Rationale. COVID-19 pandemic disease, can be transmitted during gastrointestinal procedures, via aerosolized droplets, and via fecal shedding. Both international and local endoscopy societies have issued strategies to alleviate the risk to endoscopy personnel. However, several barriers against the implementation of these recommendations exist thus individual center’s policies are employed whenever applicable. Objectives. This narrative study aims to describe the current experience and set-up in the endoscopy unit of a COVID referral center, discuss the stratification of patients for endoscopy, the operational management of the personnel and endoscopy unit in line with the adapted local and international guidelines and offer endoscopists a quick reference guide to adapt endoscopy practice during the pandemic in a resource-limited setting. Methodology. This paper reviews and consolidates current endoscopy guidelines and describes the single-center experience of Philippine General Hospital. Results. In resource-limited settings, with uncertainties of prolonged COVID-19 impact to healthcare, modification of practice, adherence to strategies and recommendations, empowerment of workforce, establishing the sustainability of resources, training, and service to patients, are essential components to combat current dilemma brought about by this pandemic. Conclusion. Integration of current local and international guidelines encompass all aspects of endoscopy practice during the pandemic. The recommendations cited are aimed to guide other resource-limited endoscopy units for potential changes and guidance in the overall practice.
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The Covid pandemic nearly brought our lives into a different dimension beyond our imagination. Measures to ensure the safety of everyone have never been stricter. The education system had to deal with similar restrictions. Everyone shifted to online virtual classes, which has never been easy to both the teachers and students. Not only are we concerned of our responsibilities as educators but responsive to the needs of students and patients as well during these times of uncertainties. This article briefly describes my personal insight on teaching medicine and how patients continue to take part in the learning process of students despite restrictions.

Introduction: Cancer patients are more susceptible to coronavirus disease-19 (COVID-19) infection because they are immunosuppressed by their disease or therapy, most of them have coexisting medical conditions, and they frequently visit hospitals for treatment and surveillance. Objective: The objective of this study was to determine the prevalence of COVID-19 infection among gynecologic oncology patients receiving treatment in a COVID-19 referral hospital. Materials and Methods: A descriptive, cross-sectional study involving 47 gynecologic cancer patients receiving treatment from June 2020 to December 2020 was performed. All patients underwent SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) swab test and symptom and exposure assessment before the start of cancer treatment. Patients with negative SARS-CoV-2 RT-PCR swab test results received their planned treatment, and a repeat swab test and triage assessment were done midtreatment and after treatment. Results: Five (10.6%) patients had positive baseline SARS-CoV-2 RT-PCR swab results, but all proceeded with treatment after negative results were obtained. Only 1 (2.13%) patient had a positive SARS-CoV-2 RT-PCR swab test result at midtreatment. All patients had no COVID-19-associated symptoms and none of them tested positive for COVID-19 infection posttreatment. Conclusion The prevalence of COVID-19 infection among gynecologic cancer patients receiving cancer treatment is 2.13%. All patients who had positive SARS-CoV-2 RT-PCR swab test results at baseline or midtreatment were able to continue and complete treatment. There were no severe clinical events or mortalities among those affected with COVID-19 infection.
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The COVID-19 pandemic created the urgent need to use online and virtual platforms to facilitate development of skills and competencies as part of remote learning of students. MyDispense®, a learning management system developed by Monash University in Australia, is a practice-based online tool utilized by the University of the Philippines College of Pharmacy to teach dispensing skills in Dispensing and Incompatibilities courses (Phar 154 and Pharm 133). This commentary describes how MyDispense® was used as an online retail pharmacy simulation through the SEIPS (Systems Engineering Initiative for Patient Safety) model, with discussion on how the person, tasks, organization, tools and technology, and virtual environment work within the teaching and learning process in dispensing. The application of MyDispense® as a learning platform both in remote and traditional teaching can be further explored to maximize its features and utility.
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Early into the pandemic, medical attention centered on the immediate need for intensive medical care of patients diagnosed to have coronavirus 2019 (COVID-19). As more data emerged on the best medical care possible, attention was also given to the complications and long-term sequelae of COVID-19.
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Background: The COVID-19 pandemic has immobilized and impaired the operation of hospitals, clinics, and other health-care facilities leaving a plethora of patients and persons-at-risk in a more precarious position. Cancer patients were vulnerable to infections and complications due to the nature of the malignancy. Their caregivers were likewise predisposed to infection while taking care of them. This paper focused on determining the concerns of both gestational trophoblastic neoplasia (GTN) patients and their caregivers and identified possible factors of improvement in the delivery of essential cancer care. Objective: The objective of the study was to describe the different concerns of GTN patients and their caregivers during chemotherapy and other adjunctive treatments during the COVID-19 pandemic in a Tertiary Government Hospital. Materials and methods: A qualitative type of research was employed in this research, for which an in-depth interview was used. A total of 12 respondents, 6 patients and 6 caregivers, were interviewed using a semi-structured pretested questionnaire. Results: Findings showed that infection with COVID-19, financial and logistical constraints exacerbated by the pandemic were the main concerns of both patients and caregivers. Other concerns recorded include change in their attending physician, survivability of the patient, and the availability of caregivers. Conclusions Despite the recorded apprehensions from the patients and caregivers, there was a general satisfaction in the delivery of health care at the Division of Trophoblastic Diseases due to the clarity in the follow-up and treatment schedules which have been optimized through the revised guidelines and protocols set by the division to adapt to the COVID-19 pandemic.
