{"id":14255,"date":"2017-08-30T15:39:22","date_gmt":"2017-08-30T15:39:22","guid":{"rendered":"http:\/\/www.pidsphil.org\/home\/?page_id=14255"},"modified":"2025-11-20T07:19:41","modified_gmt":"2025-11-20T07:19:41","slug":"2016-journals","status":"publish","type":"page","link":"https:\/\/www.pidsphil.org\/home\/2016-journals\/","title":{"rendered":"2016"},"content":{"rendered":"

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2016 Journals<\/strong><\/h1><\/div>
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Journal 2016 Vol.17 No.1<\/strong><\/span>
\nProcalcitonin \u2013 Guided Antibiotic Therapy in Pediatric Patients: a Systematic Review<\/strong>
\nAina B. Albano-Cabello M.D., Jeff Ray T. Francisco M.D., Anna Lisa T. Ong-Lim M.D., Lorna R. Abad M.D.<\/strong><\/em>
\nAbstract
\nBackground: <\/strong>Serum procalcitonin is a\u00a0useful biomarker in establishing the presence of bacterial infections and has been used in algorithms to guide antibiotic treatment among adults. It role in pediatric infections, however, remains unclear.
\nObjectives<\/strong>:\u00a0 This\u00a0 research\u00a0 aims\u00a0 to evaluate\u00a0 the\u00a0 impact\u00a0 of\u00a0 serum\u00a0 procalcitonin\u00a0 in guiding antibiotic therapy among pediatric patients with suspected local or systemic infections.
\nMethodology<\/strong>: Randomized\u00a0 controlled\u00a0 trials\u00a0 comparing\u00a0 procalcitonin-guided antibiotic\u00a0 therapy\u00a0 to\u00a0 clinically\u00a0 guided\u00a0 therapy\u00a0 in pediatric\u00a0 patients\u00a0 with\u00a0 local\u00a0 or systemic\u00a0 infections\u00a0 were\u00a0 searched\u00a0 through MEDLINE,\u00a0 Cochrane,\u00a0 EMBASE, HERDIN and\u00a0ClinicalTrials.gov. Hand search in various search engines was also done. Outcomes included antibiotic usage, morbidity and mortality. Two reviewers independently assessed potentially relevant studies. Statistical analysis was conducted using RevMan 5.3 using inverse variance weighting and random effects model.
\nResults<\/strong>: Five randomized controlled trials were included. Overall, there was a reduction in antibiotic prescription rate in the procalcitonin group compared to controls for all groups (RD -0.13, 95% CI [-021,0.06]; p <0.00001), however, pooled studies were heterogenous. Subgroup analysis showed that for children with pneumonia, procalcitonin guidance significantly reduced antibiotic prescription rate (RD – 012,95% CI [-021,0.04]; p <0.005 ), and may have potential in reducing the duration of therapy (95% CI [-6.8,2,54], p <0.0001) and antibiotic-related adverse effects (RD- 0.17, 95% CI[-0.24,-0.10], p<0.00001) compared to controls. In one study on neonates with early onset sepsis, procalcitonin guidance reduced antibiotic prescription rate by 27% (p=0.0009) and duration of therapy by 22.4 hours (p=0.0009). Procalcitonin guidance has no significant impact on antibiotic prescription rate in children with fever without a source (RD -0.11, 95% CI[0.28,0.05], p=0.190).
\nConclusion<\/strong>: Procalcitonin guidance significantly reduces antibiotic prescription rate among children with pneumonia and neonates with early onset sepsis. It has the potential in reducing the duration of antibiotic therapy and antibiotic-related side effects in these populations. ON the other hand, it had no impact among children with fever without a source. These results highlight
\nthe need for algorithm-based approaches using procalcitonin cut-off values to guide antibiotic therapy in children.
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

