1.Clinical outcomes of patients treated with short-course palliative radiotherapy in the frirst year of the COVID-19 pandemic: A single institution experience
Kurl E. Jamora ; Nonette A. Cupino
Acta Medica Philippina 2020;54(Online):1-8
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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2.Resilience among pediatric healthcare workers during the COVID-19 pandemic in a tertiary hospital.
Maria Yasmin Soriano Kalaw ; Soraya A. Alvarado
The Philippine Children’s Medical Center Journal 2023;19(1):36-46
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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3.Telemedicine use and perspectives of municipal health officers in the Cordillera Administrative Region during the COVID-19 pandemic
Stephanie Joy B. Abnasan-Diong-an, MD ; Joseph L. Alunes, MD, FPAFP ; Faith M. Garcia, MD, FPAFP ; Haydee D. Danganan, MD, FPAFP
The Filipino Family Physician 2023;61(1):70-76
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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4.The COVID-19 pandemic impact on gross income and utilization of radiologic services in a Philippine COVID-19 public tertiary referral hospital
Christine Susean Sagpao ; Nonette Cupino ; Paulo Maria Pagkatipunan
Philippine Journal of Health Research and Development 2021;25(2):55-63
Background:
The global economy has been severely affected by the COVID-19 pandemic which proved to be more than a public health crisis. Volume and gross income have also declined in the health service sector including the diagnostic imaging and radiotherapy divisions of the radiology departments in other countries.
Objective:
This study determined the change in volume and gross income of the Radiology Department of a tertiary hospital which was designated as a COVID-19 referral center in the Philippines.
Methodology:
Monthly records of the profit centers of the Radiology Department were reviewed noting the volume and gross income one year before and during the first year of the pandemic.
Results:
Records were successfully retrieved for the volume of procedures and revenue for each profit center from one year before the pandemic (from March 1, 2019 to February 28, 2020) and the first year of the pandemic (from March 1, 2020 to February 28, 2021). There was a total reduction of 120,046 procedures conducted and Php 84,837,614.16 in revenues generated between the two periods. This is equivalent to a 61.98% (range: 47.92% to 83.37%) decrease in the volume of procedures and a 45.02% (range: 31.08% to 77.86%) decrease in revenue. These changes were found to be statistically significant.
Conclusion
The COVID-19 pandemic caused a decline of all profit centers in the Radiology Department. The decline was associated with changes in quarantine restrictions. Data from this study may help the administration of the institution or other institutions to conduct their own studies and cope with future pandemics of similar magnitude or further surges of the current pandemic on decisions regarding budget and resource allocation.
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5.What are the treatment regimens commonly used for the different levels of severity of COVID-19 in the Philippines?
Christine May Perandos-Astudillo
Southern Philippines Medical Center Journal of Health Care Services 2022;8(1):1-
The Philippine COVID-19 Living Clinical Practice Guidelines (CPG) is a set of guidelines that provides up-to-date evidence-based recommendations on COVID-19 treatment, diagnosis, infection prevention and control. This living guideline follows the Department of Health’s Manual for Clinical Practice Guideline Development1 and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Approach.2
The diagram below is a summary of the treatment regimens gathered from the Philippine COVID-19 Living Recommendations website. The recommendation for each drug regimen is based on the assessment and literature review done by the Living CPG Task Force (LCTF).3 The LCTF follows the classification of quality of evidence enumerated and described in Box 1.
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6.COVID-19 vaccine roll-out in Davao City
Rodel C. Roñ ; o ; Clarence Xlasi D Ladrero
Southern Philippines Medical Center Journal of Health Care Services 2021;7(2):1-3
The Republic Act No. 11494, also known as the "Bayanihan to Recover as One Act," mandates the allocation of funds and provides guidance for the procurement of COVID-19 vaccines.1
However, with the limited availability of COVID-19 vaccines, the Department of Health (DOH) established different policies and guidelines for the selection, access, and deployment of these vaccines throughout the country.2 3 4 5 To date, the Philippine Food and Drugs Authority (FDA) has granted emergency use authorizations for eight COVID-19 vaccines, namely: Pfizer-BioNTech COVID-19 Vaccine, COVID-19 Vaccine AstraZeneca, CoronaVac, Sputnik V, Janssen COVID-19 Vaccine, Covaxin, COVID-19 Vaccine Moderna, and COVID-19 Vaccine BIBP/Sinopharm.6
One of the guidelines established by the DOH is the implementation of a prioritization scheme, wherein citizens are categorized into different prioritization groups based on risk of exposure to the virus and risk of mortality from COVID-19.4
In Davao City, the COVID-19 vaccination roll out started last 5 March 2021 among health care workers at Southern Philippines Medical Center. 7 Aiming to vaccinate 1,200,000 individuals in Davao City,8 the City Government of Davao, DOH Davao Region, and other participating sectors established 59 vaccination sites throughout the city.9
We gathered online data posted in the official facebook pages of DOH Davao Region and the City Government of Davao.
