Background: Corona Virus 2019 (COVID-19) challenged the delivery of medical education and training, especially to the 4th year medical students. Medicine's signature pedagogy, the ward rounds in the hospital, was put on hold in compliance with safety precautions during this pandemic and the Commission on Higher Education’s (CHED) suspension of face-to-face classes in all levels. How the University of Santo Tomas Faculty of Medicine & Surgery (UST FMS) Cardiology Rotation was delivered despite these restrictions is described. Using Google Classroom, Blackboard Collaborate, and Zoom, a 7-day online Cardiology Clerkship rotation was delivered to UST FMS 4th year students (clerks) using the synchronous and asynchronous mode of delivery. It consisted of the following: 1) Cardiovascular (CV) Ward Rotation with 3 cases using Google Classroom's adaptive release to create a vicarious experience of taking care of a patient and doing all the tasks that a clerk is supposed to do; 2) Virtual Ward Rounds by a consultant; 3) Outpatient Department (OPD) / Ambulatory Care Services (ACS) case discussions with a consultant and a 4) Heart Station Rotation for training in electrocardiogram (ECG) interpretation. Conclusion The advances in technology and software provided just-in-time resources that made possible the creative delivery of Medicine's signature pedagogy.
Cardiology

Background: The seafarers' poor mental health has been associated with significant morbidity, inefficiency, and accidents on board. Mental and physical health is largely dependent on the way seafarers handle stressors.
Anchored on the Transactional Model of Stress and Coping, this study aimed to identify the typology of Filipino merchant marine ratings according to their coping strategies to stressors on board vessels.

Methods: Thirty-seven (37) Filipino merchant marine ratings participated in this study. They were chosen by purposive sampling. They rank-ordered 25 opinion statements on various stressors and coping mechanisms. The rank-ordered sorts were subjected to by-person factor analysis with Varimax rotation using the PQ Method version 2.32. The resulting factors were interpreted using the inductive approach, aided by the interview done after Q sorting.

Results: Four factors were generated: solution-focused seafarers, stressor-focused seafarers, self-management- focused seafarers, and the social milieu-focused seafarers. There is a consensus on the supplication-focused seafarers who ask for God's help in times of stress.

Conclusion: The generated typology provides a better understanding of seafarers' outlook on stress and coping and may help the stakeholders craft individualized strategies to help improve their coping mechanisms and overall mental health. Occupational health research must continue to focus on understanding the role of culture and adaptation on stress and coping behaviors to retain quality seafarers and promote a healthier workplace.

Background: Adding to the current available evidence on the efficacy of exogenous corticosteroids as an adjunct to standard of care in improving the clinical outcomes of COVID-19 patients. This meta-analysis examined the experimental and clinical data supporting this therapeutic intervention in improving clinical outcomes. Objectives: This meta-analysis aimed to assess the efficacy of corticosteroids in improving outcomes in COVID-19 patients. Search methods: Literature searches of electronic databases (PubMed, Cochrane Library, Science Direct, Google Scholar) were performed to identify relevant studies. Data Collection and Analysis: Meta-analysis was performed using Review Manager (RevMan) software, version 5.4.1. Intervention effects were expressed in terms of mean differences and risk ratios for continuous and dichotomous variables, respectively. Fixed-effect or random-effects model was adopted according to heterogeneity. Main Results: A total of seven studies were included in the quantitative synthesis. Analysis of pooled data showed a 12% reduced risk of mortality in COVID patients given corticosteroids (RR 0.88, 95% CI 0.81 to 0.95). Patients who were administered with corticosteroids also had 22% decreased risk of requiring invasive ventilation support (RR 0.78, 95% CI 0.64 to 0.95). Number of adverse events were similar between the two groups (RR 1.10, 95% CI 0.49 to 2.46). Conclusion Adjunct corticosteroid therapy provided improvements in clinical outcomes such as decreased deaths and decreased need for invasive ventilation support. There was no sufficient evidence of a significant adverse effect, hence it is relatively safe and beneficial to use in COVID19 patients.
Adrenal Cortex Hormones ; COVID-19 ; Meta-Analysis

This clinical pathway for the diagnosis and risk stratification of patients presenting with acute chest pain, including acute coronary syndromes, provides recommendations and algorithms for clinicians to diagnose, risk stratify, and manage acute chest pain in adult patients. The writing committee reviewed existing international and local guidelines. Modifications to the algorithm following face-to-face and virtual meetings resulted in expert decisions written as recommendations and presented in a flow diagram format. The USTH Chest Pain Pathway provides guidance based on current guidelines and recommendations on assessing and evaluating acute chest pain, tailored to local needs and institution-specific facilities. We recommend its use to ensure quality patient care in the hospital.
Acute Coronary Syndrome|critical Pathways