The Association of Pre-Operative Hospital Stay with Surgical Site Infection Among Pediatric Patients After A Clean Neurosurgical Operation<\/strong>
\nCleo Anne Marie E. Dy-Pasco, M.D, Cecilia C. Maramba-Lazarte, M.D.<\/strong><\/em>
\nAbstract:
\nBackground<\/strong>: Surgical site infection (SSI) poses a serious threat in Neurosurgery. The mere presence of SSI would warrant a prompt medical and\/ or surgical intervention for the outcome is very poor. This study aims to establish whether a pre-operative hospital stay of >7 days & other risk factors predisposes to surgical site infections.
\nMethods<\/strong>: Retrospective, cross-sectional study of all pediatric patients who underwent clean neurosurgical procedures for the first time from January 1, 2011- June 30, 2014, in the Philippine General Hospital. The primary outcome was the development of a surgical site infection within 30 days from spine surgery or 90 days from intracranial surgery. Univariate and multivariate logistic regression analyses were performed to show the association of demographic and clinical factors with the development of SSI.
\nResults<\/strong>: 279 medical charts were available for review. Median age was 1 year(5 days to 18 years old). The overall prevalence rate of SSI was 11.26%. Patients with >7 days pre-operative hospital stay had an incidence rate for SSI of 76.47% compared to 23.53% in patients with <7 days pre-operative hospital stay (OR 1.61, CI 0.68-3.84, p=0.280).
\nConclusions<\/strong>: The incidence of SSI is high compared to other centers. There was no association of preoperative hospital stay with SSI. The association was significant only for the history of nosocomial infection. Early pre-operative clearance and surgery are recommended. Further prospective studies and surveillance are warranted
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

Association Of Clinical And Laboratory Parameters Of Patients With Neonatal Sepsis<\/strong>
\nCharlene Capili, M.D.<\/strong><\/em>
\nAbstract:\u00a0<\/strong>
\nNeonatal sepsis is one of the leading causes of death among newborns, and diagnoses is a challenge to clinicians.
\nObjectives<\/strong>: The present study describes and compares clinical, and hematological profile of neonates, and culture positive and culture negative neonatal sepsis, Children\u2019s Hospital.
\nMethods<\/strong>: This is a cross sectional study. About with neonatal sepsis with a complete blood count were included in the study. Charts were retrieved from section. Primary outcome measures are the following: increased WBC, increased ANC, IT ratio more than nucleated RBCs.
\nResults<\/strong>: Forty-seven (35%) subjects had a positive (65%) patients had a negative blood culture. The significantly associated with clinical sepsis (negative p=0.04). On the other hand, the odds of having a 2.29 times more when the patient has poor suck compared not present with poor suck (OR 2.29, p=0.04). There association with the patients’ demographic and having neonatal sepsis. Conclusion: There was no significant difference in culture or a negative blood culture among any demogr hematological profile tested between culture proven neonatal sepsis. Hence, in clinical sepsis, it is still acceptable despite a normal complete blood count and or a negative blood culture.
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

Profile Of Community-Acquired Methicillin Resistant Staphylococcus Aureus Skin And Soft-Tissue Infections Among Children Admitted At The Philippine General Hospital<\/strong>
\nPauline T. Reyes-Solis, M.D., Salvacion R. Gatchalian, M.D.<\/strong><\/em>
\nAbstract:
\n<\/strong>CA-MRSA infection is a global concern. It is important to determine the local prevalence of CA-MRSA skin and soft-tissue infection as this information will provide a more accurate and rational basis for empiric treatment, improve management and outcomes in patients, and reduce the economic burden associated with failed treatment. This study was conducted to determine the clinical profile and prevalence of CA-MRSA skin and soft tissue infections among pediatric patients admitted at the Philippine General Hospital.
\nMethods<\/strong>: A prospective, observational study was performed involving all pediatric patients admitted at U-PGH for skin and soft tissue infections from September to December 2012. Demographic profile, clinical characteristics of patients, results of laboratory examinations, the outcome of treatment were described and summarized. Risk factors for acquisition of MRSA were also determined. Period-prevalence was computed.
\nResults<\/strong>: There were 25 children admitted for SSTIs, 16 have positive cultures and 62.5% of these had CA-MRSA. The majority were male children younger than 5 years old without identifiable risk factors. infections presented as solitary masses and cellulitis usually at the head and neck area. isolates were taken from aspirates during incision and drainage. Invasive infections were seen 3 patients. The length of hospital stay, type of antibiotics used and surgery performed was variable. All patients were discharge well and there were no mortalities. The period prevalence of CA-MRSA among children with SSTI was 0.36.
\nConclusion<\/strong>: CA-MRSA as a cause of SSTIs in Filipino children is an emerging concern, especially in very young patients even without risk factors. management of SSTI’s should include incision and drainage of abcesses and prompt submission of aspirates for culture and antibiotic sensitivity testing. The period prevalence of pediatric patients with SSTI is high among hospitalized patients. Empiric antibiotics with MRSA coverage such as clindamycin and vancomycin should be considered clinical situations wherein MRSA is deemed likely.
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

