Research Papers

Patient comfort and satisfaction are utmost priorities after surgery. After general anesthesia, some patients experience emergence agitation. This may lead to feelings of pain, discomfort or injury to the patient and health personnel. This study identified emergence agitation in a population of twenty-six patients who underwent surgery using general anesthesia either with the use of Sevoflurane or Propofol during subcutaneous closure. The profile of patients with emergence agitation was also described. This is a prospective interventional study conducted in the operating room and in the Post-Anesthesia Care Unit (PACU). Low gas concentration of Sevoflurane of ≤ 2 vol% or Propofol infusion was utilized. Results revealed that ten patients experienced emergence agitation in the Sevoflurane group and also ten patients had agitation in the Propofol group. The participants in Sevoflurane group were immediately agitated at 0 minute; whereas, participants in Propofol group were agitated already at 15 minutes. In this study, the age, sex, and duration of exposure to anesthesia did not give conclusive results as to whether these variables influenced emergence agitation in patients. Patients who underwent abdominal surgeries both under laparoscopic and open approach were observed to have emergence agitation. ▲ Show less

ABSTRACT Background: In December 2019, Wuhan City, Hubei Province, China, first reported the disease caused by the novel severe acute respiratory syndrome coronavirus 2 (Avula et al., 2020). In recent literatures, infected patients may also present with neurological manifestations including cerebrovascular accidents (Mao et al, 2020). While hemorrhagic strokes are less common, the risk of ischemic stroke in COVID-19 is around 5% as reported by a panel of the World Stroke Organization (Spence et al., 2020). Objectives: This study aims to determine the characteristics and outcomes of patients with acute ischemic stroke and COVID-19 and determine whether there is a significant difference in the outcomes of these patients among non-COVID-19 acute ischemic stroke patients. Methodology: This is a single-center retrospective observational case-control study. Patients 18 years old and older presenting with stroke symptoms with radiologic evidence of stroke through CT-Scan imaging and who underwent RT-PCR NPS testing will be included in the study. Medical records of these patients admitted in ZCMC from July 2020 to July 2021 will be reviewed. Outcomes will be measured through NIHSS, mRS, mortality and ICU admission. Categorical variables will be presented as absolute values and percentages while continuous variables will be presented as median or means. Results: Respondents in this study was overall had a mean age of 57.68+12.06 years, and were predominantly male, lived within Zamboanga City, were Roman Catholics, married and widely unemployed. In terms of demographic profile, it was only employment that was statistically significantly different between groups. In terms of clinical profile, the most common comorbidity that was seen was hypertension, which was also the only comorbidity that was statistically different between groups. Other notable comorbidities are diabetes, atrial fibrillation, previous stroke and heart failure. All respondents in this study had ischemic stroke, with lacunar infarct being most common among cases and basal ganglia infarct among controls. Bamford classification showed however that strokes were more commonly partial anterior circulation stroke. Weakness remained to be the most common symptom experienced by almost all respondents, but was not significant different between groups. Significant however was far more cases suffered decreased sensorium, headache, dizziness, and aphasia compared to controls. In terms of NIHSS, cases were seen to be on a worse predicament, with 50% having severe scores on admission and 60% having severe scores on discharge (versus 33% and 35% of controls respectively). This also translated to the mRS scores where 83% of cases had poor mRS scores compared to only 34.33% among controls. More deaths occurred among cases than controls, and this was considered ii statistically significant. Finally, it can be noted that more respondents among cases had longer hospital stay and necessitated ICU upon admission – both of which were significantly different. Conclusion: It can be concluded that patients with stroke and suffering from COVID-19 suffer far more serious strokes than stroke patients without COVID-19. The greater need for ICU care and longer hospital stay among COVID-19 positive stroke patients also mean that costs are higher overall. Prognosis is also very poor as from the onset, stroke severity already leans toward a more sever stroke, and outcome among COVID-19 positive stroke patients lean towards a higher incidence of mortality. Finally, even with the remaining patients who survived stroke with COVID-19, disability was considered generally bad since modified Rankin Scale scores were poor. ▲ Show less

ABSTRACT Background: High levels of plasma triglycerides (TGs) are a risk factor for cardiovascular disease (CVD) regardless of high-density lipoprotein cholesterol (HDL-C) levels. Hypertriglyceridemia is also frequently associated with impaired fasting glucose, impaired glucose tolerance, insulin resistance, type 2 diabetes mellitus (DM), and metabolic syndrome. Elevated TGs are commonly associated with a lipoprotein phenotype designated “atherogenic dyslipidemia”; this includes reduced HDL-C and increased number of small, dense, low-density lipoproteins. Objectives: This study aims to utilize laboratory parameters like triglyceride and hdl levels as a surrogate marker for insulin resistance among adult patients admitted at Zamboanga City Medical Center. Methodology: This is a single-center retrospective observational case-control study. Patients 18 years old and older presenting who are admitted at Zamboanga City Medical Center. Medical records of these patients admitted in ZCMC from July 2020 to July 2021 will be reviewed noting the laboratory results of the patients particularly the triglyceride and HDL values. Results: This study saw a total of 250 adult patients admitted at ZCMC for a variety of reasons from June 2020 to December 2020. These adult patients denies any comorbidities such as hypertension nor diabetes. 51.2% of the participants were predominantly female and there is a mean of age 58.3 +/- 12.52 years. As for the body mass index, only 29.6% had normal BMI. One hundred sixty nine or 67.6% were overweight while 2.8% were obese. Mean blood pressure are 124 systolic and 79.31 diastolic. Mean fasting glucose level is at 122 mg/dl which is under impaired glucose level (>100 mg/dl). Variables such as age, systolic blood pressure, fasting glucose, HDL, and triglycerides and VLDL showed significant difference between groups. The group with TG/HDL >3.0 had an overall increased in weight, blood pressure, fasting glucose, triglycerides and VLDL. It was noted that there is a positive correlation between TG/HDL ratio and obese patients (r=0.691, p=0.00). However it is also interesting to note that there is also a positive correlation between TG/HDL among patients with normal BMI (r=0-012, p=0.012). Also, blood pressure (r=0.181, p=0.004) and impaired fasting glucose (r=0.240, p=0.030) showed positive correlation with TG/HDL as well. Conclusion: TG/HDL ratio may be a good predictor for insulin resistance among Filipinos especially among overweight filipinos. But an interesting result also showed that even if patients have normal BMI, their TG/HDL ratio is also high which can also predispose them to metabolic problems in the future. Hence, this is an important tool to help clinicians screen patients for insulin resistance or metabolic problems even among lean Filipinos with normal BMI. This will help in early planning and management even before the development of the disease itself. Studies regarding TG/HDL ratio in normal BMI population are still limited. Hence the author recommends to further probe on this area as metabolic derangements and lifestyle diseases such as diabetes may affect young healthy population as well. ▲ Show less

Intraoperative frozen section (FS) plays a critical role in the surgical management of ovarian neoplasms by guiding the extent of surgery. While FS accuracy has been well documented internationally, local data from Philippine government hospitals remain limited. This study evaluated the diagnostic performance of FS for ovarian neoplasms at Zamboanga City Medical Center (ZCMC), with particular emphasis on diagnostic concordance, tumor subtypes, and factors associated with discrepancy. This retrospective descriptive accuracy study included 110 ovarian tumor cases that underwent intraoperative FS with corresponding final histopathologic diagnosis at ZCMC from January 2015 to December 2024. FS diagnoses were categorized as benign, borderline, or malignant and compared with final paraffin diagnoses as the reference standard. Diagnostic performance indices (sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy) were calculated. Concordance was assessed using Cohen’s kappa coefficient. Associations between clinicopathological variables and FS discordance were analyzed using univariate and logistic regression analyses. The overall diagnostic accuracy of FS was 79.8%, with substantial agreement between FS and final histopathology (κ = 0.70, p < 0.001). FS demonstrated excellent performance for benign tumors (sensitivity 97.7%, specificity 92.2%) and high specificity for malignant tumors (98.6%), although sensitivity for malignancy was moderate (60.5%). Borderline tumors showed the lowest diagnostic reliability, with a sensitivity of 80.8% and a positive predictive value of 58.3%, accounting for the majority of discordant cases. Among clinicopathological factors, epithelial mucinous histology was the only variable significantly associated with FS discordance (p = 0.048), increasing the likelihood of misclassification. Other factors—including age, parity, menopausal status, tumor size, laterality, gross morphology, tumor stage, and number of FS samples were not significantly associated with concordance. Frozen section examination is a reliable intraoperative diagnostic tool for clearly benign and malignant ovarian neoplasms at ZCMC but demonstrates limited accuracy for borderline tumors, particularly those of mucinous histology. Cautious interpretation, targeted sampling, and multidisciplinary decision-making are essential to minimize diagnostic errors. Institution- specific audits and standardized FS protocols may further improve diagnostic performance in resource-limited settings. ▲ Show less

Work-related musculoskeletal disorders (WRMDs) are a major occupational health concern that adversely affect employee productivity, work performance, and institutional efficiency. Increasing clinic visits among ZCMC employees for musculoskeletal complaints and work absences highlighted the need to quantify the burden of WRMDs among health workers. This study aimed to determine the prevalence, anatomical distribution, severity, and work-related interference of musculoskeletal discomfort among health workers at ZCMC. A quantitative, descriptive, cross-sectional design was employed. Data were collected from 235 health workers using the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), a validated self-administered instrument assessing the frequency, severity, and functional interference of musculoskeletal discomfort across multiple anatomical regions. Descriptive statistics, including frequencies, percentages, means, and standard deviations, were used for data analysis. The prevalence of WRMDs was 91%. A substantial proportion of respondents experienced moderate to severe discomfort with varying levels of work-related interference. Musculoskeletal complaints were commonly multi-regional and predominantly involved axial and upper body regions, particularly the lower back (75%) and upper back (67%). Notably, the allied medical division demonstrated a comparatively higher burden, with equal proportions of moderate and severe WRMDs (35% each). Slight work-related interference remained common, especially among allied medical staff (45%) and medical personnel (31.25%), while substantial interference, although less frequent, was more evident in the allied medical (15%) and medical divisions (6.25%). This study demonstrated a high prevalence of work-related musculoskeletal disorders among health workers at ZCMC, reflecting a substantial occupational health burden. Although mild symptoms were most common, a considerable proportion of respondents reported moderate to severe discomfort with functional limitations, predominantly involving multi-regional and axial areas, suggesting cumulative biomechanical strain from routine healthcare tasks. Hence, these findings highlight the urgent need for comprehensive, multidisciplinary ergonomic and occupational health interventions, including institutional ergonomic improvements, continuous training on proper body mechanics, and workplace health promotion initiatives. Moreover, future longitudinal studies with objective ergonomic assessments are warranted to clarify causal relationships and evaluate the effectiveness of targeted preventive strategies. ▲ Show less

Background: Pandemics can cause widespread morbidity and mortality as well as social, political, and economic disruption. The novel coronavirus, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic with staggering speed. The COVID-19 pandemic affecting all parts of the world is also having major implications for stroke, both direct and indirect. Stroke patients themselves appear particularly susceptible to developing complications and death when suffering COVID-19 infection. (Markus, 2020 et. Al, 2020). The platelet-to-lymphocyte (PLR) was shown to be indicative of systemic inflammation, to play an important role in venous thromboembolism, and to be effective in determining the tendency to thrombosis. PLR was reported to be better indicators of inflammation than leukocyte counts in the whole blood counts (Guzel, et al., 2020). Objectives: This study aims to determine the characteristic demographic and clinical profile of COVID-19 patients with acute ischemic stroke, predictive role of platelet-to-lymphocyte ratio to the severity of Acute ischemic stroke patients with COVID 19 and if there is a significant difference between the platelet-to-lymphocyte ratio of COVID-19 and non COVID-19 patients with acute ischemic stroke in terms of patient outcome including recovery, ICU admission and mortality. Methodology: This study will utilize a cross-sectional analytical method. Included are ZCMC hospitalized patients from July 2020 to July 2021, 18 years and older who have imaging evidence of acute ischemic stroke and confirmed COVID-19 infection by RT-PCR NPS. Outcomes will be measured through severity, recovery, ICU admission, mortality. Categorical variables will be presented as absolute values and percentages while continuous variables will be presented as median or means. Results: The present study included a total of one hundred sixty-three patients (n=163) and where divided into three cohorts. The first cohort included 48 patients who were categorized as COVID (+) and Stoke (+), the second cohort will include 67 patients and categorized as COVID (-) and Stroke (+) while the last group will include 48 patients who were COVID (+) and Stoke (-). Mean age was observed to be 59 years old, 56 years old and 47 years old for Group A, B and C respectively. There is a significant difference across the study groups in terms of the following; respiratory rate, pulse rate and oxygen saturation. This observation suggests that patients who are COVID-19 positive but no history of stroke had higher respiratory rate and pulse rate in comparison with patients under Group A and B. With regards to the comorbidities, hypertension and diabetes mellitus were the most commonly observed comorbidities present among all patients across the study groups. Findings obtained in this study showed that patients who had COVID infection and stroke at the time of admission had significantly higher levels of inflammatory markers in comparison to those patients who had COVID-19 infection only. By using the medial PLR of 14.9 in the present study, we divided the patients into two groups. The first group will include patients with high PLR (PLR > 14.9) while the second group will include patients with low PLR (PLR <14.9). We observed that patients with higher PLR had longer duration of hospital and ICU stay in comparison with those with low PLR. Further analysis was done among study groups, it was worth-noted that patients with COVID-19 infection and stroke (Group A), whose PLR is >14.9 had significantly longer hospital and ICU stay in comparison with Group B and C (p-value <0.001). Moreover, higher mortality rate was observed among Group A with high PLR with 70.37%, and a p-value of <0.001 was obtained which indicates that patients with high PLR and COVID-19 positive with stroke had higher risk of mortality in comparison to those with low PLR. Conclusion: Findings of the present study suggest that patients with acute ischemic stroke with concomitant COVID-19 infection presents more severe presentation and poor clinical outcomes which includes the oxygenation status, sensorium, and COVID-19 infection severity upon admission. With regards to the role of PLR, findings of the study suggest that it is a simple, cost effective and easily obtainable novel inflammatory marker that may help in predicting the severity of disease and prognosis in terms of length of hospital and ICU stay and mortality rate. PLR may be a promising indicator to identify high-risk patients. High PLR was found to be a risk factor for COVID-19 infection and patients with acute ischemic stroke in this investigation. ▲ Show less

Teenage pregnancy is a significant public health concern and this incidence rates may be indicative of a growing adolescent pregnancy problem in the country. Its adverse effects on maternal and fetal outcomes have been widely documented. The Zamboanga City Medical Center provides specialized care for high-risk pregnancies such as those of teenage pregnancies. Objectives: this study aimed to determine the maternal and fetal outcomes of teenage pregnancies among Filipino women aged 13 – 18 years old who was admitted and delivered at Zamboanga City Medical Center (ZCMC) over the five-year period of January 1, 2015 to December 31, 2019. Method: This is a retrospective study consisting of reviewing the records of teenage mothers from years 2015–2019. Descriptive statistics were used to analyze the gathered data. Results: a total of 3,869 teenage deliveries were included in this study, making up 8.96% of the total OB admissions for the years 2015 to 2019. The mean age and standard deviation were 17.1 ± 1.5 years, and the majority of patients (70.4%) were between 37- and 41-weeks gestational age. There was a significantly higher number of deliveries in the 16–18 years age group, totaling 3,583 deliveries, compared to the 13–15 years age group who only had 7.4% or 286 deliveries during the same period. The most prevalent techniques of delivery for teenagers in this study were spontaneous vaginal delivery with 3236 (83.6%) cases and lower segment cesarean section with 370 (9.6%) cases. Obstetric outcomes include gestational hypertension 37 (0.95%), preeclampsia 199 (5.14%), stillbirth 41 (1.05%), preterm labor 478 cases (12.3%), premature rupture of membranes 377 (9.7%) anemia 341 (8.8%), and postpartum hemorrhage 54 (1.3%). Neonatal complications in teenage pregnancy included prematurity 336 (8.7 %), small for gestational age babies 473 (12.4%), neonatal pneumonia 62 (1.6%), meconium aspiration syndrome 44 (1.1), perinatal asphyxia 12 (0.31%) and fetal malformations 8 (0.22%). Conclusion: This incidence of teenage pregnancies in ZCMC is nearly identical to the 8.6% national average for the same time period. Pregnancy outcomes and complications were examined in this study. As a result, it was found that obstetric difficulties such as preeclampsia, preterm labor, premature rupture of membranes and anemia were the most common maternal outcome while prematurity and small for gestational age babies were the most common fetal outcomes. ▲ Show less

The vulnerable, disregarded population of adolescents who become pregnant have continued to rise in the Philippines. These patients have become an increasing statistic in this day and age of technology and social media. Even as the government have passed policies to address mental health issues and population control, there is still increase in adolescent pregnancies. This study aimed to determine factors associated with postpartum depression among 158 randomly selected mothers aged 15 to 19 years old who delivered, regardless of route, gestational age, or parity, in Zamboanga City Medical Center, from January to June 2025. The cross-sectional study utilized structured questionnaires about socio-demographic data, obstetric history, and pregnancy outcomes and the Edinburgh Postnatal Depression scale was the tool used to identify adolescent mothers at risk for depression. However, the study showed that none of these factors may be used to predict postpartum depression in this population, which would then make it even more challenging to accurately identify risk factors that the physicians could use to identify these patients at risk for postpartum depression. The study then recommends using other factors that may contribute to postpartum depression in the adolescent mothers such as socio-cultural factors, income, location, or future pregnancy plans. ▲ Show less

The cytologic evaluation of salivary gland tumors is challenging due to marked morphologic diversity and overlap between benign and malignant lesions. Fine-needle aspiration biopsy (FNAB) is a minimally invasive and widely used initial diagnostic tool, and the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was developed to standardize reporting and improve diagnostic consistency. This retrospective study evaluated the application of the MSRSGC at Zamboanga City Medical Center from January 2020 to January 2025 by correlating FNAB cytologic diagnoses with histopathologic outcomes. Fifty-nine cases with available surgical follow-up were included. Overall cytohistologic concordance was 83.1%, with the highest agreement observed in Categories III (Atypia of Undetermined Significance), IV-B (Salivary Gland Neoplasm of Uncertain Malignant Potential), and VI (Malignant), followed by Category IV-A (Benign Neoplasm). Agreement beyond chance was moderate and statistically significant (Cohen’s κ = 0.40; 95% CI, 0.19–0.61; p < 0.001). The overall risk of malignancy (ROM) and risk of neoplasm (RON) were 32.26% and 52.78%, respectively. ROM increased progressively across the Milan categories, reaching 100% in Category VI, consistent with the system’s prognostic design; however, Category II (Non- neoplastic) demonstrated relatively elevated ROM and RON, reflecting diagnostic challenges associated with reactive and cystic lesions. The sensitivity for detecting malignancy was 56% (95% CI: 21–86) and specificity was 74% (95% CI: 60–85). The positive predictive value was 28% (95% CI: 10–53), while the negative predictive value was high at 90% (95% CI: 77–97). Overall diagnostic accuracy was 71% (95% CI: 58–82), with a receiver operating characteristic area of 0.65. These findings support the clinical utility of the Milan System as a triage tool, particularly for ruling out malignancy, while emphasizing strict diagnostic criteria, clinic-radiologic correlation, and adequate sampling. ▲ Show less

Background: Ramadan is a month-long period of fasting that is observed by Muslims worldwide. However, for diabetic patients, fasting during Ramadan can pose significant challenges to their health and well-being. As such, understanding their knowledge, attitudes, and practices towards fasting during Ramadan is crucial for healthcare providers to provide appropriate care and support. To date, management of people with diabetes who fast during Ramadan is mostly based on expert opinion rather than medical evidence gained from clinical studies. Since diabetes has increasing incidence rate, and Muslim population is also increasing. This study will create a demographic profile of diabetic Muslim patients practicing fasting during the month of Ramadan. The study will be an exploratory research which aims to provide substantial data to serve as a stepping stone for further research Objectives: The primary objective of this study is to evaluate the knowledge, practices, and attitudes of diabetic Muslim patients towards medication, risk, and dietary modifications. Specifically, the study aims to: 1. To assess the level of knowledge among Muslim diabetic patients at Zamboanga City Medical Center on managing diabetes during Ramadan. 2. To understand the attitudes of Muslim diabetic patients towards fasting during Ramadan and its impact on diabetes management. 3. To explore the practices and experiences of Muslim diabetic patients in managing their diabetes during Ramadan. 4. To identify the challenges and facilitators that influence Muslim diabetic patients' ability to manage their diabetes during Ramadan. Methodology: This study utilizes a mixed-methods design, combining quantitative and qualitative approaches, to investigate the knowledge, attitudes, and practices of Muslim diabetic patients regarding fasting during Ramadan. The research will be conducted as a cross-sectional study in the City of Zamboanga, Philippines, targeting diagnosed diabetic patients at a local tertiary hospital's Endocrinology clinic. Purposive sampling will be used to select participants for focus group discussions based on specific inclusion criteria. The collected data will be analyzed using thematic analysis to identify recurring themes and patterns. Ethical approval will be obtained, informed consent will be obtained from participants, and confidentiality will be ensured throughout the study. The study aims to provide valuable insights into the experiences and perspectives of Muslim diabetic patients during Ramadan fasting. ▲ Show less

BACKGROUND: COVID-19 infection as a global threat to public health needs be mitigated through vaccination. However, as a novel vaccine there were multiple factors considered as to its acceptability. Poor knowledge and different perception can proportionally affect acceptance leading to severe form of infection and further spread of the disease. OBJECTIVE: Determine the factors associated to COVID-19 vaccine acceptability among high risk individuals consulting at Zamboanga City Medical Center Out Patient teleconsultation. METHOD: This study utilized an analytical, cross-sectional study that was conducted in Zamboanga City Medical Center Out Patient Teleconsultation among 203 high risk individuals. RESULTS: Both acceptors (59.69%) and non-acceptors (58.33%) have good knowledge regarding COVID-19 vaccine. The perception towards to COVID-19 vaccine categorized as susceptibility, severity, barriers, benefits and cues to actions. Most of the categories has a mean that falls within the agree scale and under items of perceived benefits of how it is recommended by doctors rated as strongly agreeable. All under the perceived barrier statements fell with the rate of neutral. SUMMARY/CONCLUSION: The level of knowledge toward covid19 vaccine among high- risk individuals and acceptability rate is high. Furthermore, significant factor associated with the decision to receive the Covid-19 vaccine includes the worrisome effect of vaccine’s adverse reaction, difficulty to get vaccine from nearby clinic due to high demand, and that vaccination can lead to normal lifestyle. Furthermore, level of knowledge does not directly affect the individual’s decision to receive covid vaccine. _______________________________ MESH WORDS: COVID-19, COVID-19 vaccine, Vaccine Acceptance, High Risk Population, Teleconsultation ▲ Show less

Burnout and job satisfaction among health care providers have been subjects of interest for the past decades due to its impact on a person’s well-being and the possible consequence of compromising patient care. Awareness of this phenomenon will aid in developing strategies to prevent burnout and increase job satisfaction in the workplace. The study aimed to determine the prevalence of burnout and job satisfaction among health care providers employed at the Zamboanga City Medical Center. The study utilized a descriptive, cross-sectional design using multi-stage random sampling. A total of three hundred sixty-two (362) employees of various occupational groups participated in the study. A self-administered questionnaire was used to gather data which comprised of questions from the Copenhagen Burnout Inventory (CBI) and Job Satisfaction Scale (JSS). The prevalence of burnout was 23.49%. It was common among nurses (38.83%) followed by doctors (24%) administrative assistants (10.59%) and nursing attendants(9.42%). Majority (33.15%) had personal burnout followed by work- related (24.04%) and client related burnout 22.93%. Around 48.35% reported satisfaction with their current jobs. Majority (80.39%) were satisfied with nature of work followed by supervision (74.04%), coworker (66.3%), communication (65.75%), pay (58.57%) and fringe benefits (44.76%). The study revealed a 23.49% prevalence of burnout among various occupational groups. In addition, the findings revealed a low prevalence of job satisfaction of only 48.35%. Hence, measures to promote mental health and to increase job satisfaction among its employees must be made. ▲ Show less

BACKGROUND: With the onset of the COVID19 pandemic, the health care work force is experiencing the highest risk of exposure being the frontline of defense against the pandemic. Poor knowledge and negative attitude can lead to inadequate infection control practices, poor preventive measure and further spread of the disease. Psychological burden of the disease has OBJECTIVE: This study aimed to determine the knowledge, attitude and risk perception of the health care workers in Zamboanga City Medical Center towards the COVID19 infection. METHODS: This study utilized a descriptive, quantitative, cross-sectional study conducted in Zamboanga City Medical Center, among 296 health care workers towards the COVID19 infection. RESULTS: Out of the 296 participants, 87.5% showed good knowledge towards the COVID19 infection, 97.97% showed positive attitude in combating COVID19 infection in our country but still 75.68% had a high risk perception towards being infected and being susceptible to the COVID19 infection CONCLUSION: In this study, we conclude that there is good knowledge regarding COVID19 infection, positive attitude towards overcoming and further prevention of COVID19 pandemic, and high risk perception in acquiring the disease among the health care workers of Zamboanga City Medical Center. We recommend to strengthen health education on COVID19 to fight against misinformation with emphasis on the online platform and to attend to the mental health of health care workers to address the psychological burden of the pandemic and thus high risk perception. ▲ Show less

Background. Stroke is the Philippines is second leading cause of death. It has a prevalence of 0·9%; ischemic stroke comprises 70% while hemorrhagic stroke comprises 30%. Central poststroke pain (CPSP) is a constant or intermittent pain reported by patients after stroke that is usually associated with sensory abnormalities such as decreased perception of harmful and sharp stimuli. The symptoms may affect the patients’ ability to carry out their activities of daily living, cause emotional disturbances, and decrease the patients’ quality of life. CPSP is a disabling condition with a prevalence 5% in stroke patients. Aim. The main objective of the study was to determine how common is central post stroke pain among stroke patients in Zamboanga City Medical Center. Methods. This study utilized a cross-sectional design. Study participants included stroke patients who were admitted and discharged from January 2020 to December 2020. Phone call interview using S-LANSS was done to assess presence of CPSP. Results. A total of 59 stroke patients were included in the study. CPSP prevalence was noted to be at 78%. The assessment was done through a phone call where bias cannot be fully eliminated, however, the primary investigator made sure that the symptom fit the criteria in the assessment tool S-LANSS. Most of the patients were more than 45 years old (83%), had ischemic stroke (76%), and hypertension (83%). CPSP was found mostly in patients with infarct in the MCA territory (91%). Among patients with hemorrhagic stroke who had CPSP, the location was mostly on the basal ganglia (81%). Conclusion. Prevalence of Central post stroke pain among stroke patients of ZCMC was 78% which is way higher than previous reports. It is commonly seen in patients more than 45 years old, those who had ischemic type of stroke and those with stroke in the MCA territory. ▲ Show less

Pancreatic cancer is generally found in the older population Pancreaticoduodenectomy seems to be the only way in resolving these resectable tumors Pancreatic cancer is generally found in the older population Pancreaticoduodenectomy seems to be the only way in resolving these resectable tumors volume centers. Pancreaticoduodenectomy, also referred to as the “Whipple’s Procedure” is the most common surgical procedure for the resection of tumors in the pancreatic head, uncinate process, and neck as well as lesions of the ampulla, extrahepatic bile duct and duodenum. This procedure has since been associated with high perioperative morbidity and mortality. Rate and improvements in surgical technique and critical care however, have reduce the perioperative mortality rate to as low as 1% in high-volume centers. In Zamboanga City Medical Center (ZCMC), Whipple’s Procedure was started around the year 2012 by a trained hepatobiliary consultant. From then on, it has been continued aiming for an oncologic resection with better patient outcomes, remission, and overall survival. With an estimate of five (5) Whipple’s Procedure annually, it is important to document the evolution and success of the procedure by looking unto the patient’s details and surgical outcome. Hence, this study aimed to provide the future medical practitioners especially the surgical residents and researchers data of the Zamboanga City Medical Center (ZCMC) experiences regarding Whipple’s Procedure. Based from the documented records since 2015 to 2019, there was a total of 27 Whipple’s Procedure including pylorus-preserving pancreaticoduodenectomy that were performed by a trained hepatobiliary consultant. Most of the patients belonged to 50-60 age group, male, resided within Zamboanga City, and presented with abdominal pain and jaundice. Furthermore, most of the patients were discharged but stayed for an average of 21 hospital days possibly due to diagnostic delays and preoperative preparation such as nutritional build-up. Hence, the researcher recommends additional study regarding Whipple’s Procedure including the perioperative complications and follow-up status of the patients. The study should at least cover a 10-year time frame for a better number of populations for analysis. ▲ Show less

Background: Ileostomy creation is frequently performed for bowel perforation, obstruction, and other acute abdominal emergencies. Its reversal, although routine, carries risks of postoperative complications. This study evaluated the demographic and clinical profiles, perioperative characteristics, postoperative outcomes, and factors associated with morbidity among patients undergoing ileostomy closure in a resource-limited tertiary government hospital. Methods: This retrospective cohort study reviewed medical records of adult patients who underwent ileostomy closure at Zamboanga City Medical Center between January 1, 2022 and December 31, 2024. Demographic, clinical, operative, and postoperative data were collected. Complications identified as using anastomotic leak, surgical site infection, bowel obstruction and others. Univariate analysis was performed to identify factors associated with postoperative complications. Results: A total of 59 patients were included, with a mean age of 38.0 ± 14.87 years; most were male (67.8%), of normal BMI, and without comorbidities. Bowel perforation (57.6%) and intestinal obstruction (15.3%) were the most common indications for ileostomy creation. Loop ileostomy was the most frequently reversed type. The mean operative time was 135.98 ± 38.10 minutes, and all patients received preoperative bowel preparation. The overall complication rate was 11.9%, and mortality was 1.7%. The mean postoperative hospital stay was 11.08 ± 5.11 days. Univariate analysis showed that younger age (18–25 years) and prolonged hospitalization were significantly associated with postoperative complications (p = 0.030 and p < 0.05, respectively). No significant associations were observed for sex, BMI, comorbidities, indication, ASA class, operative time, or spout resection. Conclusion: Ileostomy closure demonstrated a low complication rate of 11.9%, with most events classified as minor. Only younger age (18–25 years) and prolonged postoperative hospitalization showed statistically significant associations with complications, while sex, BMI, comorbidities, surgical indication, ASA class, and operative time are not. Keywords: ileostomy closure, retrospective cohort, postoperative complications, surgical outcomes, morbidity factors, Philippines. ▲ Show less

BACKGROUND: Doctors should attain quality of life to provide effective health care service. In the event of unattained quality of life, doctors cannot fully function well and may mismanage at the expense of a patient’s life. OBJECTIVE: To determine the quality of life of Zamboanga City Medical Center (ZCMC) residents based on Short Form 36 (SF-36) Health Survey. METHODS: This study utilized a cross-sectional design. Respondents include ZCMC residents who were willing to answer the SF-36 Health Survey. The components of quality of life include physical functioning, role limitations due to physical health, role limitations due to emotional problems, energy/fatigue, emotional well-being, social functioning, pain, and general health. A high score defined a more favorable health state. RESULTS: A total of 85 residents were enrolled. Majority attained quality of life scores between 50-89% – moderately favorable health state. Most residents (57 out of 85, 67%) had low scores (less than 50%) on energy/fatigue domain. All departments achieved quality of life scores between 50-89% (78 out of 85, 92%). First year and second year levels had better quality of life scores (2% had scores of ≥90%) compared to those of higher year levels (0% had scores of ≥90%). CONCLUSION: Fatigue/energy domain was the main concern that needs to be addressed. It was decreased in all year levels. Though weak in this domain, most residents in all departments had overall scores that fall between 50-89%, which means they were doing quite well in their residency training. ▲ Show less

