The Modified Ferriman-Gallwey Score and Hirsutism among Filipino Women.

BACKGROUND: The modified Ferriman-Gallwey (mFG) score is the gold standard for the clinical evaluation of hirsutism. However, racial variations in terminal hair growth limit this tool. This study aimed to determine the mFG cut-off score among Filipino women and its association with biochemical hyperandrogenism. METHODS: A total of 128 Filipino women were included in this prospective cross-sectional study and were divided into two groups: a polycystic ovary syndrome (PCOS) group (n=28) and a non-PCOS group (n=100). The participants underwent mFG score determination, ovarian ultrasound conducted by a single sonographer, and hormone testing. The mFG cut-off score was determined based on the 95th percentile of the non-PCOS group. Logistic regression was used to analyze the relationship between mFG score and biochemical hyperandrogenism. RESULTS: Although the mFG score was generally low in both the PCOS and non-PCOS groups, the former exhibited a higher mean score than the latter (4.3±3.0 vs. 2.0±2.2, P<0.001). Normal values for the total mFG score ranged from 0 to 7. Using a cut-off score of 7, a higher proportion of hirsute women (mFG score ≥7) was observed in the PCOS group versus the non-PCOS group (17.9% vs. 5.0%, P=0.025). Elevated calculated free testosterone (FT) was also found to be significantly associated with hirsutism (odds ratio, 6.2; 95% confidence interval, 1.2 to 32.4 pmol/L; P=0.030). CONCLUSION: A score of 7 and above constitutes hirsutism in this population of Filipino women. Hirsute women are more likely than non-hirsute women to have elevated calculated FT.

Clinical Profi le and Predictors of Outcomes of Patients with Peripartum Cardiomyopathy: The Philippine Heart Center Experience.

BACKGROUND: Peripartum cardiomyopathy is a rare form of dilated cardiomyopathy characterized by heart failure and left ventricular dysfunction associated with pregnancy. While clinical characteristics of these patients have been previously described in literature, there is limited data regarding the natural history and predictors of outcomes of these patients in Asia, most specifi cally in Filipino patients. METHODS: Clinical and echocardiographic data of 39 patients diagnosed with peripartum cardiomyopathy were analyzed. Patients were followed up for the occurrence of death and major adverse events (MAE) and outcomes were correlated with patient variables. RESULTS: The mean age of the patients was 28.4 ± 6.9 and the mean ejection fraction (EF) was 27.8 ± 8.4%. Heart failure was the most common symptom (98%) while arrhythmia was the initial presentation in 5 patients (12.8%). 14 patients had recovery of ejection fraction in 6 months (39%) with a mean EF of 55.5 ± 6.3. 16 patients had an initial EF of <25% (41%) and only 2 patients in this subgroup experienced improvement in EF. 29 patients experienced death and/or MAEs (74.4%). Multivariate analysis showed that an EF of <25% (HR 12.0,p=0.019), recovery of LV function (HR 0.23,p=0.05) and improvement of EF in 6 months (HR 0.32,p=0.024) were signifi cant predictors of MAEs. Kaplan Meier curves showed that patients whose ejection fraction was <25% had a 50% incidence of MAEs in 1 year with an increasing trend. Patients whose EF recovered in 6 months experienced a 60% freedom from MAE for almost 6 years. Patients with an EF of <25% had a mortality rate of 50% in two years. Patients with an EF of >25% had a 90% likelihood of survival for 8 years with a higher trend of mortality for patients whose EF did not recover in 6 months. CONCLUSION: Peripartum cardiomyopathy is associated with signifi cant morbidity and mortality. The degree of left ventricular dysfunction on presentation as well as improvement of EF within 6 months were predictive for the occurrence of death and major adverse events. This study emphasizes the need for aggressive treatment as well as clinical and echocardiographic follow up early in the course of disease in order to improve outcomes.

Association between carotid intima media thickness and measurements of adiposity among residents and interns of a tertiary hospital in the Philippines

INTRODUCTION: Atherosclerotic diseases wherein obesity is a risk factor was shown to be the leading causes of mortality according to statistics. Body mass index (BMI), waist hip ratio (WHR) and waist circumference (WC), measurements of adiposity, were consistently identified as good measures of cardio-metabolic health risks. High-resolution B-mode ultrasound measurements of carotid intima-media thickness (CIMT) have also been used as a reliable and reproducible method to detect preclinical atherosclerosis, a precursor of cardiovascular disease. OBJECTIVE: This study aims to investigate which of the measurements of adiposity would best correlate with early vascular changes primarily noted in the CIMT among non-high risk clinicians of Victor R. Potenciano Medical Center (VRPMC). METHODS: A total of 38 subjects out of 42 residents and interns of VRPMC volunteered to participate in the study from August to November 2010. They had no evidence of cardiac or vascular disease. The weight, height, WC, and hip circumference of each subject were measured. High-resolution B-mode ultrasonography of the right and left common carotid arteries was then performed.  RESULTS: A weak correlation between BMI with CMIT was found. There is no association between WC and WHR and thickness of CIMT. CONCLUSION: WC, BMI, and WHR are insignificantly associated with CIMT in this study.