Randomized Controlled Trial Comparing The Efficacy Of 70% Isopropyl Alcohol Hand Rub Versus Standard Hand Washing For Hand Hygiene Among Healthcare Workers<\/strong>
\nLoralyn Mae O. Lagaya-Aranas, M.D.<\/strong><\/em>
\nAbstract:<\/strong>
\nAccess to handwashing areas is not as convenient as having alcohol in one’s pocket or bedside. Alternatively, cleaning the hands with alcohol can save us a lot of time and effort in disinfecting our hands thus giving us more time for patient care. If alcohol can be proven as effective as soap and water in hand disinfection, then residents and nurses may use this method of hand hygiene instead.
\nObjective<\/strong>: To compare the efficacy of 70% isopropyl alcohol against standard handwashing in hand hygiene among medical residents and nurses at a tertiary hospital.
\nMethods<\/strong>: seventy-six doctors and nurses were randomly assigned to two groups with 38 subjects each. Group 1 used plain soap and water while group 2 used 70% isopropyl alcohol hand rub. hand swabbing was done before and after hand hygiene. The presence or absence of bacteria was compared for the same subject, before and after hand disinfection. The mean decrease in colony count in group 1 was compared to group 2.
\nResults<\/strong>: Both groups were successful in reducing the mean colony count. Handwashing group had a decrease from 27.34 34 +33.17to 3.58+ 6.63 CFU, while the alcohol group from 21.5 + 31.13 to 0.76 + 1.48 CFU, both with p values <0.05. But in comparison, the mean changes for both groups were not statistically significant, therefore no intervention was superior to the other and both were equally effective.
\nConclusion<\/strong>: Seven percent isopropyl alcohol is as effective as standard handwashing in disinfection. It is recommended to have 70% isopropyl alcohol at bedside\/individually carried by doctors\/nurses for easy access. Observation of proper hand washing technique should always be emphasized. Bacterial colony identification is ideal for future studies.
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

Your Diagnosis Please: 8-Year-Old Child With Chronic Ear Discharge, Infraorbital Ulcer, And Pneumonia<\/strong>
\nCarol Stephanie Tan, M.D.<\/strong><\/em>
\nAbstract:<\/strong>
\nAn 8 year-old female consulted at our institution due to left ear discharge. 6 months prior to consulting, the patient developed infraorbital swelling and erthema after she hit a metal post.\u00a0The site of trauma eventually developed into a 2 x 2 cm abscess, which spontaneously ruptured. She was given cloxacillin for 7 days with no improvement of symptoms. 4 months prior to consulting, she developed foul-smelling left ear discharge, not associated with pain. She was given unrecalled otic drops and oral medications with no improvement. She eventually developed left facial paresis. Due to the persistence of ear discharge, she was brought to a local clinic where she was diagnosed to have chronic suppurative otitis media (CSOM) and referred to our institution.\u00a0 \u00a0The patient also had an 8-month history of a recurrent cough and weight loss of 10%\u00a0 over 3 months. She had no history of fever, seizure, or change in sensorium. She has an older sibling who is an ongoing 2nd month of anti-tuberculosiis treatment. She was given BCG vaccination at birth. Her nutritional status is poor, with meals consisting usually of instant noodles, rice, bread, and cookies.
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

Journal 2016 Vol.17 No.2<\/strong><\/span>
\nEditorial:<\/strong><\/span>
\n Keep Calm, The New Editors are Here<\/strong>
\nCecilia C. Maramba-Lazarte, MD, MScID, MScCT<\/strong><\/em>
\n\u00a0<\/strong>The PIDSP Journal has been a great part of my life for the past 14 years. This is why I have conflicting emotions as I relinquish my post with this last issue. I am happy to be rid of the tedious work involved in preparing each issue. Yet, I am also sad to leave behind performing tasks I have a passion for as well as no longer experiencing the quintessential satisfaction when an issue is completed and made available online….
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

Childhood Immunization Schedule 2017<\/strong>
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