According to the DOH Davao Region reports, as of 27 July 2021, a total of 742,710 doses of COVID-19 vaccines were allotted for Davao City. From the total allotted doses, the City Government of Davao City has successfully administered a total of 330,954 first doses, and 149,122 second doses of COVID-19 vaccines.10 According to the City Government of Davao, as of 25 July 2021, Davao City has administered a total of 85,260 doses (1st dose - 47,332 doses, 2nd dose - 37,928 doses) of COVID-19 vaccine among individuals in the A1 prioritization group, 103,837 doses (1st dose - 76,472 doses, 2nd dose - 27,365 doses) among those in the A2 prioritization group, 179,479 (1st dose - 101,833 doses, 2nd dose - 77,646 doses) among those in the A3 prioritization group, 98,502 doses (1st dose - 97,446 doses, 2nd dose - 1,056 doses) among those in the A4 prioritization group, and 12,998 doses (1st dose - 7,871 doses, 2nd dose - 5,127 doses) among those in the A5 prioritization group.11
All in all, as of 27 July 2021, 149,122 individuals out of Davao City's target of 1,200,000 individuals (12.43%) have received complete COVID-19 vaccination. In addition, 181,832 individuals have already received the first dose of a two-dose COVID-19 vaccine.8
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7.COVID-19 vaccination roll out among Southern Philippines Medical Center health care workers
Southern Philippines Medical Center Journal of Health Care Services 2021;7(2):1-2
As the biggest COVID-19 facility in Mindanao, Davao City’s Southern Philippines Medical Center (SPMC) rolled out its first doses of COVID-19 vaccines to some of its frontline health care workers (HCW) last March 5, 2021.
The COVID-19 vaccination program in the Philippines is an extensive and comprehensive immunization campaign to help curb the spread of SARS-CoV-2 and protect the people against severe COVID-19. To expedite the vaccine procurement and administration process, the Republic Act 11525 or the “COVID-19 Vaccination Program Act of 2021” was enacted into law on February 26, 2021.1 The Department of Health (DOH) and the National Task Force against COVID-19 (NTF), in partnership with local governments, have been tasked to implement, facilitate, and monitor the COVID-19 vaccination program.2
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8.Modified health care services of SPMC as a designated COVID-19 facility
Christine May Perandos-Astudillo
Southern Philippines Medical Center Journal of Health Care Services 2020;6(1):1-3
In the Philippines, the coronavirus disease 2019 (COVID-19) pandemic has accorded a tremendous challenge to health care in terms of protecting frontline staff from contracting the virus and providing optimal medical management to patients with or without COVID-19. Across the globe, even countries with well-developed healthcare systems are battling COVID-19 with great difficulty.
In terms of local response, on March 15, 2020, Davao City was placed under community quarantine1 to limit the movement of people and curb the spread of SARS-CoV-2, the virus that causes COVID-19. Further restrictions on work, businesses, transportation, and other daily activities were imposed during an enhanced community quarantine (ECQ) from April 4, 2020 to May 15, 2020,2 3 4 5 followed by a 15-day general community quarantine (GCQ).6 7 Patients from Davao City who are suspected of having COVID-19 began to be referred to the Southern Philippines Medical Center (SPMC) starting in early March 2020. The SPMC Laboratory Unit also started processing reverse transcription polymerase chain reaction (RT-PCR) tests for the diagnosis of COVID-19 as a subnational laboratory late in March. Being the only subnational laboratory in the southern Philippines during the first few weeks of community quarantine, SPMC processed most of Mindanao's COVID-19 RT-PCR tests.
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9.COVID-19 research agenda for health care services
Southern Philippines Medical Center Journal of Health Care Services 2020;6(2):1-3
Due to the long quarantine, with several levels of intensity and degrees of implementation, we all have, more or less, similar experiences with the COVID-19 pandemic. Starting early this year, we stayed home for a long time, we had ourselves tested, our friends or relatives had themselves tested, and some of us may even have tested positive for the infection. We listened to, or read, or watched the news, about the statistics of COVID-19 morbidity and mortality, lockdowns, reopenings, resurgence and reinfections. And then, we received all sorts of information—true, fake, inaccurate, anecdotal—and some were derived from systematically produced knowledge, i.e., properly conducted research or ongoing research.
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10.Bus services for Southern Philippines Medical Center’s frontline healthcare workers during the COVID-19 quarantine
Southern Philippines Medical Center Journal of Health Care Services 2020;6(2):1-2
The COVID-19 pandemic has been having a negative impact on the availability of our public transportation. As the national government imposed enhanced community quarantines (March 16, 2020 in Luzon and April 24, 2020 in Visayas and Mindanao) and subsequent modifications of quarantine measures, the operation of public transportations had to be halted, and then modified to partial availability. Because of these drastic changes, it has been difficult for health care workers to commute to and from their respective workplaces.
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