This paper shall present a case of a 42-year-old nulligravid who complained of chronic pelvic pain, vaginal bleeding and palpable abdominal mass secondary to multiple large myomas. Due to the logistical and health restrictions in most hospitals during the peak of the COVID-19 pandemic, elective surgery was postponed and a temporizing medical management was instituted in the form of GnRH agonist, which afforded relief. This paper shall also discuss the mechanism of action of GnRH agonist, and its crucial role as an essential medical treatment option for patients with debilitating conditions such as myoma uteri.

Reintegration is an integral part of nursing care. Nurses play a critical role in contributing support, dependence, and continuity of care from rehabilitation to reintegration. While the reintegration of patients is a concept often used in nursing, its theoretical origin has remained unclear. This article aimed to conduct a concept analysis of reintegration for the development of nursing as a discipline and improve nursing care and health outcomes. The evolutionary strategy to concept analysis of Roger was utilized, which resulted in the characteristics of reintegration as to its attributes, antecedents, consequences, and exemplar in nursing practice in the context of COVID-19. The capacity to adapt, reorganize, offer support, and build a network of resources are attributed to the concept of reintegration. Antecedents include rehabilitation, survivorship from illnesses, trauma, and injuries, and disruption of social and physical functional performances and activities. The identified consequences include transition to recovery, quality of life, independence, successful adaptation, job satisfaction, holistic care, and continuity of care. The new conceptual definition of reintegration emerged. Reintegration is a process of nursing care among patients who demand assistance and support before transitioning to regain normality or on their way to being restored to the community in the presence of adaptation from health adversities. The patient in all areas is cared for holistically, offering support to meet his needs and overcome challenges in terms of physical, mental, social, and emotional aspects. Concept analysis is as essential as operationalizing a concept in the nursing discipline.
COVID-19

Background: The search for simple clinical and laboratory markers to help predict the clinical severity of patients presenting with COVID-19 has prompted this study to look at the predictive value of urine L-FABP (Liver Type-Fatty Acid Binding Protein) point-of-care test kit at the initial presentation of COVID-19 patients to the hospital. Methods: The validation study prospectively included 109 consecutive patients with mild to moderate COVID-19, mean age of 52.2 years (range 19-84) presenting at the Emergency Rooms of 4 participating Metro-Manila hospitals from February to April 2021, with available data for analysis for 103 patients. Urine L-FABP POC (Point-of-Care) test and other clinical parameters and the level of severity of COVID-19 were determined at Day 0, Day 4 and Day 7. Computations for Sensitivity, Specificity, Positive and Negative Predictive values and Likelihood ratios were performed. Results: Twenty-three patients tested positive for urine L-FABP, out of the 103 patients analyzed, while 80 tested negative. Of the 23 patients who tested positive for urine L-FABP, 6 has progressed in severity, while 17 did not progressed. Of the 80 patients who tested negative for urine L-FABP, 13 progressed, while 67 did not progressed in severity. Giving a Sensitivity of 31.58%, Specificity of 79.76%, Positive predictive value of 26.09%, Negative predictive value of 83.75%. Combining urine L-FABP and initial clinical parameters like SIRS (Systemic Inflammatory Response Syndrome) criteria to predict progression of severity yielded a higher Specificity of 91.67 % and Negative Predictive value of 84.62%. Conclusions The study shows the utility of initial urine L-FABP POC test as a negative screening test in triaging adult patients presenting to the ER with mild to moderate COVID-19. Patients at the ER with a negative urine L-FABP test, will most likely not progressed to severe COVID-19. Combining clinical parameters like SIRS Criteria with the urine L-FABP result can increase the negative predictive value.
COVID-19

Background: RT-PCR using respiratory tract specimens, most commonly nasopharyngeal swab (NPS), has been used to confirm the diagnosis of COVID-19. NPS is a relatively invasive procedure that causes patient discomfort and risks viral transmission. Other specimens are therefore being investigated for the detection of SARS-CoV-2 RNA. Objective: To determine the sensitivity of non-respiratory tract specimens in detecting SARS-CoV-2 RNA in patients with COVID-19. Methodology: This review summarized the results of eight studies obtained from a literature search done in May 2020 in PubMed MEDLINE, Cochrane Library and MedRxiv. Two independent investigators reviewed and appraised the studies that were included, and pooled estimates of sensitivity for each specimen were determined using Stata’s Metaprop function Results: The sensitivity in detecting SARS-CoV-2 RNA in non-respiratory tract specimens of diagnosed COVID-19 patients are as follows: Saliva 77% (95% CI 71-83%), stool/rectal swab/anal swab 22% (95% CI 22-37%), blood/serum/plasma 2% (95% CI 1-3%), and urine 22% (95% CI 18-25%). Conclusion SARS-CoV-2 RNA is detected in saliva, stool/rectal swab/anal swab, blood/serum/plasma and urine. Among these, saliva has the highest estimated sensitivity. However, more studies are needed to correct the heterogeneity brought about by factors such as timing of specimen collection, disease severity and treatment.
COVID-19

