Every patient with hair loss needs blood tests. Surprisingly, some blood tests reveal more information than you might imagine! For example- a complete blood count (CBC) provides counts of red cells, white cells, and platelets and we can tell if a patient has various issues – like anemia. But there are some interesting information that might also be hidden in test results. Let’s talk about inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Higher values generally reflect a shift toward systemic inflammation. The exact cutoffs and significance is still being studied by researchers but NLR ratios above 3 seems to be concerning and PLR ratios that rise for a given patient over time may also be concerning (although exact cutoff values are less clear) In alopecia areata (AA), several case-control and cross-sectional studies report higher NLR and PLR in patients vs controls. More interestingly, some studies show stepwise increases with disease burden—patients with extensive disease (e.g., higher SALT scores, alopecia totalis/universalis) tend to have higher NLR and PLR than those with patchy AA. A few reports also link higher baseline NLR with longer disease duration and greater activity (e.g., positive hair-pull test), suggesting these ratios may reflect ongoing immune activation. There are also early signals on prognosis and treatment response. Small cohorts have found that lower baseline NLR may be associated with better response to therapies (including corticosteroids and JAK inhibitors), whereas persistently elevated NLR & PLR can track with refractory disease. However, these findings are inconsistent across studies and often lose significance after adjusting for confounders. Importantly, evidence comes almost entirely from small, observational studies with variable cutoffs and methods. There are no validated thresholds and no randomized trials confirming clinical utility. For now, NLR and PLR are best viewed as adjunctive, research-level markers—useful for understanding systemic inflammation in AA, but not reliable standalone tools for diagnosing, staging, or guiding treatment decisions. Source link
Training for a half marathon was not straightforward, just like my journey with migraine.
My first migraine attack happened when I was 14 years old and in school. My hand and mouth became numb, I had an intense headache, and I didn’t know what was happening. Nowadays, I can go up to six months of not having a migraine attack and then have a period of having migraine symptoms daily. My symptoms begin with blurry vision, it’s as if glass has shattered and I can’t read things. When this happens, I take painkillers early to manage my symptoms, but I still experience aura. I’m lucky in that if I catch it early enough, I can treat my symptoms with basic painkillers. Sometimes, my migraine attacks can come on suddenly, for example, when I’m looking after my kids. When this happens, I need to take time out and sit in a dark room. When this occurs, I’ve had to stay in bed for the rest of the day and not interact with anyone. Source link
Technology and Artificial Intelligence in Nutrition in the Philippines
by Dr Frances Gail Turalba (Frontline Gastroenterology Global Taskforce 2025-6) The Covid 19 Pandemic has taught us that telehealth through technological advance is possible and the landscape of medical consultations has transitioned increasingly further from face-to face consults to telehealth. Even “telenutrition” has emerged as an avenue to reach more patients or clients in need of consultations and nutrition counselling. Kumar and colleagues addressed this somewhat in their systemic review on the limitations in real-world telemonitoring applicability in gastroenterology and hepatology (1). In the area of nutrition support specifically, an interesting publication on the successful implementation of remote video consultations for patients receiving home parenteral nutrition in a UK national centre demonstrated that telemedicine was able to largely replace the need for face to face clinic consultations for Home Parenteral Nutrition-dependent patients, and naturally leading to less travel to maintain follow-up (https://fg.bmj.com/content/11/4/280). The use of Artificial Intelligence (AI) has gained popularity through its increasing contribution to a number of fields from education to marketing, finance to research, and finally healthcare. In the healthcare setting, AI has proven itself particularly useful in helping to optimize patient assessment as well as in disease diagnosis, advantaged by its ability to rapidly scrutinize vast quantities of data. The improvement in performance of clinical tasks, through automation and streamlined workflows provided by AI, has already started to come to the attention of clinicians, and the promise potentially offered through these new technologies to patients is enticing to explore. Among the Southeast Asian countries, Singapore is probably the leader in AI due to its National AI Strategy 2.0, which is a comprehensive plan on digital transformation with the remit of contributing to AI breakthroughs and products that are projected to be valuable globally. In developing countries such as the Philippines, at present AI has yet to be integrated broadly into health services per se, and has found its place more as a tool in medical (and general scientific) research (although, to a degree in public health). In the field of nutrition, my own area of subspeciality interest, there is even sparser use still of AI. However, one of the AI-driven projects related to nutrition in the Philippines is the Artificial Intelligence Nutrition Assistant (AINA) spearheaded by the Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI). This AI driven project aimed to develop an automated food recognition and dietary assessment mobile application which will enable researchers, nutrition and public health professionals, food production professionals, and other stakeholders to monitor dietary intake and quality.