Introduction: Patient satisfaction is essential in evaluating and understanding patients' healthcare experience, promoting partnership and increasing treatment compliance. By measuring this, it helps improve and ensures services continuous service with outmost quality. During the Covid-19 pandemic, it was difficult to cater patients face to face due to easy infectivity with close contact. Zamboanga City Medical Center started teleconsultation as a means of out-patient consultation for patients needing non-urgent care. This research was done to determine the satisfaction on the Out-patient teleconsultation service. Objective: The study aims to determine the level of satisfaction among teleconsultation clients catered to at Zamboanga City Medical Center in structure, process, and human resources. Methodology: This was a cross-sectional descriptive study. A voice-call survey was conducted using the modified 10-item Telehealth Satisfaction Scale (TeSS) questionnaire and was participated in by 18 to 70-year-old clients availing the service. Results: The results showed more than 90% of the respondents were satisfied with the teleconsultation service of the Zamboanga City Medical Center in structure, process, and human resources. Seventy-five of the respondents rated the overall teleconsultation service as excellent while 25% rated the overall service as fair. The respondents (98.48%) would Page | vii Page | viii Republic of the Philippines Department of Health ZAMBOANGA CITY MEDICAL CENTER Page | ix recommend the ZCMC teleconsultation service to others for the reason of its convenience, positive treatment experience, quick services provided and approachable staff. Conclusion/ Recommendation: Seventy-five percent of respondents have excellent experience using the teleconsultation service. With these results, the researcher recommends continuing these services since some respondents see it as an alternative to face-to-face consultation. The areas that rated less than 95% of the clients satisfied are the voice equipment used by the clients and the ease of getting into the teleconsultation hotline. These were the areas identified as room for improvement. ▲ Show less

The Zamboanga City Medical Center is a multi-specialty tertiary hospital in the Zamboanga Peninsula. One of the services it provides is the field of Anesthesia, with perioperative anesthesia care being considered an important component. Being a patient- centered institution, patient satisfaction has become a critical tool for measuring quality care. Although patient satisfaction surveys are conducted at the Zamboanga City Medical Center, perioperative anesthesia experiences are not usually evaluated. Hence, this study aims to determine the level of patient satisfaction with perioperative anesthesia care, as well as the patient’s perceptions and experiences among Zamboanga City Medical Center surgical inpatients through an exploratory sequential design using interviewer-administered questionnaires including the Leiden Perioperative Care Patient Satisfaction Questionnaire. A total of 75 respondents, who underwent elective inpatient surgical procedures under any type of anesthesia from June 1 to 30, 2023, participated in this study. The findings of this study emphasized the importance of patient-centered care, effective communication, and continuous improvement in healthcare practices. Anesthesia and postoperative care need to be individualized to further enhance patient experiences and satisfaction levels. ▲ Show less

Background. cancer is the third leading cause of morbidity and mortality among Filipino women. Primary prevention of breast cancer is still not available, so efforts to promote early detection continue to be the major focus in fighting breast cancer. Objective. The objective of this study is to discuss the factors that hinder early diagnosis of breast cancer among patients in ZCMC. Method. Qualitative and quantitative study design. Virtual interview was conducted using the Zoom app. Clinical and demographic information were interpreted using descriptive statistics. Qualitative information was obtained using focus group discussion/interview. Results. Patients with advanced breast cancer had common initial presenting symptom of painless nodule (9, 60%). Others had painful nodule (20%) and swollen axillary lymph node (20%). Most patients did not do routine self-breast exam (80%) and all did not undergo clinical breast exam and screening mammography. The most frequently reason for the delay were fear of cancer diagnosis (33%), lack of knowledge about cancer diagnosis and treatment (33%) and financial constraint (33%). Other patients mentioned about non-cancer consideration, distance from the hospital, false-negative initial diagnostic results, non-bothersome symptoms, self or alternative treatment, false beliefs about cancer symptoms, fear of the Covid-19 pandemic, and seeking second opinion. Most patient tend to not seek consult, few opted alternative or traditional healer. Poor referral system and prolonged result of the diagnostic result also caused delay. Conclusion. Reasons for delay were mostly fear of cancer diagnosis, lack of knowledge about cancer, and are financially constrained. Others include non-cancer consideration, distance from hospital, false-negative diagnostic results, non-bothersome symptoms, self or alternative treatment, false beliefs, fear of pandemic, and seeking second opinion. Poor referral system and prolonged result of diagnostic results are health system factors causing delay. ▲ Show less

BACKGROUND: In the Philippines, Breast cancer is the most prevalent cancer among women and in both sexes. About 15 to 20% of breast cancers overexpress human epidermal growth factor receptor-2 (HER2) – a clinically important subtype of breast cancer that is associated with aggressive disease phenotype and shortened survival outcomes, resulting in poorer prognosis compared to other subtypes. This study is aimed to evaluate patient compliance, treatment response and outcome among cancer patients receiving Trastuzumab enrolled under the Department of Health Cancer And Supportive - Palliative Care Medicines Access Program (CSPMAP) at Zamboanga City Medical Center. METHODOLOGY: The study utilized a descriptive, cohort study design which included all HER2 positive breast cancer patients enrolled in the program. Patients received either intravenous Trastuzumab (Hertraz) or subcutaneous Trastuzumab (Herceptin SC) for 18 cycles with 21-day interval together with the standard 6-8 cycles cytotoxic chemotherapy and/or hormonal therapy in the neoadjuvant, adjuvant or palliative setting as clinically indicated. Patient compliance was described by the number of cycles each patient completed. Treatment response was evaluated radiographically using computed tomography. Treatment outcomes were reported as to treatment completed, discontinued or dropped out of the program and whether the patient is alive or has expired during the course of the study. Among stage 4 patients, improvement in performance status was assessed through a focused group discussion (FGD). The incidence rate was computed by the number of new diagnosed cases of HER 2 positive breast cancer divided by the total number of population breast cancer for 2021 at ZCMC Cancer Center. RESULTS: Forty-one (41) HER2 positive breast cancer patients were enrolled in the study which resulted to increased compliance to treatment with 37/41 (90.24%) patients completing 18 cycles of Trastuzumab with little to no missed schedule. An improvement in treatment response was observed in the adjuvant chemotherapy group wherein 18/20 (90%) patients having no identifiable disease and in the palliative chemotherapy group, 3/21 (14.29%) with partial response, 14/21 (66.66%) had stable disease, upon post treatment evaluation. Treatment outcomes resulted to 37/41 (90.24%) of patients completing 18 cycles of trastuzumab with 35/41 (85.36%) were alive, 2/41 (4.87%) dropped out from the program due to travel distance and decision to discontinue treatment, 2/41 (4.87%) died while undergoing treatment and 2/41 (4.87%) died after completing 18 cycles of Trastuzumab. There was an overall improvement in performance score of patients undergoing palliative chemotherapy. The incidence rate of HER2 positive breast cancer at ZCMC- Cancer Center from January to December 2021 is 43 cases per 100 persons. CONCLUSION: The up-front and proper allocation of Trastuzumab ensures that patients can complete the standard of care, 18 cycles targeted therapy regardless of disease status resulting in an increased patient compliance to chemotherapy and targeted therapy which translates to an improvement in treatment response and disease outcome. Programs such as DOH - CSPMAP can eliminate barriers, primarily the cost of treatment which leads to improvement in patient’s adherence and treatment outcome. RECOMMENDATION: Foresight to a formulary (PNDF) second line anti HER 2-treatment drug should be considered by the DOH - CSPMAP bearing in mind that a significant number of HER 2 positive patients were diagnosed to be locally advanced to metastatic disease with high probability of disease recurrence and/or progression in the future. KEYWORDS: DOH CSPMAP, Trastuzumab, HER2 positive breast cancer ▲ Show less

This study investigates the health-related quality of life (QoL) of People Living with HIV (PLHIV) enrolled at the Zamboanga City Medical Center (ZCMC) Treatment Hub in the post-pandemic era. With the global impact of the COVID-19 pandemic, the quality of life for PLHIV may have been significantly affected due to disruptions in healthcare access, social support, and mental health resilience. This research aims to assess the physical, psychological, and environmental factors influencing the QoL of PLHIV in Zamboanga City. The study employed a quantitative, cross-sectional design, utilizing the WHOQOL-HIV BREF questionnaire to collect data from participants aged 18 to 60 years. The research explores the association between sociodemographic factors, HIV-related variables, and QoL domains, including physical health, psychological well-being, social relationships, environmental health, and spirituality. Preliminary findings indicate that PLHIV who rated their overall QoL as "Good" reported significantly higher scores in psychological well-being, physical health, and environmental conditions. Conversely, those with "Poor" QoL ratings expressed dissatisfaction with their health, lower functional capacity, and greater symptom burden. Furthermore, the study observed a notable relationship between higher educational attainment and better QoL, particularly in the domains of social relationships and environmental health. These results underscore the importance of addressing both healthcare and socio-environmental factors to improve the overall well-being of PLHIV. This study highlights the necessity of tailoring interventions and support services to the unique needs of PLHIV in Zamboanga City, particularly in light of the post-pandemic challenges. The findings will provide valuable insights for healthcare policymakers, practitioners, and researchers, guiding future initiatives aimed at enhancing the quality of life of PLHIV in the region ▲ Show less

Not available in the manuscript ▲ Show less

INTRODUCTION The study investigates the significant financial burden of Acute Lymphoblastic Leukemia (ALL) treatment on families in the Philippines. It examines the Acute Lymphoblastic Leukemia-Medical Access Program (ALL-MAP), a government initiative providing free chemotherapeutic drugs, aiming to improve access to quality care for the poorest and marginalized population in Zamboanga City Medical Center (ZCMC). METHODOLOGY This was a retrospective descriptive study reviewing the records of 74 pediatric ALL patients diagnosed at ZCMC from 2006-2017. Patients were divided into the PRE ALL-MAP group (2006-2011, N=16) and the ALL-MAP group (2012-2017, N=58). Clinical outcomes (alive, expired, lost to follow-up, relapse) were compared between the two groups using statistical analysis (Z-score) with a significance level of p<0.05. RESULTS No significant difference was found in the number of patients who were Alive (ALL-MAP 41.4% vs. PRE ALL-MAP 31.25%, p=0.73). However, the ALL-MAP group, which received free medication, showed significantly more Expired patients (31.03% vs. 6.25%, p=0.0444) and significantly more Lost to follow-up patients (27.59% vs. 62.5%, p=0.009) compared to the pre-program group. The expected positive impact of the free medicine program on survival and follow-up was not evident in the data. CONCLUSION Despite providing free chemotherapy, the ALL-MAP program did not show an expected positive impact on patient outcomes, with a significant increase in deaths and loss to follow-up in the ALL-MAP group. The discussion suggests that non-modifiable clinical characteristics, geographical challenges, and other socio-economic and psychological barriers play a crucial role, indicating that free medication alone is insufficient to ensure treatment adherence and successful outcomes. ▲ Show less

Pain ranks among the most difficult and common problem in healthcare, and is often the cause of hospitalization. It often goes undetected and grossly under treated even after patients seek medical care. In an effort for better pain management, many healthcare systems have required routine healthcare screening and made pain as the 5th vital signs. Objective: The aim of the study is to evaluate the implementation of pain as the 5th vital sign among surgical ward nurses of the Zamboanga City Medical Center secondary is to determine the factors or difficulties they have in assessing pain as 5th vital sign. Methodology: The study utilized a cross-sectional method in conducting interview among the surgical ward nurses. Results: 51 nurses were included, a 100% response rate. 78.4% said that they assess pain routinely making it the 5th vital signs, 21.6% and 17.5 % believes that pain assessment is important for patient’s well-being and the patient should not feel pain during hospitalization respectively. Moreover, the main difficulty they encounter in pain assessment is patient’s level of understanding 76.4% and lack of time 13.7%. The hospital has fully encouraged pain assessment to be part of the vital signs 64.7% and barely 9.8% were not informed of the inclusion. The main type of scale utilized by the respondents is the verbal-numeric scale (94.1%). Furthermore, Courses, trainings and updates on the importance of 5th vital sign and Strict implementation and requirement in its use are among the most viewed ways to improve proper pain assessment. In Conclusion, the nurses find pain assessment as fifth vital sign to be important, the major difficulty they find in implementing it the patient’s level of understanding which falls as communication barrier as well as the lack of time. Making pain assessment as the fifth vital sign requires training, persistence, encouragement with supervision and guidance emphasized. ▲ Show less

Background: Cerebrovascular diseases include some of the most common and devastating disorders: ischemic stroke and hemorrhagic stroke. Stroke is the second leading cause of death worldwide and is a major cause of disability. An occlusion of the distal vertebral or proximal basilar artery could result in a complete basilar thrombosis which carries a high mortality. Early signs of posterior circulation infarction, such as dense basilar artery sign, when identified, can help confirm the diagnosis and may guide treatment or prevent further catastrophic complications when managed early. Objectives: To determine the demographic characteristics of stroke patients with dense basilar artery sign on plain brain CT scans and whether its presence can predict a PCA infarction, andshort-term clinical outcome of patients with DBAS on CT scan. Methodology: This study utilized a prospective, descriptive design. Adult stroke patients admitted with CT scan imaging done in ZCMC were included. An interview using a premade form was employed in this study to collate baseline characteristics of patients admitted as stroke at ZCMC. Demographic variables such as age, gender, risk factors, signs and symptoms of stroke, comorbidities, admitting and discharge NIHSS scores, location of infarction and short-term-clinical outcomes on discharge were analyzed and used to profile patient with identified DBAS on CT scan. Only one radiology expert reviewed all the scans and identified the presence or absence of DBAS. Results:A total of 74 patients (53 males, 21 females) were enrolled in this study, with a mean age of 55. Out of all stroke patients included, 33 had DBAS on CT scan and 41 did not show DBAS. This study revealed that the prevalence of DBAS on CT scan of stroke patients was 46%. Among those with DBAS, 85% were classified to have ischemic type of stroke and 15% with hemorrhagic type. 68% of all stroke patients had hemiplegia, and 73% of patients with DBAS. There were 28 patients who had posterior circulation stroke (PCA and/or basilar artery), of these 24 had DBAS on CT scan, with a sensitivity and specificity of 85% and 80%, respectively, and accuracy of 82%. The positive predictive value of DBAS is 77.9%. In terms of outcomes, 46% of the total population resulted in death, where 48% of which had severe type of stroke on admission and 61% at time of discharge. Conclusion: In conclusion, the presence of dense basilar artery on plain brain CT scan can predict a posterior circulation infarction. Higher NIHSS scores were found in patients with stroke in the posterior circulation with DBAS on CT scan, which may portend a poor prognosis. There is an association between the presence of DBAS and the outcome of stroke patients at discharge. A strong conclusion cannot be made owing to the limited sample size, hence conducting the study with a bigger sample size is strongly recommended. ▲ Show less

Diabetes mellitus is a major health problem affecting an increasing number of individuals worldwide. Its chronicity causes a significant health burden adding to the complications and complex nature of its management. Family function and chronic illness care have an impact on the health of people with diabetes influencing health behavior and outcome. The study aimed to determine the association of family function and chronic illness care to medication adherence and glycemic control of type 2 diabetic patients consulting at the out-patient department of Zamboanga City Medical Center. The study utilized an analytical cross-sectional design utilizing convenience sampling in choosing the respondents among type 2 diabetic patients consulting at the out-patient department of Zamboanga City Medical Center. It employs a set of interviewer-guided questionnaire among the participants on their socio-demographic profile, family functionality, chronic illness care experiences and medication adherence. Hemoglobin A1C was used as basis for glycemic control as set by the guidelines published by the American Diabetes Association. The data gathered were analyzed through frequency distribution and Chi-square analysis. The results of this study noted that Type 2 diabetic patients consulting at the out-patient department of Zamboanga City Medical Center perceived their family as functional (64.83 percent), 91.20 percent claimed to have positive chronic illness care experiences, 71.42 percent have good medication adherence to their prescribed regimen and 92.30 percent have good glycemic control. Association was analyzed using chi-square analysis where family function was noted to be associated with glycemic control (p value = .00001) and chronic illness care experiences with medication adherence (p value = .00369). The data from this study shows that family function and chronic illness care experiences may have an influence on health behaviors and health outcomes such as medication adherence and glycemic control. Thus, looking into these factors might be useful in improving diabetic care and quality of life of Type 2 diabetic patients. ▲ Show less

Post-operative nausea and vomiting (PONV) are some of the most common undesirable adverse effects post-surgery performed under general anesthesia. The aim of this study was to test the efficacy of metoclopramide versus dexamethasone in preventing PONV. A total of 50 patients undergoing elective procedures under general anesthesia were seen in this study – 25 receiving Metoclopramide and 25 receiving Dexamethasone with the goal of preventing PONV. The respondents were identical in mean age, gender, smoking history, reports of co-morbidities, and reports of motion sickness, with p value of 0.99 to 1. Overall incidence of nausea and/or vomiting was at 18%. Two patients reported nausea (1) and vomiting (1) 0–1-hour post-procedure in the treatment group while three reported only nausea in the control group. Only 1 and 2 respondents in the control group complained of nausea at 2-5- and 12-24-hours post-treatment respectively, and 1 patient complained of vomiting at 12-24 hours post-treatment in the treatment group. Both groups were statistically similar and equally effective in preventing occurrences of nausea or vomiting among patients undergoing elective ENT or abdominal surgeries under general anesthesia. Metoclopramide is recommended in the prophylactic treatment for PONV as it is cheaper than dexamethasone (P4.00 versus P85.00). ▲ Show less

Gestational Trophoblastic Disease (GTD) is a rare disease afflicting women all over the world in varying incidences. Incidence of GTD can be as low as 0.94 per 1000 pregnancies in Saudi Arabia to 12.99 per 1000 pregnancies in Indonesia. In the Philippines, GTD accounts for 2.4 cases per 1000 pregnancies nationwide, with a specifically high incidence noted in UP-PGH at 14 per 1000 pregnancies. In Zamboanga City Medical Center, there were 97 cases of GTD in 2015 alone, but the true incidence of GTD from 2010 to 2015 is unknown. Although data on the incidence of Gestational Trophoblastic Disease are easily available, no data are available and no study has been done yet identifying the characteristics and maternal outcomes of these groups of patients in our region. The researcher then wish to conduct a medical record study in order to carefully know the characteristics of the patients with GTD and later on potentially open an avenue for other research that would help find more ways to improve care among these patients. A retrospective review of records was done, where medical records of all patients with Gestational Trophoblastic Disease admitted at the department of Obstetrics and Gynecology (OB-Gyn) had been reviewed. Socio-demographic characteristics, medical history, obstetric history, signs and symptoms on admission, and maternal outcomes were recorded. Data was encoded and then analyzed and presented through Microsoft Excel using frequencies and percentages. ▲ Show less

Gestational Trophoblastic Disease (GTD) is a rare disease afflicting women all over the world in varying incidences. Incidence of GTD can be as low as 0.94 per 1000 pregnancies in Saudi Arabia to 12.99 per 1000 pregnancies in Indonesia. In the Philippines, GTD accounts for 2.4 cases per 1000 pregnancies nationwide, with a specifically high incidence noted in UP-PGH at 14 per 1000 pregnancies. In Zamboanga City Medical Center, there were 97 cases of GTD in 2015 alone, but the true incidence of GTD from 2010 to 2015 is unknown. Although data on the incidence of Gestational Trophoblastic Disease are easily available, no data are available and no study has been done yet identifying the characteristics and maternal outcomes of these groups of patients in our region. The researcher then wish to conduct a medical record study in order to carefully know the characteristics of the patients with GTD and later on potentially open an avenue for other research that would help find more ways to improve care among these patients. A retrospective review of records was done, where medical records of all patients with Gestational Trophoblastic Disease admitted at the department of Obstetrics and Gynecology (OB-Gyn) had been reviewed. Socio-demographic characteristics, medical history, obstetric history, signs and symptoms on admission, and maternal outcomes were recorded. Data was encoded and then analyzed and presented through Microsoft Excel using frequencies and percentages. ▲ Show less

Although more patients had survived coronavirus disease 2019, there are limited data on outcomes after initial hospitalization. While some completely recover, others’ conditions inevitably get worsen or unimproved resorting to hospital readmissions. Hospital readmissions not only cause burden on patients but also to the health care facility as it surely demands more hospital resources. This study is conducted to determine the incidence of readmissions among COVID-19 recovered patients previously admitted in Zamboanga City Medical Center. In addition, this study would like to know the sociodemographic profile, clinical characteristics, treatment received during initial hospitalization, clinical outcomes of these patients and more importantly the cause/s for hospital readmission. This is a retrospective study that will utilize chart review from electronic medical records. Medical charts of all COVID-19 recovered patients who get readmitted will be taken into account and included in the study. The study will cover admitted patients from March to December 2020. The result of this study will be of great help to clinicians to identify patients who has the possibilities of getting readmitted, hence intensification of follow-up care is practiced. This study is also very timely as we are currently still facing this pandemic on COVID-19 and is of relevant value as the results would be of great help in future policy making with goals of preventing future hospital readmissions and improving hospital quality care. This study saw a total of 786 patients being admitted for COVID-19 from June 2020 to June 2021, with 76 (9.67%) being readmission at a later time, not necessarily due to COVID. Findings of readmissions are at par with other studies such as those done in USA and Spain, and lower compared to studies that were done in UK, Israel and Germany. On the other hand, the group of respondents in this study is relatively younger than those seen in most studies, and predominantly female rather than male as compared to other studies. Mean interval between discharge and readmission was at par with other studies, being one to two weeks post discharge, and length of stay also similar across other studies (less than 2 weeks). Most common cause for readmission was still difficulty of breathing but was followed closely by a need for surgical intervention. Despite this, readmission due to COVID-19 was low at 17.1%, and care was efficient having 86.84% going home well. This study concludes that rate of readmission was relatively low compared to several studies but may have been lower if the factor looked into was readmission due to COVID-19. Moreover, it can be concluded with these findings that care of patients on their initial admission as COVID-19 patients have been at par or better, and timely discharge has been properly observed, considering readmission for COVID-19 itself was low. ▲ Show less

Introduction. Appropriate clinical use of blood are pivotal for safety and effectiveness of blood transfusion. Quality indicators like crossmatched/ transfusion ratio (C:T), outdating and missing are adapted to evaluate the quality of the therapeutic transfusion practices at the Zamboanga City Medical Center. Method. Using a descriptive cross sectional type of study, transfusion data of all patients in our hospital from January 01 to December 31, 2015 were reviewed and was fed into the database management system application program for analysis. Results. A total of 3528 patients was served. Of the 8637 blood requisitions, 6434 were transfused to the patients. Packed red blood cells are the most requested component and the most common known indication was due to neoplasm. Over all our hospital had a C:T ratio of 1.36, outdated and missing blood components at 290/6010 (4.8%) and 2,627 (43.7%) respectively. Conclusion. Blood transfusion practices in our hospital was found to be acceptable and appropriate. However, excessive ordering, poor blood monitoring and inventory control was noted during this study. ▲ Show less

Objectives: This study determined the prevalence of new-onset psychiatric symptoms among COVID-19 positive patients referred to the Department of Psychiatry at Zamboanga City Medical Center (ZCMC). Methodology: Utilizing a retrospective chart review of 32 patients, the study characterized the demographic profile, reasons for referral, psychiatric diagnoses, and comorbidities of the cohort. Results: The study analysis revealed an equal gender distribution (50% male n=16, 50% female n=16) with a mean age of 45 years; notably, 34.4% of patients (n= 11) were aged 60–70 years. The most frequent referral complaints included restlessness, irritability, and sleep disturbance. The primary psychiatric diagnoses were stress-related disorders (n=12, 37.5%%), while 21.9% (n=7) presented with non-specific and ill-defined symptoms. Comorbidity analysis indicated that 53.1% of patients (n=17 ) had COVID-19 concurrent with respiratory and infectious complications. Conclusion and Recommendations: These findings establish a baseline understanding of psychiatric manifestations in COVID-19 patients at ZCMC, highlighting that stress-related disorders and sleep issues are common, even in those without prior psychiatric history. The results underscore the critical need for early psychiatric screening and intervention, particularly for older 5 patients and those with severe physical illnesses. Thus, it is recommended that an integrated medical and mental health care approach and long-term psychological monitoring to manage potential conditions such as PTSD, anxiety, and depression post-recovery. Public health awareness and accessible mental health services are essential to ensure comprehensive patient and family care. ▲ Show less

Annual health examinations (AHE) are essential preventive services that facilitate early disease detection and promote employee well-being. However, participation among healthcare workers remains suboptimal, limiting the effectiveness of preventive programs. This study aimed to determine factors associated with non-adherence among employees of Zamboanga City Medical Center (ZCMC). A cross-sectional analytic study was conducted among 423 regular employees using a structured questionnaire assessing patient-, provider-, and healthcare system-related factors. Non-adherence was defined as failure to complete all components of the AHE, including the wellness checklist, laboratory investigations, and physical examination. Descriptive statistics and multivariate logistic regression were performed. Forgetfulness was the strongest predictor, increasing the likelihood of non-adherence by approximately sevenfold. Employees who perceived themselves as healthy and those who consulted only when sick were about four and three times more likely to be non-adherent, respectively. Work-related constraints and healthcare system barriers increased the likelihood by approximately two to three times. Non-adherence remains high and is largely driven by modifiable behavioral, occupational, and system-related factors; thus, addressing these barriers requires a multifaceted approach. Strengthening institutional support is essential to improve adherence among healthcare workers. ▲ Show less

INTRODUCTION This research addresses the global tobacco epidemic, which disproportionately targets adolescents, a stage where smoking is hard to stop. The study's primary objective was to determine the current knowledge, attitudes, and practices (KAP) regarding smoking among secondary level students in Zamboanga City, as updated local data was needed. The study utilized a revised Global Youth Tobacco Questionnaire, which included the use of e-cigarettes or vape. METHODOLOGY A descriptive cross-sectional research design was employed. The study involved 387 secondary level students from 40 selected public and private schools in Zamboanga City during the School Year 2020-2021. Students were selected through a random sampling method, with the sample size doubled due to the constraints of the pandemic. RESULTS The prevalence of current cigarette smoking was 8.2% (6.4% male, 1.8% female), with current e-cigarette use at 4.6% (2.8% male, 1.8% female). Overall, males were significantly more likely to be current tobacco users (6.7% vs. 2.0% for females) and demonstrated higher susceptibility to future tobacco use (12.7% of never users). 35% of respondents reported seeing someone smoking on school premises. CONCLUSION The study establishes a crucial baseline of adolescent smoking KAP in Zamboanga City, confirming a significant prevalence and high susceptibility, particularly among male students. The findings provide essential and up-to-date information to guide health policy-makers in developing targeted, adaptive local tobacco control programs. ▲ Show less

Background: Hypertension remains a leading cause of cardiovascular morbidity and mortality, particularly in underserved populations with limited access to health education and preventive care. Objective: This study evaluated the effectiveness of a Health Screening and Medical Education (HSME) intervention in improving knowledge, attitudes, and practices (KAP) related to hypertension among community members. Methods: A total of 51 participants were enrolled, with 48 completing pre- and post-intervention assessments. The intervention included blood pressure screening and structured health education sessions. Changes in KAP scores were analyzed using paired sample t-tests, with additional descriptive statistics to identify key improvements. Results: Statistically significant improvements were observed across all domains. Knowledge scores increased from 5.96 (SD = 1.91) to 7.69 (SD = 1.75) (p < .001); attitude scores from 31.71 (SD = 4.23) to 39.77 (SD = 3.61) (p < .001); and practice scores from 26.35 (SD = 4.18) to 30.40 (SD = 4.66) (p < .001). The most notable knowledge gain was recognizing that hypertension can be asymptomatic (+42%), while the greatest behavioral change was reducing daily salt intake (+37%). Conclusion: The HSME intervention effectively enhanced hypertension-related literacy and promoted healthier behaviors in a high-risk community. These findings underscore the value of community-based education and screening as scalable strategies to address non-communicable disease burdens in resource-constrained settings. ▲ Show less

Background: The coronavirus disease 2019 (COVID-19) pandemic has given rise to the need to develop a vaccine as quickly as possible. The immunization of healthcare workers (HCWs) plays a recognized key role in prevention in the COVID-19 pandemic (Modenese et al,. 2021) Objectives: This study aims to determine the immune response to covid 19 vaccines among health care workers and office personnel in ZCMC. Methodology: This is a crossectional descriptive analytical study. Patients 18 years old and older who are vaccinated with only one vaccine. Completed two doses of vaccine will be included in the study. RESULTS: The study included a total of 90 respondents for analysis from the targeted 100 respondents who submitted their blood samples. The study compares antibody titer levels in individuals who received two COVID-19 vaccine doses with and without four booster shots. The average titer level was 161.59 BAU/mL for those with only two doses and 172.0 BAU/mL for those with four boosters, indicating a higher average titer level in the booster group. CONCLUSION: The study analyzes immune responses to COVID-19 vaccination in healthcare workers and office personnel. Healthcare workers, especially those with booster shots, showed higher antibody levels, likely due to greater virus exposure and booster effects. Challenges included hemolyzed blood samples from office personnel, emphasizing the need for sample integrity in serological studies. RECOMMENDATION: The study emphasizes the importance of booster vaccination programs, particularly for healthcare workers in high-risk settings, and regular monitoring of antibody levels to assess immunity duration. It highlights the need for tailored strategies for different occupational groups, improved sample handling to prevent hemolysis, and further research to identify protective antibody thresholds and factors affecting immune response. Public health messaging should promote vaccination and boosters, while ongoing research and adaptive strategies remain crucial for managing the pandemic effectively. KEYWORDS: SARS-CoV-2,covid vaccine, covid booster ▲ Show less

Introduction: The physiologic changes in pregnant women, and the immature immune system of neonates, are some of the reasons why these populations are vulnerable to infection, specially to a highly contagious virus like SARS-CoV-2. Despite several studies, there are still varied data on the effect of maternal COVID-19 to the fetus. Objectives: This study aimed to determine the neonatal outcomes of COVID-19 confirmed mothers in Zamboanga City Medical Center from January-December 2021. Methodology: This study employed a cross-sectional analytical study utilizing retrospective review of charts. Results: Out of 283 neonates, 7 (2.47%) tested positive for COVID-19. One was critical while the rest were asymptomatic. Among the neonatal outcomes, the (1) Need for Admission (p-value: 0.034), (2) Positive Neonatal RT-PCR result (p-value: 0), (3) Neonatal Diagnoses of Small for Gestational Age (p-value: 0.016) and Sepsis (p-value: 0.024, 0.019) were proved to be significantly associated with maternal COVID-19 classification. Conclusion and Recommendation: Specific Neonatal outcomes were associated with the Maternal COVID-19 classification. In general, the neonatal outcomes were good however there was still a possibility for poor outcome. To generate more conclusive data, it is recommended that larger sample size, longer time frame and comparison to a control group be utilized. ▲ Show less

Introduction/Background: Zinc is a vital element for the growth and neurological development of neonates. Low birth weight infants often have insufficient zinc storage, which can lead to poor development and undernourishment. This study therefore provided zinc supplementation to a number of low birth weight neonates while tracking their growth and developmental status. Objectives: This study aimed to describe the neuro-development and growth status of low birth weight neonates given oral zinc supplementation at Zamboanga City Medical Center. Methodology: This was a descriptive cohort study. Low-birth-weight neonates were recruited on their first day of life. They were given oral zinc supplementation at a dose of 2.1 mg/day daily for 6 weeks. Results: Among the neonates who received zinc supplementation, weight increased by 47% at the first monitoring (6 weeks of age) and by 254% at the second monitoring (9 months of age) compared to baseline. Length also increased by 14% at six weeks of age and 40% at nine months of age. Female neonates had a greater weight gain, while male neonates had a higher length gain. No neuro-developmental concerns were found in any of the infants. Conclusion: Low birth weight neonates who received zinc supplementation were able to achieve the expected neurodevelopment and growth for their age. ▲ Show less

The 2019 coronavirus disease (COVID 19) pandemic is a public health issue of epic proportion spreading at a record-breaking speed throughout the world affecting most if not all the daily lives of all walks of life. In response to this, the president of the Philippines passed a republic act placing the entire country under a State of Public Health Emergency and State of Calamity, making several government tertiary hospital to a COVID Referral Center. One of the cities with the most cases outside of NCR is Zamboanga City (Nonato, 2020) and Zamboanga City Medical Center is the only COVID Referral Center in the province. The aim of this study is to determine the mental health status of health care providers assigned at COVID 19 wards in Zamboanga City Medical Center in terms of levels of anxiety, depression, and stress. This could serve as baseline data for policy making, clinical interventions, and future researches. Method: This is a retrospective chart review study. All the members of the health care team tasked to handle COVID positive patients were asked to answer the Depression Anxiety Stress Scale (DASS) and the Patient Health Questionnaire (PHQ9). Additional questions on demographic data and coping mechanisms were also asked. Their results will be then reviewed. The frequency of their scores will be tabulated and classified according to mild, moderate, and severe depression, anxiety and stress respectively. The scores will also be classified according to the demographics they belong and the kind of coping mechanisms they employ. ▲ Show less