The Use of Fluorescent Marking Technique as an Indicator Of Cleanliness and Disinfection in the Neonatal Intensive Care Unit<\/strong>
\nExpedito T. Yala, M.D.*; Cecilia C. Maramba-Lazarte, M.D.<\/strong><\/em>
\nAbstract:
\nBackground:\u00a0<\/strong>Environmental surfaces harbor pathogens that transmit them and there is a need for environmental cleaning and disinfection to prevent the spread of infection.
\nObjective: <\/strong>This study aimed to determine if the use of fluorescent marking\u00a0(FM) technique in high touch areas can be used as an index of cleanliness and\u00a0disinfection as determined by aerobic colony count.
\nMethods: <\/strong>This was an experimental study done at the University of the\u00a0Philippines Philippine General Hospital Neonatal Intensive Care Unit (NICU).\u00a0A total of 40 surfaces were swabbed for cultures with aerobic colony count\u00a0(ACC) then adjacent areas are marked with fluorescent gel. After cleaning and\u00a0disinfection, checking for residual fluorescent markings with congruent\u00a0environmental culture with an aerobic colony count of the same surface was\u00a0done. The rate of removal and colony count were then compared to assess the\u00a0specificity and sensitivity of the fluorescent marking technique as a gauge of\u00a0cleanliness of high touch surface areas. Any residual fluorescence of the marked\u00a0areas was considered unclean and an aerobic colony count of < 2.5 – 5CFU\/ml 2<\/sup>\u00a0were\u00a0considered an acceptable level of cleanliness.
\nResult:\u00a0<\/strong>A total of 40 high contact surfaces were sampled from 5 areas were\u00a0collected. Prior to cleaning, 60% (24) of the\u00a0 surfaces (60%) did not contain\u00a0microorganisms. After cleaning, the (FM) had 38% and in the ACC 83% were\u00a0assessed to be clean. The sensitivity of FM is 85.71% and specificity of 42.42%.\u00a0The positive predictive value (PPV) is 24% with the positive likelihood ratio\u00a0(positive LR) of 1.49 and the negative predictive value (NPP) is 93.33%.
\nConclusion:\u00a0<\/strong>The use of Fluorescent Marking technique in high touch areas as\u00a0an index of cleanliness and disinfection is a good marker for cleanliness and\u00a0disinfection. Furthermore, it is a simple, rapid, inexpensive and has potential to\u00a0increase awareness of the environment that can be utilized as an objective\u00a0parameter to assess cleanliness and disinfection.
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

Clinical Profile and Outcomes in Acute Viral Encephalitis<\/strong>
\nAlbert Roland Alcaraz, M.D., Martha Lu-Bolanos, M.D., Ma. Liza Antoinette M. Gonzales, M.D.<\/strong><\/em>
\nAbstract:
\nObjective:\u00a0<\/strong>This study aimed to determine the clinical profile and outcome of pediatric patients with acute viral encephalitis syndrome admitted at a single tertiary government hospital.
\nMethods:<\/strong>\u00a0 All pediatric patients admitted at the Philippine General Hospital from January 2011 to December 2014 and discharged with a final diagnosis of acute\u00a0 viral\u00a0 encephalitis\u00a0 were\u00a0 included.\u00a0 After\u00a0 demographic\u00a0 data,\u00a0 clinical manifestations,\u00a0 and\u00a0 laboratory\u00a0 findings\u00a0 were\u00a0 collected,\u00a0 the\u00a0 outcome\u00a0 was determined\u00a0 using\u00a0 the\u00a0 Modified\u00a0 Rankin\u00a0 Scale\u00a0 for\u00a0 children.\u00a0 The\u00a0 data\u00a0 were summarized using descriptive statistics. The median test was used to compare the outcomes while the chi-square test was used to analyze the comparison between study groups.
\nResults:<\/strong> Sixty-four patients diagnosed with acute viral encephalitis syndrome were included in the study. The highest number of cases was reported in ages 1- 4 years (32.81%) and among the male population (68.75%). The\u00a0 most common symptoms were seizure (46.87%), abnormal behavior (21.88%), and altered sensorium (20.31%). Forty-four patients had CSF viral studies done, and among them, the 11 (25%) were positive for Japanese encephalitis. The modified\u00a0 Rankin\u00a0 scale\u00a0 showed\u00a0 that\u00a0 41\u00a0 (64.08\u00a0 %)\u00a0 subjects\u00a0 showed\u00a0 good outcomes,\u00a0 while\u00a0 23\u00a0 (35.23%)\u00a0 exhibited\u00a0 poor\u00a0 outcomes.\u00a0 There\u00a0 was\u00a0 no significant difference in the modified Rankin scale for Japanese encephalitis compared to the other etiologic agents of acute viral encephalitis (p value= 0.717).
\nConclusion:<\/strong> In\u00a0 patients\u00a0 with\u00a0 acute\u00a0 viral\u00a0 encephalitis,\u00a0 the\u00a0 most\u00a0 common symptoms were seizures, abnormal behavior, and altered sensorium. Majority of the subjects did not show any significant symptoms and disability. No difference was seen in the clinical outcome of patients infected with Japanese encephalitis compared to other etiologic agents, but these results need to be verified by larger studies.<
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

