April 22, 2018, 1:21 am
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1 Philippine Peso = 0.07053 UAE Dirham
1 Philippine Peso = 1.99923 Albanian Lek
1 Philippine Peso = 0.03418 Neth Antilles Guilder
1 Philippine Peso = 0.38677 Argentine Peso
1 Philippine Peso = 0.02467 Australian Dollar
1 Philippine Peso = 0.03418 Aruba Florin
1 Philippine Peso = 0.03841 Barbados Dollar
1 Philippine Peso = 1.59228 Bangladesh Taka
1 Philippine Peso = 0.03034 Bulgarian Lev
1 Philippine Peso = 0.00724 Bahraini Dinar
1 Philippine Peso = 33.62742 Burundi Franc
1 Philippine Peso = 0.0192 Bermuda Dollar
1 Philippine Peso = 0.02503 Brunei Dollar
1 Philippine Peso = 0.13175 Bolivian Boliviano
1 Philippine Peso = 0.06526 Brazilian Real
1 Philippine Peso = 0.0192 Bahamian Dollar
1 Philippine Peso = 1.26032 Bhutan Ngultrum
1 Philippine Peso = 0.18403 Botswana Pula
1 Philippine Peso = 384.48243 Belarus Ruble
1 Philippine Peso = 0.03837 Belize Dollar
1 Philippine Peso = 0.02421 Canadian Dollar
1 Philippine Peso = 0.01858 Swiss Franc
1 Philippine Peso = 11.41406 Chilean Peso
1 Philippine Peso = 0.12052 Chinese Yuan
1 Philippine Peso = 52.12791 Colombian Peso
1 Philippine Peso = 10.7778 Costa Rica Colon
1 Philippine Peso = 0.0192 Cuban Peso
1 Philippine Peso = 1.71039 Cape Verde Escudo
1 Philippine Peso = 0.39282 Czech Koruna
1 Philippine Peso = 3.39601 Djibouti Franc
1 Philippine Peso = 0.11551 Danish Krone
1 Philippine Peso = 0.94891 Dominican Peso
1 Philippine Peso = 2.1798 Algerian Dinar
1 Philippine Peso = 0.24262 Estonian Kroon
1 Philippine Peso = 0.33916 Egyptian Pound
1 Philippine Peso = 0.52276 Ethiopian Birr
1 Philippine Peso = 0.01551 Euro
1 Philippine Peso = 0.03865 Fiji Dollar
1 Philippine Peso = 0.01348 Falkland Islands Pound
1 Philippine Peso = 0.01349 British Pound
1 Philippine Peso = 0.08525 Ghanaian Cedi
1 Philippine Peso = 0.89975 Gambian Dalasi
1 Philippine Peso = 172.80584 Guinea Franc
1 Philippine Peso = 0.14089 Guatemala Quetzal
1 Philippine Peso = 3.95007 Guyana Dollar
1 Philippine Peso = 0.15072 Hong Kong Dollar
1 Philippine Peso = 0.45249 Honduras Lempira
1 Philippine Peso = 0.11491 Croatian Kuna
1 Philippine Peso = 1.24505 Haiti Gourde
1 Philippine Peso = 4.8093 Hungarian Forint
1 Philippine Peso = 264.60534 Indonesian Rupiah
1 Philippine Peso = 0.06739 Israeli Shekel
1 Philippine Peso = 1.26727 Indian Rupee
1 Philippine Peso = 22.73862 Iraqi Dinar
1 Philippine Peso = 806.60649 Iran Rial
1 Philippine Peso = 1.91031 Iceland Krona
1 Philippine Peso = 2.37565 Jamaican Dollar
1 Philippine Peso = 0.01361 Jordanian Dinar
1 Philippine Peso = 2.06171 Japanese Yen
1 Philippine Peso = 1.92145 Kenyan Shilling
1 Philippine Peso = 1.32194 Kyrgyzstan Som
1 Philippine Peso = 76.97331 Cambodia Riel
1 Philippine Peso = 7.61206 Comoros Franc
1 Philippine Peso = 17.28442 North Korean Won
1 Philippine Peso = 20.40042 Korean Won
1 Philippine Peso = 0.00575 Kuwaiti Dinar
1 Philippine Peso = 0.01575 Cayman Islands Dollar
1 Philippine Peso = 6.25043 Kazakhstan Tenge
1 Philippine Peso = 158.93989 Lao Kip
1 Philippine Peso = 28.9034 Lebanese Pound
1 Philippine Peso = 2.99693 Sri Lanka Rupee
1 Philippine Peso = 2.50451 Liberian Dollar