Background: COVID-19 is an ongoing health concern that hospitals have struggled to keep up with, given its increasing burden with the passage of time. Considerations for the management of COVID-19 should be made especially for pregnant patients and their neonates. Objectives: To determine COVID-19 prevalence and the clinical profile of mothers admitted for childbirth at Chinese General Hospital and Medical Center from May 2020 to July 2020. The profile and outcomes of neonates born to these mothers were likewise studied. Materials and Method: A descriptive cross-sectional study was done that included mothers admitted for childbirth who had SARS-CoV-2 RT PCR swab test and their neonates. A total of 408 medical records of mother and neonate dyads were reviewed. Relevant variables such as the patients’ demographic profile, clinical characteristics, co-morbidities and the maternal and neonatal outcomes were obtained. Frequency distributions were made to assess the prevalence of COVID-19 among the patients, as well as maternal and neonatal outcomes. Results: Twenty-two (5.39%) mothers tested positive for COVID-19, while all neonates (n = 22) that underwent RT-PCR swab at the 24th hour of life had negative results. Of the 22 COVID-19 positive mothers, 2 (9.09%) were symptomatic upon admission while 20 (90.09%) were asymptomatic. The following were the key trends among those mothers who tested positive for COVID-19: (1) 81.82% were from ages 20-39 years old, (2) 72.73% were multigravida mothers, (3) 54.55% had normal spontaneous delivery, (4) diabetes mellitus was the only noted comorbidity. Key findings on the neonatal outcomes observed in the study population of both COVID-19 positive and negative cases, include: (1) majority of neonates had an APGAR score of greater than 7 at 1st and 5th minute of life; (2) higher frequency of neonates with Ballard’s score of more than 37 weeks AOG; (3) more male neonates as compared to female neonates; (4) a normal birth weight for majority of cases; (5) 45.45% of neonates born to COVID positive mothers had a length of stay of <48 hours as compared to 72.8% of neonates born to COVID negative mothers; and (6) neonatal pneumonia as the most common comorbid condition in both cases. Conclusion This study noted a prevalence of 5.39% COVID-19 positive mothers. SARS-CoV-2 virus was not detected in all of the neonates born to COVID-19 affected mothers. Neonates delivered to COVID-19 positive mothers had similar trends in the neonatal outcomes when compared to neonates delivered to mother who were COVID-19 negative.
COVID-19

Background and Objectives: The immediate post-discharge period of COVID-19 patients is a vulnerable state due to several complications that may arise during this time. Some patients get readmitted shortly after being discharged while others report persistence of symptoms, develop specialized needs, or observe a decline from their baseline functional capacity. Information on the outcomes of post-COVID discharge patients in our institution is currently lacking. This study described the outcomes of patients with COVID-19 after their discharge from the service areas of Philippine General Hospital. Methods: This study is a retrospective chart review involving charts of all adult patients discharged from the PGH COVID service areas last August 2021 to October 2021. Data from their follow up consults at 1 week, 1 month, and 3 months post-discharge were reviewed. Baseline characteristics and post-discharge outcomes including post-COVID symptoms, special care needs, mortality, rehospitalization, emergency consult, level of dependence, and ability to return to work were assessed. Results: A total of 171 patient charts were included. The mean age of patients was 53.7 years. Most were male (60.2%), unemployed (59.7%), non-smoker (55%), hypertensive (57.9%), diabetic (50.2%), and obese (50.2%). Most of them were oxygen requiring (80%) and with severe to critical COVID infection (72.5%) during admission. At 3 months post-discharge, 113 (66%) were stable and able to complete the follow up, 8 (4.6%) died, 9 (5.2%) got readmitted, and 41 (23.9%) were lost to follow up. Among those who were able to follow up after 3 months, 84 (74%) were asymptomatic. Among those who remained symptomatic, the most common symptoms were dyspnea, fatigue, and cough. After 3 months, 100 (88%) did not require special care needs, 100 (88%) were fully independent, and 45 (39.8%) were able to return to baseline work. Conclusions Despite the majority of patients having severe to critical COVID infection during admission, most were asymptomatic within 3 months post-discharge. In those who developed persistent symptoms, dyspnea, cough, and fatigue were the most common symptoms identified regardless of COVID severity. Majority did not require special care needs.
COVID-19