General anesthesia is a state of unconsciousness associated with the absence of sensations over the entire body by administering anesthetic drugs in preparation for surgery. It induces physiologic and psychological effects that may include intraoperative awareness with recall, which is the unintentional clear recall of events that happened during the intraoperative phase. Intraoperative awareness with recall is a traumatic occurrence with the possibility of enduring psychological effects. This is a cross-sectional study to determine the incidence of intraoperative awareness among patients undergoing general anesthesia during elective surgery in Zamboanga City Medical Center using a semi-structured questionnaire including the modified Brice questionnaire. A total of 80 respondents who underwent elective surgical procedures under general anesthesia from June to November 2021 participated in this study. Findings of this study revealed that the incidence of intraoperative awareness with recall under general anesthesia among patients undergoing elective surgery in Zamboanga City Medical Center is 0%. This might indicate sound anesthetic management of residents during elective surgical procedures. However, further studies must be conducted to supplement the findings of this study. ▲ Show less

This research study aimed to determine the effects of intracuff lidocaine on the prevention of emergence phenomena after general endotracheal anesthesia to prevent post-operative complications. The analysis of this study was mainly focused on patients at the Zamboanga City Medical Center where the usage of intracuff lidocaine is not a current practice. This study used a single blind randomization. Patients who underwent general surgical procedures not needing muscle relaxation that require reversal using neostigmine and atropine, in a prospective, randomized, single – blinded trial were included in the study. The anesthesiologist observed the incidence of coughing, increase in blood pressure, and increase in heart rate after extubation. This study found out that a small dose of lidocaine, as an alternative to air instilled in the endotracheal tube cuff significantly prevented the incidence of cough and increase in heart rate post extubation. ▲ Show less

The study aimed to determine the prevalence of work related stress and burnout among ZCMC employees during the 2nd year of the COVID pandemic. A cross sectional study was done and utilized a convenient sampling to acquire 278 respondent at which only 172 responded and completed the questionnaires. Descriptive analysis was utilized on the data. Frequency distribution and ANOVA test was done to determine the statistical significance of the data acquired. A P-value test was done to determine that the sample population acquired gave significant. Analysis was performed with the help of data processing software (IBM Statistical Package for Social Sciences). 18.53% of Hospital employees experience work stress. Burnout can especially be seen in age group of 31-40 and in the female gender. The prevalence of work stress such as High Job and Mental demands, Role ambiguity, their psychological status and their coping mechanisms may reflect the high prevalence of burnout. It is shown that 43.75% of respondents have Personal burnout and are much higher than the work (16.47%) and client related (24.43%) burnout. The study only focuses on the prevalence of the variables. This implies that any correlation on work-related stress and burnout of the participants needs further research. With the result of the study, it is recommended to develop activities to address high levels of burnout. The activities might be focused on one of the factors or all of the work-related stress if possible that may lead to this high levels ▲ Show less

Background: Critical congenital heart disease (CCHD) is a serious illness in the neonatal period if not detected early. Many newborns who are diagnosed late with CCHD go back to the hospital after discharge with complications and succumb to death. Thus, a newborn screening through the pulse oximetry was introduced to diagnose early CCHD and to have early intervention for a better prognosis. Objective: This study aims to determine the prevalence rate of critical congenital heart disease among asymptomatic term newborns in Zamboanga City Medical Center. Methodology: This is a descriptive cross-sectional study on asymptomatic term newborns ages 24 to 72 hours of life who were directly roomed in with their mother. Result: Out of 926 asymptomatic term newborns screened aged 24 to 72 hours of life, only 1 newborn failed the pulse oximetry screening test. His 2D echo result showed dextrocardia, complete atrioventricular septal defect, double outlet right ventricle, malposed great arteries, moderate to severe pulmonary stenosis, closed ductus, mild atrioventricular regurgitation, and right sided aortic arch. Therefore, the prevalence rate of CCHD among asymptomatic term newborns born in ZCMC is 1.08 per 1,000 live births. Conclusion and Recommendation: The prevalence rate of CCHD in Zamboanga City Medical Center is 1.08 per 1, 000 live births. Pulse oximetry screening as a tool for detection of CCHD is recommended for early recognition and for appropriate medical and surgical interventions to reduce mortality rate. ▲ Show less

Objective: To determine and compare the accuracy, anatomical correctness, and applicability of 3D printed synthetic temporal bones printed using Polyethylene Terephthalate Glycol (PETG), SimuboneTM, and Standard Photopolymer Resin for surgical simulation. Methods: Design: This is a quantitative, experimental, matched pairs design for the development and design of a potential surgical simulation device Participants: Otologists/neurotologic surgeons Results: In terms of anatomical accuracy, structures in the Standard Resin model were evaluated to be significantly accurate than PETG and Simubone™. Standard Resin had a higher mean score of 31 ± 0.71 compared to PETG (28.4 ± 1.8), and Simubone™ (29 ± 4.53) for simple mastoidectomy. For canal wall down mastoidectomy, Standard resin (24 ± 2.79) was significantly favored over PETG (19 ± 2.61), and Simubone™ (20 ± 2.70). All models were significantly less accurate for structures evaluated in Posterior Tympanotomy (Resin = 27 ± 3.96; PETG = 20 ± 7.58; Simubone™ = 24 ± 3.27) and in Labyrinthectomy (Resin = 8.8 ± 1.3; PETG = 7.6 ± 0.89; Simubone™ = 7.67 ± 0.89). Comparison between CT scan measurements showed that there were no significant differences among the models. Moreover, the dissection experience for Standard Resin best-replicated bone in all aspects (Haptic feedback, Drillskip, Creation of bone dust, Bone hardness, and change in drill pitch). All dissectors deemed Standard Resin to be applicable for Simple and Canal Wall Down Mastoidectomy. However, most dissectors found all models to be unsuitable for Posterior Tympanotomy and Labyrinthectomy. Conclusion: Desktop-grade 3D printers may be used to create synthetic temporal bone models for surgical simulation of Simple and Canal Wall Down Mastoidectomy. ▲ Show less

Background: Breast cancer, the leading cause of female mortality globally after lung cancer, presents a significant public health challenge. Within this context, Triple-negative breast cancer (TNBC), an aggressive subtype comprising 15-20% of cases worldwide and 8% in the Philippines, predominantly affects younger women and exhibits a poor prognosis. Current treatment strategies include chemotherapy and surgery, but research is limited, especially in the Philippines. Methods: This retrospective cohort study assessed TNBC patients at the Zamboanga City Medical Center Cancer Institute, aiming to profile demographic and clinicopathological characteristics, evaluate treatment response, outcomes, and time to progression. Descriptive statistics was employed for data analysis. Data were obtained through medical record chart reviews, funded by ZCMC – Cancer Institute under the DOH Research Exploration Sub allotment for 2020. Results: The study included 25 TNBC patients, predominantly premenopausal women under 50 residing in Zamboanga City, presenting with advanced stage 4 cancer, primarily with lung metastases. Adjuvant chemotherapy showed the highest response rate, followed by neoadjuvant and palliative chemotherapy. However, disease progression was observed in some patients despite treatment. Those in the neoadjuvant setting exhibited faster progression than those in the adjuvant setting. The study found an incidence rate of 4.24% for TNBC among breast cancer patients seen at ZCMC Cancer Institute from 2018-2021. Conclusion: TNBC presents as an aggressive subtype with typical clinical characteristics. Adjuvant chemotherapy may offer survival benefits, but rapid progression and poor prognosis persist. Further research and innovative treatment approaches are essential. Recommendations: Future research should expand sample sizes, participate in clinical trials, promote early detection, collaborate internationally, and enhance palliative care services for TNBC patients. These endeavors are important in advancing TNBC management and improving patient outcomes. ▲ Show less

This research utilized a phenomenological study design focused on the lived experiences on phantom limb pain of patients who underwent limb amputation in Zamboanga City Medical Center. There were ten participants initially recruited; however only five were actual respondents due to non-consent or loss to follow up. Data saturation was still achieved from those respondents who took part in this endeavour. They were conversed with by means of a semi-structured interview guide. Translation of the said questionnaire involved participation of local English teachers who speak the same dialect as the respondents. Necessary revisions on the questionnaire were taken into consideration to accurately reflect the views of the patient-respondents. The semi-structured interview guide questionnaire is composed of five open-ended questions that elicited responses pertaining to the experience of phantom limb pain at least two weeks post-amputation. These responses were recorded and transcribed verbatim. Analysis of the transcripts made use of the steps described in Interpretative Phenomenological Analysis by Jonathan Smith and Mike Osborn (2007) serving as a guide. The resultant superordinate themes are outcomes of the steps described as follows: (1) The beginning, (2) Search for Respite, (3) The Here and now, and lastly, (4) Moving Forward. Themes noted describes the patient-respondents’ Development of phantom limb pain, personal description of pain along with its location and triggers. Also noteworthy of these themes are their use of pharmacologic therapies and alternative forms of relief. The daily lives of patient-respondents were also highlighted in how their pain impacted their productivity and social constructs. Remarkable also are their ways of adjustment and as advocates for social justice to include betterment in the fight for best health care access for all. The results of this study will be valuable as this will give a better understanding of phantom limb pain in the perspective of the patients. As health professionals, we can tailor specific approach in managing phantom limb pain based on the needs verbalize. And to further foster the motivation to formally launch a Comprehensive Pain Center capable of addressing Phantom Limb Pain and other pain syndromes. ▲ Show less

Background: Laparoscopic cholecystectomy is a common procedure done in the operating room today. It is preferred because of its benefits. However, post-operative nausea and vomiting (PONV) were higher after laparoscopic cholecystectomy than other surgeries, these side-effects may not be immediately life-threatening but are unpleasant experience for patients and increases length of post anaesthetic care unit stay. Metoclopramide, it is an anti-emetic which acts on both central dopamine and serotonin receptors. It is commonly used in hospitals because of its availability and inexpensiveness. In ZCMC it is the common pre-operative anti-emetic drug in Laparoscopic Cholecystectomy procedures. Objective: the study aims to determine the incidence of PONV in patients given pre-operative anti-emetic (metoclopramide) after laparoscopic cholecystectomy in ZCMC. Methods: The study utilized a prospective cohort design, as the researcher observed the incidence of PONV after laparoscopic cholecystectomy among patients not given vs given metoclopromide as a pre-operative medication. Results: a total of 16 patients were included in the study, a 34% response rate. 62.5% of the respondents had no PONV and from the 37.5% with PONV, mostly where from the control group (without metoclopramide given): 50% with PONV are from the control and only 25% from the metoclopramide group; 75% with PONV are within the normal BMI; a weak negative correlation (-0.15) betweem age and PONV among the metoclopramide group and a weak positive correlation (0.042) between age and PONV in the control group. 25% (2) with 13mmHg intraabdominal pressure were from the control group plus 12.5% from 14 and 15mmHg and only 25% at 13mmHg from the metoclopramide group. Conclusion: This study showed that metoclopramide decreases incidence of PONV when given preoperatively. Moreover, likelihood of PONV will be observed among ages 45-50, female gender and intraabdominal pressure adminitration whether given metoclopramide preoperatively or not. ▲ Show less

BACKGROUND: Malnutrition is known to be a common occurrence in Chronic Kidney Disease (CKD) patients and may have an impact on their quality of life and survival. OBJECTIVE: The aim of this study is to use Malnutrition Inflammation Score (MIS) as a screening tool in evaluating the nutritional risk of the CKD patients to assess the correlation of their malnutrition-inflammation status with mortality and morbidity. METHOD: An analytical, cross sectional study was performed on 60 Zamboanga City Medical Center (ZCMC) maintenance haemodialysis patients, selected through convenience sampling. The Malnutrition Inflammation Score (MIS) was used as the standard screening tool, it is a combination of the seven components of Subjective Global Assessment (SGA) of Nutrition (weight loss during the previous 6 months, symptoms of gastrointestinal tract, dietary intake, functional capacity, comorbidity and metabolic demand, muscle wasting, fat stores) and three new components which are body mass index, serum albumin and total iron binding capacity. Each component has four levels of severity, from 0 (normal) to 3 (very severe). The sum of the ten components ranges between 0 and 30. The score is directly proportional with the severity of malnutrition and inflammation. In this study, the MIS was modified with the laboratory tests eliminated. Mortality and hospitalization were monitored prospectively for the next three months. RESULTS: The area under the curve of modified MIS was 0.4649 (0.27 0.66), indicating that there's no correlation between modified MIS Score and morbidity and mortality of maintenance hemodialysis patients. CONCLUSION: We do not recommend modified MIS as a tool in predicting morbidity and mortality in maintenance hemodialysis patients, Scoring is not useful without the laboratory tests. The patients need to be monitored for an extended period of time, > 6 months, to further evaluate clinical outcome. ▲ Show less

Background: The use of herbal and dietary supplement in cancer patients has been increasing over the past years while the risk of its adverse effects and undesirable reactions with conventional cancer treatment has also been accumulating. Limited studies involving perception of HDS by cancer patients has been conducted in our setting. This study aims to explore factors affecting herbal and dietary supplement use and it's financial impact among adult cancer patients undergoing treatment at the Zamboanga City Medical Center (ZCMC) Cancer Institute Methodology: An initial survey was conducted among adult cancer patients undergoing treatment at the ZCMC Cancer Institute. HDS users were recruited for the Focus Group Discussion (FGD) via purposive sampling. Focus groups were conducted until no new information was achieved. A total of four groups were conducted. Clinical and demographic data were presented through descriptive statistics while data from the FGD were subjected to coding and thematic analysis Results: Among 22 respondents, more than half (65.4%) of the participants were noted to have used HDS and most (54.5%) of them were breast cancer patients with stage II-III disease. Treatment of cancer, coping with chemotherapy, and relief of cancer symptoms were the major reasons for HDS use. Majority (36.36%) of patients were influenced by the media/internet and most (50%) did not disclose information to their primary health care providers. Eight ofthe respondents whose income were below minimum wage, spend more than 25% of their income on HDS, with some of them having spent more than 50% of their monthly income. This may seriously limit their funds and result in failure to adhere to treatment Conclusion: Among cancer patients in ZCMC, HDS use is widely practiced and half do not disclose this information to their physicians. The expenditure on HDS consumes one fourth to half of the population's meager monthly income. The secrecy surrounding its use and attendant cost may possibly limit adherence and adversely affect outcomes ▲ Show less

ABSTRACT Increasing concerns of Vaginal Birth after previous cesarean section remained a controversy few years ago. There are factors in achieving success of vaginal delivery after cesearean section. According to Williams Obstetrics (24th Edition), in general there is approximately 75% success rate for women who attempt Vaginal Birth After Cesarean Section (VBAC) but may vary according to institution and providers. The primary objective of this study was to evaluate the maternal and fetal outcome in women with one previous cesarean section. This is the primary research in analyzing maternal and fetal outcome who underwent VBAC in Zamboanga City Medical Center. There were a total of 114 cases included in this study. This is a cross sectional study that was conducted at the Zamboanga City Medical Center. Admitted patients in the institution during the year 2017-2019 one previous uterine scar and are qualified for the study was identified. Retrieval of records was made after the patients were identified. Thus, Maternal outcome was evaluated according to: Mode of delivery, Indication of Previous CS, Gravidity and fundic height was noted. For the Neonatal Outcome as to: Apgar Score, Sex of the baby, ballard's score and discharge outcome. This study can conclude that VBAC can be given as a safe option to the patients in Zamboanga City Medical Center and have been selected with appropriate criteria. Hence, these women with one previous cesarean section have the chance to deliver vaginally and undergo Trial of Labor after Cesarean Section (TOLAC) especially for tertiary hospital facility and double setup is readily available ▲ Show less

Tuberculous meningitis is the most dreaded manifestation of tuberculosis and is a common central nervous system infection especially in developing countries like the Philippines. The outcome is dependent on early diagnosis and prompt treatment. Diagnosis is difficult and differentiation from bacterial meningitis is often impossible through clinical features alone. Objective: This study aims to differentiate acute bacterial meningitis from tuberculous meningitis using the Thwaites' diagnostic scoring in adult patients with central nervous system infection admitted at Zamboanga City Medical Center. Methods: Chart review was done to gather patients admitted with a final diagnosis of central nervous system infection. The charts were reviewed as to the clinical presentation of the patients and the following baseline diagnostic tests: complete blood count, chest radiograph, cranial CT scan with contrast, and lumbar puncture for CSF analysis. CSF analysis which may include AFB smear, TB culture, Nucleic Acid Amplification, and routine gram stain and culture were also retrieved. Patients were included in the study according to the inclusion and exclusion criteria. Forty-eight charts were available for analysis. Of the 48 patients, 15 had a final diagnosis of tuberculous meningitis and 33 had bacterial meningitis. The prediction of tuberculous meningitis was determined using Thwaites' Diagnostic Scoring using parameters such as age, history of illness, white blood cell count and the percent of neutrophils in the CSF. Results: The sensitivity and specificity of Thwaites' diagnostic scoring were 100% and 72.7%, respectively. The positive predictive value and negative predictive values were 62.5% and 100%, respectively. Conclusion: Thwaites' diagnostic scoring, although simple, is helpful in differentiating tuberculous meningitis from acute bacterial meningitis. ▲ Show less

Tuberculous meningitis is the most dreaded manifestation of tuberculosis and is a common central nervous system infection especially in developing countries like the Philippines. The outcome is dependent on early diagnosis and prompt treatment. Diagnosis is difficult and differentiation from bacterial meningitis is often impossible through clinical features alone. Objective: This study aims to differentiate acute bacterial meningitis from tuberculous meningitis using the Thwaites' diagnostic scoring in adult patients with central nervous system infection admitted at Zamboanga City Medical Center. Methods: Chart review was done to gather patients admitted with a final diagnosis of central nervous system infection. The charts were reviewed as to the clinical presentation of the patients and the following baseline diagnostic tests: complete blood count, chest radiograph, cranial CT scan with contrast, and lumbar puncture for CSF analysis. CSF analysis which may include AFB smear, TB culture, Nucleic Acid Amplification, and routine gram stain and culture were also retrieved. Patients were included in the study according to the inclusion and exclusion criteria. Forty-eight charts were available for analysis. Of the 48 patients, 15 had a final diagnosis of tuberculous meningitis and 33 had bacterial meningitis. The prediction of tuberculous meningitis was determined using Thwaites' Diagnostic Scoring using parameters such as age, history of illness, white blood cell count and the percent of neutrophils in the CSF. Results: The sensitivity and specificity of Thwaites' diagnostic scoring were 100% and 72.7%, respectively. The positive predictive value and negative predictive values were 62.5% and 100%, respectively. Conclusion: Thwaites' diagnostic scoring, although simple, is helpful in differentiating tuberculous meningitis from acute bacterial meningitis. ▲ Show less

Introduction: Hypokalemia is said to be a common occurrence among preeclamptic patients, which in return, further affects the severity of hypertension. This study sought to determine the prevalence of hypokalemia in pre-eclampsia and its feto-maternal effects on term pregnant women in Zamboanga Medical Center from January 2016 to December 2017. Methods: This study used a retrospective descriptive correlational design, utilizing 114 respondents with preeclampsia who were employed in this study, accounting for the completeness of their data. Data were tabulated using excel, and percentage and frequency were used to present the different potassium levels and APGAR scores at birth and 5 minutes after birth, while linear regression was used to find correlation between APGAR score and maternal potassium levels. Result: In this study, it can be noted that hypokalemia had a prevalence rate of 30.4% among pre-eclamptic patients. Furthermore, among respondents with low potassium, hypokalemia was noted to be only either mild to moderate, as the majority had potassium levels of 2.5-3.4mEq/L APGAR scores for the neonates of this group of respondents were identified to be good despite hypokalemia. Almost all of the neonates had APGAR scores of 7-10 both at birth and at the 5th minute of life. Correlation was virtually non-existent, hence it can be said that there was no relationship between maternal potassium level and fetal APGAR score Conclusion: It can be concluded from the study that there is a relatively few number of parturients with preeclampsia that have low potassium levels, however, the magnitude of which could not be ascertained due to lack of data. Moreover, it can also be concluded that no relationship exists between maternal potassium level and fetal APGAR score. Hence APGAR score is almost entirely unaffected by maternal hypokalemia. Recommendation: Potassium was not noted to be related to the fetal outcome, the researcher recommends that potassium need not be taken routinely among pregnant mothers. Also that further research on this topic in the specific setting is no longer warranted. ▲ Show less

INTRODUCTION Cardiovascular diseases (CVDs) are the number 1 cause of death globally, taking an estimated 17.9 million lives each year according to world health organization. Diabetes mellitus is a significant risk factor and correlates with a higher incidence of silent myocardial infarction. OBJECTIVE This study was conducted to determine the incidence and clinical profile of silent myocardial infarction among diabetes mellitus patients admitted at Zamboanga City Medical Center METHODOLOGY This is a cross sectional study. All diabetic patients will be identified via list of admitted patients in Zamboanga City Medical Center. RESULTS A total of 130 patients were admitted as Diabetes Mellitus from May to November 2019 in Medical Center. Only 110 patients with diabetes mellitus were included in the study. The other 20 patients were excluded due to incompleteness of data. Out of 110 patients, there are 39 patients who had myocardial infarction then out of 39 patients, only 29 patients had silent myocardial infarction while 10 patients had typical myocardial infarction. Most of the silent MI noted with uncontrolled diabetes. CONCLUSION This study demonstrates that silent myocardial infarction are common in female sex which is also proven in the study of Dr. Sebar Sala as one of the predictors of silent myocardial infarction. Most of the patient had uncontrolled diabetes that could lead to occurrence of MI. Out of 110 diabetic patients, only 29 patients or 26% of population had silent myocardial infarction. Clinician must have a higher suspicion on patients with diabetic but further work ups must be done. Further studies with a larger sample size and prospective approach can help validate the findings of this study. ▲ Show less

PREVALENCE OF SUBSTANCE-RELATED DISORDERS AMONG PATIENTS SEEN AT THE ZAMBOANGA CITY MEDICAL CENTER PSYCHIATRY OUT- PATIENT DEPARTMENT FROM JANUARY 2016 TO JANUARY 2018 In partial fulfillment of the Requirements in Completion of Residency Training in the Department of Psychiatry DR.RAIZA RASUL JUMAANI Department of Psychiatry OCTOBER 2020 ABSTRACT Substance-Related disorder refers to a group of mental disorders that involves the use of drugs that directly activate the brain's reward system. Substance-Related disorder has been a global phenomenon that has affected almost every country to varying extent and character. In the Philippines alone, there has been a growing concern over the rampant use of illegal substances in the country. However, despite the burden of this group of disorders, local studies on Substance-Related Disorders have been very scarce. This study aims to determine the prevalence rate of substance use disorders among patients seen at the Zamboanga City Medical Center Psychiatry Out-Patient Department from January 2016 to January 2018. The result of this study would serve as baseline data for future studies and as a basis for policymaking and program development. This study utilized a retrospective chart review method, with a total of 1665 charts reviewed. The calculated prevalence rate of Substance-Related Disorders was 6.1% or 103 out of the 1665 total new consults. There was a predominance in substance-induced psychosis at 60.2% (n = 62) . Majority of cases were males 99% (n = 102) , in the 18-89 age group college levels 35% (n = 34) , Roman Catholics 60.2% (n = 62) , Zamboangenos 45.45% (n = 77) , unemployed 57.3% (n = 59) , single 61.2% (n = 63) , and living in Zamboanga City 74.7% (n = 77) In conclusion, the lower prevalence rate of Substance-Related Disorders of this study compared to the global data implies a need for strategies for better detection of these disorders. Psychoeducation that this is a mental disorder with possible treatment should be done to the public, clinicians, and policymakers to encourage affected individuals to obtain help and not end up locked-up in jail. Another possible reason for the lower prevalence rate is that more affected individuals were admitted to the hospital due to severe psychiatric symptoms. Therefore, the author recommends the inclusion of admitted patients for future studies. ▲ Show less

ABSTRACT COVID 19 is a global public health emergency that we are facing today. The study is a clinical case series in describing the fetal and maternal outcomes of mothers diagnosed with COVID 19 and delivered in Zamboanga City Medical Center from March 27, 2020 to September 30, 2020. This study is a retrospective descriptive type research which utilized the medical records of the mothers diagnosed with COVID 19. The fetal health outcomes included evaluation of APGAR score, neonatal birthweight, newborn's medical complications during and after delivery. and discharge outcome. For the maternal outcome, the study included the medical complications developed antepartum, postpartum, length of hospital stays, and discharge outcome. Demographic data of the respondents were analyzed using frequency and percentage distribution. Central tendency using median and mode were utilized as statistical treatment for the study. The study gathered a total of 49 mothers who tested positive, three of the newborns tested positive and one case of intrauterine fetal death who was not tested. Thirty-seven mothers had normal vaginal delivery and 12 delivered via low segment cesarean section due to obstetric reasons and not because of COVID 19 infection. All neonates delivered have normal APGAR score. Majority of the neonates have appropriate weight for their gestational age, and most were roomed in with their mothers while only 3 required neonatal ICU admission. All the respondents improved and subsequently discharged with no COVID 19 related complications. ▲ Show less

COVID 19 is a global public health emergency that we are facing today. The study is a clinical case series in describing the fetal and maternal outcomes of mothers diagnosed with COVID 19 and delivered in Zamboanga City Medical Center from March 27, 2020 to September 30, 2020. This study is a retrospective descriptive type research which utilized the medical records of the mothers diagnosed with COVID 19. The fetal health outcomes included evaluation of APGAR score, neonatal birthweight, newborn's medical complications during and after delivery. and discharge outcome. For the maternal outcome, the study included the medical complications developed antepartum, postpartum, length of hospital stays, and discharge outcome. Demographic data of the respondents were analyzed using frequency and percentage distribution. Central tendency using median and mode were utilized as statistical treatment for the study. The study gathered a total of 49 mothers who tested positive, three of the newborns tested positive and one case of intrauterine fetal death who was not tested. Thirty-seven mothers had normal vaginal delivery and 12 delivered via low segment cesarean section due to obstetric reasons and not because of COVID 19 infection. All neonates delivered have normal APGAR score. Majority of the neonates have appropriate weight for their gestational age, and most were roomed in with their mothers while only 3 required neonatal ICU admission. All the respondents improved and subsequently discharged with no COVID 19 related complications. ▲ Show less

This research is a cross sectional study aimed to determine the clinical and biochemical characteristics of young patients with diabetes at Zamboanga City Medical Center. Besides determination of patient profiles, prevalence of diabetic retinopathy among the population was also determined. Results showed that among the patients who participated in the study, 27.5% already had diabetic retinopathy. Common characteristics determined was that most were females with ages on the higher range, belonging to the Chavacano and Visayan ethnic groups. Majority of the population are employed and educated, without vices but without regular weekly exercises. Most patients also had a strong family history of diabetes. Contributing factors to the development microvascular complications such as lipid profile, blood pressures, BMI and waist-to-hip ratio, were mostly within normal. Despite this, most of the patients had poor glycemic control. Association of this finding to the population's low adherence to medications however, was not established. ▲ Show less

Management of diabetic foot ulcers is multi-disciplinary as it not only involves purely medical management. Surgical intervention such as wound debridement or even amputation is crucial once the complication has set in. Looking at the patients' outcomes can provide insights as to the efficiency and sufficiency of the managements currently rendered in a multidisciplinary approach. Objective: This study aims to examine cases of diabetic foot ulcers admitted in ZCMC and determine the factors present in the patients' demographics, clinical background and in-hospital conditions and their association with the outcomes of their management. Methods: This is an analytical cross sectional study. Chart review was done to all cases of diabetic foot ulcers admitted from January 2017 to December 2017 utilizing the revised Diabetes Extremity Care Team (DECT) census form, initially used in Philippine General Hospital. Results: A total of 132 patients were included in the study. 108 were labeled as "discharged/improved," while 24 were labeled as unimproved. For the breakdown of unimproved, there were 11 mortalities, 7 HAMA and 6 readmissions. Patients with HbAlc more than 7% had an odds ratio of 5.676 for unimproved outcomes (p-value 0.003), while those with Hbalc less than or equal to 7% had an odds ratio of 10.52 for improved outcome (p-value 0.000). Comorbidities such as CKD and IHD are associated with unimproved outcome (OR 15.87, p-value 0.007 and OR 20, p-value 0.000 respectively). Likewise, in-hospital complications are associated with unimproved outcome. This include hospital acquired pneumonia (OR 18.55, p-value 0.000) and sepsis (OR 9.43, p-value 0.030). There is also statistically significant difference in the average number of days from admission to surgical procedure, with lesser days for improved outcome compared to unimproved outcome (4.28 days VS 7.58 days, p-value 0.000). Average length of hospital stay is also lower for patients with improved outcome (7.76 VS 11.38, p-value 0.000). Deferral and delay in surgery are also associated with unimproved outcomes (OR 31.8, p-value 0.000 and OR 18.4, p-value 0.000, respectively). Conclusion: Good glycemic control influences better outcome. On the other hand, co-morbidities, such as chronic kidney disease and ischemic heart disease, and in-hospital complications such as hospital acquired pneumonia and sepsis all leads to unimproved outcomes. Shorter hospital stay and lesser number of days for scheduling of surgical procedure both lead to improved outcome. Both deferral and delay in surgical management influence towards unimproved outcome. ▲ Show less

Pancreaticoduodenectomy, also referred to as the "Whipple's Procedure" is the most common surgical procedure for the resection of tumors in the pancreatic head, uncinate process, and neck as well as lesions of the ampulla, extrahepatic bile duct and duodenum. This procedure has since been associated with high perioperative morbidity and mortality. Rate and improvements in surgical technique and critical care however, have reduce the perioperative mortality rate to as low as 1% in high-volume centers. In Zamboanga City Medical Center (ZCMC), Whipple's Procedure was started around the year 2012 by a trained hepatobiliary consultant. From then on, it has been continued aiming for an oncologic resection with better patient outcomes, remission, and overall survival. With an estimate of five (5) Whipple's Procedure annually, it is important to document the evolution and success of the procedure by looking unto the patient's details and surgical outcome. Hence, this study aimed to provide the future medical practitioners especially the surgical residents and researchers data of the Zamboanga City Medical Center (ZCMC) experiences regarding Whipple's Procedure. Based from the documented records since 2015 to 2019, there was a total of 27 Whipple's Procedure including pylorus-preserving pancreaticoduodenectomy that were performed by a trained hepatobiliary consultant. Most of the patients belonged to 50-60 age group, male, resided within Zamboanga City, and presented with abdominal pain and jaundice. Furthermore, most of the patients were discharged but stayed for an average of 21 hospital days possibly due to diagnostic delays and preoperative preparation such as nutritional build-up. Hence, the researcher recommends additional study regarding Whipple's Procedure including the perioperative complications and follow-up status of the patients. ▲ Show less

The increasing trend of teenage deliveries in ZCMC is alarming. In 2015. fourteen percent of the total deliveries were teenage deliveries, and in 2017, the total number of teenage deliveries reached twenty-seven percent. The problem of teenage pregnancy is further compounded by rapid repeat pregnancy, meaning, the teenage mothers tend to have another pregnancy soon after the current pregnancy. Hence, proper birth spacing among teenage mothers is encouraged. With the various contraceptive methods available, Post Partum Intrauterine Device (PPIUD) is deemed as the best contraceptive to offer because of its long duration and with the least compliance and side effect. This study aims to determine the acceptance rate in the percentage of PPIUD among teenage mothers and identified contributory factors affecting the decision to accept PPIUD as their Family Planning Method. This descriptive study utilized a survey questionnaire patterned in the study of PPIUD in Embu, Kenya, with 183 subjects selected through convenience sampling. The acceptance rate of PPIUD among teenage mothers in ZCMC is low. During the prenatal check-up, family planning counseling was conducted, but LARC should be highlighted. ZCMC healthcare provider must also emphasize more effort and clarity of PPIUD follow-up. ▲ Show less