1 Philippine Peso = 0.22892 Lesotho Loti
1 Philippine Peso = 0.05855 Lithuanian Lita
1 Philippine Peso = 0.01192 Latvian Lat
1 Philippine Peso = 0.02543 Libyan Dinar
1 Philippine Peso = 0.17577 Moroccan Dirham
1 Philippine Peso = 0.31452 Moldovan Leu
1 Philippine Peso = 0.94968 Macedonian Denar
1 Philippine Peso = 25.52333 Myanmar Kyat
1 Philippine Peso = 45.86134 Mongolian Tugrik
1 Philippine Peso = 0.15521 Macau Pataca
1 Philippine Peso = 6.76013 Mauritania Ougulya
1 Philippine Peso = 0.64144 Mauritius Rupee
1 Philippine Peso = 0.29902 Maldives Rufiyaa
1 Philippine Peso = 13.70175 Malawi Kwacha
1 Philippine Peso = 0.35007 Mexican Peso
1 Philippine Peso = 0.07459 Malaysian Ringgit
1 Philippine Peso = 0.22915 Namibian Dollar
1 Philippine Peso = 6.87536 Nigerian Naira
1 Philippine Peso = 0.59554 Nicaragua Cordoba
1 Philippine Peso = 0.14884 Norwegian Krone
1 Philippine Peso = 2.01652 Nepalese Rupee
1 Philippine Peso = 0.02629 New Zealand Dollar
1 Philippine Peso = 0.00739 Omani Rial
1 Philippine Peso = 0.0192 Panama Balboa
1 Philippine Peso = 0.06176 Peruvian Nuevo Sol
1 Philippine Peso = 0.06241 Papua New Guinea Kina
1 Philippine Peso = 1 Philippine Peso
1 Philippine Peso = 2.21836 Pakistani Rupee
1 Philippine Peso = 0.06459 Polish Zloty
1 Philippine Peso = 106.04187 Paraguayan Guarani
1 Philippine Peso = 0.0699 Qatar Rial
1 Philippine Peso = 0.07223 Romanian New Leu
1 Philippine Peso = 1.16816 Russian Rouble
1 Philippine Peso = 16.22066 Rwanda Franc
1 Philippine Peso = 0.07202 Saudi Arabian Riyal
1 Philippine Peso = 0.14768 Solomon Islands Dollar
1 Philippine Peso = 0.25792 Seychelles Rupee
1 Philippine Peso = 0.34667 Sudanese Pound
1 Philippine Peso = 0.161 Swedish Krona
1 Philippine Peso = 0.02513 Singapore Dollar
1 Philippine Peso = 0.01349 St Helena Pound
1 Philippine Peso = 0.42646 Slovak Koruna
1 Philippine Peso = 146.53351 Sierra Leone Leone
1 Philippine Peso = 10.79316 Somali Shilling
1 Philippine Peso = 380.06338 Sao Tome Dobra
1 Philippine Peso = 0.16804 El Salvador Colon
1 Philippine Peso = 9.89015 Syrian Pound
1 Philippine Peso = 0.22917 Swaziland Lilageni
1 Philippine Peso = 0.599 Thai Baht
1 Philippine Peso = 0.04602 Tunisian Dinar
1 Philippine Peso = 0.04292 Tongan paʻanga
1 Philippine Peso = 0.07736 Turkish Lira
1 Philippine Peso = 0.12961 Trinidad Tobago Dollar
1 Philippine Peso = 0.56365 Taiwan Dollar
1 Philippine Peso = 43.7488 Tanzanian Shilling
1 Philippine Peso = 0.50259 Ukraine Hryvnia
1 Philippine Peso = 70.84694 Ugandan Shilling
1 Philippine Peso = 0.0192 United States Dollar
1 Philippine Peso = 0.54158 Uruguayan New Peso
1 Philippine Peso = 154.65719 Uzbekistan Sum
1 Philippine Peso = 1139.831 Venezuelan Bolivar
1 Philippine Peso = 437.43038 Vietnam Dong
1 Philippine Peso = 2.00538 Vanuatu Vatu
1 Philippine Peso = 0.04922 Samoa Tala
1 Philippine Peso = 10.16881 CFA Franc (BEAC)
1 Philippine Peso = 0.05185 East Caribbean Dollar
1 Philippine Peso = 10.16881 CFA Franc (BCEAO)
1 Philippine Peso = 1.83983 Pacific Franc
1 Philippine Peso = 4.79931 Yemen Riyal
1 Philippine Peso = 0.2292 South African Rand
1 Philippine Peso = 99.66391 Zambian Kwacha
1 Philippine Peso = 6.95026 Zimbabwe dollar