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Objective: This study aimed to describe the clinical profile and treatment outcomes of patients treated with a short course (<10 fractions) of palliative radiotherapy during the first year of the COVID-19 pandemic. Another aim of the study is to compare patients treated with short-course and long-course palliative radiotherapy in terms of the site and volume irradiated. Methods: An ambispective study comprised 23 patients treated with short-course palliative radiotherapy from March 2020 to February 2021. The retrospective aspect of this study included a review of medical records and radiotherapy plans, while the prospective part involved communication with patients or legally authorized representatives via phone call. Demographic, clinical, and treatment-related information were gathered. Results: Of 92 patients receiving palliative radiotherapy, 23 were treated with a short course, while 69 were planned for at least ten fractions. Of the 23 patients receiving short-course radiotherapy, most had colorectal (35%) and head and neck (26%) primary malignancies. The most commonly treated sites were the pelvis (24%), vertebral bones (21%), and head and neck masses (21%), and the most common indications were pain (45%) and bleeding (32%). The majority were treated with 20 Gy in 5 fractions (42%) and 25 Gy in 5 fractions (38%). Complete resolution of symptoms was observed in 43% of cases, and more than half reported no side effects (58%). Median survival was 71 days. All patients treated in the lung, stomach, and brain underwent a long course of palliative radiotherapy. Patients with a long course also had higher mean irradiated volumes (1871 cm3 vs. 2150 cm3). Conclusion In this single institution review, a short course of palliative radiotherapy was proven to provide good symptom control with few side effects. During the COVID-19 pandemic, its use should be strongly considered, especially in patients with poor performance status, transportation difficulties, and limited life expectancy.
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OBJECTIVES: Healthcare workers are at the center of the pandemic, dealing with cases while being at risk of acquiring the infection themselves, causing work-related stress. Despite this, they continue reporting for duty. This paper aims to determine the factors that affect resilience of pediatric healthcare-workers in close contact with patients suspected with COVID infection and its association to sleeping disturbance during the first two years of COVID – 19 pandemic in a tertiary hospital in the Philippines. METHODOLOGY: This is a cross-sectional study. Healthcare-workers who render bedside patient care for those suspected or with COVID-19 infection, not diagnosed with any mental health illness, and fit the inclusion criteria were chosen through purposive sampling and asked to answer questionnaires with demographic survey, BRS and PSQI tool. RESULTS: Among 89 participants, females were predominant (60.67% ). Majority were in the 30- 39 age group (44.94%) and are nurses (40.45%) or doctors (39.33%) who were single (76.40%). Many have normal resilience as measured from their BRS scores with an average PSQI per category equal to or exceeded 5.00. The correlation coefficient was at -0.338 (p-value 0.001) between the BRS and PSQI scores, indicating that a significant negative correlation exists between the two scores. CONCLUSION Normal resilience was reported in the majority of the healthcare workers. All study participants had poor sleep quality as determined in the overall average PSQI score. A negative correlation between resilience and sleep quality was observed, denoting that poor sleep quality can be associated with lower resilience, and vice versa. However, temporality cannot be assumed with this study.
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Background: Telemedicine has proven essential during COVID-19. However, concerns remain about the rural municipalities in the country such as those from the Cordillera Administrative Region (CAR), wherein perceived barriers by Municipal Health Officers (MHOs) include poor internet connectivity and inadequacy of the current telemedicine service. Objective: This study aimed to assess the extent of Telemedicine use and perspectives in terms of perception, attitudes and perceived barriers among MHOs in CAR during COVID-19. Methods: This is an analytical cross-sectional study that used a validated online questionnaire to 62 MHOs and DTTBs in CAR. Logistic regression analysis was employed to determine the effect of sociodemographic factors and physician perceptions and attitudes on the extent of Telemedicine use. Results: Most MHOs use Telemedicine frequently in their practice for 0-1 year during COVID-19. There is no significant effect of sociodemographic factors to the extent of Telemedicine use except for IT expertise which had a negative influence on the extent of use [prevalence (p=0.011), frequency (p=0.013), length of use (p=0.044)]. Generally, MHOs agree that telemedicine is beneficial for them in performing consults with a positive effect on frequency (p=0.004) and length of use (p=0.009). There is positive attitude towards telemedicine, however, with no significant effect on extent of use (p=0.352, p=1.00, p=0.484). Compromised decision-making and network issues are the most prevalent perceived barriers that limit MHOs to practice Telemedicine. Conclusion and Recommendation This study showed that during COVID-19, there is good utilization of Telemedicine among MHOs in CAR. MHOs perceive Telemedicine as beneficial in their work and positive attitude remains. However, presence of barriers makes them apprehensive to fully incorporate it in their practice. Study results can contribute to policy-making on telemedicine as it is a key player in e- health to improve access to healthcare services in the attainment of the goal of Universal Healthcare.
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The question, “what does life mean?" used to be considered as a paradigm of philosophical investigation. As a researcher, life is meaningless without paradigm and perspective. These are indispensable in peoples' lives as we encounter research in our daily lives. According to James Tartaglia (Veal, 2017), when properly defined, the topic of life's purpose is "the keystone of philosophy," serving to "lock its traditional preoccupations in place" and "allow them to bear weight in an intellectual culture dominated by science." He also contends that we should consider this idea as he rejects the premise of the question and draw the conclusion that "life is meaningless." More precisely, James Tartaglia is one philosopher who is not at all happy about it; in fact, he appears to be absolutely furious about it, as readers who have read this journal's recent symposium on Thaddeus Metz's book Meaning in Life: An Analytic Study would be aware. What enrages Tartaglia the most, it seems, is that the "traditional" topic of life's meaning has been completely disregarded by what he refers to as the "new paradigm" in analytic philosophy, which is purportedly devoted to exploring this question. He further states that the conventional question of life's purpose is not only the only genuine, legitimately philosophical inquiry of life's meaning, but it is also the most important one.
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