This study is a prospective and descriptive study design that aimed to study and investigate the incidence of breakthrough pain among post-operative patients who underwent major abdominal surgeries under General Endotracheal Tube Anesthesia (GETA) at the Zamboanga City Medical Center. The researcher utilized an assessment tool that gathered the demographic and surgical profile of each patient. The assessment tool were composed of mixed nominal and interval data. Data collated from the study have undergone appropriate statistical treatment supported with descriptive analysis. There were a total of sixty-two (62) subjects who voluntarily participated at the beginning of the study. Among the sixty-two (62) subjects, only fifty (50) who met the inclusion criteria. A total of 12 subjects were taken out of the study: five (5) of them dropped-out due to post-operative complications and seven (7) subjects were lost to follow-up. It can be concluded that of the 50 subjects, a total of nineteen (19) or thirty-eight (38) percent experienced post-operative breakthrough pain. And among the 38 percent, most of the subjects who experienced breakthrough pain falls under the age category of 46-55 years old, and are predominantly females, mostly are married, majority are Chavacanos, and are employed. For the surgical profiling, among the thirty-eight (38) percent, most of the subjects who experienced breakthrough pain falls under the normal weight category, subjects are predominantly classified as ASA 2 patients and mostly have undergone right upper quadrant procedures, and most of the procedures done lasted three (3) to four (4) hours. The highest number of subjects who experienced post-operative breakthrough pain had a VAS Score of seven (7); out of the nineteen (19) who experienced breakthrough pain, eleven (11) of them scored or had a rate or score of seven (7). ▲ Show less

INTRODUCTION In the Philippines, thyroid cancer ranks 7th overall, with an incidence of 5926 new cases per year. In Zamboanga City, no recent studies conducted regarding clinical profile of Thyroid cancer patients. OBJECTIVE This study was conducted to determine the clinical profile of diagnosed Thyroid cancer patients in Zamboanga City. METHODOLOGY This is a cross-sectional retrospective medical record review. RESULTS A total of 155 patients diagnosed with thyroid cancer by final histopathologic biopsy were included in this study. Majority of cases (68%) from Zamboanga City Medical center and (94%) from outpatient private clinic were diagnosed as Papillary Thyroid Cancer. Majority are females and occurring at the younger age group (<45 y.o.). Fine needle aspiration biopsy (FNAB) as an initial histologic test for malignancy showed low sensitivity as 32.07% of Papillary thyroid cancer and 58.82% of Follicular thyroid cancer were initially resulted as benign case in contrast to patient in outpatient private clinic wherein FNAB showed high sensitivity for detecting malignancy. Calcifications, hypo echogenicity, and solid predominance were the most common ultrasonographic findings and majority were diagnosed as Stage 2. A majority of cases were treated by complete thyroidectomy, followed by radioactive iodine therapy Chemotherapy was done for those unresponsive to RAI therapy 1.39% patient with papillary thyroid cancer. CONCLUSION In Zamboanga city, papillary thyroid cancer is the most common thyroid cancer. presents at a younger age group (<45 yr.) predominantly female with an incidence of distant metastasis at presentation. Thyroid surgery remains the treatment choice for thyroid cancer. Post- surgical radio ablation is important to eliminate residual tumor cells and was noted among patients consulted at outpatient private clinic. Follow up post thyroidectomy is important to monitor recurrence ▲ Show less

Tuberculosis ranks alongside HIV as a leading cause of death worldwide and the Philippines has one of the highest burdens of MDR-TB. Health-seeking behavior influences TB disease and compliance with treatment; However, studies that seek to understand TB health-seeking behavior have been few. This is the first analytical cross sectional investigation conducted on factors associated with TB health-seeking behavior in the region. PTB presumptive diagnosed patients consulted at Out-Patient Department of Family and Community Medicine from January 3 to June 30, 2019 were included. The data collection method was face-to-face interviews through a structured standardized questionnaire. To identify the prevalence of appropriate health-seeking behavior among presumptive TB patients, frequency distribution table was used. Out of the 246 PTB presumptive patients, only 77 (31%) had appropriate health-seeking behavior while 169 (69%) had inappropriate health-seeking behavior. To determine the factors associated with appropriate health-seeking behavior, the multiple regression was utilized. Based on this analysis, there were only 5 out of 30 identified factors associated with appropriate health-seeking behaviors: having Body Weight Loss (OR-2.12, p = 0.03 Cl = 1.07 - 4.2 ) Chest Pain (OR-15.38, p = 0 CI = 7.6 - 31.14 ) Shortness of Breathing ( OR = 2.58 , p = 0.02 CI-1.14-5.84), Heard about TB ( OR = 2.04 , p = 0.05 CI = 0.99 - 4.23 ) and information dissemination about TB through television (OR-1.39, p-0.01, C1-1.05-1.83). On the other hand, those who consider TB as not a serious or less serious disease ( OR = 0.73 , p = 0I CI-0.57-0.93) are less likely to have appropriate health-seeking behavior. The study revealed that health-seeking behavior was poor. Factors on TB symptomatology. psychosocial and health-related service factors has been associated with appropriate health-seeking behavior. To improve the outcome in health-seeking behavior, it is vital to have knowledge about the importance of health care. Furthermore, health advocacy on Tuberculosis must be intensified through mass media such as television. ▲ Show less

Background Developmental delay amongst institutionalized children has been widely prevalent. Earlier studies provide the following data: 78% of children adopted from Romanian orphanages were delayed in all four areas of development; 20 of the 25 children in the Romanian orphanage functioned at levels that were less than half their chronological age; a significant deficit in IQ was recorded in a study conducted in Lebanese children; and 35.7% of the 2514 children aged 6-35 months in eighty-three villages in Shanxi and Guizhou Provinces, China demonstrated suspected developmental delay. This study aims to determine the prevalence and common domains of developmental delay in institutionalized children in an orphanage in Talon-Talon, Zamboanga City. Methods This is a cross-sectional study among children institutionalized in the Reception Study Child Center in Talon-Talon, Zamboanga City. The Early Childhood Developmental Screening tool was used to identify the risk for developmental delay as well as the domains involved. Results There were 20 institutionalized children in the RSCC with ages 0-5 years. However, only 18 of these children were screened since two (2) children were already screened and diagnosed with developmental disabilities before. Among the screened institutionalized children, 55.56% of the population had risk for developmental delay. The most common domain involved was language. Conclusion The prevalence of risk for developmental delay was high at 55.56% and the most common domain of risk for developmental delay in children in RSCC, Talon-Talon, Zamboanga City is Language. ▲ Show less

Introduction: Home Against Medical Advice (HAMA) refers to the decision of patients to discontinue the recommended treatment and leave the hospital against the advice of the attending physician. These patients are at a high risk of complications and death. Objectives: To determine the reasons for going home against medical advice among patients admitted in the Internal Medicine wards of Zamboanga City Medical Center and describe their outcome after four months. Methods: In July 2018, a total of 65 HAMA cases were recorded for the Zamboanga City Medical Center-Internal Medicine Department of whom 36 consented to be interviewed. On follow up, four months later, 20 respondents agreed to be interviewed by phone. Responses were subjected to thematic analysis. Results: In this study, Community Acquired Pneumonia, Cerebrovascular diseases, and Non-healing Diabetic foot ulcers were the 3 most common diagnoses. The decision to go HAMA was made by the patients themselves in 15/36 (42%), and by their care givers in 13/36 (36%). The most common reason for HAMA was unclear treatment benefits 26/36 (72%); followed by dissatisfaction with treatment/care or unmet expectations 16/36 (44%); while 5/36 (14%) went HAMA because the patient was perceived to be well enough to go home. Factors contributing to dissatisfaction were poor hospital facilities 3/36 (8%) (bad ventilation and poorly sanitized latrines). On follow up 6/20 30% who went HAMA died. Of the 12/20 Sixty percent who were readmitted 6/20 returned to ZCMC. Conclusion: Lack of awareness of the disease or fear of the treatment were the most common reasons to go HAMA. ▲ Show less

This research study utilizes descriptive, qualitative- quantitative research design. The objective of the study aims to determine the nurses self assessment competency on the management of medical equipment in the Emergency Department of Zamboanga City Medical Center, and to find out if its hospital policies and other procedural guidelines are being observed and implemented. Also, it determines the factors that affect competency of the nurses managing the device. There are a total of 34 respondents from the emergency department were chosen and where the study was conducted. The respondents were invited on focus group discussion and instructed to answer the interview guide questions. Collection of the tool was done right after the survey and the data is processed and analyzed utilizing simple frequency and percentage method. The study shows the competency level of the nurses in the emergency department of Zamboanga City Medical Center based on the study conducted and individually assess the 34 nurses, the researchers findings prove that nurses are competent as much as necessary to handle the medical equipment as an end user understands, demonstrates specific device safely, can relate problem solving to device and patient care The study concludes that nurses in the emergency department are competent to handle the medical equipment for patient safety in spite of not having a formal training, seminar-workshop and teaching demonstration as the end-users. A recommendation to improve nurse's competency on the management of medical equipment in the unit. Based on the identified problems resulting to lack of training and seminar workshops for medical equipment for the nurses as the end-user in the unit. Continuous development program should also be provided to nursing personnel's to help them keep abreast with new technological trends and advancements on management of medical equipment as the end-user, Guidelines for re-training competency and self assessment with medical devices; Proposed Guidelines and Policy on Nursing Care Management of Medical Equipment, And utilizing the proposed Training Competency Management Tool, 1. Medical Equipment Competency Self Assessment Questions -A, 2. Competency Management Tool -B, 3. Staff Record of Medical Equipment Training Safety & Operation Medical Equipment -C. ▲ Show less

Tuberculosis (TB) is a major public health problem in the Philippines. The country ranked ninth among the 22 high tuberculosis burden countries. In children, tuberculosis occurs in as much as 40% of all new tuberculosis cases Accurate and rapid detection of tuberculosis, including smear negative tuberculosis and drug resistance - tuberculosis are critical for improving patient outcomes and decreasing tuberculosis transmission. The update recommends that the GeneXpert MTB/RIF test may be used as the initial diagnostic test in place of the conventional microscopy and culture on all children suspected to have tuberculosis. This is a cross-sectional study to identify the prevalence of pulmonary tuberculosis among pediatrics patients with clinical signs and symptoms of tuberculosis in the Pediatric out-patient department of Zamboanga City Medical center using Gene Xpert MTB/RI Participants were aged 8-17 years with signs and symptoms of tuberculosis like chronic cough, unexplained fever for 2 weeks, and loss of weight. The result of this study showed that less than half (39/160 24%) of suspected pulmonary tuberculosis cases with a main symptom of chronic cough were found to be positive for pulmonary tuberculosis as per Gene XpertMTB/Rif. Given the high sensitivity of Gene Xpert MTB/RIF (88%)and specificity (99%)the importance of its use should be emphasized on the issue of over diagnosing and unnecessary treatment. The researcher concludes that Gene Xpert MTB/RIF should be recommended as the standard test in detecting pulmonary tuberculosis as well as the Rifampicin resistant strain in children so that over diagnosing pulmonary tuberculosis in children will be avoided and subsequent unwarranted treatment will be prevented. ▲ Show less

Anemia is a global problem and has affected all types of people in different age groups. Anemia in Pregnancy has been recorded worldwide and Philippines has a prevalence of 25.2% in 2013 (DOST-FNRI, 2013). In Zamboanga City, it is said to be much higher, but little is known about the true picture of anemia among pregnant women at the Zamboanga City Medical Center (ZCMC) Obstetrics and Gynecology (OB-Gyne) Ward. This study aims to determine the prevalence of anemia among pregnant women 37-42 weeks age of gestation at ZCMC. Moreover, this seeks to identify the maternal and fetal outcomes of pregnant women with anemia. A cross-sectional descriptive design was used in this study, where respondents were interviewed using a tailored questionnaire. Charts of the rest of the admissions from June 1 to June 30, 2017 were also reviewed for the prevalence. This study reveals a prevalence of anemia among pregnant women 37-42 weeks of gestation to be at 54.69%. Sixty nine respondents were interviewed and observed for maternal and fetal outcomes and it revealed that majority of the mothers in this study were 21-25 years (34.78%), single (52.17%), Bisaya (33.33%), and were housewives (92.75%). In terms of their diet, all respondents were non-vegetarian, most ate three times a day (97.10%), ate fish (71.01%) everyday, included pork (52.17%), beef (73.91%). chicken (79.71%), and egg (65.22%) occasionally in their diet, and almost have never drank tea at all (56.52%). Respondents in this study were mostly primigravidas (44.93%), were registered on the first (47.83%), second (37.68%) or third (13.04%) trimester, visiting a local health center (75.36%) for four or more times (79.71%). and took in iron supplements regularly (59.42%). Deliveries were mostly via NSVD (75.36%), with majority having clear amniotic fluid (65.22%). Three (4.35%) respondents suffered from postpartum hemorrhage due to retained placenta, whereas 6 (8.70%) had pregnancy-induced hypertension. In terms of anemia, a great bulk were mild (49.27%), closely followed by moderate (40.58%). Thirteen (18.84%) necessitated blood transfusion. All respondents eventually survived their pregnancy, thereby anemia included, and were sent home eventually well. Birthweight, APGAR score on the 1st and 5th minute and disposition upon delivery for majority of the newborn were good and acceptable. However, two eventually died and 16 were admitted either at the neonatal or sick intensive care unit for neonatal pneumonia (5.80%), neonatal sepsis (4.35%) and perinatal asphyxia (1.45%). Three (21.43%) among those with CBC results were noted to also have anemia. It can be concluded that the problem of anemia among pregnant women at ZCMC is severe, based on the WHO criteria, and should be addressed immediately. Food intake most likely was linked to development of anemia while there is doubt whether iron supplementation is sufficient to avoid development of the same. This however needs further support and could be identified in a future study in comparison to controls. It can be surmised though that anemia is multifaceted and involves many factors. Maternal and fetal outcomes were considered good, since a great majority surfaced from their admission alive and improved. ▲ Show less

INTRODUCTION: The Philippines ranked 9th of the highest TB-burden countries in the world and has one of the highest burdens of multi-drug resistant TB (MDRTB). There is a global increase of prevalence of MDRTB which is an alarming problem. Aside from the previous treatment of Pulmonary TB other important risk factors for acquiring MDRTB is a spontaneous mutations or transmission of drug resistant strain to a treatment- naïve patient. OBJECTIVES: The primary objective of this study was to determine the prevalence of MDRTB among newly diagnosed PTB 3 category I patients in Zamboanga City Medical Center and to identify the association of multidrug resistant status with the following patient factors: age, sex, civil status, occupation, duration of cough, co-morbidities, TB exposure, socio-economic status, chest x-ray finding, sputum AFB and BCG vaccination. METHODS: This is a cross-sectional study, which was conducted at Zamboanga City Medical Center from June 2016 to June 2017. Patients who were diagnosed as PTB 3 category I were subjected for testing of sputum for Gene Expert at PMDT (Programmatic Management of Drug-Resistant TB). Those patients who tested positive was diagnosed as having Multi-Drug Resistant TB. RESULTS: There were 221 patients newly diagnosed with PTB3 category 1. The prevalence of MDRTB was 8.60% (19 out of 221); the significant predictors identified were cough duration of 2 to <4weeks (P-value of 0.004) and chest X-ray findings of extensive TB (P-value 0.0001); other demographic data such as the age group between 25-34 years old and single were also associated with MDRTB. CONCLUSION: The prevalence of MDRTB among newly diagnosed PTB 3 category I patients in ZCMC was 8.60%, as compared to WHO Drug resistance surveillance data which showed an estimated 3.9% updated last 2016. This result is quite alarming hence formulation of Public Health programs to ensure effective prevention, early detection and treatment are vital. The significant predictors identified were cough duration and chest x-ray findings of extensive TB. ▲ Show less

This study is a descriptive, cross-sectional, prospective studywas conducted at Zamboanga City Medical Center with the following objectives: (1) to determine the demographic and clinical characteristics of patients diagnosed with hypokalemic paralysis admitted at Zamboanga City Medical Center, and (2) to describe their biochemical profile such as serum electrolytes, urine electrolytes, ECG, TTKG and urine potassium-creatinine ratio, urinalysis, ABG, and thyroid panel. It was noted that only seven (18%) respondents have urine potassium of 15mmol/L or more which would indicate a renal potassium-wasting and is seen among six (16%) respondents diagnosed with renal tubular acidosis while only one respondent (3%) was labled as unidentified due to lack of other laboratory work-up for Bartter or Gittleman syndrome. Since all respondents have a urine osmolarity value less than plasma osmolarity, the TTKG results became unvalid and so, urine potassium-to-creatinine ratio was computed which revealed an elevated urinary potassium-creatinine ratio of >2.5 was seen in patients with renal potassium loss (27 in RTA, and 3 unidentified etiology due to lack of further laboratory work-up), and 3 patients with history of diarrhea (with concomitant renal potassium loss). ▲ Show less

This is a descriptive cross-sectional research design to determine the pulmonary function of tricycle drivers in Zamboanga City with the following objectives: (1) To determine the clinical profile of male tricycle drivers. (2) To determine the duration of exposure in relation to exposure to air pollution. The researcher utilized convenience sampling method in identifying respondents in this study. The researcher randomly asked respondents to undergo the investigation. Respondents underwent Chest X-ray in order to determine patients with other pulmonary diseases and Pulmonary Function Profile in Zamboanga City Medical Center. This study aims to determine data availability regarding nonsmoking individuals exposed to air pollution by being a tricycle driver can be a risk to develop COPD. Eighty-three tricycle drivers were included in the study. Result showed 41% had a FEV1/FVC ratio of <0.70 compatible of diagnosing COPD. Twenty-four percent had less than 10 pack year smoker. Eighty-two percent had clinical symptoms of COPD. Result of this study served as a database on Pulmonary function of tricycle drivers in Zamboanga City and promote awareness of individuals who are likely to develop COPD hence the researcher decided to do this research. ▲ Show less

Introduction. Automated analyzers include rapid, objective, and statistically significant cell counts that are not subjected to the distribution bias. This study aims to evaluate Nucleated Red Blood Cell Flagging using automated hematology analyser. Methodology. CBC results generated by the automated hematology analyzers of Zamboanga City Medical Center Integrated Laboratory during (insert date here) that have not been otherwise excluded was included in this study. Slide review was done for all samples. Results. A total of 800 PBS slides were assessed. There were 26 patients who had nRBC on peripheral blood smear, giving a prevalence of 3.25%. The XN-550 demonstrated a sensitivity of 42.3% and a specificity of 99.1%. Conclusion. The Sysmex XN-550 had demonstrated good sensitivity and specificity to NRBCs with an overall accuracy of 97.25%. ▲ Show less

Introduction. Automated hematology analyzers provide a reliable quantitative count. However, for samples with qualitative abnormalities such as presence of immature cells, peripheral blood smear examination is still required. This study aimed to assess the accuracy of the XN-550 (Sysmex) in detecting blasts in blood samples submitted for Complete Blood Count (CBC) examination among adult patients at the Zamboanga City Medical Center. Methodology. This is a prospective cross-sectional study involving complete blood examination of adult patients from November 2019 to December 2019 using XN-550 (Sysmex) automated hematology analyzer. Samples with blast flagging were subjected for peripheral blood smear examination for microscopic identification of blasts. We then calculated the sensitivity, specificity, PPV, NPV and likelihood ratios and determined the accuracy of blast flagging using automated hematology analyzer against microscopic examination using peripheral blood smear as the reference standard. Results. A total of 1325 unique blood samples were included in the study. Eighty-three (83) of which had blasts on peripheral blood smear, giving a prevalence of 6.27%. The sensitivity, specificity, PPV, and NPV of XN-550 compared with the reference standard using peripheral blood smear were 91.6%, 97.3%, 69.7%, and 99.4% with an overall accuracy of 96.98% to detect blasts. Conclusion. XN-550 analyzer has a good sensitivity, specificity and overall high accuracy in detecting blasts. Differential white blood cells count can be released with confidence using XN-550. ▲ Show less

Background: Stroke or cerebrovascular accident is an abrupt onset of neurologic deficit that is attributable to a focal vascular cause. Thus, the diagnosis of stroke requires both clinical and laboratory test particularly a brain imaging for confirmation. Stroke ranks as the second leading cause of mortality globally and leading cause of disability. Objectives: The primary objective of this study is to determine the clinical and risk factor profile of stroke in the young and elderly among admitted patients at ZCMC IM Department between Jan 1 2020-Dec 10, 2020. Methodology: A descriptive, cross-sectional design was utilized as a method for data gathering to determine the clinical and risk factor profile of selected admitted patients under the Zamboanga City Medical Center Internal Medicine Department presenting as cerebrovascular disease who consented. Data was obtained through direct observation and face-to-face interview utilizing a structured checklist for cerebrovascular disease clinical and risk factor profile. Frequency distribution and central tendency was used in interpreting the gathered information. Results: A total of 80 admitted cerebrovascular disease (CVD) patients were included in this study. Majority belonged to the older population with 59 (73.8%) respondents while only 21 (26.3%) belonged to the younger population. The demographic characteristics of young and older cerebrovascular disease patients were similar in which majority was male, married, Roman Catholic, Chavacano, unemployed with low socioeconomic status. Hypertension, Diabetes Mellitus, and smoking are the most common risk factors and co-morbidities in general. CVD bleed was more common in the young CVD age group with an average of 57.1% (12 out of 21) while CVD infarct was more common in the older CVD age group with an average of 57.6% (34 out of 59). Conclusion: In conclusion, there are minimal differences in the clinical and risk factor profiles among young and older CVD patients admitted at Zamboanga City Medical Center department of Internal Medicine. The presentation is the same with regards to risk factor and most clinical profile of both age groups but it was notable that cerebrovascular bleed was more common in the younger age group. Recommendations: A bigger prospective study with a similar distribution of patients under the young and older age group with further investigation on the different practices of individuals from their respective ethical background. Inclusion of other diagnostic and laboratory tests would be beneficial to investigate and identify the causes and mechanism of stroke especially in the younger age group. ▲ Show less

Background: Depression is well known to affect adults with end-stage renal disease (ESRD). It has been identified as the primary mental health problem among dialysis patients with a 2-10 higher prevalence compared to general population". CKD cases on the Philippines are on the rise. The Department of Health reports that one person dies every hour from kidney failure or about 120 Filipinos per million populations per year, making kidney failure as the ninth-leading cause of death among Filipinos today'. Screening and providing appropriate care for CKD patients with depressive symptoms is important since it can impair recovery. treatment, self-management and quality of life. Objectives: The primary aim of this study is to determine the demographic factors contributing to depression among patients undergoing hemodialysis in Zamboanga City Medical Center. Methodology: A cross-sectional study was utilized. Data were collected by means of the PHQ-9 Questionnaire. Results: A total of 93 respondents were included in the analysis, a 78.15% response rate. 60.22% of the respondents experiences depression at a varied rate. The demographic data that showed significant association to depression includes: employment status with p-value of 0.039, duration of HD with p-value of 0.0307, and family income (p-0.00084), and creatinine levels with p value of 0.045. Inferential analysis showed that ages 45-54 (12.9%), male gender (31%,), married (39.78%), higher educational background (27.5%), sleep disturbances (45.17%), hypertension (37.63%) have the most incidence of depression. Conclusion: There is a high prevalence (60.22%) of depression among the CKD patients that undergo dialysis. Patients that are unemployed, with low income, longer duration of HD and high creatinine levels will most likely experience depression. ▲ Show less

BACKGROUND: Individuals who are not known hypertensives are noted to have blurring of vision as an initial presentation. Preventable comorbidity such as hypertension is essential in saving sight in patients with cataract. OBJECTIVE: To determine the prevalence of hypertension and stage of hypertensive retinopathy among individuals who underwent cataract surgery and to identify the association between the stage of hypertension and the risk factors for hypertension and the stage of hypertensive retinopathy METHODS: This was a prospective study which included 203 individuals. All of the participants were noted to have mature cataract surgery done and was noted to have followed up at Tzu Chi Eye center from July 1, 2017, to March 30, 2018. The nature, significance, and procedure of the study were explained to every identified respondent. There was only one ophthalmologist who saw the participants who enrolled in the study. Once they understood the study, a written informed consent was taken. They were asked to answer questions provided by the researcher and their laboratory results were recorded. A follow-up after 2 weeks was done in order to determine the stage of retinopathy of the patients. Demographic variables, hypertensive retinopathy, history of hypertension, medication usage, compliance, ECG changes, proteinuria, creatinine, and cardiomegaly on chest x-ray, radiographic identification of Atheromatous aorta and fundoscopic examination were analyzed The Wong and Michell classification and the Keith, Wagner and Barker staging system was used for retinopathy grading RESULTS: A total of 203 patients (117 men, 86 women) with mature cataract were enrolled in this study, mean age was 64.33 +/-9.7 years. Upon inclusion, 92% are noted for hypertension and 7 out of 10 were noted to have severe hypertension. One out of four patients were newly diagnosed with hypertension. Among previous hypertensives, Twenty-one percent were not compliant to treatment. The Grade of hypertensive retinopathy correlated with duration of illness but did not with severity of hypertension. CONCLUSION: The American Heart Association stage of hypertension and the stage of hypertensive retinopathy by Keith, Wagner, and Barker has been shown to be directly associated with each other. The Grade of Hypertensive Retinopathy reflects duration and not the severity of hypertension. RECOMMENDATION: Although cataract operations are low risk, the current practice of referring these patients for medical evaluation prior to surgery is an excellent opportunity to diagnose new hypertensives and identify noncompliant cases. Initiating appropriate treatment may prevent complications among these elderly patients. ▲ Show less

Approximately 8 million babies worldwide are born each year with a serious birth defect (BD) which is the leading cause of death in the first year of life, and babies who survive may be physically or mentally disabled, taking a costly toll on their families, communities and nations. In the Philippines birth defects remain in the top 10 causes of infant mortality for the past 50 years. Around 50% of all BD have no specific cause but could either be one or a combination of risk factors: socioeconomic and demographic factors, genetic factors, infections, maternal nutritional status and environmental factors. Hence, a study was conducted to determine the prevalence rate and information about birth defects at the Zamboanga City Medical Center (ZCMC) from January to December 2018. A total of 59 BD cases were recorded out of 7,287 livebirths at ZCMC. A prevalence rate of BD was estimated at 0.81% where limb and facial deformities ranked as the top 2 types of deformity. Results of the following factors that has significantly associated with the occurrence of birth defects are the following: increasing maternal age, no pre-pregnancy planning, twin births, no vitamin intake and prematurity. The ones with protective factors associated with birth defects are no intake of medications during pregnancy, paracetamol intake and no pre-pregnancy chronic conditions such as hypertension, obesity, or diabetes. Results from this study would serve as an important information on the prevalence of birth defects in the Zamboanga Peninsula and could contribute to the database of the birth surveillance system in the Philippines. The study would also help address public health concerns on preconception and underscore the crucial factors on pre-natal care that could result to modifying practices and prevention associated with birth defects. ▲ Show less

Background: The World Health Organization considers at least 6.5% of the world's total population to be potential carriers of Thalassemia. In the Philippines, the incidence of Thalassemia is significantly high due to the different cultural and communal practices. Blood transfusions are the primary therapy for thalassemia but it comes with cumulative risks. Objectives: This research aims to determine the Serum Ferritin level, EF, ALT and Hepatitis Profile of Thalassemia syndrome patients in Zamboanga City Medical Center (ZCMC). It also aims to determine the number of thalassemia syndrome patients within two years, describe the clinico-demographic profile, determine the clinical outcomes of Thalassemia Syndrome patients and determine the association of Serum Ferritin levels and EF with age, gender, splenectomy, ongoing blood transfusion, number of blood transfusion, duration of illness and total volume of blood transfused. Methodology: This is a case control study among thirty Pediatric Thalassemia Syndrome patients seen at the ZCMC Pediatric Ward and OPD. The data gathered were analyzed using measures of central tendencies (Mean) and dispersion (SD) and logistic regression. Conclusion: The clinico-demographic profile shows equal distribution of all genders and all were alive. The mean age was 6.9 years old. Six underwent splenectomy and seventeen were receiving blood transfusions at the time of the study. The mean duration of illness was 1.94 days. The mean blood transfused was 1,337 cc. The loss to follow-up rate was twenty-seven percent. Increased serum ferritin was significantly associated with age and splenectomy. The serum ferritin and the other variables analyzed against ejection fraction showed no significant results. Hemosiderosis, Elevated Serum Ferritin, Depressed Ejection Fraction and Elevated Alanine Transaminase were prevalent during the study. ▲ Show less

Pain ranks among the most difficult and common problem in healthcare, and is often the cause of hospitalization. It often goes undetected and grossly under treated even after patients seek medical care. In an effort for better pain management, many healthcare systems have required routine healthcare screening and made pain as the 5th vital signs. Objective: The aim of the study is to evaluate the implementation of pain as the 5th vital sign among surgical ward nurses of the Zamboanga City Medical Center secondary is to determine the factors or difficulties they have in assessing pain as 5th vital sign. Methodology: The study utilized a cross-sectional method in conducting interview among the surgical ward nurses. Results: 51 nurses were included, a 100% response rate. 78.4% said that they assess pain routinely making it the 5th vital signs, 21.6% and 17.5% believes that pain assessment is important for patient's well-being and the patient should not feel pain during hospitalization respectively. Moreover, the main difficulty they encounter in pain assessment is patient's level of understanding 76.4% and lack of time 13.7%. The hospital has fully encouraged pain assessment to be part of the vital signs 64.7% and barely 9.8% were not informed of the inclusion. The main type of scale utilized by the respondents is the verbal-numeric scale (94.1%). Furthermore, Courses, trainings and updates on the importance of 5th vital sign and Strict implementation and requirement in its use are among the most viewed ways to improve proper pain assessment. In Conclusion, the nurses find pain assessment as fifth vital sign to be important, the major difficulty they find in implementing it the patient's level of understanding which falls as communication barrier as well as the lack of time. Making pain assessment as the fifth vital sign requires training, persistence, encouragement with supervision and guidance emphasized. ▲ Show less

This research study aimed to determine the effects of intracuff lidocaine on the prevention of emergence phenomena after general endotracheal anesthesia to prevent post-operative complications. The analysis of this study was mainly focused on patients at the Zamboanga City Medical Center where the usage of intracuff lidocaine is not a current practice. This study used a single blind randomization. Patients who underwent general surgical procedures not needing muscle relaxation that require reversal using neostigmine and atropine, in a prospective, randomized, single blinded trial were included in the study. The anesthesiologist observed the incidence of coughing, increase in blood pressure, and increase in heart rate after extubation. This study found out that a small dose of lidocaine, as an alternative to air instilled in the endotracheal tube cuff significantly prevented the incidence of cough and increase in heart rate post-extubation. ▲ Show less

The aim of this study was to evaluate the effect of Gabapentin on post operative pain in patients who underwent elective lower limb orthopedic surgeries under spinal anesthesia. In a randomized double blind study, 27 patients classified as ASA grade I and Il for elective orthopedic lower limb surgeries under spinal anesthesia were randomized into two groups. The Experimental Group received 300 mg oral Gabapentin and Omeprazole 40 mg oral 2 hours prior to surgery while the Control group only received Omeprazole 40 mg oral 2 hours prior to surgery. The postoperative pain was assessed by visual analog scale (VAS) at 2h, 4h, 12h and 24h after the conclusion of surgery. The number of rescue doses of Tramadol 50 mg given intravenously and side effect/s of Gabapentin within 24 hours (2h, 4h, 12h, 24h) after conclusion of the surgery were recorded. The pain score of the two groups within 24 hours after the conclusion of surgery were not significantly different. The number of patients requiring rescue doses within 24 hours after the surgery were also not significantly different between the two groups. There were no noted side effects after taking a single dose of Gabapentin in this study. ▲ Show less

Filipino families are under pressure to maintain "ownership" of taking care of their respective elderly relatives. Globalization and international migration pattern on the other hand puts pressure on the family as traditional caregivers. In anticipation of the eventual ageing of the Philippine society, it is just noteworthy to factor in cultural perspectives in managing senior citizens' long term care. Despite the Filipino "family values", the number of government-, non-government and privately owned nursing homes in the country keep increasing. A sign of the times, this trend could hardly be ignored. This paper explored the factors that are associated with the intention of the family decision-maker in considering the nursing home facility as second home for the elderly. Specifically, it estimated the proportion of decision-makers who were likely to enrolll their elderly relatives in a home for the aged. It also sought to determine the relationship of the identified factors to the intention or the decision in enrolling the elderly in said facility. The study was an analytic cross-sectional one. An interview schedule for the purpose was developed and pre-tested. Multiple logistic regression was used in the analysis of data. Despite the Filipinos growing up in a culture of reverence and deep respect for the elderly, the estimated proportion of 26% of the respondents who manifested intention to send their elderly to the home for the aged could not be ignored. Based on the findings, decision-maker's intention to enroll the elderly in a home for the aged is attributed to subjective norm, the opinions and perceptions of the people they consider significant and with authority. Furthermore, the elderly who is pensioner, in good health condition, perceives himself as not lonely along with the decision-maker earning at least Php 5,000.00 monthly have shown good response in the intention to enroll the elderly in a home for the aged. The outcome of the study was conceived as input in helping re-shape the Filipino's perception on the home for the aged. Results were also seen important in policy formulation for both government and non-governmental organizations tasked with the long term care for elderly citizens. In addition, the study may pave way for hospitals to look into the home for the aged as an additional option for health care services. ▲ Show less

