each other.

Keywords: whispered voice test, pure tone audiometry, hearing screening, sensitivity, specificity, accuracy, diagnosis, hearing loss

Videotape Instruction Vs Brochure On The Effectiveness Of Unsupervised Home Exercise Program In Patients With Knee Osteoarthritis

Optimum treatment for osteoarthritis is a combination of education, medication, weight reduction and exercise.  However adherence to exercise decreases with treatment duration. This study aims to determine the effectiveness of a home exercise program in patients with knee osteoarthritis delivered through brochure or videotape  in improving compliance, pain and function; and in  the reduction of  intake of paracetamol. 

Keywords: osteoarthritis, video exercise, brochure exercise, home exercise program

HLAB27 and HLADRB1 Genotyping of Spondyloarthropathies among Filipino Patients

Objective: To investigate the role of HLA genes among Filipino patients of varying ages with spondyloarthropathies compared to healthy controls in a tertiary center.

Conclusion: This first genetic study on genetic polymorphism among Filipino patients strengthened the association of HLAB27 with AS. However, there was no pattern of association with HLADRB1 alleles in this cohort of patients.

This is the first study that confirms a significant HLAB27 susceptibility of Filipino spondyloarthropathy patients. However, exploratory findings did not find a HLADRB1 genotype to extend a similar susceptibility pattern.

Clinical Practice on Gout Management Among Filipino General Care Practitioners

Evidence-based practice guidelines for gout management is widely available. However, management by general care practitioners is still far from ideal.

This study aims to determine the current trends in the management of gout among general care practitioners.

Botulinum Toxin Injection for Pain in Muscle Spasm and Visceromotor Disorders: A Meta-Analytic Study

Apart from the popular use of botulinum neurotoxin type A (BoNT/A) for neuro-rehabilitation and cosmetic purposes, its analgesic potential has been highlighted in various studies. Although BoNT/A is effective, there is a paucity of literature explicating its effectiveness on muscle-based and visceromotor pain.

This meta-analysis determined the effectiveness of botulinum type A (BoNT-A) in treating muscle-based (nociceptive) and visceromotor pain.

Efficacy of cinnarizine/dimenhydrinate compared to betahistine in the Management of Adults with Peripheral Vestibular Disorder: A Systematic Review of Randomized Controlled Trials

Objective: To compare the effectiveness of cinnarizine/dimenhydrinate with betahistine in the management of Adult patients with Peripheral Vestibular Disorder

Conclusions: This systematic review of Randomized Controlled Trials confirms that the fixed combination of cinnarizine/dimenhydrinate could decrease the intensity of vertigo and improve the concomitant symptoms better than betahistine after 4 weeks of treatment (Grade C Recommendation, NHMRC guidelines 2009).  

Key words: cinnarizine, dimenhydrinate, betahistine, vertigo, vestibular disorder

Recurrent Bifacial Neuropathy in a Case of Steroid Responsive Neurosarcoidosis: A Case Report

Neurosarcoidosis is a rare or misdiagnosed disease that can be masked in a case with fl eeting neurologic defi cits, especially craniopathy. We present a 26-year-old Chinese-Filipino male who presented with recurrent facial neuropathy that was heralded by fl eeting blurring of vision bilaterally. He was apparently responsive to corticosteroids (intravenous and oral methylprednisolone) from initiation to date. During the course, he also noted selective weakness of the right fi nger fl exors. Nodules in the face eventually appeared that led to a biopsy disclosing a noncaseating granuloma. Apart from electrodiagnostic tests, a supportive diagnostic test for sarcoidosis was the presence of lymphadenopathies on his chest noted on Computed Tomography (CT) scan. Cerebrospinal fl uid (CSF) and brain Magnetic Resonance Imaging (MRI) tests were not yielding. To our knowledge, this was the fi rst reported Chinese-Filipino case of neurosarcoidosis involving cranial and peripheral nerves.

Post-Varicella Acute Inflammatory Demyelinating Polyradiculoneuropathy in a 51-year old Filipino Male: A Case Report

Primary varicella zoster infection is commonly observed in school-aged children. There are increasing reports of adults being affected. Varicella zoster infection has a myriad of clinical complication. The rarer of these complications is GuillanBarre syndrome (GBS) or acute inflammatory demyelinatimgpolyradiculoneuropathy, with less than 50 cases in reported literature.

Keywords: varicella, acute inflammatory demyelinating polyradiculoneuropathy, GuillanBarre Syndrome

Patient Perception of Medical Student Engagement in Community- Based Outreach Activities During Community Health Clerkship: A Q-Methodology Study

The essence of the medical profession is providing service not only to individual patients but to the community at large. The patient-physician interaction is essential in community-based learning delivered through the Community-Based Medical Education (CBME) Program component of the medical curriculum of the University of Santo Tomas Faculty of Medicine and Surgery (UST-FMS) students for more than five decades. The covenant relationship is a valuable concept in the context of healing that emphasizes interdependence between the patient and his physician (1). The modern view of the patient however, is now veering away from paternalism. Today, the patient is the most important member of the health team, an ‘evaluator of care’ and a potential ‘agent of change’ (2).  Evidence-based guidelines on health promotion in adult patients recommend giving them “voice” and involving them in projects (3). Interventions may be considered worthless if they are inconsistent with the beliefs, attitudes and expectations of patients. Attitudes and expectations of adult patients regarding the role of the medical students in community-based projects are as yet unreported. Limited data are available concerning the opinions of patients towards the respective services offered in programs integrated as part of the community outreach activities involving medical students in Community Health Clerkship, a four-week highly individualized rotation.

Prevalence and Predisposing Factors of Parkinson Disease: A Community-Based Study In Barangay Mangilag Sur, Candelaria, Quezon: A Research Protocol

Parkinson Disease is a neurodegenerative disorder affecting the central nervous system caused by the death of dopaminergic cells in the ventral region of the pars compacta of the substancia nigra. The subsequent lack of dopamine causes movement-related disorders including tremors, rigidity, hypokinesia, and postural instability. The clinical diagnosis of PD is hinged on the triad of asymmetric bradykinesia, rest tremors and rigidity, with an expert (usually a Neurologist) eliminating those cases having mimics of the symptomatology. Development of the disease is through certain environmental, hereditary, and genetic factors. In the Philippines, PD is a rarely seen disorder and establishing of a prevalence study has been difficult for neurologists. Prevalence of the disease in the country has been estimated to be less than 1% based on a 2007 study conducted by the Philippine Neurologic Association but without ascertainment of cases. The researchers aim to determine the disease’s prevalence in a locale and explore on the possible predisposing factors on the development of the disease.

Keywords: Parkinson’s Disease, Prevalence, Community Survey, Rural