Cardiac involvement in Kawasaki disease patients: A Retrospective Study<\/strong>
\nPilarica I. Caguiat, M.D., Cherica A. Tee, M.D., Leonila F. Dans, M.D.<\/strong><\/em>
\nAbstract:
\nBackground: \u00a0<\/strong>Kawasaki disease is a self-limited disease but it can lead to potentially fatal cardiac complications if not detected and managed accordingly.
\nObjective:<\/strong>\u00a0 To\u00a0 determine\u00a0 the\u00a0 incidence\u00a0 of\u00a0 cardiac\u00a0 involvement\u00a0 in\u00a0 patients with Kawasaki disease admitted in PGH
\nMethods:<\/strong> Medical records of patients with KD admitted from January 2012 to\u00a0 December\u00a0 2013\u00a0 were\u00a0 reviewed.\u00a0 Demographic,\u00a0 clinical,\u00a0 laboratory,\u00a0 chest radiographic,\u00a0 \u00a0electrocardiographic,\u00a0 \u00a0and\u00a0 \u00a0echocardiographic\u00a0 \u00a0data\u00a0 \u00a0were recorded. The course, management, length of hospital stay, clinical outcome, duration of OPD follow-up, and medications were evaluated.
\nResults:<\/strong>\u00a0 Thirty-eight\u00a0 patients\u00a0 with\u00a0 mean\u00a0 age\u00a0 of\u00a0 2.67\u00a0 \u00b1\u00a0 2.26\u00a0 years\u00a0 old,\u00a0 66% males\u00a0 with\u00a0 KD\u00a0 were\u00a0 included.\u00a0 Fifty-nine\u00a0 percent\u00a0 had\u00a0 cardiac\u00a0 involvement, and\u00a0 among\u00a0 those\u00a0 with\u00a0 cardiac\u00a0 involvement,\u00a0 68%\u00a0 have\u00a0 coronary\u00a0 artery dilatation. Seventy-six percent of cases received intravenous immunoglobulin (IVIG) with 55% receiving IVIG within 10 days of illness. The initial cardiac findings\u00a0 resolved\u00a0 in\u00a0 the\u00a0 subsequent\u00a0 2d-echo\u00a0 after\u00a0 IVIG\u00a0 except\u00a0 for\u00a0 some coronary\u00a0 artery\u00a0 abnormalities,\u00a0 which\u00a0 resolved\u00a0 in\u00a0 5\u00a0 \u00b1\u00a0 3.11\u00a0 months\u00a0 during follow-up.\u00a0 There\u00a0 was\u00a0 no\u00a0 mortality.\u00a0 The\u00a0 possible\u00a0 predictive\u00a0 factors\u00a0 for\u00a0 the development\u00a0 of\u00a0 cardiac\u00a0 abnormalities\u00a0 published\u00a0 in\u00a0 other\u00a0 studies\u00a0 were\u00a0 not found to be significantly associated in this study population.
\nConclusion:<\/strong> The incidence of cardiac involvement in patients with Kawasaki disease\u00a0 among\u00a0 children\u00a0 admitted\u00a0 in\u00a0 PGH is\u00a0 59% with68% having\u00a0 coronary artery dilatation, higher than in other published studies.
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