Malnutrition is among the top healthcare issues that can be fatal if nutrition-care is not addressedby healthcare providers. Until now, this problem equally affects adults as well as children due to the lack of systematic nutritional assessment of hospitalized patients upon admission and adequate nutritional intervention. Therefore, as the initial health care provider to assess patients upon admission it is fundamentalto evaluate the physician's knowledge, attitude and practices on nutrition provision among hospitalized patients to facilitate better patient outcomes Objectives: The primary aim of this study is to describe the knowledge, attitude and practices of physicians on nutrition provision among adult hospitalized patient in Zamboanga City Medical Center using the M-KAP Questionnaire. Methodology: A cross-sectional study will be utilized. Data were collected by means of a Questionnaire. Purposive sampling was used in the study which included all residents and consultants who manage adult patients currently employed in ZCMC. Results: A total of 68 physicians both consultant and residents were included in the study, 70.3% response rate. The mean awareness of importance of nutrition in recovery is 80.88%(55, n=68), the respondents consciousness of their role on nutrition education (67.65%) on patients, and the collaborative effort to patient's proper nutrition is 50%. 30.88% gave a neutral response and 35% strongly agreed in making nutrition as a priority. There was a poor response rate on the practice of nutrition care, only 8% checks that the patient has all that they need to eat, 51.47% seldom checks the patient's nutritional need, whereas 41.17% and 44.11% seldom assist the patient during meal when they need help. A negative correlation was seen between the KA and P(r=-0.28801 ±1). No significant difference was seen in comparing the KA and P between the consultants and residents and ages, gender and years of practice (p=>0.05). Conclusion: Despite having a strong sense of awareness about the role of nutrition in the optimal recovery of their patients, this was not applied into practice. Therefore, there is a need to create strategies to educate and promote suitable nutritional assessment and support among physicians. ▲ Show less

Diabetes mellitus is a major health problem affecting an increasing number of individuals worldwide. Its chronicity causes a significant health burden adding to the complications and complex nature of its management. Family function and chronic illness care have an impact on the health of people with diabetes influencing health behavior and outcome. The study aimed to determine the association of family function and chronic illness care to medication adherence and glycemic control of type 2 diabetic patients consulting at the out-patient department of Zamboanga City Medical Center. The study utilized an analytical cross-sectional design utilizing convenience sampling in choosing the respondents among type 2 diabetic patients consulting at the out-patient department of Zamboanga City Medical Center. It employs a set of interviewer-guided questionnaire among the participants on their socio-demographic profile, family functionality, chronic illness care experiences and medication adherence. Hemoglobin AIC was used as basis for glycemic control as set by the guidelines published by the American Diabetes Association. The data gathered were analyzed through frequency distribution and Chi-square analysis. The results of this study noted that Type 2 diabetic patients consulting at the out-patient department of Zamboanga City Medical Center perceived their family as functional (64.83 percent). 91.20 percent claimed to have positive chronic illness care experiences, 71.42 percent have good medication adherence to their prescribed regimen and 92.30 percent have good glycemic control. Association was analyzed using chi-square analysis where family function was noted to be associated with glycemic control (p value = .00001) and chronic illness care experiences with medication adherence (p value = .00369). The data from this study shows that family function and chronic illness care experiences may have an influence on health behaviors and health outcomes such as medication adherence and glycemic control. Thus, looking into these factors might be useful in improving diabetic care and quality of life of Type 2 diabetic patients. ▲ Show less

At Zamboanga City Medical Center (ZCMC), different expert opinions are followed regarding core needle biopsy (CNB) because there are no local studies regarding CNB of breast tumors. This retrospective analytical cross sectional study through chart and slide review measured the diagnostic accuracy of non-imaging guided CNB against excision histopathologic examination of breast lesions at ZCMC from May 2015 to December 2018. Sn, Sp, PPV, NPV was computed and ROC analysis was used to show the discriminative power of the non-imaging guided CNB. A total of 106 histopathologic samples from patients were included in the study. Result shows that the sensitivity of non-imaging guided CNB of breast lesions is only 73.5% with a positive and negative predictive value of 96.2% and 66.7%, respectively. Moreover, if the total number and proportion of CNB samples submitted are taken into account, the ROC area under the curve drops to 0.5753, further lowering the sensitivity and specificity at 4.41% (for 4 CNB samples) and 0% (for 1 CNB sample), respectively. Furthermore, the agreement rate of non-imaging guided CNB and excision histopathologic examination is only at 81%. Non-imaging guided CNB of breast lesions has an inferior diagnostic accuracy compared to histopathologic examination of excised tumor. ▲ Show less

The aim of this study was to compare Nalbuphine and Butorphanol in the control of perioperative shivering following spinal anesthesia among obstetric patients for elective or emergency cesarean section. Twenty-one adult patients included 10 respondents for Nalbuphine group and 11 respondents for Butorphanol group. Each week throughout the duration of the study was randomly designated with Nalbuphine or Butorphanol. Group A received Nalbuphine 5 mg via intravenous route while Group B received Butorphanol 1 mg also via intravenous route. The onset time of shivering. cessation and recurrence were recorded. The severity of shivering was classified 5, 10 and 15 minutes after drug administration. There were no noted side effects in both groups. Both were effective in the treatment of shivering although Butorphanol was significantly faster in onset. In Nalbuphine group, shivering was completely controlled in 18.18% while it was 60% in Butorphanol group. However, this was not statistically significant. ▲ Show less

The Coronavirus Disease 2019 (COVID-19) pandemic has caused a global health crisis with significant mental health consequences associated with suicidal behaviors, hospital admission, and referrals to the psychiatry department. This study aims to determine the prevalence of suicidal behaviors of patients referred to the Zamboanga City Medical Center (ZCMC) Department of Psychiatry during the COVID-19 pandemic period from January to December 2020. The results will provide local epidemiologic records of suicidal attempts and NSSH that can be used as a basis for policy-making, clinical assessment, intervention, monitoring, and preventive strategies for suicide and mental health illnesses. This is a cross-sectional chart review retrospective descriptive study conducted in a COVID referral hospital with 97 charts. A total of 38% (37 out of 97) prevalence rate of referred patients with suicidal behavior identified. Referred patients with suicidal behaviors are predominantly males ( n = 20 , 54%), 22-40 years old (n = 17, 46%) married (n = 17, 46%) Roman Catholic (n = 27, 73%) Bisaya (17, 46%), elementary level (n = 14, 28%) and unemployed (n = 19, 51%) Suicidal attempt (n = 22, 59.5%) referral is significantly higher (p-value <0.5) than the suicidal ideation (n = 15, 40.5%) with stabbing (n = 7, 32%) as the most common method. Depressive-anxiety disorder (43%) was the prevalent psychiatric morbidity in referred patients with suicidal behavior. Surgery Department has the highest number of referred patients with suicidal behavior (n = 12, 32%) The month of August (n = 6, 16%) has the most number of referrals. The recommendation is to make a longitudinal, comparative, and correlational study on suicide risk factors, suicidal behavior, and mental health morbidity of at least a 5-year time frame with the inclusion of patients seen in the outpatient department. ▲ Show less

This study was done to determine the incidence rate of post-operative complications mainly Surgical Site Infection (SSI) in closure of ileostomy using the purse string closure technique in Zamboanga City Medical Center from May 2016 to May 2017. A prospective, descriptive design was utilized among 30 patients from the Surgical Department through purposive sampling. Purse string technique was done during closure of the participant's ileostomy and the wound site was assessed twice-on the 7th and 30th days of post-hospital discharge. The results showed that the majority of the participants did not develop Surgical Site Infection. Among the participants (N=30), only 3.3% or 1 out of 30 developed SSI within 30 days post-surgery and the other 96.7% or 29 out of 30 participants did not have any complications during the 2 hospital visits, 7 days and 4 weeks after discharge. In conclusion, findings of this study indicate that the use of purse string method decreases the rate of complication mainly Surgical Site Infection, after surgical closure of ileostomy. ▲ Show less

Burnout and job satisfaction among healthcare providers have been subjects of interest for the past decades due to its impact on a person's well-being and the possible consequence of compromising patient care. Awareness of this phenomenon will aid in developing strategies to prevent burnout and increase job satisfaction in the workplace. The study aimed to determine the prevalence of burnout and job satisfaction among healthcare providers employed at the Zamboanga City Medical Center. The study utilized a descriptive, cross-sectional design using multi-stage random sampling. A total of three hundred sixty-two (362) employees of various occupational groups participated in the study. A self-administered questionnaire was used to gather data which comprised of questions from the Copenhagen Burnout Inventory (CBI) and Job Satisfaction Scale (JSS). The prevalence of burnout was 23.49%. It was common among nurses (38.83%) followed by doctors (24%) administrative assistants (10.59%) and nursing attendants (9.42%). Majority (33.15%) had personal burnout followed by work-related (24.04%) and client related burnout 22.93%. Around 48.35% reported satisfaction with their current jobs. Majority (80.39%) were satisfied with nature of work followed by supervision (74.04%), coworker (66.3%), communication (65.75%), pay (58.57%) and fringe benefits (44.76%). The study revealed a 23.49% prevalence of burnout among various occupational groups. In addition, the findings revealed a low prevalence of job satisfaction of only 48.35%. Hence, measures to promote mental health and to increase job satisfaction among its employees must be made. ▲ Show less

The cardiometabolic syndrome (CMS) has been recognized as an emerging disease entity. It constitutes a myriad of maladaptive cardiovascular, renal, metabolic, prothrombotic, and inflammatory abnormalities. It faces treatment challenges as it may require meticulous patient involvement and may create financial burdens. It is a major medical problem and is a pressing global health issue. In relation to this concern, more scientific studies must be done to address the constellation of risk factors to be able to develop more improved approaches in treating these risk factors across the globe. Objective: The primary objective of this study will be to determine that FAT BONE Ratio is a good predictor for Cardiometabolic Syndrome by using a PA Chest Radiograph and will be calculated by dividing the mean soft tissue height by the mean clavicle diameter. Methodology: This study used a prospective design. It will be conducted at the Zamboanga City Medical Center. Prospective review of upright posterior-anterior (PA), the soft tissue height overlying the acromioclavicular joint was calculated and divided by the mid-clavicle width by a research assistant to determine the Fat/Bone Ratio. The Determination of Hip waist Ratio and the determination of BMI were also done. Co morbidities of cardiometabolic syndrome were determined through chart review and final diagnosis. Results: Out of 81 enrolled patients, Cardiometabolic syndrome was seen in more than half (56.79%) of enrolled patients, having fulfilled at least three of the criteria, with decreased level of HDL, elevated plasma glucose and increased waist circumference as the most common culprits. There were only 21 (26%) individuals with elevated triglyceride, but 65 (80.24%) with decreased HDL cholesterol. Plasma glucose and waist circumference were also elevated in 47 (58%) and 42 (51.85%) of the respondents respectfully. Although there were only 22 (27.16%) respondents with elevated BP, majority (56.70%) of the respondents within this group met the minimum criteria to be diagnosed with metabolic syndrome. A Fat Bone Ratio of 1.0 and 1.25 were both pre-obese and met the criteria for cardio-metabolic syndrome. This was contrary to the classification of metabolic syndrome by BMI that where only 21 were pre-obese. Diabetes (51.85%) and hypertension (29.63%) were the most commonly seen complications or comorbidities associated to cardiometabolic syndrome. It was only dyslipidemia that was associated to an increasing Fat bone ratio with a p value of 0.034, with no comorbidity noted to be related to increasing BMI. Both BMI and Fat bone ratio were seen to be associated with Cardiometabolic Syndrome for this study with a significant p value of <0.00001 and 0.011863 respectively. Conclusion: Fat bone ratio had higher sensitivity in detecting comorbidities in five (5) different fat bone ratio measurements compared to BMI. At the same time, BMI also had higher sensitivity in identifying comorbidities among 5 different BMI levels compared to fat bone ratio. Moreover, fat bone ratio was the only one that was associated with a comorbidity which was dyslipidemia. Overall, Fat bone ratio and BMI were significantly associated to cardiometabolic syndrome, with the two having no difference in terms of predicting the latter, thereby accepting the alternate hypothesis. ▲ Show less

This study utilizes a cross-sectional descriptive design to assess the acceptability and utilization of postpartum intrauterine device (PPIUD) among male partners for their postpartum female partners in Zamboanga City Medical Center. This study identifies the socio-economic and demographic history, reproductive history, and information access of the male partner to determine whether an association exists regarding the acceptability and utilization of PPIUD. The computed sample size is 183 respondents, utilizing the one-sample proportion test with a 10% non-response rate. Randomization was used in selecting the respondents with odd numbers as the last digit of their hospital number A total of 183 teenage respondents were included in the study. The respondents' ages were as follows: 2 percent or 4 respondents were aged 14 years old, 6 percent or 11 respondents were 15 years old, 15 percent or 27 respondents were 16 years of age, 18 percent or 34 respondents belonged to 17 age group, 32 percent or 58 were 18 years old, and 27 percent or 49 respondents were 19 years old. In other words, 92 percent of the respondents belong to ages 16-19 years, the age intended for college entrants. Among the 183 teenagers who had PPIUD, only 6 among them or 3 percent had PPIUD as their first Family Planning method of choice. Forty-four percent or 80 respondents had pills as their preferred method, 17 respondents or 9 percent chose injectable contraceptives, and 17 respondents or 9 percent chose Implant. In contrast, none of the respondents chose Lactational Amenorrhea. Twelve teenage respondents, or 7 percent, refused Family Planning Method, while 50 respondents or 27 percent were undecided In this study of 183 teenage respondents, most subjects are from ages 16 years to 19 years old. Almost 50% of the respondents said they do not want another baby yet. But when asked about their FP of choice, 44% opts to use Pills, 27% had no answer, and 7% refuse FP. Most of the respondents decided PPIUD insertion during their labor with 5 respondents and right after they deliver with 5 respondents. Only 2 respondents decided on PPIUD during their prenatal care. Fifty percent of the respondents opt to return to the same healthcare provider, ZCMC, for follow-up. Three respondents said it doesn't matter which healthcare facility they will go to for follow-up, and 2 respondents said they do not know yet. Young pregnant women are special clients with special needs in the form of counselling. education, and psychiatric evaluation. Aside from the usual OB-Gyne history and physical examination during prenatal, it is best to include psychosocial history taking using the HEADSSS (Home, Education/Employment, Activities, Drugs, Sexuality/Sexual Activity, Suicide/Depression, Safety) must be included. Likewise, a proper birth spacing of 3 to 5 years must also be advised. ▲ Show less

Background: The coronavirus disease 2019 (COVID-19) pandemic reached the Phillippines in the latter part of January 2020. We aimed to describe the characteristics of hospitalized patients of this disease in a predominantly Filipino cohort. Methods: This was a retrospective, multicenter, observational cohort study among rt-PCR confirmed COVID-19 patients admitted in 89 participating hospitals across the Philippines from February 1, 2020 to July 15, 2020. Data collection forms were electronically uploaded, and analyzed for descriptive and analytical statistics. This preliminary study is mainly descriptive. Findings: Our study recorded a bimodal peak of 20-30 years and 50-60 years COVID-19 incidence in the Philippines. The most common co-morbidities were hypertension and diabetes. The most common presenting symptoms were cough, fever, and difficulty of breathing. Overall mortality was 19.4%. Those who died were predominantly older, from urban areas, and with at least one co-morbidity. They presented on admission with abnormal vital signs, higher QSOFA scores, and deranged laboratory and radiographic findings. ARDS is the most common cause of mortality among hospitalized COVID-19 patients. More intensive treatment, higher ICU admission and use of mechanical ventilation were proportional to increasing severity of the disease. Interpretation: This preliminary report of Filipino hospitalized COVID-19 patients has given us very interesting data of characteristics consistent with other countries, despite possible variances due to the limitations of participating hospitals at the early stage of the pandemic. Our study is consistent with other countries where highest mortality is recorded among the elderly population with pre-existing diseases. Clininco-pathologic, laboratory, and treatment features reflect the ever-improving attempts of the heroic Health Care Workers in Increasing survival against all odds in this modern-day pandemic. Funding: Philippine College of Physicians and the Philippine Council for Health Research & Development ▲ Show less

Introduction: The doctor-patient relationship is the core of the practice of healthcare and is vital for the delivery of quality healthcare with the ultimate goal of achieving the best outcome and patient satisfaction, which are essential for the effective delivery of healthcare. Objectives: This study aims to determine the correlation of patient perception on physician-patient relationship and outcome of care among adult patients. Research Hypothesis: There is no correlation between the patient perception on physician-patient relationship and outcome of care. Methodology: This is an analytical cross-sectional study. The respondents were recently admitted adult patients on follow-up consultation at the out-patient department of Zamboanga City Medical Center. It employed stratified random sampling obtaining a total of 385 respondents. Data collection was accomplished through an interviewer-guided questionnaire that included General Data, Patient-Doctor Relationship Questionnaire, and Outcome of Visit Questionnaire. The demographic profile and the patients' perception were analyzed through frequency distribution. Results: Results showed that 66% had very good physician-patient relationship, while 59% had very sufficient outcome of care. Spearman correlation was utilized in analyzing the correlation, obtaining a correlation coefficient (r) of 0.343 implying a positive but weak correlation between the physician-patient relationship and outcome of care. ▲ Show less

Introduction: Tuberculosis (TB) remains a significant global health challenge, with HIV co-infection substantially increasing the risk of poor clinical outcomes. In the Philippines, the integration of provider-initiated HIV testing and counseling (PITC) into TB care is essential for early diagnosis and treatment. However, various socioeconomic and perceptual barriers continue to influence the level of acceptance and hesitancy among patients. Understanding these specific determinants is crucial for optimizing TB-HIV collaborative services and improving patient survival rates. Objectives: This study identified the factors associated with the acceptance and hesitancy of provider-initiated HIV screening among patients diagnosed with pulmonary tuberculosis (PTB) at Zamboanga City Medical Center (ZCMC). Methods: A cross-sectional study was conducted among 117 patients diagnosed with PTB at ZCMC. Data were collected using a structured questionnaire covering sociodemographic, patient-related, and health-related factors. Data analysis was performed using STATA version 17. Bivariate logistic regression was first utilized to screen for significant associations, followed by multiple logistic regression to identify independent predictors of screening behavior. Statistical significance was set at p < 0.05, and the model's goodness of fit was assessed. Results: The final explanatory model revealed that male gender and employment status were the strongest demographic predictors of screening uptake, with male patients being 1.27 times more likely (p = 0.038) and employed individuals being 7.51 times more likely (p<0.05) to accept testing. Additionally, patient perception played a critical role; those who believed HIV testing should be a routine part of TB care demonstrated significantly higher acceptance (p=0.006). Factors such as health insurance coverage and HIV-related knowledge also contributed to the model. The final multivariate model demonstrated a statistically reliable fit (Prob> chi2 = 0.0013). Conclusion: Most TB patients in this study population demonstrated a higher likelihood of accepting HIV screening when they possessed socioeconomic stability and viewed the test as a normalized component of clinical care. Male gender and employment emerged as key facilitators of uptake, while the perception of screening as "routine" served as a primary driver for overcoming hesitancy. These findings suggest that while individual characteristics influence behavior, the systemic integration and normalization of PITC within the TB diagnostic pathway are essential for increasing screening coverage and strengthening integrated TB-HIV care. ▲ Show less

Introduction: Upper gastrointestinal bleeding (UGIB) remains a significant cause of hospital admission worldwide, frequently associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs). In patients with chronic musculoskeletal conditions, such as poorly controlled arthritis, the reliance on NSAIDs for pain management often leads to severe gastrointestinal complications. In the Philippines, particularly in regional centers like Zamboanga City, the clinical profile and the specific proportion of UGIB cases attributable to arthritis-related NSAID use remain under-documented. Objectives: This study aimed to determine the proportion of UGIB cases associated with NSAID use for poorly controlled arthritis among patients admitted to Zamboanga City Medical Center (ZCMC) and to describe their sociodemographic profiles, clinical characteristics, and health outcomes. Methods: A retrospective cross-sectional study was conducted involving 106 adult patients diagnosed with UGIB at ZCMC over a one-year period (June 2024-June 2025). Using purposive and total population sampling, patients were screened to identify those whose bleeding was associated with NSAID therapy for arthritis. Data were extracted from electronic medical records (EMR) using a standardized form. Categorical data were summarized using frequencies and percentages, while clinical outcomes were analyzed through descriptive summary measures. Results: Out of 106 UGIB cases, 20 (18.9%) were associated with NSAID use, and 7 (6.6%) were specifically attributed to the management of poorly controlled arthritis. The arthritis cohort had a mean age of 59 years and was predominantly male (71.4%). The universal presenting symptom was melena (100%), and 85.7% of patients reported concurrent smoking and alcohol use. Clinical findings revealed profound anemia (mean Hb 7.14 g/dL) in all patients, requiring blood transfusions. Endoscopic evaluations identified gastric and duodenal ulcers as the primary sources of bleeding, with severities ranging from Forrest Class Ia (spurting hemorrhage) to Class III (clean-based ulcers). While 85.7% of the patients were successfully discharged, one mortality (14.3%) was recorded. Conclusion: NSAID-induced UGIB represents a significant, yet largely preventable, clinical burden at ZCMC. Although the proportion of cases specifically linked to poorly controlled arthritis is relatively low, the clinical impact is severe, characterized by life-threatening anemia and the need for intensive intervention. The findings highlight a critical lack of gastroprotective prophylaxis and a prevalence of unsupervised medication use among these patients. There is an urgent need for improved risk stratification, patient education, and the implementation of standardized prescribing guidelines to mitigate these risks. ▲ Show less

Introduction. The coronavirus disease 2019 (COVID-19) is a highly contagious disease which has now become a global health crisis. Although COVID-19 is not primarily a surgical disease, it has significantly affected surgical practice in multiple ways. Most organizations recommended postponement of elective surgeries indefinitely. However, some cases are associated with progressive disease that warrants immediate surgical intervention. Thus, the decision to proceed or postpone a surgical procedure must be made in the context of numerous factors. Objective. This study aimed to present the outcomes of surgical procedures during the COVID-19 at the only referral hospital for COVID-19 in Western Mindanao. Study Design & Setting. A retrospective cohort study done at Zamboanga City Medical Center Subjects and Methods. A total of 696 surgical procedures were done from April 2020 to December 2020 and will be included in this study. Data that will be extracted includes patients' demographic characteristics to include comorbidities, types of major surgery, morbidities and mortalities. Results. Three Hundred forty-nine out of 696 (50.1%) respondents underwent major emergency surgeries under general anesthesia for the duration of the study period. This group of respondents were predominantly male (258, 74%) with a young population at a mean age of 33.78±20.6 years old. Most common comorbidity seen among the respondents was cancer (33, 9.5%), with Trauma surgeries (65, 18.6%) and Neurosurgeries (57, 16.3%) make up most of the surgical procedures of this study, with GETA alone being the main choice of anesthetic (315, 90.3%). Surgical site infection was the most common post-operative complication (7, 2%), with pneumonia and anastomotic leak following close in second place (both at 1.4%). Mortality rate was low for this study considering more than 99% of respondents were non-COVID patients. Conclusion. Conclusion for this study is rather difficult as this study focused primarily on non-COVID patients however, inference can be made that morbidity and mortality for this study was lower than other studies since "frailty" was not a major problem for respondents since only 37 respondents were technically senior citizens. Moreover, due to the young mean age of the respondents, hypertension and diabetes mellitus were only a problem for some patients. ▲ Show less

Objective: To determine and compare morbidity and mortality rates of post-surgical patients and the satisfaction level of PACU nurses using a standardized handover checklist versus the traditional endorsement at the Zamboanga City Medical Center. Methods: A prospective cohort study of patients transferred to the PACU from July 25, 2022 to August 23, 2022 using purposive sampling for mortality/morbidity rates and systematic sampling for satisfaction level. Data were collected through chart review, anesthesia weekly census reports, and a satisfaction survey. Results: The standardized method was superior to the traditional method in terms of clarity and completeness of patient information transfer, ability to prioritize patient problems, and facilitating clarification. Statistical analysis using paired t-tests were all significantly in favor of the standardized checklist across all items (p<0.001). The use of standardized checklist methods led to decreased rates of morbidity and mortality observed during the study period. For the satisfaction surveys, combined approval rates for completeness, structure, and practicality were 86% for the checklist. Conclusion: Implementation of a standardized handover checklist in the PACU improves patient safety, decreases post-surgical complications, and increases satisfaction among healthcare providers. This work provides strong support for the standardization of the handover process subsequent to anesthesia and surgery and how vital it is for improved patient outcomes. ▲ Show less

Background: The COVID-19 pandemic is believed to have originated in Wuhan, China, in late 2019. likely stemming from zoonotic transmission at a seafood market (Gupta, S., et al. 2021). It has not only posed unprecedented challenges to healthcare systems worldwide but has also exacerbated the issue of burnout among healthcare professionals, particularly doctors. Burnova has long been a concern in the medical field. However, the demands of combating a global health crisis have intensified these stressors, leading to alarming rates of burnout among doctors (Shanafelt, et al., 2020) It has emerged as a significant global concern, affecting healthcare systems and patient care worldwide (Westwood, S., et al, 2022) Objectives: This study aims to determine the prevalence of burnout, encompassing dimensions such as emotional exhaustion, depersonalization, and reduced personal accomplishment, among physician in-training during COVID-19 pandemic in Zamboanga City Medical Center (ZCMC) and its association with their socio-demographic profile Methodology: This is a single center analytical cross-sectional study. Physicians undergoing residency training in all departments of the medical center including internal Medicine (IM). general surgery (GS), pediatrics, and obstetrics and gynecology (OB-Gyne) who actively handled suspect, probable, and confirmed COVID 19 patients from June 2020 to June 2021 was included in the study. A total of thirty-seven (37) doctors participated in the study. It is a questionnaire-based survey and adopted the Maslach Burnout Index to assess burnout. The survey was conducted online. Results: Results showed a high level of burnout among most of the doctors surveyed. Consistently, the study revealed a high level of burnout among doctors, particularly prevalent in specific demographic groups. Doctors aged 30-34 years old and single (with a statistically significant p-value of <0.05), as well as female physicians, and those in their third year of residency training exhibited elevated levels of burnout across dimensions such as occupational exhaustion, depersonalization/loss of empathy, and reduced personal accomplishment. Additionally, doctors who reported sleeping less than 8 hours per day and handled fewer than 10 patients daily, with three or fewer mortalities per week, also experienced heightened burnout levels. Conclusion: The study reveals a concerning prevalence of burnout among doctors in residency training during the COVID-19 pandemic, with socio-demographic factors showing a significant association. The study also illuminates a consistent pattern of high burnout levels among doctors aged 30-34 and those who are single, characterized by elevated occupational exhaustion, depersonalization/loss of empathy, and diminished personal accomplishment during the COVID-19 pandemic. ▲ Show less

Background: Breast cancer, the leading cause of female mortality globally after lung cancer, presents a significant public health challenge. Within this context, Triple-negative breast cancer (TNBC), an aggressive subtype comprising 15-20% of cases worldwide and 8% in the Philippines, predominantly affects younger women and exhibits a poor prognosis. Current treatment strategies include chemotherapy and surgery, but research is limited, especially in the Philippines. Methods: This retrospective cohort study assessed TNBC patients at the Zamboanga City Medical Center Cancer Institute, aiming to profile demographic and clinicopathological characteristics, evaluate treatment response, outcomes, and time to progression. Descriptive statistics was employed for data analysis. Data were obtained through medical record chart reviews, funded by ZCMC-Cancer Institute under the DOH Research Exploration Sub allotment for 2020. Results: The study included 25 TNBC patients, predominantly premenopausal women under 50 residing in Zamboanga City, presenting with advanced stage 4 cancer, primarily with lung metastases. Adjuvant chemotherapy showed the highest response rate, followed by neoadjuvant and palliative chemotherapy. However, disease progression was observed in some patients despite treatment. Those in the neoadjuvant setting exhibited faster progression than those in the adjuvant setting. The study found an incidence rate of 4.24% for TNBC among breast cancer patients seen at ZCMC Cancer Institute from 2018-2021. Conclusion: TNBC presents as an aggressive subtype with typical clinical characteristics. Adjuvant chemotherapy may offer survival benefits, but rapid progression and poor prognosis persist. Further research and innovative treatment approaches are essential. Recommendations: Future research should expand sample sizes, participate in clinical trials, promote early detection, collaborate internationally, and enhance palliative care services for TNBC patients. These endeavors are important in advancing TNBC management and improving patient outcomes. ▲ Show less

Introduction: The SARS-COV 2 virus, more commonly known as coronavirus 2019 (COVID-19) is a novel respiratory virus that was first recognized in China and has now spread across the world. COVID-19 appears to have a lower case fatality rate but a higher rate of transmission, leading to far more total deaths. Hundreds of health care facilities in the country are now working above and beyond their maximum capacities and resources to simply continue to cater to COVID-19 patients. Despite the social distancing and mobility restriction measures implemented in the Philippines, COVID-19 infections continue to rapidly consume the country's health care systems limited resources, even more so after mass vaccination of the population. Thus, it is necessary to find risk groups that can benefit from more aggressive preventive measures in a high-density population. Objectives: To identify risk factors with mortality among intubated hospitalized patients with COVID-19. Methodology: A retrospective observational (archival) study held at Zamboanga City Medical Center were the socio-demographic and clinical characteristics, to include co-morbidities, associated with mortality among all 201 intubated adult COVID-19 positive patients admitted from March 2020 to March 2021 were analyzed via logistic regression to determine the factors associated with mortality. Results: Only three (3) factors were significantly associated with mortality (p value <0.05), this includes, ages 60 y/o (OR=0.39, 95% CI 0.173-0.867, p = 0.021 ) ages >60 y/o ( OR = 2.58 95% CI 1.155-5.779, and being hypertensive ( OR = 2.67, 95% 1.299-5.501, p 0.008). p = 0.021 ), Conclusion and Recommendation: Among the factors under study, hypertension ( OR = 2.82 , 95% CI 1.349-5.881, p = 0.006 ) , was noted to be significantly associated with mortality. Moreover, hypertension factor that poses more than twofold increase risk of mortality from COVID-19. Consequently, since hypertension is a modifiable risk factor, it is crucial that actions be taken to intensify efforts to address this disease. It is also recommended that further studies be conducted to identify the risk factors associated not only with mortality but also, to a lesser degree, with factors associated with intubation. This study emphasized the necessity for additional efforts aimed to promote primary prevention. Understanding the risk factors associated with mortality among intubated COVID-19 patients will aid improvement in the disease management. ▲ Show less

Introduction. Artificial intelligence (AI) creates machines, and one of its branches is natural language processing (NLP), which allows computers to analyze human language. Chat generative pre-trained transformer (ChatGPT) is a form of NLP that uses prompt engineering to improve its performance. The comparison of three (3) types of manual prompting in pediatrics for diagnostic accuracy remains unexplored. Objectives: To determine the clinical diagnostic accuracy of ChatGPT version 3.5 compared to the diagnoses made by ZCMC senior pediatric resident and pediatric consultants among admitted patients in the pediatric emergency room. Methodology. This was a cross-sectional analytical study. The computed sample size for the study was 28. Results: A total of 95 respondents were analyzed in the study. Zero-shot prompt had the highest rate of exactly correct diagnoses, with 20% for admitting diagnoses and 16% for final diagnoses. Zero-shot prompt also exhibited the highest concordance rate, 20% for admitting diagnoses and 15% for final diagnoses. The concordance rate of zero-shot prompt was significantly higher compared to iterative prompt (20% vs. 7%, p 0.11) in determining admitting diagnoses but not in determining the final diagnoses Conclusion and Recommendation: ChatGPT version 3.5 may function only as an adjunct but not as a primary means of generating clinical diagnosis. Future studies should focus on the application of newer versions of ChatGPT and other types of Al models in the clinical practice. ▲ Show less