Introduction: The coronavirus pandemic has affected millions worldwide. Better understanding of COVID-19 in pediatric hematology-oncology patients in a resource-limited setting is crucial to improve care as the pandemic ensues. Objectives: This study describes the clinical profile and outcomes of pediatric hematology oncology patients with COVID-19 seen at the Philippine General Hospital (PGH). Methods: A retrospective, descriptive review of pediatric hematology oncology patients with COVID-19 seen between March 2020 to March 2021 in PGH was done. Results: Forty patients were identified. Seventeen percent had non-malignant hematologic conditions, 40% had leukemias, and 42.5% had solid tumors. Fever and cough were the most common manifestations. Seventy-six percent were on treatment, 9% were newly diagnosed, and 7% were in relapse or disease progression. Fifty-five percent had mild COVID-19; 5% and 2.5% had severe and critical COVID-19, respectively. Thirty-seven percent were asymptomatic. Cancer-related therapy was placed on hold for most patients. There were two mortalities, none was due to COVID-19. Conclusion Results suggest that patients with hematologic and oncologic conditions have a mild course, with majority showing recovery from COVID-19. Delays in cancer-related therapy however, may contribute to disease progression and mortality.
COVID-19

Background: The COVID-19 pandemic and its effects such as community restrictions, lockdowns, and unemployment have greatly affected the household food security status in urban poor communities leading to poor accessibility of sufficient nutritious food and subsequently affecting the nutrition of children. Objectives: This present study aims to determine the prevalence of household food insecurity in households with children aged 0-10 amid the COVID-19 pandemic in an urban poor community in Quezon City. Methodology: A descriptive cross-sectional study was done to evaluate the food security status and experiences of households amid the COVID-19 pandemic. Results: A total of 405 households were surveyed to answer questions designed to determine their general profile relative to their food security experiences during the pandemic. It was observed that the majority of the households in the urban poor community belong to Class D earning between PhP 8,001.00 - PhP 15,000.00. The heads of these households as well as caregivers mostly belong to the high school graduate level. Based on the conducted survey, it was revealed that 59.5% of the households were severely food insecure (90% CI: 55.4-63.4) and only 4.2% ( 90% CI: 2.8-6.2) were food secure. Conclusion The prevalence of food insecurity in the urban poor community is determined to be high, with 31.6% households having moderate food insecurity, while only 4.2% households are food secure. The majority of surveyed households were anxious and uncertain about their food supply, and also reported experiencing varying levels of food insecurity related to sufficiency of food quality.
COVID-19

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.
COVID-19

Introduction: Globally, COVID – 19 (SARS COV -2) became an enormous challenge with serious threat to the healthcare workers. This study aimed to provide the psychological coping mechanisms among healthcare workers in tertiary hospital during the COVID-19 pandemic in the locale of Eastern Visayas. Objective: This study was conducted to determine the psychological coping mechanisms among healthcare workers in tertiary hospital during the COVID-19 pandemic. The secondary objectives were to determine the demographic profile of health care workers as to: age, sex, civil status, profession and area of assignment, to identify the issues of concern that contribute to the mental or psychological stress affecting the healthcare workers, to identify the psychological coping mechanisms of healthcare workers to ease their stress and to determine the correlation between issues of concern and coping mechanisms to the demographic profile of the healthcare workers. Methods: Utilized a cross-sectional descriptive study with analytical component. Sample size of 142 was computed using the Epi Info 7 software with confidence interval of 95% and the margin of error of 5%. Descriptive analysis was utilized to identify the socio- demographic profile of HCWs and Pearson r tests in SPSS used in correlation to issues of concern and psychological coping mechanisms. Results: One hundred forty two healthcare workers were included in the study. Of these, almost all respondents belong to aged 20-39 (92.3%). Majority were female and single. As to profession, many were physicians and nurses while as to area of assignments, some in the COVID Ward (24.6%). As to issues of concern, the results showed moderately in physical issues (2.55), mental and emotional issues (2.12). With regards to coping mechanisms, appraisal- focused (adaptive –cognitive) (3.55), emotion- focused (3.50) and problem- focused (adaptive – behavioral) coping mechanisms (3.18) were all very important. The correlational analysis showed that issues of concern and psychological coping mechanisms experienced by HCWs were not significantly related or associated to their demographics profile. Conclusion Based on the findings, the appraisal- focused (adaptive – cognitive), emotion- focused and problem- focused (adaptive – behavioral) coping mechanisms were all very important coping mechanisms among HCWs. Demographic profiles were not significantly associated with issues of concern and psychological coping mechanisms of HCWs in a tertiary hospital during COVID-19 pandemic.
COVID-19