(3). A study published by Javier and colleagues in 2024 illustrated the usefulness of the digitalization of food component forms of the National Nutrition Survey (NNS) and a fully digital dietary survey collection system. This involved the compilation of a mobile household dietary survey data collection system with an AI-based food recognition tool (4). Another recent example leveraging AI in the area of diet and nutrition is an ongoing joint research project between the Philippines and Taiwan that is due to be completed in 2027. This fascinating project aims to develop an AI model that will cross-reference personal health record data of individuals with chronic diseases with another database containing information on local diet (availability and preferences), with a view to generating a precise analysis and tailored meal plan for the client/patient. Results of this study will help create a mobile application which can be accessed by patients and healthcare practitioners alike, facilitating the ongoing monitoring of nutritional intake by patients over time, and allowing for the provision of further recommendations (5). Somewhat tangentially, but still addressing the issue of nutrition in the developing Southeast Asian region, this time on a population-level, is an initiative of a non-profit organization operating in the Philippines. In terms of food security, since rice is considered a staple food in the country, the International Rice Research Institute (IRRI) – an international agricultural research and training organization located in the Philippines – has been attempting to harness AI to improve the production of rice in the country since 2023. Through the integration of AI-based analyses, they have been able to advise on a number of areas of optimization for farmers, such as directing the efficient application of fertilizer through Site-Specific Nutrient Management (SSNM) principles, for instance. Additionally, technology more broadly is being increasingly applied in the agriculture sector in the Philippines, such as through the equipping of drones capable of precision agriculture in crop establishment. Such initiatives have undoubtedly led to an improvement in food (and nutrition) security locally, as well as globally (6). Although AI has arrived in the Philippines, it is somewhat in its infancy. Its (responsible) use in the field of nutrition, gastroenterology, and medicine overall, and specifically in the clinical/hospital setting, wherein doctors, allied healthcare professionals and patients, stand to gain the most significant benefit, warrants careful expansion going forward. References Kumar A, Gananandan K, Robinson G, et al Limitations in real-world telemonitoring applicability in gastroenterology and hepatology: a systematic review Frontline Gastroenterology 2026;17:19-29. Cloutier A, Bond A, Taylor MI, et al Successful implementation of remote video consultations for patients receiving home parenteral nutrition in a national UK Centre Frontline Gastroenterology 2020;11:280-284. Accessed from: https://www.pchrd.dost.gov.ph/heartnovation/aina-artificial-intelligence-nutritionassistant Javier et al.: Development of Mobile Dietary Data Collection System. Philippine Journal of Science Vol. 153 No. 5, October 2024 Accessed from: https://registry.healthresearch.ph/index.php/registry?view=research&layout=details&cid=8651 Accessed from: https://www.irri.org/news-and-events/news/irri-leveraging-ai-secure-food-and-nutrition-security-current-and-future (Visited 259 times, 1 visits today) Source link
Learning to Savor the Small Moments
By Kari McBride I remember my daughter’s first steps like they were yesterday. After 18 months of appointments, hospital stays, and therapy sessions, those little feet finally took off. Watching her swagger and sway down the hall, I was filled with overwhelming joy and excitement. It was a moment I knew I wanted to hold onto forever. People often say, “Savor this moment; it won’t happen again.” At the time, I was pretty sure I understood what this meant. My daughter is a teenager now. Recently, she insisted that we needed a bird feeder to feed all the birds in the neighborhood. After some back-and-forth negotiating, I gave in. We now have bird feeders in both the front yard and the backyard. I was convinced this would become just another chore on my already long to-do list. But instead, it has become something else entirely. There is something almost soothing about watching the birds come and go. A dove lands on the grass. A mockingbird hops along the edge. Each bird has its own little personality. And for a few quiet moments, I find myself standing still. Watching. Breathing. Noticing. In those instants, the pain and uncertainty that usually fill my days start to loosen their grip. These moments don’t last long. The birds fly away. Reality draws me back inward. And while the pain may not go away, this brief reprieve gives me something to hold onto. In a life that is now shaped by chronic pain, both my daughter’s and mine, these are the small experiences I’m learning to savor. They won’t all be as big as my daughter’s first steps. After all, there is only one “first.” But I am starting to notice the smaller moments now. The ones that pass quickly—unless I choose to stop and see them. Maybe this is what it means to savor a moment. —by Kari McBride Source link