Background: Surgical nutrition status before surgery is an important factor in determining the risk of developing post-operative malnutrition, length of hospital stay, hospital costs, and post-op morbidities. Thus, optimization of patients perioperatively has a significant role in the overall management of surgical patients. Objectives: To determine post-operative complications of colon cancer patients in Zamboanga City Medical Center using the Surgical Nutrition Risk Assessment Form (SNARF) Methodology: This will be a prospective cross-sectional study. The surgical procedures that will be included are all colorectal surgeries that are scheduled as electives performed from age 18 and above from April 1-December 2023. Results: The study included 58 patient's records for review and analysis, with a prevalence rate of 20.69% in the post-operative complications; mean age is 52.4, with most at ages 51-60 37.93%), male gender (58.52%) and with hypertension as a comorbidity (15.52%), hospital stay is at the average of 4.7(SD+8) and majority of the disposition is discharged improved (77.59%). The NRL is Low (53.45%), moderate (29.31%, and high (3.45%) while the nutrition status is mostly normal (55.17%), however, the SNARF total score falls mostly on 1 and 0 at 36.21% and 31.03% respectively. Factors from the SNARF that were significant in development of complications includes the +1-+2 subcutaneous fat loss (p=0.002 OR 3.87 CI 1.309-11.424) and +3 loss of subcutaneous fat/muscles (p=0.045 OR 279 CI 136-572): BMI of <18.5/30 (p=0.044, OR0.98 CI 0.87-1.23) and albumin level of 2.5-3.4 (p=0.006 OR 1.02 C100.94-2.55). Complications that were impacted by malnutrition include dehiscence, SSI, and pneumonia. Conclusion: Ages 51-60 and male gender remain the common factors in colorectal diagnosis and treatment. Hypertension is the most common comorbidity. Hospital days averages 4.7 days and dispositions are commonly improved. The overall nutritional status of colorectal surgery patients is normal and the majority of the nutritional risk level is low. however, the SNARF total mostly is 1-2. Symptoms associated with complications include loss of subcutaneous fat and muscles low albumin levels and malnutrition, while complications that occur mostly among moderately or severely malnourished are pneumonia, dehiscence, and SSI. ▲ Show less

The study aimed to determine the prevalence of work related stress and burnout among ZCMC employees during the 2nd year of the COVID pandemic. A cross sectional study was done and utilized a convenient sampling to acquire 278 respondent at which only 172 responded and completed the questionnaires. Descriptive analysis was utilized on the data. Frequency distribution and ANOVA test was done to determine the statistical significance of the data acquired. A P-value test was done to determine that the sample population acquired gave significant. Analysis was performed with the help of data processing software (IBM Statistical Package for Social Sciences). 18.53% of Hospital employees experience work stress. Burnout can especially be seen in age group of 31-40 and in the female gender. The prevalence of work stress such as High Job and Mental demands, Role ambiguity, their psychological status and their coping mechanisms may reflect the high prevalence of burnout. It is shown that 43.75% of respondents have Personal burnout and are much higher than the work (16.47%) and client related (24.43%) burnout. The study only focuses on the prevalence of the variables. This implies that any correlation on work-related stress and burnout of the participants needs further research. With the result of the study, it is recommended to develop activities to address high levels of burnout. The activities might be focused on one of the factors or all of the work-related stress if possible that may lead to this high levels ▲ Show less

Hypertension is known as "silent killer" and a serious medical condition and can increase the risk of heart, brain, kidney and other diseases. It is a major cause of premature death worldwide, with upwards of 1 in 4 men and 1 in 5 women having the condition. Strategies and programs have been developed to address and control elevated blood pressure. However, it has remained to be a global burden of disease and a public health problem. In 2019, hypertension is the top 1 leading cause of morbidity in Zamboanga peninsula. The main objective of this study was to determine what are the Factors Associated with Treatment Compliance among Hypertensive Employees of Zamboanga City Medical Center. The results provided this institution with information and served as a baseline to effectively promote strategies towards good compliance among hypertensive employees of this ins. It employed a cross-sectional, analytical study to determine the prevalence and factors of treatment compliance where all hypertensive employees answered a self-administered questionnaire to gather necessary data. Calculated sample size was 132. 132 participated in this study utilizing convenience sampling design. Data and results were analyzed through the multivariate analysis in SPSS. The prevalence of treatment compliance among 132 hypertensive employees were 91 (68.9%) while 41 (31.1%) were the non-compliant. Factors that have significant positive association with compliance were those belonging to medical group, those had commitment to follow up and those who comply with the prescribed intake. Employees belonging to medical field had positive association due to their increase awareness of the illness condition. Having time commitment were most likely to comply because they had greater interaction with health personnel and can be given advised which increases the chance of adhering to medication schedule and subsequent follow-ups because through this, they get a better view of their condition. ▲ Show less

This retrospective study described the clinical characteristics, risk factors, stroke subtypes, severity, in-hospital management, and short-term outcomes of adult stroke patients admitted to Zamboanga City Medical Center (ZCMC), a tertiary referral hospital in Western Mindanao, from January 2022 to December 2024. Medical records of 350 patients were reviewed. The cohort was predominantly older adults (mean age 65.6 years) with a modest male predominance and mainly urban residence, reflecting the hospital's catchment from Zamboanga City and surrounding provinces. Ischemic stroke comprised 73.1% of cases, intracerebral hemorrhage 22.9%, and subarachnoid hemorrhage 4.0%; among ischemic strokes, partial anterior circulation infarct was the most common Oxfordshire Community Stroke Project subtype, followed by lacunar, posterior circulation, and total anterior circulation infarcts. Hypertension was the leading risk factor (73.4%), with smoking, diabetes mellitus, and alcohol use also frequent, and important comorbidities included congestive heart failure and chronic kidney disease. On admission, more than half of patients had only mild impairment of consciousness, yet over one quarter had National Institutes of Health Stroke Scale scores greater than 15, and the most common presenting symptoms were hemiparesis or hemiplegia, dysarthria, and aphasia. Hemorrhagic strokes showed higher severity scores and longer median length of stay (15.5 days for intracerebral hemorrhage and 13.5 days for subarachnoid hemorrhage) than ischemic strokes (8.0 days), although overall in-hospital mortality remained high across types at 22.9%. Within ischemic stroke, lacunar infarcts had the lowest severity and no deaths, whereas posterior and total anterior circulation infarcts were associated with markedly higher severity, prolonged hospitalization, and mortality exceeding 60%. These findings highlight a substantial burden of largely preventable, risk-factor-driven stroke in Western Mindanao and underscore the need for stronger hypertension control, integrated vascular risk management, systematic use of simple severity scores for triage, and better-organized acute stroke pathways at ZCMC and within its regional referral network. ▲ Show less

Background: COVID-19 is a respiratory illness brought on by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2). A specialized polymerase chain reaction (PCR) test using a nasopharyngeal swab, sputum, or bronchoalveolar lavage is the gold standard for SARS-CoV-2 detection. Commercial tests have recently been made available for the serological analysis of particular COVID-19 antibodies. Similar to other coronaviruses. neutralizing antibodies are probably essential for the development of SARS-CoV-2 herd immunity. Understanding how immunity develops is therefore important for directing preventive actions in the future. Furthermore, the presence or absence of re-infection immunity in COVID-19 infected patients may be determined by antibody levels. Since SARS-CoV-2 is a recently discovered virus, the antibody response is still mostly unclear. Objectives: This study aims to determine the sociodemographic and clinical factors and outcomes of COVID 19 patients with seronegative antibodies on rapid diagnostic test and determine whether there is a significant difference in the outcomes of these patients with seropositive antibodies on rapid diagnostic test. Methodology This is a single-center retrospective observational case-control study. Patients 18 years old and older who tests positive for COVID-19 by RT-PCR NPS and underwent Rapid Diagnostic Testing, will be included in the study. Medical records of these patients admitted in ZCMC from June 2020 to June 2021 will be reviewed. Categorical variables will be presented as absolute values and percentages while continuous variables will be presented as median or means. Results: Sixty-eight patients (n=68) who tested positive for COVID-19 were included in this study. Of them, 56 were classified as RDT positive and 12 as RDT negative. For the RDT positive and RDT negative groups, the observed mean ages were 53 and 54 years old. respectively. Based on the findings of the study, it examined differences between patients testing positive or negative on a rapid diagnostic test. There were no significant differences in age, weight, or health conditions between the positive and negative groups, but the positive group was more likely to be Female and Catholic, and to be unemployed and smoker. The oxygen levels and vital signs were comparable in both groups. Moreover, COVID-19 markers were comparable. Both groups' clinical courses seemed to be going comparable overall. Conclusion: The overall findings of the current study suggest that the clinical and sociodemographic trajectories of the two groups appeared to be similar. RDT negative patients have mild symptoms. Nonetheless, a few unique instances were reported to have been classified as COVID-19 severe or critical. They were admitted to the intensive care unit (ICU) and had only mild respiratory symptoms and normal chest x-ray results. Later, they were found to have negative RDT results. The study's findings aligned with the PSMID's recommendations, which state that RT-PCR is still the gold standard for diagnosing COVID 19 in asymptomatic individuals because due to low likelihood of viral load, hence RT-PCR remains the gold standard for detecting COVID 19. ▲ Show less

Introduction: Platelet indices can be readily generated by Automated Hematology Analyzers that are widely used nowadays. There has been increased interest in their potential clinical use in conditions involving platelet derangement particularly in Dengue Fever. Objectives: This study aims to establish the association of Platelet Indices and Dengue Fever in the local setting and to further evaluate the diagnostic accuracy of these indices in the detection of Dengue Fever. Methodology: Febrile pediatric patients who were admitted in the pediatric ward of the Zamboanga City Medical Center from April 2021 to May 2022 and met the inclusion criteria were included in this study. Univariate analysis was used to identify the potential association between platelet indices and dengue fever among the subjects. Multiple logistic analysis was used to calculate adjusted odds ratio for dengue fever in febrile patients. The performances of platelet indices in predicting dengue fever were assessed by Receiver Operating Characteristic (ROC) curves. Results: A total of 269 patients met the inclusion criteria. After adjusting for other platelet indices in the multivariate analysis, platelet (PLT) count remained independently associated with an increased likelihood of dengue fever (adjusted OR: 0.98, 95% CI: 0.97-0.99, p 0.018) among febrile pediatric patients. The diagnostic performance of PLT count (cut off value of ≤ 190 x10^9/L) and Platecrit (PCT) (cut-off value of ≤ 0.175%) were excellent in predicting dengue fever with the largest areas under ROC of 0.988 and 0.974, respectively. Likewise, Mean Platelet Volume (MPV) (cut-off of ≥ 9.45 fL), Platelet Distribution Width (PDW) (cut-off of ≥ 9.95%), and Platelet-Large Cell Ratio (P-LCR) (cut-off of ≥ 23.05%) also demonstrate strong diagnostic performance in detecting dengue fever, with ROC of 0.851, 0854, and 0.855, respectively. Conclusion and Recommendation: Platelet Count and PCT, are strongly associated with the diagnosis of dengue fever in children, demonstrating high sensitivity, specificity, and diagnostic accuracy, making them reliable markers for identifying dengue fever in febrile pediatric population. Validation of the cut-off values among wider population in various settings should be done in future studies. ▲ Show less

INTRODUCTION Transfusion therapy is for patients with insufficient oxygen-carrying capacity or those with blood loss. Commonly in practice, there is an excessive request for blood products pre-operatively that can lead to increased cost and wastage of resources. During crossmatching, large amounts of crossmatched blood are processed however, only very little amount is utilized leading to wastage of time, supply and reagents. OBJECTIVE This research aimed to determine if the current blood utilization practice is effective and if there is wastage of blood requisition among surgical patients in Zamboanga City Medical Center. METHODOLOGY Data was collected through purposive sampling method of the total number of elective surgeries and total number of crossmatched and transfused blood units per department from January 2022 to June 2022. Descriptive and quantitative statistics was used to compile categorical data and summarized using tables and graphs. RESULTS Crossmatch to transfusion ratio (C/T ratio) is 1.8, Transfusion Probability (%T) is 56%, Transfusion index (TI) is 0.6 and Maximum Surgical Blood Ordering Schedule (MSBOS) of 0.9. CONCLUSION AND RECOMMENDATION The current blood requisition and utilization practice among surgical patients is efficient but could be further improved in terms of crossmatch to transfusion ratio. The MSBOS can be an effective guide to decrease blood wastage without compromising patient safety. ▲ Show less

BACKGROUND: COVID-19 infection as a global threat to public health needs be mitigated through vaccination, However, as a novel vaccine there were multiple factors considered as to its acceptability. Poor knowledge and different perception can proportionally affect acceptance leading to severe form of infection and further spread of the disease. OBJECTIVE: Determine the factors associated to COVID-19 vaccine acceptability among high risk individuals consulting at Zamboanga City Medical Center Out Patient teleconsultation. METHOD: This study utilized an analytical, cross-sectional study that was conducted in Zamboanga City Medical Center Out Patient Teleconsultation among 203 high risk individuals. RESULTS: Both acceptors (59.69%) and non-acceptors (58.33%) have good knowledge regarding COVID-19 vaccine. The perception towards to COVID-19 vaccine categorized as susceptibility, severity, barriers, benefits and cues to actions. Most of the categories has a mean that falls within the agree scale and under items of perceived benefits of how it is recommended by doctors rated as strongly agreeable. All under the perceived barrier statements fell with the rate of neutral. SUMMARY/CONCLUSION: The level of knowledge toward covid19 vaccine among high- risk individuals and acceptability rate is high. Furthermore, significant factor associated with the decision to receive the Covid-19 vaccine includes the worrisome effect of vaccine's adverse reaction, difficulty to get vaccine from nearby clinic due to high demand, and that vaccination can lead to normal lifestyle. Furthermore, level of knowledge does not directly affect the individual's decision to receive covid vaccine. ▲ Show less

Introduction: Zamboanga City Medical Center (ZCMC) is one of the many institutions which implemented a teleconsultation service during the COVID 19 health crisis. There have been no studies done in the past to assess teleconsultation acceptability among patients. Hence, the initiative to conduct one for this could be a potential service that can be established as mainstream or adjunct to the regular healthcare Objectives: Determine the perception and acceptability of teleconsultation among adult clients. Specifically, to determine the acceptability of teleconsultation among adult clients who sought consultation at ZCMC and to determine perception on teleconsultation in the following domains: enhanced quality of care, accessibility, ease of use, usefulness, privacy and discomfort, availability, and intention to use. Methodology: The study utilized a descriptive cross-sectional design. A total of 230 respondents participated in the study. Stratified random sampling technique proportional to the size was utilized. Results: Respondents perceived that teleconsultation increases access to healthcare with a mean score of 4.41, enhances quality of care (4.27), easy to use (4.37), useful (4.35), readily available (4.25) and does not invade their privacy with a mean score of 1.78. An acceptability rate of 97% was obtained having 224 out of the 230 respondents agreeing to use teleconsultation should they have access to it. Summary/Conclusion: Providing healthcare through teleconsultation can be as effective as face-to-face visits as evidenced by the high acceptability rate among end users. This is further supported that teleconsultation is perceived positively in the different domains explored. ▲ Show less

Introduction: In Filipino culture, there is a deep-rooted commitment to supporting older adults within the community, often reflected in the informal caregiving networks that exist in many households. However, some older adults succumb to abandonment and neglect, leading them to seek care in nursing facilities. This situation highlights the critical need for health advocates to examine the Quality of Life (QoL) of older adults residing in these shelters, as it relates to the overall assessment of their general well-being. Understanding this is essential for improving care practices and enhancing their quality of life. Objective: The study aimed to determine the quality of life of older adults living in a government nursing facility in Zamboanga City. Methodology: The study employed a cross-sectional analytical research design in interviewing the participants using the WHOQOL-BREF in three versions - English, Filipino and Visayan as preferred by the participant. Results: A total of 12 participants were included; mean age was 71.25; same number of male and female, 75% were Roman Catholic; single (75%); and hypertensive (50%). Females have higher Qol compared to males (0.04). Married and separated individuals have significant differences of QoL, with higher QoL in aspects of physical (0.04) and social domains (<0.00) for married and psychological (0.02) and environmental domains (0.01) for separated. Comorbidities affect all dimensions with p<0.05. Conclusion: The findings revealed that female gender has higher Qol, while married older adults have higher QoL in the physical and social aspect, and the separated older adults have higher QOL in their psychological and environmental domains, with a low QoL in their social aspect. Chronic conditions significantly affect the Qol of older adults in all four domains. ▲ Show less

Introduction: Teleconsultation services have emerged as a valuable tool in pediatric healthcare delivery. This study investigated the perceptions and satisfaction of watchers regarding teleconsultations offered by the Zamboanga City Medical Center (ZCMC) Department of Pediatrics. Objectives: The primary objective was to determine the perception and overall satisfaction of watchers with teleconsultation services. Specific objectives included examining watchers' demographics, reasons for teleconsultation, perceptions of the service, and overall satisfaction. Methodology: A cross-sectional observational study was conducted with watchers of pediatric patients who used teleconsultation services from March to May 2024. Participants provided verbal consent for interviews conducted via telephone, collecting sociodemographic data, reasons for consultation, and feedback on doctor-patient communication and system perception. Results: The analysis revealed that watchers are dominantly aged 30-39, with children mostly aged 13 months to 6 years, consulting for URTIS, PCAP-A, and suspected viral infections. Watchers expressed high satisfaction with teleconsultation's technical aspects, communication and efficacy despite some concerns about its role as a primary solution and adequacy of consultation time. Conclusion and Recommendation: The study concluded that teleconsultation services at the Zamboanga City Medical Center Department of Pediatrics hold significant potential for enhancing pediatric healthcare delivery, with recommendations focused on improving service effectiveness and reach. ▲ Show less

Background: Postoperative pain management is crucial for enhancing recovery after abdominal surgery, and dexamethasone, a glucocorticoid, has shown promise as an analgesic adjunct. This study aimed to evaluate the effectiveness of 8 mg intravenous dexamethasone in reducing postoperative pain and opioid analgesic consumption in patients undergoing emergency lower abdominal surgery under spinal anesthesia. Methods: This randomized, double-blind, placebo-controlled clinical trial evaluated the analgesic effect of 8mg intravenous dexamethasone on postoperative pain in patients undergoing emergency lower abdominal surgery under spinal anesthesia at Zamboanga City Medical Center. A total of 100 participants were randomly allocated to either a dexamethasone group or a placebo group. Postoperative pain scores and analgesic consumption were recorded at 12 and 24 hours after surgery. Results: The dexamethasone group showed significantly lower pain scores at 12 and 24 hours compared to the placebo group (p<0.00001). However, there was no significant difference in tramadol consumption between the two groups. Conclusion: A single 8mg intravenous dose of dexamethasone significantly reduced postoperative pain in patients undergoing lower abdominal surgery under spinal anesthesia. While dexamethasone effectively alleviates pain, it does not substantially reduce the need for opioid analgesics within the first 24 hours postoperatively. ▲ Show less

General anesthesia is a standard medical procedure in todays' hospital practice. It offers the highest level of patient sedation hence, the patient is at risk for a myriad of side effects and possible complications, one of which is intraoperative awareness. Intraoperative awareness is one of the most psychologically devastating sequel of surgery, here There have been no studies to identify its prevalence among emergency procedures in our locality. The limited amount of drugs available and the lack of monitoring devices increases the chances of intraoperative awareness to occur, hence the necessity to determine the incidence of intraoperative awareness. The objective of this study is to determine the incidence of intraoperative awareness under general anesthesia among patients undergoing emergency surgery in Zamboanga City Medical Center. The population of the study were the patients who underwent emergency surgery under general anesthesia at the period of implementation, and who are between the ages of 18 to 60 years old. This study revealed that the incidence of intraoperative awareness under general anesthesia among patients undergoing emergency surgery in Zamboanga City Medical Center is 0%. However, further studies must be conducted to strengthen the findings of this study. The author of this study recommends looking into this particular complication in other institutions with a bigger population. Furthermore, it would also be interesting to conduct the same study among pediatric patients. ▲ Show less

This research utilized a phenomenological study design focused on the lived experiences on phantom limb pain of patients who underwent limb amputation in Zamboanga City Medical Center. There were ten participants initially recruited; however only five were actual respondents due to non-consent or loss to follow up. Data saturation was still achieved from those respondents who took part in this endeavour. They were conversed with by means of a semi-structured interview guide. Translation of the said questionnaire involved participation of local English teachers who speak the same dialect as the respondents. Necessary revisions on the questionnaire were taken into consideration to accurately reflect the views of the patient-respondents. The semi-structured interview guide questionnaire is composed of five open-ended questions that elicited responses pertaining to the experience of phantom limb pain at least two weeks post-amputation. These responses were recorded and transcribed verbatim. Analysis of the transcripts made use of the steps described in Interpretative Phenomenological Analysis by Jonathan Smith and Mike Osborn (2007) serving as a guide. The resultant superordinate themes are outcomes of the steps described as follows: (1) The beginning, (2) Search for Respite, (3) The Here and now, and lastly, (4) Moving Forward. Themes noted describes the patient-respondents' Development of phantom limb pain, personal description of pain along with its location and triggers. Also noteworthy of these themes are their use of pharmacologic therapies and alternative forms of relief. The daily lives of patient-respondents were also highlighted in how their pain impacted their productivity and social constructs. Remarkable also are their ways of adjustment and as advocates for social justice to include betterment in the fight for best health care access for all. The results of this study will be valuable as this will give a better understanding of phantom limb pain in the perspective of the patients. As health professionals, we can tailor specific approach in managing phantom limb pain based on the needs verbalize. And to further foster the motivation to formally launch a Comprehensive Pain Center capable of addressing Phantom Limb Pain and other pain syndromes. ▲ Show less

Introduction: The physiologic changes in pregnant women and the immature immune system of neonates, are some of the reasons why these populations are vulnerable to infection, specially to a highly contagious virus like SARS-CoV-2. Despite several studies, there are still varied data on the effect of maternal COVID-19 on the fetus. Objectives: This study aimed to determine the neonatal outcomes of COVID-19 confirmed mothers in Zamboanga City Medical Center from January-December 2021. Methodology: This study employed a cross-sectional analytical study utilizing retrospective review of charts. Results: Out of 283 neonates, 7 (2.47%) tested positive for COVID-19. One was critical while the rest were asymptomatic. Among the neonatal outcomes, the (1) Need for Admission (p-value: 0.034), (2) Positive Neonatal RT-PCR result (p-value: 0), (3) Neonatal Diagnoses of Small for Gestational Age (p-value: 0.016) and Sepsis (p-value: 0.024, 0.019) were proved to be significantly associated with maternal COVID-19 classification. Conclusion and Recommendation: Specific neonatal outcomes were associated with the maternal COVID-19 classification. In general, the neonatal outcomes were good however there were still possibilities for poor outcome. To generate more conclusive data, it is recommended that larger sample size, longer time frame and comparison to a control group be utilized. ▲ Show less

Introduction: Teenage pregnancy remains a pressing global public health issue, particularly in low- and middle-income countries, with significant implications for both maternal and child health outcomes. According to the World Health Organization (WHO) report of 2024. adolescents aged 15-19 years in low- and middle-income countries accounted for an estimated 21 million pregnancies annually, half of which were unintended. In the Philippines, data from the 2022 National Demographic Health Survey conducted by the Philippine Statistics Authority reveal a noticeable decline in teenage pregnancy rates among Filipino women aged 15 to 19 years, decreasing from 8.6 percent in 2017 to 5.4 percent in 2022. In Zamboanga Peninsula. teenage pregnancy poses a significant and ongoing challenge mirroring trends observed in other regions across the country and globally. In 2019, Zamboanga Peninsula recorded 2,811 cases of teenage pregnancies, representing a notable decrease from the previous year's figure of 11,554 cases in 2018. The recorded figures for teenage pregnancy rates in the region for the years 2015 to 2018 are as follows: 10,922 cases in 2015, 10,877 cases in 2016, 13,122 cases in 2017, and 11,554 cases in 2018. Despite the decline in teenage pregnancy rates, there is limited research on the awareness, acceptability, and utilization of modern contraception among teenage mothers in the Philippines. Objectives: The study aimed to investigate the awareness and acceptability of modern contraceptive methods among postpartum teenage mothers. Methods: A descriptive cross sectional observational study was conducted among 88 postpartum teenage mothers in Zamboanga City Medical Center. Purposive sampling was utilized to identify eligible participants. A modified self-administered structured questionnaire from a study (Akokuwebe, 2016) was used to collect data on awareness and acceptability among postpartum teenage mothers. Data were analyzed using descriptive statistics, frequency distribution and percentage analysis. Results: Findings revealed a high level of awareness among 88 postpartum teenage mothers regarding modern contraceptive methods (81.8%) and the availability of family planning services (72.7%) in the community. However, there was a significant gap in the promotion of modern methods of contraception. Despite high acceptability (95%), contraceptive utilization remained affected due to perceived inconveniences, concerns about side effects, health risks, decreased sexual pleasure and economic constraints. Husbands' approval of modern contraception (89%) was found to greatly affect teenage mother's decision to practice modern contraception. Conclusion: Efforts to improve contraceptive utilization among postpartum teenage mothers should focus on addressing perceived inconveniences, providing comprehensive information campaigns, and mitigating health and economic concerns. Involving husbands in family planning decisions could also enhance the acceptability and uptake of modern contraceptive methods. ▲ Show less

Background: In December 2019, the rapidly growing global infection of COVID19 has forced international governments and organizations to urgently produce vaccine, however WHO also identified vaccine hesitancy as potential threats to global health. Objectives: This study aims to determine factors affecting COVID 19 Vaccine Hesitancy among health care workers of Zamboanga City Medical Center hence may aid and fill in potential gaps to help mitigate the impact of vaccination hesitancy. Methodology: This research utilized a qualitative-quantitative descriptive design. The study reviewed and identified overall census for COVID Vaccination and factors hesitancy among health care workers of ZCMC by survey and focus group discussions. Confidentiality was assured at all times and FGD sessions were recorded for documentation, transcription and coding purposes only. Results and Conclusion: Among 1,942 identified employees working in Zamboanga City Medical Center, 24 individuals were found to be COVID-19 vaccine hesitant, representing about 1.2% of the total working population. Four factors/themes were identified in contributing to COVID-19 vaccine hesitancy namely (1) influenced by employer to take vaccine, (2) concerns on safety and efficacy of COVID-19 vaccine, (3) issues with vaccine novelty and how it is created and, (4) unpleasant personal, family, and/or community members experience with vaccination. ▲ Show less

Background: Although more patients had survived coronais disease 2019, there are limited Inevitably get worsen or unimproved resorting to hospital readmissions. Hospital readmissions on outcomes after initial hospitalization. mot only cause burden on patients bra also to the health care facility as it surely demands more hospual resources. Objectives: This study is conducted to determine the incidence of readmissions among COVID 19 recovered patients previously admitted in Zamboanga City Medical Center. In addition, this study would like to know the sociodemographic profile, clinical characteristics, treatment received during initial hospitalization, clinical outcomes of these patients and more importantly the cause s for hospital readmission. Methodology: This is a retrospective study that will utilize chart review from electronic medical records. Medical charts of all COVID-19 recovered patients who get readmitted will be taken into account and included in the study. The study will cover admitted patients from March to December 2020. The result of this study will be of great help to clinicians to identify patients who has the possibilities of getting readmitted, hence intensification of follow-up care is practiced. This study is also very timely as we are currently still facing this pandemic on COVID-19 and is of relevant value as the results would be of great help in future policy making with goals of preventing future hospital readmissions and improving hospital quality care Results: This study saw a total of 786 patients being admitted for COVID-19 from June 2020 to June 2021, with 76 (9.67%) being readmission at a later time, not necessarily due to COVID. Findings of readmissions are at par with other studies such as those done in USA and Spain, and lower compared to studies that were done in UK, Israel and Germany. On the other hand, the group of respondents in this study is relatively younger than those seen in most studies, and predominantly female rather than male as compared to other studies. Mean interval between discharge and readmission was at par with other studies, being one to two weeks post discharge, and length of stay also similar across other studies (less than 2 weeks). Most common cause for readmission was still difficulty of breathing but was followed closely by a need for surgical intervention. Despite this, readmission due to COVID-19 was low at 17.1%, and care was efficient having 86.84% going home well. Conclusion: This study concludes that rate of readmission was relatively low compared to several studies but may have been lower if the factor looked into was readmission due to COVID-19. Moreover, it can be concluded with these findings that care of patients on their initial admission as COVID-19 patients have been at par or better, and timely discharge has been properly observed, considering readmission for COVID-19 itself was low. ▲ Show less

Introduction: The COVID-19 pandemic collected various effects on people with different degree of understanding on the crisis and apparently noted with different response to it. Objectives: This research paper aimed to determine the mental health status of uniformed personnel detailed in checkpoint areas within Zamboanga City during the COVID-19 pandemic from March to September 2020. Specifically, it aimed to determine the prevalence rate of depression, anxiety, and stress levels using the DASS 21 screening tool. Methodology: This study is qualitative research employing a cross-sectional design. Thematic analysis was utilized to collate the responses from the key informant questionnaire. Multivariate logistic regression analysis was also used to predict the relationship of the different variables to each other. The study was conducted in Zamboanga City with a total of 212 participants from the Philippine National Police and the Armed Forces of the Philippines. Results: The majority of the respondents did not fulfill the criteria for depression, anxiety, and stress based on the DASS 21 screening tool. The prevalence rate of depression, anxiety, and stress is 15.42%, 20.55%, and 5.14%, respectively. Moreover, there was no evidence of association with any of the sociodemographic characteristics, indicating that these variables did not contribute to the conditions of depression, stress, and anxiety. The levels of depression, anxiety, and stress have a high direct relationship with each other and were observed to be significant at 0.05 level. Anxiety and depression have a greater relationship with each other at 0.75, compared to depression and stress with 0.54 or stress and anxiety at 0.54. Conclusion and Recommendation: Given that the organization had the early implementation of the pandemic guidelines such as quarantines and information dissemination to its people, the key informants collectively agreed that their approach to the pandemic was not only through their physical needs but extended to their psychological needs. This was also highly influenced as none of the respondents had reported COVID symptoms and were admitted to quarantine facilities ▲ Show less

The outbreak of SARS-CoV-2 has led to a global COVID-19 pandemic, causing severe respiratory illness. A significant subset of COVID patients develops acute respiratory distress syndrome (ARDS), requiring intubation and mechanical ventilation. Unplanned extubation, a serious complication, increases risks such as respiratory failure and mortality. particularly in resource-limited settings like Zamboanga City Medical Center. This study aimed to determine if COVID patients had a higher incidence of unplanned extubation compared to non-COVID patients. A retrospective cohort study analyzed data from intubated patients at Zamboanga City Medical Center from January to December 2021. Demographic characteristics, incidence rates, and frequency of unplanned extubation were compared between COVID and non-COVID patients. Of the 145 intubated patients studied, COVID patients had a higher incidence of unplanned extubation (30%) compared to non-COVID patients (11%), with statistical significance (p=0.037). Demographic analysis indicated that male patients aged over 51, obese, and with respiratory indications were more likely to experience unplanned extubation, mostly occurring in the ICU with fatal outcomes. In terms of intubation frequency, most patients in both groups (COVID 69% and non-COVID 89%) were only intubated once. However, 21% of the COVID group were intubated twice compared to 11% in the non-COVID group. The mean frequency of intubation was higher in COVID patients (1.41±0.71) compared to non-COVID patients (1.2±0.31) (p=0.006). The study concluded that COVID patients had a significantly higher incidence of unplanned extubation. To mitigate this risk, strategies should be implemented, particularly targeting older male patients with respiratory indications, and emphasizing preventive measures in the ICU. This research highlights the need for improved management and preventive strategies to address unplanned extubation, especially in resource-limited healthcare settings ▲ Show less

Postoperative recovery plays a crucial role in determining outcomes of patients who have undergone surgical procedures. Nutritional status, comorbid conditions, functional reserve, overall physical fitness, along with other factors contribute to a patient's ability to recover from surgery. Among these, muscle strength has gained attention as a potential predictor of postoperative outcomes. Handgrip strength (HGS), a simple and non-invasive measure of muscle function, has been widely used in various clinical settings as a marker of frailty, nutritional status, and overall health. HGS has been gaining traction on its role in predicting surgical recovery and complications following surgery. This is a prospective, observational study that aims to understand the relationship between preoperative handgrip strength (HGS) and postoperative outcomes arnong patients undergoing elective gyne-oncologic surgery using a Jamar dynamometer. A total of 27 respondents who underwent elective gyne-oncologic procedures from July to October 2025 participated in this study. Findings of the study demonstrated that preoperative handgrip strength, measured one day prior to elective gyne-oncologic surgery, was significantly associated with length of hospital stay, with higher handgrip strength corresponding to shorter postoperative hospitalization. However, preoperative handgrip strength was not found to be a significant predictor of postoperative complications within 30 days, and its association with readmission and mortality could not be evaluated due to limited event occurrence. Recommendations for future research endeavors should include larger, multicenter cohorts to enhance statistical power and allow stronger evaluation of the predictive value of preoperative handgrip strength. ▲ Show less

