2.Delusional disorder in a 25 year old Filipino male diagnosed with Retinitis Pigmentosa: A case report
Lawrence George Garcia ; Gabino Rañ ; oa
The Philippine Journal of Psychiatry 2019;41(2):42-45
Delusional disorder is an illness presenting with ideas of false
beliefs based on incorrect inference about external reality
that persist despite the evidence to the contrary and these
beliefs are not ordinarily accepted by other members of the
person's culture or subculture1
•
2
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The patient is a 25-year old, male, single, former massage
therapist, 1st in a brood of 3 children from a province in
Visayas, Philippines, brought to the clinic due to talking
incoherently with inconsistent responses. This presented
after competing in Palarong Pambansa for the disabled. He
participated in the blind category since he was diagnosed
with Retinitis Pigmentosa.
Retinitis pigmentosa (RP) is a group of genetic disorders
that affect the retina's ability to respond to light. This
inherited disease causes a slow loss of vision, beginning with
decreased night vision and loss of peripheral (side) vision,
and eventually blindness3
•
He won many competitions, after which started hearing
voices accusing him of cheating. This persisted for months
which lead him to develop incoherent responses when talked
to, which prompted his relatives to bring him for psychiatric
consult.
This is an interesting case of patient with a psychiatric
condition who also presented with a degenerative disease.
Retinitis
3.Botulinum neurotoxin a for hand tremors in Parkinson’s disease: A meta-analytic study
Lawrence George P. Garcia ; Raymond L. Rosales
Journal of Medicine University of Santo Tomas 2022;6(1):814-822
Background:
Resting tremor is a prominent cardinal motor symptom of Parkinson’s disease (PD). In some cases, the tremor may be refractory to dopaminergic and anticholinergic treatment. Multiple studies were previously done to evaluate the effectiveness of Botulinum Neurotoxin A (BoNT/A) with essential tremors and dystonia, but data regarding its use on tremors of PD is still lacking.
Objective:
This meta-analytic study aims to determine the effectiveness of BoNT/A in treating tremors of patients with PD.
Data Sources:
Data Sources: Researches were searched at PubMed, ScienceDirect and EBSCO Host.
Review Methods:
Articles on the effect of BoNT/A on PD hand tremors were searched. Studies and data pertaining to non-PD tremors like essential tremors excluded in the analysis due to difference in pathophysiology. Standardized mean difference was used as the effect measure and was computed with Review Manager version 5.4 software.
Results:
Three open label studies were used for final analysis in this study. Studies included are those pertaining to tremors due to PD. Pooled estimates showed a significant change in decreasing tremor score after BoNT/A injection.
Conclusion
Botulinum Toxin A injections can be used to manage PD tremors effectively.
Botulinum Toxins, Type A
;
Tremor
4.Betwixt and between: Exploring the liminal space of the 'first generation' Filipino physician through the lens of the rites of passage.
Lawrence George P. GARCIA ; Maria Minerva P. CALIMAG ; Alejandro C. BAROQUE ; Ma. Lourdes P. CORRALES-JOSON
Journal of Medicine University of Santo Tomas 2021;5(1):564-571
Introduction: The 'first generation' physician gathers a lot of strength to venture into a world unknown to him. Unlike a physician born to a family of physicians who has a family to guide him, the 'first generation' physician only has himself to survive this endeavor. Through the life worlds of a select group of 'first generation' physician-in-training, this study seeks to answer the following central question: How do 'first generation' Filipino physicians collectively characterize their liminal spaces in transition from medical school to clinical practice?
Methodology: Anchored on the Theory of the Rites of Passage, this phenomenological inquiry, intends to surface the lebenswelt or essence of the experience of being the only physician in the family. Respondents comprised a purposive sample of physicians-in-training (residents and fellows), who are the only physicians in the family. Data were gathered using semi-structured interviews. Triangulation and member checking procedures were done to ensure the data reliability. Data were then subjected to cool (categorization) and warm analysis (thematization) using the Colaizzi's method.
Findings and Discussion: With all the transcribed experiences summarized and those with the same meaning analyzed, the following categories and themes were generated: The Intending Facet / Purpose: From Uncertainty towards Redefinition; The Thinking Facet / Process: From Perplexity towards Self-efficacy; The Relating Facet / People: From Isolation towards Integration; and The Transforming Facet / Power: From Vulnerability towards Empowerment. It was shown that a 'first generation' physician in this liminal space undergoes challenges and struggles during his training in medicine. This served as his Rite of Passage to transition him to someone dreaming only to become a physician, to become redefined with conviction, supported and integrated into the health system, empowered and transformed to the physician he is meant to be.
Recommendations: Physicians undergo a lot of challenges and mental stress and it means a lot for trainers to enter into the trainees' life-world, especially that of a 'first generation' physician, so that they can build socio-emotional learning and mentoring programs and counselling services that address different facets of liminal space that the trainees go through.
Physicians