Generalized pains

OF the 7.8 billion people on earth as of March 2018, more than 300 million individuals suffer daily from aches and pains all over their body. In the past, these otherwise healthy individuals were suspected to be psychotic or malingering, until 1981 when this condition was discovered and confirmed as a disease entity called Fibromyalgia.

When I was a pre-med student, a teenager cousin of mine had pains all over her body, which, today, would be obvious as due to fibromyalgia, and yet in the mid 1950s, it was an unknown entity, with no medications for it, except ineffective pain pills.

Everyone thought she was malingering or had a psychosomatic ailment. 

What is fibromyalgia?
Fibromyalgia is a disorder that causes achy muscle aches and pain, tenderness, spasm, and stiffness of the muscle, areas of the tendons and ligaments, chronic fatigue. These tender points are common around the neck and shoulders, in the front of the knees, elbow, hip joints, chest, low back, thighs and calf (lower leg) muscles. There is an exaggerated nerve excitation and sensitivity all over the body. All symptoms are magnified. There are 10 million people in the United States, and 3-6 percent of the global population, have fibromyalgia, 75 to 90 percent of them females.

When was this condition first diagnosed?
The signs and symptom complex of what is today known as fibromyalgia was first described in the 1800s. It was thought then that this could me a mental illness. The first report of the tender spots all over the body was by a Scottish physician in 1820. It was called fibrositis. The first recognition of fibromyalgia as a disease entity was in 1976, but it was in only 1981 when it was scientifically confirmed and the first diagnosis of fibromyalgia was made.

What is Primary Fibromyalgia Syndrome?
Abbreviated as PFS, the typical pattern of this condition is generalized, idiopathic (of unknown cause) fibromyalgia accompanied by anxiety, fatigue, impaired sleep and irritable bowels, with no evidence of underlying diseases contributing to the symptom complex, among 5 percent of the population in the US. PFS afflicts healthy young or middle-aged women who are anxious, stressed, tense, depressed. Children and adolescents (usually females) and older adults who have PFS may also have osteoarthritis of the spine. Men usually have localized fibromyalgia which is related to recreational or occupational strain.

What causes fibromyalgia?
This is a challenging illness, not only for the patient but for the diagnostic prowess of the physician. In some cases, making a definite diagnosis is a dilemma, since the cause is unclear. There are various conditions that have been found to contribute to the causation of fibromyalgia, either alone or in combination, depending on the individual’s genetic make-up or predisposition. Among them are: a stress and trauma, as in a vehicle accident; rheumatoid arthritis, or autoimmune diseases, central nervous system problems, and genetics (MTHFR mutation). In some cases, no risk factors are found, the cause never confirmed, and only tentative diagnosis is made from clinical evidence, and the patient is treated empirically.

What are the symptoms?
The onset of the muscle pain, tender spots all over the body and stiffness is gradual and diffuse. The pain may be a deep ache or burning, is worsened by straining and overuse, and may be constant but varies in severity in response to weather changes, stress and activity. The pain may move around the body. There may be spasms or muscle tightening. Most sufferers feel fatigued or out of energy, have problem sleeping and a few may have diarrhea/constipation, difficulty swallowing, gas, heartburns and abdominal cramps. There may be sensation of tingling or numbness in various parts of the body. Many patients have super sensitivity to odor, loud noise, bright lights, or even to medicines. Headache and pains in the jaws may also be present. Sometimes, they have dry eyes or problem focusing on objects that are near, imbalance or dizziness. Others may have palpitation or shortness of breath. Women with fibromyalgia may have urinary complaints, pelvic pains, painful menstrual periods, or even painful sexual intercourse. No permanent damage to any organ in the body results from fibromyalgia. The condition, while chronic and causing many bothersome symptoms, is not life-threatening either.

Does exercise aggravate fibromyalgia?
No. As a matter of fact, exercise is one of the best therapies for fibromyalgia. Starting with gentle, low-impact, stretching exercises, like walking, bicycling, and aerobics, this physical regimen should be performed daily and gradually increased. At first, there will be muscle soreness, as could be expected, but the exercise becomes more comfortable as days go.

What is the treatment for fibromyalgia?
The comprehensive management of fibromyalgia includes ruling out or treating diseases causing the symptoms, reassurance from the attending physician that the condition is benign and not hopeless, stretching and aerobic exercises (brisk walking, yoga, swimming, tai bo), local application of heat and gentle massage, improvement in sleep, low-dose tricyclic antidepressant drugs. If drowsiness is encountered with one drug, an alternative drug may be used. 

The 3 drugs the US-FDA has approved to help treat fibromyalgia are: Pregabalin (Lyrica) was first used to treat seizures and nerve pain linked to diabetes; Duloxetine hydrochloride (Cymbalta) is an antidepressant that’s also been used to treat diabetic nerve pain; and, Milnacipran (Savella), the first drug designed specifically for fibromyalgia treatment. It affects brain chemicals linked to pain. Some of the drugs may also aggravate the insomnia. Aspirin and NSAIDS (non-steroidal anti-inflammatory drugs), even opioids, have generally not been found to be of any help. For severe persistent tenderness, local injection with 1% lidocaine (alone or in combination with hydrocortisone) has been effective. Depression, serious emotional problem, as a result of fibromyalgia may require behavioral modification, group support therapy and/or professional guidance.

What is the prognosis?
Functional prognosis is usually very good with aggressive and comprehensive treatment. Fundamental in the success of therapy are family reassurance, support from friends, patient-motivation, involvement and discipline. Armed with these three, the person with fibromyalgia is soon on her way to a more comfortable, happier, more productive and a fulfilling life.

***

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