Introduction: Blood donor screening and testing for transfusion-transmitted infections are important for a safe blood supply. A fundamental part of preventing TTI is to notify and counsel reactive donors and eventually prevent secondary transmission of infectious diseases in the community. Objective. To determine the response rate among blood donors with reactive test against transfusion-transmitted infections (TTIs) to donor notification at ZCMC Blood Bank from April 2022 to September 2022. Method: This is a descriptive, cross-sectional study, wherein blood donors with reactive confirmatory Blood Bank staff phone call for 2 attempts and logged in the notification logbook. Donor ary testing are notified by the profiles are determined by age, gender, residence, marital status, level of education, occupation/socio-economic status, history of previous donation and presence of high risk behavior. Results: 2.35% of 4220 donors were reactive to TTI screening tests. The median age is 32 years, with the majority (53.93%) aged 30-44 years. The donor sex distribution is predominantly male (86.52%) and single (67.50%). 74.75% tested positive for Hepatitis B, followed by HIV (13.13%), Syphilis (7.07%), and Hepatitis C (6.06%). Most reside within Zamboanga City (92.94%). Majority are under transportation and delivery (19.70%) and government and public service (18.18%) as occupation. Two-thirds of the donors were repeat donors (67.05%), and high-risk behavior was denied by the respondents. Conclusion: The rate of all markers for TTI's was 2.35% which is lower compared to other studies. The response rate of donors with reactive screening tests in ZCMC is relatively low (22.73%) compared to majority of studies with the same respondents. HIV and Hepatitis C reactive donors had the poorest response. There is a need to review the effectiveness of the current deferral system, which is based on the cooperation of the donor to disclose personal health risk factors. ▲ Show less

Introduction: Intracranial hemorrhage (ICH) is a severe form of stroke associated with high mortality rates. Acetazolamide, a carbonic anhydrase inhibitor, has shown potential in reducing intracranial pressure and improving cerebral blood flow in ICH patients. This study aimed to determine the clinical outcomes of hemorrhagic stroke patients with intraventricular extension treated with acetazolamide Objectives: This study aimed to determine the clinical outcomes of hemorrhagic stroke patients with intraventricular extension who have received acetazolamide in Zamboanga City Medical Center. Methodology: A retrospective cross-sectional study was conducted at Zamboanga City Medical Center, Philippines. The study included 38 patients with hemorrhagic stroke with intraventricular extension who received acetazolamide. Clinical outcomes, including mortality, length of hospital stay, stroke severity (NIHSS score), and degree of disability (modified Rankin Scale score), were identified. Results: The median age of the patients was 53.5 years, with most being male (71.1%). The majority had hypertension (92.1%), and over half were obese (55.3%) and engaged in smoking (55.3%) and alcohol consumption (50%). The mortality rate was 84.2% Most patients presented with severe strokes (NIHSS score 21-42), and this number increased at discharge or death. The median length of hospital stay was 3 days for those who died and 7 days for those who were discharged. Conclusion and Recommendation: While the study observed a high proportion of patients who did not survive, it is important to acknowledge the small sample size and the inherent severity of this type of stroke. Further research with larger cohorts is needed to confirm these findings and fully explore the potential benefits of acetazolamide in improving outcomes such as length of hospital stay and reducing the degree of disability for this specific patient population. ▲ Show less

Snakebite is a potentially life-threatening disease which results from the venom released by a venomous snake following a bite, symptoms can be localized, neurotoxic, cardiotoxic, and hematoxic like tissue damage, paralysis, bleeding and necrosis that can result to limb amputation and permanent disability. It is already a major health problem especially in sub tropical and tropical countries like the Philippines The study aimed to determine the profile of snake bite patients who consulted and admitted at Zamboanga City Medical Center, this will then provide baseline data. The profile of the snake bite patients included the demographic, clinical profile, management and final outcome of patients. By determining these patients, health advocacy on snake bite will be implemented using information dissemination and education especially in communities with high incidence of snake bite. These will then aid health care providers and other concerned agencies in the awareness, control and management of snake bite. The study is a retrospective descriptive study in which cases of snakebite at Zamboanga City Medical Center from January 2015 to December 2019 were recorded and analyzed. A checklist was used in the collection of data and analyzed through frequency distribution. ▲ Show less

Background: Brachytherapy for gynecologic carcinomas often requires effective anesthesia to ensure patient comfort, immobility, and optimal treatment outcomes. At present, there is no existing study that establish better post-operative outcome between TIVA and LSA. This study will compare the post-operative outcomes of Total Intravenous Anesthesia (TIVA) and Low Spinal Anesthesia (LSA) in patients undergoing brachytherapy. Methods: A retrospective comparative effectiveness design was used. Medical records of 143 adult female patients with gynecologic carcinomas who received either Total Intravenous Anesthesia or Low Spinal Anesthesia during brachytherapy at Zamboanga City Medical Center were reviewed and compared. Post-operative outcomes, including operating room duration, post-operative voided volume, post-anesthesia discharge time, indications for rescue medications, intraprocedural rescue medications, and pain scores were assessed. Descriptive and inferential statistics were used to analyze the findings. Results: TIVA demonstrated advantages in operating room duration and procedural efficiency. Patients in the TIVA group had significantly shorter post-anesthesia discharge times and required fewer rescue medications, compared to those in the LSA group Conclusion: Total Intravenous Anesthesia (TIVA) and Low Spinal Anesthesia (LSA) are both safe and effective for gynecologic cancer patients undergoing brachytherapy. However, TIVA offers potential advantages in terms of recovery efficiency, reduced variability in procedural duration, and lower need for adjunctive medications. Hence, it may be considered a preferred anesthetic technique for gynecologic brachytherapy in appropriate patients. ▲ Show less

Introduction: In the Philippines, cervical cancer is the second leading cancer among women, with an estimated 7,277 new cases and 3,807 deaths each year. To date, there has been no local investigation on the sociodemographic, clinical profile, and treatment outcomes of cervical cancer patients in Zamboanga City. Objectives: The aim of this study was to investigate the sociodemographic and clinical profile, and treatment outcomes of cervical cancer in the Obstetrics and Gynecology department of Zamboanga City Medical Center. Methodology: This was a retrospective cohort study through records review. A total of 259 patients' records were reviewed in this study Results: Mean age during year of diagnosis was 47. 90.8% of the patients were from Region IX which includes Zamboanga City. Sexual debut was at an average of 19.5 and with history of at least 2 sexual partners. Disease histology were of squamous cell type at 70.4% and 13.4% were adenocarcinoma in origin. Majority of the patients seen and managed in the institution were diagnosed with stage IIIB (64%), IIB (8.1%), and IIIC1r (7.3%) cervical cancer. Two hundred twenty-two (85.7%) of the patients were for concurrent chemoradiation therapy (CCRT) while 28 (10.8%) were for systemic chemotherapy. However, only 48,6% and 28.5% were able to complete the regimen and only 34% and 10.7% of these patients were found to have no evidence of disease post treatment for both groups respectively. The prevalence of loss to follow-up cases was at 50,1%. Conclusion and Recommendation: Cervical cancer screening should be of priority in the setting to be able to catch premalignant lesions and early stages of cervical cancer. A cervical cancer registry should be established to safeguard the monitoring and observation of registered cervical cancer patients. ▲ Show less

Anemia is a common complication of chronic kidney disease (CKD) and contributes to increased morbidity and reduced quality of life. Early identification and appropriate management of anemia among patients with CKD not on dialysis are essential, particularly in the outpatient setting. This study aimed to determine the prevalence of anemia among patients with CKD stages 3-5 not on dialysis treated in the Outpatient Department of Zamboanga City Medical Center according to age, sex, etiology, and body mass index, to assess iron statius among anemic patients, to describe the clinical management of anemia, and to propose a protocol for outpatient anemia management A descriptive, cross-sectional study was conducted involving 155 adult patients with CKD stages 3-5 not on dialysis. Data on sociodemographic characteristics, clinical parameters, iron studies, and anemia management were collected and analyzed using descriptive statistics and selected inferential tests. Anemia was present in 69.0% of patients. Hypertensive kidney disease and diabetic kidney disease were the most common etiologies among anemic patients. Among anemic patients, 71.0% had iron studies performed, and iron deficiency was identified across all CKD stages Iron supplementation was the most frequently used treatment, while erythropoiesis-stimulating agents were more commonly administered in patients with moderate to severe anemia. Significant associations were observed between anemia and age as well as duration of CKD Anemia and iron deficiency are highly prevalent among patients with CKD stages 3-5 managed in the outpatient setting. Variations in iron evaluation and anemia management highlight the need for a structured, guideline-based outpatient anemia management protocol to improve patient care and optimize resource utilization. ▲ Show less

Background: Anastomotic leakage (AL) is a major complication following colorectal and small bowel anastomosis, leading to increased morbidity, mortality, and extended hospital stays. This study investigates the prevalence and clinical outcomes of Al. in a tertiary hospital in Zamboanga City over five years. Methods: A retrospective review of 148 inpatient charts (2018-2022) was conducted to assess AL prevalence, sociodemographic characteristics, surgical factors, and outcomes in patients undergoing elective and emergency colorectal and small bowel anastomosis. Chi-square tests were used to determine associations between AL and various patient-related, laboratory, and intraoperative factors. Results: The overall AL prevalence was 18.92% (28/148). Among large bowel anastomoses (129 cases), 19.8% (25/129) developed leaks, with rectal anastomoses exhibiting a higher leakage rate (23.08%; 3/13). No leaks occurred in small bowel anastomoses significantly associated with male gender ( x ^ 2 = 2.604 p = 0.002 ) advanced age ( x ^ 2 = 64.208 . p = 0.001 ) ASA classification ( x ^ 2 = 6.523 , p < 0.001 preoperative bowel preparation (x² = p = 0.0323 ) and smoking ( x ^ 2 = 12.31 . p = 0.002 ) . A borderline significant association was with blood transfusion ( x ^ 2 = 1.954 . p = 0.05 ) while type and level of anastomosis, surgical indication, urgency, and BMI were significantly related to AL Outcomes: Among AL patients, 92.86% were discharged, while 7.14% died. Morbidity included surgical site infection (3.38%), intraabdominal abscess (6.08%), dehiscence (2.03%), and reoperation (4.06%). AL was significantly associated with postoperative morbidity (x²= 6.303, p = 0.04 ). Conclusion: AL remains a significant complication in colorectal surgery, with notable associations with male gender, advanced age, ASA classification, preoperative bowel preparation, and smoking. Identifying these risk factors can guide preoperative optimization and surgical decision-making to improve outcomes. ▲ Show less

Background: Neck dissection is a critical procedure in the surgical management of head and neck malignancies. This study aims to describe the demographic, clinical, and surgical profiles of patients who underwent neck dissection at Zamboanga City Medical Center (ZCMC) over a 13-year period. Methods: A retrospective review of 220 patient charts from 2011 to 2023 was conducted. Data collected included demographics, primary tumor site, type of neck dissection, duration of surgery, length of hospital stay, and tumor recurrence. Descriptive statistics and Welch's t-test were used for analysis. Results: Of the 220 patients, 65.5% were female and 34.5% were male, with a mean age of 49.85 years (SD plus/minus 14.37) The majority were residents of Zamboanga City (54.55%), while others were referred from neighboring provinces. The thyroid was the most common primary tumor site (66.36%), predominantly in females, followed by the parotid gland (15.9%) and submandibular salivary gland (8.6%), with the latter more frequent in males. Modified Radical Neck Dissection (MRND) Type III was the most frequently performed procedure. Consultants performed 75% of the surgeries. The mean operative time was 419 plus/minus 224.6 minutes for consultants and 385 plus/minus 197.42 minutes for residents. Welch's 1-test revealed no statistically significant difference the two groups ( t(218) = 0.88 , p = 0.38 ) except for central neck dissection, where residents had significantly longer operative times (p = 0.002) The average postoperative hospital stay was 7.6 days, with 12.27% of patients requiring hospitalization for over 15 days. Tumor recurrence was most frequently observed in thyroid cancer cases (75%). Conclusion: Thyroid and salivary gland malignancies were the leading indications for neck dissection at ZCMC, with thyroid cancer being the most prevalent and recurrent. While consultants performed the majority of procedures and generally had shorter operative times, differences in surgical duration were not statistically significant overall. These findings highlight the need for continued surgical training and monitoring of long-term outcomes. ▲ Show less

Introduction: Guidelines from nephrology societies recommend hepatitis B virus vaccination for high-risk groups, this includes people undergoing hemodialysis. Unfortunately, a non-mandatory strategy is being used for vaccination against HBV in high-risk individuals in the Philippines. Moreover, there has been no study conducted determining the hepatitis B virus vaccination status and anti hepatitis B surface antibody titer of chronic kidney disease patients on hemodialysis in Zamboanga City. Objectives: This study aimed to determine the hepatitis B virus vaccination status and the levels of anti-HBs antigen titer of chronic kidney disease (CKD) patients undergoing hemodialysis in Zamboanga City Medical Center (ZCMC). Materials and methods: This study employed a prospective cohort design conducted at ZCMC, targeting chronic kidney disease (CKD) patients undergoing hemodialysis. Participants who met the inclusion criteria, including prior hepatitis B vaccination, were purposively sampled, resulting in 27 respondents. Data collection involved obtaining demographic details (age, sex), hemodialysis frequency, and baseline anti-HBs titers, which were re-evaluated six months later. Statistical analysis included descriptive measures (frequency and mean) and inferential tests (independeni and dependent t-tests) for comparing anti-HBs titers between and within groups, as well as chi-square tests to assess associations between categorical variables. Results: Most participants were only partially vaccinated, highlighting the need to improve coverage in ZCMC. No significant differences were found in titers across gender, age groups, dialysis frequency and duration. Additionally, the was a recorded decline in antibody levels six months after baseline suggesting necessity for booster doses, higher vaccine dosages, and regular monitoring for this high-risk population. Conclusion and recommendation: This study recommends All CKD patients must receive vaccination against hepatitis B and strengthening the Zamboanga City Medical Center Hemodialysis Unit Hepatitis B vaccination protocols to improve vaccine adherence. Future research should focus on prospective, controlled studies to comprehensively examine the factors influencing hepatitis B vaccine response in hemodialysis patients. ▲ Show less

ABSTRACT Background: Around 1 million Filipinos have active Tuberculosis (TB) disease, the third highest prevalence worldwide. TB is an infectious disease, airborne in nature of transmission but is highly curable. However, it is continuously lined as the primary killer among all infectious diseases (WHO, 2019). In the Philippines, there are about a quarter of a million new TB cases and at least 26 000 TB deaths annually in a country of approximately 80 million people., most of them have developed drug resistance, a strain more difficult and expensive to treat. Alarmed, the department of health expanded their campaign in their goal of eliminating the continuous increasing population of TB cases (DOH, 2019) by the year 2030. Yet, we still have a long way to go. Objective: GENERAL OBJECTIVE: To determine the socio-demographic factors, physiologic and psychological factors that causes non adherence from Tuberculosis treatment. SPECIFIC OBJECTIVE: 1. To determine the rate of non-adherence and treatment discontinuation among TB patients 2. To determine the socio demographic factors that contribute to non-adherence from treatment among TB patients. 3. To identify the physiologic status of TB patients who discontinued TB treatment 4. To determine the psychological factors that caused discontinuation and/or non adherence from TB medications. 5. To determine the significant association of factors of non-compliance in the discontinuation of TB treatment. Methodology: The study utilized a descriptive cross-sectional study in determining the factors that are related to discontinuing of TB treatment among diagnosed TB patients from January 2019 to December 2022. Purposive sampling was used in determining the samples that will be included in the study. Conclusion: The study on factors associated with non-adherence to anti-TB medications among patients enrolled in TB DOTS in Zamboanga City Medical Center reveals critical insights into the challenges impacting treatment compliance. Through comprehensive analysis, several contributing factors have emerged, including gender, occupation, and BMI are factors influencing tb treatment adherence. Majority of the reason of discontinuing treatment is due to side effects, and however most has not experienced any symptoms after discontinuation of treatment. Recommendation: Addressing non-adherence demands a multifaceted approach involving tailored interventions. Strategies like patient education, enhancing social support networks, simplifying medication regimens, reducing stigma, and improving healthcare accessibility are imperative to mitigate non-adherence rates. Additionally, fostering collaboration between healthcare providers, policymakers, and communities is essential for implementing sustainable solutions to enhance adherence and ultimately improve TB treatment outcomes. The study also recommends further investigation of the identified significant factors that can help explore intervention to address or manage the further occurrence of nonadherence. ▲ Show less

Endometrial cancer is one of the most common gynecologic malignancies worldwide, with increasing incidence in low- and middle-income countries, including the Philippines. Data on treatment outcomes from regional public hospitals remain limited. This study aimed to determine the clinicopathologic characteristics, treatment modalities, and outcomes of endometrial cancer patients managed at the Department of Obstetrics and Gynecology of Zamboanga City Medical Center (ZCMC). This retrospective descriptive study reviewed medical records of patients diagnosed with endometrial cancer and managed at ZCMC from January 2022 to December 2024. Data collected included sociodemographic characteristics, comorbidities, stage at diagnosis, histopathologic findings, treatment modalities, treatment outcomes, and loss to follow-up. Descriptive statistics were used to summarize the findings. A total of 67 patients were included. The mean age at diagnosis was 52.14 years. Most patients were diagnosed at Stage II disease, with endometrioid carcinoma being the most common histopathologic subtype. Hypertension was the most prevalent comorbidity. Multimodal treatment, particularly surgery combined with chemotherapy and radiotherapy, was the most frequently administered intervention. Regarding outcomes, 8 patients had no evidence of disease, 42 were under persistence or surveillance, 9 experienced disease progression, 3 had recurrence, 2 died, and 3 were lost to follow-up. Among referred patients who had surgery prior to presentation at ZCMC (n=11), most were undergoing ongoing adjuvant treatment. while a smaller proportion experienced progression or loss to follow-up. Endometrial cancer patients managed at ZCMC exhibited diverse clinical, pathologic, and treatment characteristics. While many patients were diagnosed at relatively earlier stages and received multimodal therapy, persistent disease and ongoing surveillance remained common outcomes. These findings highlight the need for continued efforts in early detection, comprehensive treatment planning, and strengthened follow-up systems to improve patient outcomes in regional healthcare settings. ▲ Show less

Background: The coronavirus disease 2019 (COVID-19) pandemic has given rise to the need to develop a vaccine as quickly as possible. The immunization of healthcare workers (HCWs) plays a recognized key role in prevention in the COVID-19 pandemic (Modenese et al. 2021) Objectives: This study aims to determine the immune response to covid 19 vaccines among health care workers and office personnel in ZCMC. Methodology: This is a crossectional descriptive analytical study. Patients 18 years old and older who are vaccinated with only one vaccine. Completed two doses of vaccine will be included in the study RESULTS: The study included a total of 90 respondents for analysis from the targeted 100 respondents who submitted their blood samples. The study compares antibody titer levels in individuals who received two COVID-19 vaccine doses with and without four booster shots. The average titer level was 161.59 BAU/mL for those with only two doses and 172.0 BAU/mL for those with four boosters, indicating a higher average titer level in the booster group. CONCLUSION: The study analyzes immune responses to COVID-19 vaccination in healthcare workers and office personnel. Healthcare workers, especially those with booster shots, showed higher antibody levels, likely due to greater virus exposure and booster effects. Challenges included hemolyzed blood samples from office personnel, emphasizing the need for sample integrity in serological studies. RECOMMENDATION: The study emphasizes the importance of booster vaccination programs, particularly for healthcare workers in high-risk settings, and regular monitoring of antibody levels to assess immunity duration. It highlights the need for tailored strategies for different occupational groups, improved sample handling to prevent hemolysis, and further research to identify protective antibody thresholds and factors affecting immune response. Public health messaging should promote vaccination and boosters, while ongoing research and adaptive strategies remain crucial for managing the pandemic effectively. ▲ Show less

Introduction: As of March 2020, the World Health organization has declared COVID 19 as a global pandemic. In severe and critical cases of COVID 19, excessive immune response against SARS-CoV-2 results in cytokine storm characterized by uncontrolled overproduction of pro-inflammatory cytokines. Hemoperfusion is an extracorporeal blood purification modality, and is used in the treatment of COVID 19 by removing excessive cytokines and endotoxins. Despite promising results in previous studies, in the Philippine setting, there is insufficient evidence on the use of hemoperfusion among patients with COVID-19 infection, and its efficacy is still being studied. Objectives: This study aimed to determine the clinical outcomes of COVID 19 patients treated with hemoperfusion determine whether there is a significant difference in the outcomes of these patients compared to COVID 19 patients who have not been treated with hemoperfusion. Methodology: This is a single-center retrospective matched case-control study. Patients 18 years and older who have confirmed COVID-19 infection by RT-PCR NPS, and have met 2 or more criteria for initiation of hemoperfusion were included in this study. Medical records of these patients admitted in ZCMC from April 2021 to July 2022 were reviewed. Outcomes measured in terms of mortality or recovery, length of hospital stay, need for ICU admission, need for invasive mechanical ventilation, and development of complications. Results: majority of the subjects that were treated with hemoperfusion were admitted to ICU and were intubated and hooked to mechanical ventilator, as compared to the control group. More than half were discharged improved, for both case and control groups. However, there is no significant difference in terms of duration of admission and disposition. Hence, there is no significant difference in terms of death and recovery between the two groups Conclusion and Recommendation: it can be concluded that patients who were treated with hemoperfusion were more likely to be admitted in the ICU and need mechanical ventilation compared to patients who had not been treated with hemoperfusion. The researcher recommends to conduct a similar study in the local setting that will investigate on the factors that may contribute to the morbidity among COVID patients who have received hemoperfusion, as well as to investigate on the association of these outcomes to hemoperfusion itself. ▲ Show less

Ovarian cancer is one of the most fatal gynecologic malignancies due to its late-stage detection. CA-125, a high-molecular-weight glycoprotein, is widely used as a tumor marker. but its diagnostic specificity remains limited, especially in premenopausal women. This study aims to assess the diagnostic value of CA-125 in differentiating benign, borderline, and malignant ovarian masses among premenopausal and menopausal women. A retrospective descriptive study was conducted at Zamboanga City Medical Center, involving 120 women who underwent CA-125 testing prior to ovarian surgery from 2019 to the present. Data including CA-125 levels, menopausal status, and histopathologic findings were reviewed Statistical analyses such as ANOVA and chi-square tests were used to determine associations Malignancies comprised 52.5% of cases, with benign and borderline masses accounting for 31.7% and 15.8%, respectively. Mean CA-125 levels were highest in malignant cases (614.15 U/mL) compared to borderline (62.30 U/mL) and benign (44.54 U/mL), though differences were not statistically significant (p = 0.44) due to high variability. However, chi-square analysis revealed a significant association between CA-125 levels and malignancy (p 0.001784), with 41.27% of malignant cases having levels above 100 U/mL Additionally. benign tumors were more common in premenopausal women (p0.036), indicating menopausal status as a relevant factor in interpretation. CA-125 remains a valuable adjunct in evaluating ovarian masses but is insufficient as a standalone diagnostic tool due to overlapping values across histologic types and menopausal status. A multimodal approach, combining CA-125 with imaging and clinical models, is recommended to improve early detection. Further research is warranted to evaluate novel biomarkers and refine diagnostic algorithms. ▲ Show less

Background: Laparoscopic cholecystectomy is the gold standard for managing gallstone disease and is commonly performed in teaching hospitals by both surgical residents and consultants Concerns remain regarding operative efficiency and patient safety when procedures are performed by supervised resident-independent surgeons. Methodology: This retrospective record review compared clinical and surgical outcomes of laparoscopic cholecystectomy performed by independent residents versus conltant asseted residents ar the Zamboanga City Medical Center from January 1 to December 31, 2023. Patients were grouped by surgeon category: resident-independent or consultare-arsend Demographic variables, operative characteristics, and postoperative outcomes-inchading operative time, hospital stay, conversion to open surgery, convulsant takeover, postoperative pain, antiemetic use, complications (Clavien-Dindo system), and 30-day mortality were analyzed. Descriptive and inferential statistics compared ontcomes between groups. Ethical clearance was obtained from the ZCMC's Institutional Review Bourd (IRB), with strict adherence to patient confidentiality. Results: Of all casex, 38.9% were performed independently by residents and 60.3% were consultant-assisted. Baseline demographics- including age, sex, body mass index, ASA classification, and prior abdominal surgery- were comparable between groups. Laparoscopic approach predominated, wah a very low conversion rate to open surgery Resident-independent cases had a significantly longer mean operative time compared to connllunt assisted cases. However, no significant differences were observed in hospital stay postoperative pain, antiemetic requirements, or complication rates. Most patients experienced no postoperative complications, and only minor (Clavien-Dundo Grade 1-II) events were reported. No major complications or mortality were recorded, and all patients were discharged Conclusion: Resident-independent laparoscopic cholecystectomy is safe and yields outcomes comparable to consultant-assisted surgery, despite longer operative times. These findings support structured resident autonomy within supervised training programs in tertury teaching hospual. ▲ Show less

Background: Diabetes mellitus (DM) has been identified as a potential risk factor for poor outcomes in COVID-19. However, the impact of preexisting diabetes on clinical characteristics, management, and prognosis among hospitalized COVID-19 patients remains unclear. Objective: To compare the characteristics, clinical outcomes, and antihyperglycemic management of COVID-19 patients with and without type 2 diabetes at Zamboanga City Medical Center Methods: A retrospective analysis was conducted on 101 confirmed COVID-19 patients. including 23 (22.8%) with type 2 diabetes and 78 (77.2%) without diabetes. Demographic, clinical, laboratory, and outcome data were collected and compared between groups using appropriate statistical tests. Results: The mean age of patients was 61.24 plus/minus 12.36 years, with no significant differences between DM and non-DM patients (60.309.57 vs. 61.2/13.13 years: p = 0.604 ) Females comprised 51.5% of the cohort, and body mass index was comparable between groups (26.09 plus/minus 4.67 vs. 26.9 plus/minus 6.3 ) . DM patients had a higher prevalence of comorbidities, particularly hypertension (78.3% vs. 61.5%; p < 0.004 ) , and lower hemoglobin ( 116.52 plus/minus 23.79 * v 127.0 p = 0.009 ) and hematocrit levels (p = 0.009) FBS levels did not differ significantly, but HbAlc levels were significantly higher in the DM group (9.472.52 vs. 7.45 ± 2.91; p = 0.003), indicating poorer long-term glycemic control. Complications such as acute kidney injury, ARDS, and hospital-acquired pneumonia were observed in both groups, but no statistically significant differences were noted. Mortality was similar between DM and non-DM patients (73.9% vs. 76.9%; p = 0.784 ) Among DM patients, 66.7% of recovered patients received insulin and 33.3% received metformin, while 70.6% of expired patients received insulin only. plus/minus 31.4 Conclusion: Although diabetes was associated with higher comorbidity burden and lower hematologic indices, it was not significantly linked to worse outcomes or mortality in this cohort. Appropriate glycemic management and supportive care may help mitigate the impact of diabetes on COVID-19 prognosis. ▲ Show less

INTRODUCTION Stroke is a medical emergency requiring urgent recognition and treatment to prevent disability and mortality. Identifying factors contributing to consultation delays is essential for improving healthcare services, raising public awareness, and enhancing stroke management. OBJECTIVES The increasing trend of delayed hospital consultation among stroke patients highlights the need to evaluate contributing factors. Identifying these determinants can improve healthcare services, shape awareness campaigns, and enhance stroke management strategies. This prospective cohort analyzed the medical records of stroke patients admitted to Zamboanga City Medical Center from January 2025 to December 2025. A structured data abstraction form will be used to collect relevant information. To address the study objective, the association between delayed hospital consultation (>4.5 hours from symptom onset) and in-hospital mortality was examined using the Chi-square test, with statistical significance set at p<0.05. OUTCOMES The study determined key factors contributing to delayed consultation, assessing variables such as age, stroke severity, transportation, and symptom awareness. It will also examine the impact of delays on mortality and disability. Findings will support improvements in stroke awareness, emergency response, and hospital protocols, ultimately enhancing patient outcomes and reducing stroke-related disabilities. ▲ Show less

Introduction: Anastomotic leak (AL) remains a serious and potentially life-threatening complication following colorectal surgery, contributing to increased morbidity, prolonged hospitalization. and, in some cases, mortality. Identifying predictive factors in the local setting is essential for targeted interventions and improved patient outcomes. This study aims to determine the incidence, outcomes, and predictive factors of AL among adult patients undergoing colorectal anastomosis at a tertiary hospital in Zamboanga City. Methods: A retrospective cohort design was employed, reviewing medical records of adult patients who underwent colorectal anastomosis from January 2018 to December 2022. Records were systematically selected based on predefined inclusion and exclusion criteria to ensure data completeness. Patient demographics, clinical characteristics, comorbidities, and perioperative factors were summarized using descriptive statistics. Comparative analyses between patients with and without AL were performed using Fisher's exact tests for categorical variables. Results: Among 79 patients included, the incidence of AL was 5.1%. All patients with leaks were male, and most had comorbidities, prior abdominal surgery, or low preoperative albumin levels. Operative duration exceeding three hours was observed in all leak cases, and hand-sewn anastomoses were predominant. Patients with AL experienced longer hospital stays (14.6 vs. 8.8 days) and higher postoperative morbidity, including dehiscence and strictures. Mortality was low and did not differ significantly between groups. Conclusion: Anastomotic leak is a multifactorial complication influenced by patient-related, clinical, and surgical factors. Early identification of high-risk patients, preoperative optimization, meticulous surgical technique, and vigilant postoperative monitoring are critical to reducing AL incidence and improving outcomes. These findings support the development of institutional protocols tailored to the local hospital setting. ▲ Show less

INTRODUCTION Breast mass is among the most common specimens for histopathologic examination. Prompt histopathologic diagnosis from core needle biopsies is essential for timely. targeted therapy. Data on tumor infiltrating lymphocytes (TIL) can be essential in formulating treatment options for a breast carcinoma patient once its predictive value in the hormonal and axillary lymph node status in breast carcinoma has been established. OBJECTIVE This study aimed to determine the sensitivity, specificity and prevalence of the predictive value of tumor infiltrating lymphocytes in breast carcinoma grading, lymphovascular invasion, hormonal status, and lymph node status among breast carcinoma cases submitted in Zamboanga City Medical Center. METHODOLOGY Data was collected through purposive sampling method of the total number of breast carcinoma cases submitted from January 2017 to December 2024. Core breast tissue biopsy slides were reviewed for tumor infiltrating lymphocytes. Sensitivity, Specificity, NPV, PPV, and Likelihood Ratios were used to determine the diagnostic accuracy of tumor infiltrating lymphocytes. RESULTS A total of 130 breast cancer patients with complete diagnostic data were included in this study. The majority of tumors were ductal carcinoma (91.5%) and histologic grade 2 (59.2%), with most categorized as T2 (55.4%) and 53.1% exhibiting no nodal metastasis. Hormonal receptor analysis showed 75.2% ER positivity, 57.4% PR positivity, and 51.9% HER2 positivity, while 53.9% of cases demonstrated lymphovascular invasion Patients were stratified by stromal (sTIL) and intratumoral (iTIL) tumor-infiltrating lymphocyte levels. Higher STIL and ITIL. levels were significantly associated with younger age and higher histologic grade (p <0.05). No significant differences were observed for tumor size, lymph node involvement, or hormone receptor and HER2 status, though trends suggested greater ER and PR negativity in high TIL. groups. Diagnostic performance analysis revealed that STIL 240% demonstrated the most balanced sensitivity (70%) and specificity (81%) for predicting high histologic grade, with high negative predictive value (90%) and moderate positive likelihood ratio (3.68), making it a clinically useful biomarker. Stromal TILs were less reliable in predicting lymphovascular invasion, hormonal status, and lymph node involvement. Intratumoral TILs generally exhibited lower diagnostic accuracy, with poor sensitivity and specificity across all outcomes. Overall, stromal TILs, particularly at a ≥40% cutoff, appear to be a more reliable indicator of tumor aggressiveness, whereas the predictive value of both stromal and intratumoral TILs for other clinicopathologic features remains limited. Future studies incorporating detailed lymphocyte subtyping and genomic analyses may further elucidate the functional role of TILs in breast cancer. CONCLUSION AND RECOMMENDATION Stromal (sTIL) and intratumoral (iTIL) tumor-infiltrating lymphocytes exhibit varied but generally limited diagnostic utility across multiple pathological features in breast cancer. Increasing the sample size in future studies would enhance statistical power. ▲ Show less