Predictors of Mortality among Pediatric Patients with Leptospirosis: A Multicenter Retrospective Study<\/strong>
\nRosalia Belen F. Bonus, M.D., Grace Devota Go, M.D., Joanne De Jesus, M.D., Marxengel Asinas Tan, M.D., Cecilia C. Maramba-Lazarte, M.D.<\/strong><\/em>
\nAbstract
\nObjective: \u00a0<\/strong>Leptospirosis in children is one of the most common diagnostic dilemmas, hence this study was performed to determine the clinical profile, outcome and risk factors associated with mortality in patients seen at tertiary government hospitals from January 2008 to December 2012.
\nMethods:<\/strong> A\u00a0 case-control\u00a0 retrospective\u00a0 study\u00a0 was\u00a0 done\u00a0 among\u00a0 admitted patients\u00a0 at\u00a0 UP-PGH,\u00a0 SLH,\u00a0 and\u00a0 RITM.\u00a0 Descriptive\u00a0 statistics\u00a0 and\u00a0 multiple logistic regressions were utilized.
\nResults:<\/strong> Among the 404 leptospirosis cases included in the study, 94% were male, with 43% belonging to 16-18-year-old age group (age range 3 to 18 years old). A higher occurrence was noted during the rainy season and in Manila.\u00a0 Clinical findings include fever, abdominal pain, calf tenderness, vomiting and conjunctival\u00a0 suffusion.\u00a0 Significant\u00a0 correlation\u00a0 was\u00a0 noted\u00a0 in\u00a0 patients\u00a0 with jaundice (p-value 0.014; OR 6.293, CI 1.449-27.335), dyspnea (p-value 0.004; OR\u00a0 7.880,\u00a0 CI\u00a0 1.967-31.561)\u00a0 and\u00a0 cardiac\u00a0 abnormality\u00a0 (p-value\u00a0 0.042;\u00a0 OR 15.343, CI 1.106-212.853).\u00a0 Abnormal\u00a0 laboratory\u00a0 findings\u00a0 include\u00a0 neutrophilia,\u00a0 azotemia,\u00a0 creatinemia, anemia,\u00a0 \u00a0elevated\u00a0 \u00a0bilirubin\u00a0 \u00a0levels\u00a0 \u00a0and\u00a0 \u00a0thrombocytopenia.\u00a0 \u00a0Prolonged prothrombin time was associated with poor outcome (p-value 0.004, OR 23, CI 2.79-189.67).\u00a0 Penicillin\u00a0 was\u00a0 the\u00a0 drug\u00a0 of\u00a0 choice\u00a0 given\u00a0 to\u00a0 96.8%.\u00a0 94.6%\u00a0 of\u00a0 cases\u00a0 who\u00a0 had oliguric renal failure were conservatively converted to non-oliguric type. 5.4% underwent\u00a0 peritoneal\u00a0 dialysis\u00a0 and\u00a0 survived.\u00a0 Inotropes\u00a0 were\u00a0 used\u00a0 in\u00a0 93%\u00a0 of non-survivors. The case fatality rate was 3.5% with the cause of death mostly due to Weil\u2019s disease.\u00a0 The\u00a0 average\u00a0 hospital\u00a0 stay\u00a0 among\u00a0 survivors\u00a0 was\u00a0 6.8+3.3\u00a0 days\u00a0 as compared\u00a0 with\u00a0 1.8+1.9\u00a0 days\u00a0 in\u00a0 non survivors.\u00a0 Shorter\u00a0 hospital\u00a0 stay\u00a0 (p-value 0.00; OR 3.514, CI 2.115-5.839), as well as inotropic support (p-value 0.035; OR 62.511, CI 1.33-2949.134), were associated with poorer outcome, but these findings\u00a0 can\u00a0 be\u00a0 attributed\u00a0 to\u00a0 late\u00a0 presentation\u00a0 of\u00a0 cases\u00a0 at\u00a0 the\u00a0 hospital\u00a0 for admission.
\nConclusion<\/strong>:\u00a0 \u00a0A5\u00a0 year\u00a0 review\u00a0 of\u00a0 patients\u00a0 with\u00a0 leptospirosis\u00a0 showed\u00a0 that jaundice, dyspnea, cardiac abnormality and prolonged prothrombin time were predictive of mortality.
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

