This study aimed to share the authors’ preliminary experience with endoscopic nipple-sparing mastectomy in the Philippines. All medical records of patients who underwent endoscopic mastectomy done by the same surgeons in two institutions from March to October 2019 were collected and analyzed. Surgical margin, operating time, blood loss volume, and post-operative complications were noted. Three cases were recorded during the study period. The mean operative time was 341 minutes and the mean blood loss volume was < 20 mL. All cases had negative margins of resection on final histopathology. One patient developed ecchymosis on the axilla, while the other patients had unremarkable post-operative courses. Endoscopic nipplesparing mastectomy is a potentially safe and feasible alternative in breast cancer management. Further evaluation of the procedure is recommended.

Objective: To compare PhilHealth case rate versus actual charge of hospitalization of common general surgery procedures in a Level 3 government hospital from 2017-2019. Methods: The five most common procedures were determined and records were reviewed. Hospital bills and professional fees (PF) were compared to the PhilHealth rates using t-test. The range of perceived acceptable PF was determined by an online survey. Results: The most common procedures were open appendectomy, open cholecystectomy, initial repair of inguinal hernia, total thyroidectomy and modified radical mastectomy. The study included 1934 charts. For service cases, the hospital bill for appendectomy was significantly lower than the PhilHealth institutional fee, while the rest were significantly higher. For private cases, hospital bills for open cholecystectomy and modified radical mastectomy were significantly higher, while that of open appendectomy was lower. The average PF of private patients in all procedures were significantly higher than the PhilHealth rate, also reflected on the survey. Conclusion The significant discrepancies between the actual charges and the PhilHealth case rates showed that the PhilHealth rates were insufficient for the five most common general surgery procedures in a Level 3 government hospital.
Philippines ; Insurance

Key Findings Current evidence does NOT support use of IgM/IgG rapid test kits for the definitive diagnosis of COVID-19 in currently symptomatic patients. • The present standard for diagnosis of COVID-19 is through qualitative detection of COVID-19 virus nucleic acid via reverse transcription polymerase chain reaction (RT-PCR). • Due to long turnaround times and complicated logistical operations, a rapid and simple field test alternative is needed to diagnose and screen patients. • An alternative to the direct detection and measurement of viral load (RT-PCR) is the qualitative detection of specific antibodies to COVID-19. ELISA (discussed in a separate rapid review) and lateral flow immunoassay (LFIA) IgM/IgG rapid test kits are two currently available, qualitative, antibody tests for COVID-19. • Two low quality clinical trials showed that there is insufficient evidence to support the use of IgM/IgG rapid test kits for the definitive diagnosis of COVID-19. Diagnostic accuracy varies greatly depending on the timing of the test. The test performed very poorly during the early phase of the disease (i.e., less than eight days from onset of symptoms). • Existing guidelines do not recommend serologic antibody tests for the diagnosis of COVID-19 in currently symptomatic patients.
Coronavirus ; Covid-19