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Background: The epidemic of diabetes mellitus (DM) poses a threat for global tuberculosis (TB) co... more Background: The epidemic of diabetes mellitus (DM) poses a threat for global tuberculosis (TB) control. Objective: This study attempts to assess the value of screening for diabetes in patients with pulmonary tuberculosis and reviews the disease burden, clinical and radiographic manifestations, rates of sputum smear positivity and time to conversion, treatment outcomes and fatality rates, in the local setting. Methods: This is a prospective observational cohort study involving adults diagnosed with pulmonary tuberculosis at the PTSI TB DOTS out-patient clinic, r e g a r d l e s s o f s p u t u m -s m e a r s t a t u s , f r o m J u l y 2011-November 2012. A diabetes screening tool was used and patients were screened for presence of DM. Treatment outcomes were also determined. Results: Of the 38 patients enrolled, seven (18.4%, 95% confidence interval 7.7-34.3) were diagnosed with DM. This is higher than the estimated 12.9% in 2010 and 14.4% projected estimate in 2030 in our country by a report of WHO as well as in reported prevalence of DM among patients with PTB in large studies done in China (12.4%) and India (13%). There was no significant difference noted in the basic profile, clinical and radiographic presentation, sputum conversion and treatment outcomes among patients with DM and without DM who were being treated for PTB. Conclusion: This study demonstrates the value and feasibility of screening for DM among patients with PTB. Although the findings of this study are consistent with most of previous similar studies, the estimate on the true prevalence of DM may not be very accurate because of the small sample size. Hence, a multi-center study with a larger sample size must be conducted to more accurately measure the true prevalence of DM among patients with TB and to determine associations of various clinical and radiographic presentations and clinical outcomes. Keywords: diabetes mellitus, pulmonary tuberculosis, screening Abstract Introduction

Background: Infectious diseases remain a significant cause of morbidity and mortality. Cefpirome,... more Background: Infectious diseases remain a significant cause of morbidity and mortality. Cefpirome, a fourth generation Cephalosporin, is a potent antibiotic against a wide variety of organisms that may be used alone or in combination with other antimicrobials to combat various infections. Objective: This is a post-marketing surveillance study documenting the safety and efficacy of cefpirome among Filipino patients. Methodology: This was a multicenter, open-label, noncomparative study involving 402 patients who received at least one dose of cefpirome. Safety and efficacy data were gathered. Results: Cefpirome was used as monotherapy in majority of the cases. Pneumonia (76%) was the most frequent indication for the use of this drug. The most commonly utilized dosage regimen was 2.0 grams every 12 hours for a mean of 4.2 days. This was associated with a successful clinical outcome in almost 90% of cases. There was almost negligible side effect reported. Conclusion: The use of cefpirome was shown to be safe and well-tolerated with associated successful clinical outcomes among Filipino patients.

Introduction. The University of the Philippines-Philippine General Hospital (UP-PGH) began its op... more Introduction. The University of the Philippines-Philippine General Hospital (UP-PGH) began its operations as a COVID-19 referral center on March 30, 2020. Local studies reporting characteristics of patients in the intensive care units (ICUs) are lacking. Objectives. 1) To describe the baseline characteristics and outcomes of the initial cohort of COVID-19 patients in the medical ICU. 2) To report the initial situation and strategies in the ICU during the first two months of being a COVID-19 referral center. Methods. We conducted a review of records of all patients with confirmed COVID-19 admitted to the medical ICU of UP-PGH between April 1 to May 31, 2020. Patient demographics, comorbidities, APACHE-II score, signs and symptoms, laboratory and radiologic results, respiratory and vasopressor support, and outcomes were collected. Results. Out of 35 patients with confirmed COVID-19, majority were above 60 years old (63%). Hypertension was the most frequent comorbidity (77%). Fever was...

There are no definite criteria of weaning patients from the ventilator. In many instances, the pr... more There are no definite criteria of weaning patients from the ventilator. In many instances, the procedure to be used of weaning depends on the physicians experience with previous other methods. In order to examine this further, a literature search was made covering publications from 1970-1998. In addition, queries were also made from each local pulmonary training institution for any unpublished data. Articles were then rated according to their reliability based on an accepted scoring system. Based on this, we conclude the following: (1) Although theoretically rational, data from prospective studies dealing with the certain utility of physiologic and clinical parameter in connection with weaning is not currently sufficient. However the differences in values noted between success and failure deserve due attention. (2) Among the conventional weaning parameters, the tidal volume has the most attractive feature in terms of accuracy, feasibility, and reproducibility. (3) The rapid shallow breathing index using a cutoff value  100, may be used as a tool to accurately predict a successful weaning outcome. (4) A 2-hour trial of spontaneous breathing thru a T-tube prior to extubation maybe recommended. If a patient fails this, then gradual weaning may be attempted using either T-piece or pressure support ventilation.

Respirology

Background and Aims: Positive fluid balance is an independent predictor for mortality in patients... more Background and Aims: Positive fluid balance is an independent predictor for mortality in patients with septic shock. The role of fluid balance in sepsis-induced multi-organ dysfunction syndrome (MODS) has not been well addressed. Methods: The study retrospectively recruited patients with septic shock in intensive care units of a tertiary hospital. Patient's baseline characteristics, cumulative intake, output and fluid balance in the first 24, 48, and 72 h since the onset of septic shock, presence of MODS, sequential organ failure assessment (SOFA) score, and clinical outcomes were analyzed.

European Respiratory Journal, Sep 1, 2013

Obstetric Medicine: The Medicine of Pregnancy, 2014

Pregnancy outcomes in patients with pulmonary arterial hypertension have not been documented in o... more Pregnancy outcomes in patients with pulmonary arterial hypertension have not been documented in our local setting. In our institution, access to therapies like nitric oxide, inhaled prostacyclin and iloprost is limited. We describe two such women given sildenafil monotherapy between April and May 2011. Both had an atrial septal defect complicated by Eisenmenger syndrome. Both survived – one after elective Caesarean section for malpresentation (breech) under general anaesthesia, the other after an assisted vaginal delivery. In addition to oral sildenafil, both received oxygen supplementation. To date, there have been three reported cases of pulmonary arterial hypertension in pregnancy treated with sildenafil in combination with another drug. Our two cases demonstrate that treatment for pulmonary arterial hypertension using sildenafil as monotherapy may allow stabilization of the maternal condition and improve clinical outcomes for both mother and baby. However, pregnancy is still dis...

D104. MECHANICAL VENTILATION, 2011

Journal of Bronchology, 2002

... Singapore. Address correspondence to Dr. Anne Hsu Ann Ling, Department of Respiratory and Cri... more ... Singapore. Address correspondence to Dr. Anne Hsu Ann Ling, Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore 169608; e-mail: gm3hal@sgh.gov.sg. Collapse Box Abstract. In ...

CHEST Journal, 2006