Randomized Controlled Trial on the Effect of Coconut Oil, Vinegar Plus Cooking Coconut Oil Versus 1% Permethrin Shampoo in the Treatment of Pediculosis<\/strong>
\nMarian Moreno-Alsasua, M.D.<\/strong><\/em>
\nAbstract
\nObjective:\u00a0<\/strong>To determine the efficacy of cooking coconut oil and vinegar as compared to 1% Permethrin shampoo in the treatment of Pediculosis humanus capitis in children 3 – 12 years old.
\n Methodology<\/strong>: The study was conducted in Barangay 704, Zone 77 in Malate among children 3 – 12 years old.\u00a0 Two hundred forty-five subjects were screened and the computed sample size was 150.\u00a0 Subjects were randomized to three treatment groups: coconut oil (CO) group; vinegar plus coconut oil (CV) group; and 1% permethrin shampoo (PS) group. Treatments were given on the 1st and 8th day.\u00a0 The final level of infestation was determined on the 14th day. Cure rates, failure rates, and expenses were also determined.
\nResults<\/strong>: Permethrin achieved superiority over plain coconut oil (X2=18.77\u00a0 p-value = 0.00). There was no sufficient evidence to prove the superiority of permethrin over coconut-vinegar solution (X2=1.04 p-value = 0.30). Twenty-two percent (11) of the participants from the PS group developed itching and irritation.\u00a0 No\u00a0 adverse\u00a0 effect\u00a0 was\u00a0 reported\u00a0 from\u00a0 the\u00a0 CO\u00a0 and\u00a0 CV\u00a0 groups. Permethrin was 14 times and five times more expensive than coconut oil and vinegar plus coconut oil, respectively.
\nConclusion<\/strong>: Permethrin shampoo had a cure rate of 98%. Plain coconut oil and vinegar plus coconut oil had cure rates of 68% and 94%, respectively. Plain coconut oil had the highest failure rate at 36%, vinegar plus coconut oil at 6%, and permethrin shampoo with 2%. Adverse effects were exclusive to the PS group. Plain coconut oil was the most economical but coconut oil with vinegar with\u00a0 its\u00a0 significant\u00a0 cure\u00a0 rate\u00a0 can\u00a0 be\u00a0 an\u00a0 alternative\u00a0 therapy\u00a0 to\u00a0 permethrin shampoo in the treatment of head lice in children.
\nView Full Article in PDF format<\/a><\/strong><\/p>\n

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Year<\/b><\/h2>\n

1996\u00a0<\/a>|\u00a01997<\/a>\u00a0|\u00a01998<\/a>\u00a0|\u00a01999<\/a>\u00a0|\u00a02000<\/a>\u00a0|\u00a02001<\/a>\u00a0|\u00a02002<\/a>\u00a0|\u00a02003<\/a>\u00a0|\u00a02004<\/a>\u00a0|\u00a02005<\/a>\u00a0|\u00a02006<\/a>\u00a0|\u00a02007<\/a>\u00a0|\u00a02008\u00a0<\/a>|\u00a02009<\/a>\u00a0|\u00a02010<\/a>\u00a0|\u00a02011<\/a>\u00a0|\u00a02012<\/a>\u00a0|\u00a02013<\/a>\u00a0|\u00a02014<\/a>\u00a0| 2015<\/a>\u00a0| 2017 <\/a>| 2018<\/a>\u00a0| 2019<\/a>\u00a0| 2020<\/a> | 2021<\/a> | 2022<\/a> | 2023<\/a> | 2024<\/a> | 2025<\/a><\/span><\/span><\/p>\n<\/div>

<\/div><\/div><\/div>
\n

EDITORS-IN-CHIEF:
\n<\/strong>Arlene Dy-Co, M.D.
\nCarmina Delos Reyes, M.D.<\/p>\n

ASSOCIATE EDITORS-IN-CHIEF:<\/strong>
\nFrancesca Mae Pantig, M.D.
\nPaul Sherwin Tarnate, M.D.<\/p>\n

EDITORIAL BOARD:<\/strong>
\nAubrey Artienda, M.D.
\nJohn Andrew Camposano, M.D.
\nMichelle Carandang-Cuvin, M.D.
\nGiselle Enriquez-Briones, M.D.
\nElizabeth Gallardo, M.D.
\nFatima Gimenez, M.D.
\nJonathan Lim, M.D.
\nMary Antonette Madrid, M.D.
\nSarah Makalinaw, M.D.
\nSally Jane Velasco-Aro, M.D.<\/p>\n

ADVISERS:<\/strong>
\nLulu Bravo, M.D.
\nCecilia Maramba-Lazarte, M.D.<\/p>\n

JOURNAL MANAGER:<\/strong>
\nRoan Buenaventura-Cabrera, M.D.<\/p>\n<\/div>

<\/div><\/div><\/div>
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