Background: Prediabetes is a widespread condition causing early peripheral and autonomic neuropathy, primarily affecting small, unmyelinated nerve fibers (SFN) Since conventional methods like Nerve Conduction Studies (NCS) cannot detect this early small fiber injury, an objective alternative is required. The Sympathetic Skin Response (SSR) non-invasively evaluates the function of these specific unmyelinated sympathetic fibers. Studies show that prediabetic patients exhibit significantly reduced SSR amplitude, which quantifies functional axonal loss, making SSR a promising objective biomarker for detecting subclinical neuropathy. Objectives: The principal aim of this study is to determine the prevalence of peripheral neuropathy among prediabetic ZCMC employees of ZCMC. The study aims to accomplish the following specific objectives: identify the prevalence of ZCMC employees with pre-diabetes according to fasting blood sugar measurement; describe the sociodemographic and clinical profile of pre-diabetic ZCMC employees, determine the prevalence of peripheral neuropathy using Sympathetic Skin Response (SSR) among pre-diabetic employees of ZCMC Methodology: The study employed a descriptive cross-sectional design and was carried out at ZCMC between April 1, 2025, and October 20, 2025. Those personnel who are prediabetic, at least 20 years old, and do not have a medical history of diabetes were included in the study. Peripheral neuropathy was assessed using the sympathetic skin response (SS). Microsoft Excel was utilized for data analysis, and the results were presented as frequencies and percentages. Results: Among 420 ZCMC employees who underwent annual medical exams, 70% had normal glucose levels, 11.7% had diabetes mellitus, and 18.3% classified as pre-diabetic. The mean age of pre-diabetic participants was 36.03 ± 6.17 years. Clinically. 61.1% reported a family history of diabetes, 30.6% had coexisting hypertension. Moreover, 91.6% were classified as overweight or obese (BMI ≥ 25 kg/m²), while 83.3% had high-risk waist circumference (> 90 cm in men,> 80 cm in women). Among pre-diabetic employees assessed with Sympathetic Skin Response (SSR) testing, 63.89% exhibited abnormal evoked responses, suggesting early peripheral neuropathy. Conclusion and Recommendation: This study revealed that nearly one-fifth of ZCMC employees were pre-diabetic. Over half of pre-diabetic employees exhibited early signs of neuropathy. Obesity, hypertension, and family history were common risk factors. These results highlight the need for proactive metabolic monitoring even in healthcare settings and demonstrate that occupational health programs must address lifestyle-related risks among medical personnel. ▲ Show less

Background: Perioperative shivering is a common complication of spinal anesthesia, affecting patient comfort and recovery. This study compares the efficacy, onset of action, and safety of nalbuphine and tramadol in managing perioperative shivering among obstetric and gynecologic patients. Methods: A double-blinded controlled trial was conducted. Patients were randomized into two groups: Group A (nalbuphine) and Group B (tramadol). Shivering intensity, time to cessation, blood pressure changes, and adverse effects (nausea and vomiting) were recorded at 5, 10, 15 minutes, and 1-hour post-administration. Results: Nalbuphine demonstrated a significantly faster time to shivering cessation (3.9 ±1.96 min) compared to tramadol (9.81 +4.5 min, p=0.004). A significant difference in shivering scale was observed only at the 5-minute mark. Nalbuphine maintained more stable hemodynamics, with significant differences in DBP and MAP at 10 minutes (p-0.035, p-0.05. respectively). No significant differences in nausea and vomiting were found. Conclusion: Nalbuphine provides more rapid shivering control with a comparable safety profile to tramadol. ▲ Show less

Measles is a highly contagious disease caused by a virus that could lead to serious complications. As a result, the government passed the Mandatory Infants and Children Health Immunization Act of 2011, which provides free and mandatory immunization of vaccine-preventable diseases, including measles. Despite this, there is low vaccination coverage in the Municipality of Sumisip. In 2024, four (4) measles cases were recorded, three (3) of which involved unvaccinated patients. The aim of this study is to identify factors associated with compliance among mothers to their children's Measles Mumps Rubella (MMR) vaccination in Sumisip, Basilan. An analytical cross-sectional study was employed among 186 mothers utilizing univariate and multivariate logistic regression to determine association between demographics, knowledge, attitude, and other factors and compliance to MMR vaccination. Maternal knowledge on vaccination was a strong predictor of MMR vaccine compliance. Mothers who were knowledgeable were 13.94 times more likely to comply with MMR vaccination compared to those who were not. In contrast, children with prior BCG vaccination had significantly lower odds of MMR vaccine compliance. These findings highlight the need to develop programs and interventions targeting improvement on the knowledge of mothers, alongside efforts in identification of factors and gaps contributing to noncompliance. ▲ Show less

This study evaluated the effectiveness of the Family Catharsis-Education-Action (CEA) intervention on treatment adherence among hypertensive adults residing in a geographically isolated and disadvantaged area (GIDA) in Baliguian, Zamboanga del Norte. Employing a quasi-experimental pre-post design, 85 hypertensive patients enrolled in barangay hypertension clubs and their families underwent a structured 30-45 minute Family CEA intervention. Treatment adherence was assessed before and one month after the intervention using the validated Treatment Adherence and Support for Hypertension Patients (TASHP) questionnaire, encompassing domains of medication adherence, poor medication behavior, daily life management, and smoking and alcohol use. Pre-intervention scores ranged from 52 to 96 (mean 71.1. SD-10.3), with no participants classified as adherent (TASHP score ≥109). Following the intervention, significant improvements were observed, with post-intervention scores ranging from 66 to 118 (mean=98.3, SD-11.5) and 19 participants achieving good adherence status. Paired t-test analysis demonstrated a statistically significant increase in scores (p<.001), indicating substantial behavioral changes in medication management, dietary practices, physical activity, and emotional self-care. Lower post-intervention adherence was associated with contextual barriers, including symptomatic misinterpretation. grief-related disruption, work-related stress, and caregiving burden, reflecting the influence of competing psychosocial demands on treatment consistency. The Family CEA model's holistic, family-centered approach shows promise for scalable, community-based chronic disease management in resource-limited settings. Future research with extended follow-up is recommended to assess long-term sustainability and clinical outcomes. ▲ Show less

Introduction: Spinal anesthesia is commonly used for cesarean section because it works quickly and reduces airway complications compared with general anesthesia. However, it can cause maternal hypotension due to sympathetic blockade, which leads to vasodilation and decreased venous return. One preventive method is the use of a pneumatic compression device that intermittently compresses the lower limbs to improve venous return and maintain circulatory stability. Objective: This study aimed to compare the effects of a standard portable pneumatic compression device (PCD) on intraoperative hemodynamic stability during repeat cesarean section under spinal anesthesia at Zamboanga City Medical Center. Methods: This randomized controlled study included 60 patients planned for repeat cesarean section under spinal anesthesia. Participants were randomly allocated into two groups: an intervention group with an activated pneumatic compression device and a control group with identical pneumatic sleeves applied but the device remained inactive. All patients underwent a standard preoperative evaluation by the attending anesthesiologist. Intraoperative monitoring focused on hemodynamic parameters, including the incidence of hypotension, vasopressor requirements, occurrence of bradycardia, and episodes of oxygen desaturation. Results and Discussion Hypotension occurred more frequently in the control group than in the intervention group. Within the first fifteen minutes after spinal anesthesia, hypotension developend in nineteen (19) patients in the control group compared with seven (7) patients in the intervention group. During the later stages of surgery, hypotension was recorded in twenty-seven (27) patients in the control group and nine (9) patients in the intervention group. Vasopressor therapy was required in sixteen (16) patients in the control group and five (5) patients in the intervention group. No cases of bradycardia or oxygen desaturation were observed in either group. Conclusion: The use of a standard portable pneumatic compression device was associated with fewer hypotensive episodes and reduced vasopressor requirements, indicating improved hemodynamic stability during cesarean section performed under spinal anesthesia. ▲ Show less

Background and Objectives: This study investigated the prevalence postpartum depression (PPD) among adolescent mothers at the Zamboanga City Medical Center (ZCMC) from March to August 2025. PPD, with a global prevalence of 25-42%, disproportionately affects young mothers, necessitating a holistic approach to understanding its complexities and developing effective solutions. This research aims to determine the prevalence of PPD in this setting. providing critical data to enhance healthcare policies for adolescent mothers. Methodology: This cross-sectional study utilized the Patient Health Questionnaire 9-item (PHQ-9) for PPD assessment. Purposive sampling was conducted among eligible participants aged 10-18 who met the inclusion criteria. Data collection included sociodemographic and obstetric histories, analyzed through descriptive statistics. Results: Eighty-two adolescent mothers participated, with a mean age of 16.20 1.17 years; fifty tree percent (53.7%) were in their late adolescence. The majority were cohabitating (64.6%), unemployed (100%), and had low household incomes, with 95.1% earning under Php 5,000 monthly. Most participants reported no family history of mental illness and experienced unplanned pregnancies. The PHQ-9 assessment showed a mean score of 2.94 and a prevalence of 6.1% (n=5) at 2 weeks, declining to a mean score of 2.27 and a prevalence of 1.2% (n-1) by 4 weeks. Conclusion: The prevalence of postpartum depressive symptoms among adolescent mothers was low and mild, with notable improvement over time. Recommendations for comprehensive screening at multiple time points and tailored support interventions are essential for enhancing mental health resources for this vulnerable population. ▲ Show less

This study determined the prevalence of new-onset psychiatric symptoms among COVID-19 positive patients referred to the Department of Psychiatry at Zamboanga City Medical Center (ZCMC). The study is a cross-sectional descriptive study to determine the prevalence of new-onset psychiatric symptoms in COVID-19 patients referred to the Department of Psychiatry of Zamboanga City Medical Center. It utilized retrospective chart review of 32 patients, the study characterized the demographic profile, reasons for referral. psychiatric diagnoses, and comorbidities of the cohort. Results showed that the prevalence rate of new-onset psychiatric symptoms among COVID-19 confirmed patients referred to the Department of Psychiatry of Zamboanga City Medical Center is 2.56%. Study analysis revealed an equal gender distribution (50% male n=16, 50% female n=16) with a mean age of 45 years; notably. 34.4% of patients (n= 11) were aged 60-70 years. The most frequent referral complaints included restlessness, irritability, and sleep disturbance. The primary psychiatric diagnoses were stress-related disorders (n=12, 37.5%%), while 21.9% (n=7) presented with non-specific and ill-defined symptoms. Comorbidity analysis indicated that 53.1% of patients (n=17) had COVID-19 concurrent with respiratory and infectious complications. These findings establish a baseline understanding of psychiatric manifestations in COVID-19 patients at ZCMC, highlighting that stress-related disorders and sleep issues are common, even in those without prior psychiatric history. The results underscore the critical need for early psychiatric screening and intervention, particularly for older patients and those with severe physical illnesses. Thus, it is recommended that an integrated medical and mental health care approach and long-term psychological monitoring to manage potential conditions such as PTSD, anxiety, and depression post-recovery. Public health awareness and accessible mental health services are essential to ensure comprehensive patient and family care. ▲ Show less

Background and Objectives: Hypertension, once considered uncommon in children and adolescents, is now recognized as an emerging public health issue both globally and in the Philippines. Early onset of elevated blood pressure increases the risk of long-term cardiovascular morbidity, making early identification of risk factors essential. This study aimed to determine the prevalence of hypertension, its associated risk factors, and complications among senior high school students in Zamboanga City Methodology: A descriptive cross-sectional design was utilized, involving 197 participants selected through multistage random sampling from selected public and private schools in Zamboanga City. Data were collected using a researcher-administered questionnaire covering sociodemographic characteristics, family and medical history, smoking and alcohol use, dietary habits, and physical activity. Anthropometric measurements and blood pressure readings were obtained, and hypertensive participants were referred for further laboratory and diagnostic evaluation. Results: Of the 197 participants of the study. 2% were prehypertensive and 3.6% were hypertensive. Risk factors for developing hypertension were seen among older adolescents (5.5%), with a family history of hypertension (5.5%), elevated BMI (2.5%), unhealthy dietary intake (high sodium (3%), fat (4.5%) and cholesterol (3.5%), law fiber [3.5%]), and low physical activity (4%). Complications of hypertension were not present among the hypertensive individuals. Conclusion: The findings indicate that there is low prevalence of adolescent hypertension. Nevertheless, among those with hypertension, there is a high occurrence of hereditary and modifiable risk factors. Strengthening health education, promoting healthier lifestyles, and implementing routine blood pressure monitoring among population are essential to prevent the progression of adolescent hypertension into adulthood and reduce long-term cardiovascular risks. ▲ Show less

Work-related musculoskeletal disorders (WRMDs) are a major occupational health concern that adversely affect employee productivity, work performance, and institutional efficiency. Increasing clinic visits among ZCMC employees for musculoskeletal complaints and work absences highlighted the need to quantify the burden of WRMDs among health workers. This study aimed to determine the prevalence, anatomical distribution, severity, and work-related interference of musculoskeletal discomfort among health workers at ZCMC. A quantitative, descriptive, cross-sectional design was employed. Data were collected from 235 health workers using the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), a validated self-administered instrument assessing the frequency, severity, and functional interference of musculoskeletal discomfort across multiple anatomical regions. Descriptive statistics, including frequencies, percentages. means, and standard deviations, were used for data analysis. The prevalence of WRMDs was 91%. A substantial proportion of respondents experienced moderate to severe discomfort with varying levels of work-related interference. Musculoskeletal complaints were commonly multi-regional and predominantly involved axial and upper body regions, particularly the lower back (75%) and upper back (67%). Notably, the allied medical division demonstrated a comparatively higher burden, with equal proportions of moderate and severe WRMDs (35% each). Slight work-related interference remained common, especially among allied medical staff (45%) and medical personnel (31.25%), while substantial interference, although less frequent, was more evident in the allied medical (15%) and medical divisions (6.25%). This study demonstrated a high prevalence of work-related musculoskeletal disorders among health workers at ZCMC, reflecting a substantial occupational health burden. Although mild symptoms were most common, a considerable proportion of respondents reported moderate to severe discomfort with functional limitations, predominantly involving multi-regional and axial areas, suggesting cumulative biomechanical strain from routine healthcare tasks. Hence, these findings highlight the urgent need for comprehensive, multidisciplinary ergonomic and occupational health interventions, including institutional ergonomic improvements, continuous training on proper body mechanics, and workplace health promotion initiatives. Moreover, future longitudinal studies with objective ergonomic assessments are warranted to clarify causal relationships and evaluate the effectiveness of targeted preventive strategies. ▲ Show less

Nursing professionals represent one of the most influential sectors within the public health system. Evidence indicates that nurses experience burnout at higher rates than other healthcare workers, with significant implications for patient safety, interprofessional collaboration, and healthcare system performance. A descriptive cross-sectional study at Zamboanga City Medical Center (ZCMC) by Fermo, 2021 found a significant burnout among particularly among nurses. Hence, the study aimed to explore the actual experiences of burnout nurses in ZCMC and look into the occupational factors that contribute to burnout among ward nurses. This qualitative descriptive study explored the lived experiences of ward nurses at Zamboanga City Medical Center who reported symptoms of burnout, with the aim of identifying occupational factors contributing to this condition. Using purposive and snowball sampling, eleven nurses from medical, obstetrics-gynecology, pediatrics, and surgical wards were recruited until data saturation was achieved. Data were collected through in-depth interviews guided by open-ended questions and analyzed using thematic content analysis. Findings revealed that burnout among ward nurses was shaped by five interrelated domains: overwhelming workload and staffing shortages, institutional and organizational challenges, physical and emotional exhaustion, fears of errors, health, and safety, questioning the profession and seeking better opportunities. The study underscores the urgent need for organizational reforms and policy interventions that address workload management, leadership support, compensation equity, and workplace safety By amplifying the voices of nurses, this research contributes to a deeper understanding of burnout in the Philippine context and provides evidence to guide strategies for strengthening resilience, retention, and the sustainability of the nursing workforce. ▲ Show less

This study investigates the health-related quality of life (QoL) of People Living with HIV (PLHIV) enrolled at the Zamboanga City Medical Center (ZCMC) Treatment Hub in the post-pandemic era. With the global impact of the COVID-19 pandemic, the quality of life for PLHIV may have been significantly affected due to disruptions in healthcare access, social support. and mental health resilience. This research aims to assess the physical, psychological, and environmental factors influencing the Qol of PLHIV in Zamboanga City. The study employed a quantitative, cross-sectional design, utilizing the WHOQOL-HIV BREF questionnaire to collect data from participants aged 18 to 60 years. The research explores the association between sociodemographic factors, HIV-related variables, and Qol domains, including physical health, psychological well-being, social relationships, environmental health, and spirituality. Preliminary findings indicate that PLHIV who rated their overall Qol. as "Good" reported significantly higher scores in psychological well-being, physical health, and environmental conditions. Conversely, those with "Poor" Qol ratings expressed dissatisfaction with their health, lower functional capacity, and greater symptom burden. Furthermore, the study observed a notable relationship between higher educational attainment and better QoL, particularly in the domains of social relationships and environmental health. These results underscore the importance of addressing both healthcare and socio-environmental factors to improve the overall well-being of PLHIV. This study highlights the necessity of tailoring interventions and support services to the unique needs of PLHIV in Zamboanga City, particularly in light of the post-pandemic challenges. The findings will provide valuable insights for healthcare policymakers, practitioners, and researchers, guiding future initiatives aimed at enhancing the quality of life of PLHIV in the region ▲ Show less

Occupational exposure to air pollutants has been recognized as a significant risk factor for respiratory diseases, particularly Chronic Obstructive Pulmonary Disease (COPD). This study aims to evaluate the pulmonary function test (PFT) profile of traffic enforcers in Zamboanga City to determine the severity of airflow limitation and its association with the duration of occupational exposure. Utilizing a cross-sectional design, this study employed a convenience sampling method to recruit actively employed traffic enforcers. Participants underwent a comprehensive screening process, including a structured questionnaire and chest radiography, to exclude individuals with pre-existing pulmonary conditions, comorbidities, or lifestyle factors such as smoking and alcohol use that could confound the results. Pulmonary function testing was conducted to assess airflow limitation, categorized according to established diagnostic criteria. The findings of this study provide critical insights into the prevalence of airflow obstruction among traffic enforcers and the potential role of occupational exposure in the pathogenesis of COPD. The results underscore the importance of routine pulmonary function assessments as an early detection tool for at-risk populations. Furthermore, this research highlights the need for evidence-based policies aimed at mitigating occupational hazards, improving workplace air quality, and implementing preventive health measures. By bridging gaps in existing occupational health research, this study contributes to the development of targeted interventions to safeguard the respiratory health of traffic enforcers, ultimately fostering a safer and healthier working environment. ▲ Show less

Caregiver Strain, Anxiety, and Depression among Family Caregivers of Adult Cancer Patients in Zamboanga City Medical Center In partial fulfillment of the Requirements in Completion of Residency Training in the Department of Family and Community Medicine EVERLYN T. JAJI, MD Department of Family and Community Medicine DECEMBER 2024 ABSTRACT TITLE OF RESEARCH Caregiver Strain, Anxiety and Depression among Family Caregivers of Adult Cancer Patients in Zamboanga City Medical Center NAME OF PRINCIPAL INVESTIGATOR EVERLYNT JAJI, MD NAME OF ADVISER WARITH-THIA M. ELANG-GAPUR, MD, DFM Background: Family caregivers are essential to the care and support of adult cancer patients yet they often experience caregiver strain, anxiety and depression. Despite the psychological and emotional burden they endure, formal assessments of their mental health needs are seldom conducted. This study aimed to determine the prevalence of caregiver strain, anxiety, and depression among family caregivers of adult cancer patients at a tertiary hospital in the Philippines. Methods: This study included 346 family caregivers chosen through purposive sampling at the Cancer Center of Zamboanga City Medical Center. It utilized the Modified Caregiver Strain Index-Pilipino version to identify cases of caregiver strain, and the Hospital Anxiety and Depression Scale-Pilipino version to identify cases of anxiety and depression. Data was analyzed using descriptive statistics in frequencies and percentages. Results: Among the family caregivers of adult cancer patients undergoing outpatient treatment at the Cancer Center of Zamboanga City Medical Center, the prevalence of caregiver strain was 9.83%. Moreover, the prevalence of anxiety was 32.66% and the prevalence of depression was 29.77%. Conclusion: Though the majority of family caregivers did not experience significant caregiver strain, anxiety, or depression, a notable proportion still reported symptoms These findings highlight the need for screening and monitoring of family caregivers so that targeted mental health interventions and support can be given to improve their well-being and caregiving capacity. Keywords: Caregiver strain, anxiety, depression ▲ Show less

Intraoperative frozen section (FS) plays a critical role in the surgical management of ovarian neoplasms by guiding the extent of surgery. While FS accuracy has been well documented internationally, local data from Philippine government hospitals remain limited. This study evaluated the diagnostic performance of FS for ovarian neoplasms at Zamboanga City Medical Center (ZCMC), with particular emphasis on diagnostic concordance, tumor subtypes, and factors associated with discrepancy. This retrospective descriptive accuracy study included 110 ovarian tumor cases that underwent intraoperative FS with corresponding final histopathologic diagnosis at ZCMC from January 2015 to December 2024. FS diagnoses were categorized as benign, borderline, or malignant and compared with final paraffin diagnoses as the reference standard. Diagnostic performance indices (sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy) were calculated. Concordance was assessed using Cohen's kappa coefficient. Associations between clinicopathological variables and FS discordance were analyzed using univariate and logistic regression analyses. The overall diagnostic accuracy of FS was 79.8%, with substantial agreement between FS and final histopathology (x 0.70, p < 0.001). FS demonstrated excellent performance for benign tumors (sensitivity 97.7%, specificity 92.2%) and high specificity for malignant tumors (98.6%), although sensitivity for malignancy was moderate (60.5%). Borderline tumors showed the lowest diagnostic reliability, with a sensitivity of 80.8% and a positive predictive value of 58.3%, accounting for the majority of discordant cases. Among clinicopathological factors, epithelial mucinous histology was the only variable significantly associated with FS discordance (p=0.048), increasing the likelihood of misclassification. Other factors including age, parity, menopausal status, tumor size, laterality, gross morphology, tumor stage, and number of FS samples were not associated with concordance. significantly Frozen section examination is a reliable intraoperative diagnostic tool for clearly benign and malignant ovarian neoplasms at ZCMC but demonstrates limited accuracy for borderline tumors, particularly those of mucinous histology. Cautious interpretation, targeted sampling, and multidisciplinary decision-making are essential to minimize diagnostic errors. Institution-specific audits and standardized FS protocols may further improve diagnostic performance in resource-limited settings. ▲ Show less

Introduction: Tuberculosis (TB) remains a significant global health challenge, with HIV co-infection substantially increasing the risk of poor clinical outcomes. In the Philippines, the integration of provider-initiated HIV testing and counseling (PITC) into TB care is essential for early diagnosis and treatment. However, various socioeconomic and perceptual barriers continue to influence the level of acceptance and hesitancy among patients. Understanding these specific determinants is crucial for optimizing TB-HIV collaborative services and improving patient survival rates. Objectives: This study identified the factors associated with the acceptance and hesitancy of provider-initiated HIV screening among patients diagnosed with pulmonary tuberculosis (PTB) at Zamboanga City Medical Center (ZCMC). Methods: A cross-sectional study was conducted among 117 patients diagnosed with PTB at ZCMC. Data were collected using a structured questionnaire covering sociodemographic, patient-related, and health-related factors. Data analysis was performed using STATA version 17. Bivariate logistic regression was first utilized to screen for significant associations, followed by multiple logistic regression to identify independent predictors of screening behavior. Statistical significance was set at p < 0.05, and the model's goodness of fit was assessed. Results: The final explanatory model revealed that male gender and employment status were the strongest demographic predictors of screening uptake, with male patients being 1.27 times more likely (p = 0.038) and employed individuals being 7.51 times more likely (p<0.05) to accept testing. Additionally, patient perception played a critical role; those who believed HIV testing should be a routine part of TB care demonstrated significantly higher acceptance (p=0.006). Factors such as health insurance coverage and HIV-related knowledge also contributed to the model. The final multivariate model demonstrated a statistically reliable fit (Prob> chi2 = 0.0013). Conclusion: Most TB patients in this study population demonstrated a higher likelihood of accepting HIV screening when they possessed socioeconomic stability and viewed the test as a normalized component of clinical care. Male gender and employment emerged as key facilitators of uptake, while the perception of screening as "routine" served as a primary driver for overcoming hesitancy. These findings suggest that while individual characteristics influence behavior, the systemic integration and normalization of PITC within the TB diagnostic pathway are essential for increasing screening coverage and strengthening integrated TB-HIV care. Keywords: Provider-Initiated HIV Testing and Counseling (PITC), Tuberculosis (PTB), Screening Hesitancy ▲ Show less

PROPORTION OF UPPER GASTROINTESTINAL BLEEDING (UGIB) IN PATIENTS WITH POORLY-CONTROLLED ARTHRITIS ON NSAID THERAPY ADMITTED AT ZAMBOANGA CITY MEDICAL CENTER RESEARCH PROTOCOL PRESENTED TO ZAMBOANGA CITY MEDICAL CENTER RESEARCH COMMITTEE IN PARTIAL FULFILLMENT OF THE REQUIREMENTS IN COMPLETION OF THE RESIDENCY TRAINING THE DEPARTMENT OF INTERNAL MEDICINE DR. RAFSHANIJANI C. ADIL PRINCIPAL INVESTIGATOR DR. MELCHOR ALLAN SIRIBAN CONSULTANT ADVISER 2025 ABSTRACT Introduction: Upper gastrointestinal bleeding (UGIB) remains a significant cause of hospital admission worldwide, frequently associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs). In patients with chronic musculoskeletal conditions, such as poorly controlled arthritis, the reliance on NSAIDs for pain management often leads to severe gastrointestinal complications. In the Philippines, particularly in regional centers like Zamboanga City, the clinical profile and the specific proportion of UGIB cases attributable to arthritis-related NSAID use remain under-documented. Objectives: This study aimed to determine the proportion of UGIB cases associated with NSAID use for poorly controlled arthritis among patients admitted to Zamboanga City Medical Center (ZCMC) and to describe their sociodemographic profiles, clinical characteristics, and health outcomes. Methods: A retrospective cross-sectional study was conducted involving 106 adult patients diagnosed with UGIB at ZCMC over a one-year period (June 2024-June 2025). Using purposive and total population sampling, patients were screened to identify those whose bleeding was associated with NSAID therapy for arthritis. Data were extracted from electronic medical records (EMR) using a standardized form. Categorical data were summarized using frequencies and percentages, while clinical outcomes were analyzed through descriptive summary measures. Results: Out of 106 UGIB cases, 20 (18.9%) were associated with NSAID use, and 7 (6.6%) were specifically attributed to the management of poorly controlled arthritis. The arthritis cohort had a mean age of 59 years and was predominantly male (71.4%). The universal presenting symptom was melena (100%), and 85.7% of patients reported concurrent smoking and alcohol use. Clinical findings revealed profound anemia (mean Hb 7.14 g/dL) in all patients, requiring blood transfusions. Endoscopic evaluations identified gastric and duodenal ulcers as the primary sources of bleeding, with severities ranging from Forrest Class Ia (spurting hemorrhage) to Class III (clean-based ulcers). While 85.7% of the patients were successfully discharged, one mortality (14.3%) was recorded. Conclusion: NSAID-induced UGIB represents a significant, yet largely preventable, clinical burden at ZCMC. Although the proportion of cases specifically linked to poorly controlled arthritis is relatively low, the clinical impact is severe, characterized by life-threatening anemia and the need for intensive intervention. The findings highlight a critical lack of gastroprotective prophylaxis and a prevalence of unsupervised medication use among these patients. There is an urgent need for improved risk stratification, patient education, and the implementation of standardized prescribing guidelines to mitigate these risks. ▲ Show less

INTRODUCTION: The COVID-19 pandemic is believed to have originated in Wuhan, China, in late 2019. likely stemming from zoonotic transmission at a seafood market (Gupta, S., et al. 2021). It has not only posed unprecedented challenges to healthcare systems worldwide but has also exacerbated the issue of burnout among healthcare professionals, particularly doctors. Burnova has long been a concern in the medical field. However, the demands of combating a global health crisis have intensified these stressors, leading to alarming rates of burnout among doctors (Shanafelt, et al., 2020) It has emerged as a significant global concern, affecting healthcare systems and patient care worldwide (Westwood, S., et al, 2022) Objectives: This study aims to determine the prevalence of burnout, encompassing dimensions such as emotional exhaustion, depersonalization, and reduced personal accomplishment, among physician in-training during COVID-19 pandemic in Zamboanga City Medical Center (ZCMC) and its association with their socio-demographic profile Methodology: This is a single center analytical cross-sectional study. Physicians undergoing residency training in all departments of the medical center including internal Medicine (IM). general surgery (GS), pediatrics, and obstetrics and gynecology (OB-Gyne) who actively handled suspect, probable, and confirmed COVID 19 patients from June 2020 to June 2021 was included in the study. A total of thirty-seven (37) doctors participated in the study. It is a questionnaire-based survey and adopted the Maslach Burnout Index to assess burnout. The survey was conducted online. Results: Results showed a high level of burnout among most of the doctors surveyed. Consistently, the study revealed a high level of burnout among doctors, particularly prevalent in specific demographic groups. Doctors aged 30-34 years old and single (with a statistically significant p-value of <0.05), as well as female physicians, and those in their third year of residency training exhibited elevated levels of burnout across dimensions such as occupational exhaustion, depersonalization/loss of empathy, and reduced personal accomplishment. Additionally, doctors who reported sleeping less than 8 hours per day and handled fewer than 10 patients daily, with three or fewer mortalities per week, also experienced heightened burnout levels. Conclusion: The study reveals a concerning prevalence of burnout among doctors in residency training during the COVID-19 pandemic, with socio-demographic factors showing a significant association. The study also illuminates a consistent pattern of high burnout levels among doctors aged 30-34 and those who are single, characterized by elevated occupational exhaustion, depersonalization/loss of empathy, and diminished personal accomplishment during the COVID-19 pandemic. ▲ Show less

INTRODUCTION: The Clinical Diagnostic Accuracy of Zero-Shot Prompt vs Structured Prompt vs. Iterative Prompt in Chat Generative Pre-Tr 3.5 among admitted Patients in the Pediatric Emergency Room of Zamboanga City Medical Trained Transformer Version Center NAME OF PRINCIPAL INVESTIGATOR: NAME OF ADVISER. Cesar Jeffrey G. Masilungan, MD, FPPS Edward Ariel M. Tadea, MD, MPH Introduction. Artificial intelligence (AI) creates machines, and one of its branches is natural language processing (NLP), which allows computers to analyze human language. Chat generative pre-trained transformer (ChatGPT) is a form of NLP that uses prompt engineering to improve its performance. The comparison of three (3) types of manual prompting in pediatrics for diagnostic accuracy remains unexplored. Objectives: To determine the clinical diagnostic accuracy of ChatGPT version 3.5 compared to the diagnoses made by ZCMC senior pediatric resident and pediatric consultants among admitted patients in the pediatric emergency room. Methodology. This was a cross-sectional analytical study. The computed sample size for the study was 28. Results: A total of 95 respondents were analyzed in the study. Zero-shot prompt had the highest rate of exactly correct diagnoses, with 20% for admitting diagnoses and 16% for final diagnoses. Zero-shot prompt also exhibited the highest concordance rate, 20% for admitting diagnoses and 15% for final diagnoses. The concordance rate of zero-shot prompt was significantly higher compared to iterative prompt (20% vs. 7%, p 0.11) in determining admitting diagnoses but not in determining the final diagnoses Conclusion and Recommendation: ChatGPT version 3.5 may function only as an adjunct but not as a primary means of generating clinical diagnosis. Future studies should focus on the application of newer versions of ChatGPT and other types of Al models in the clinical practice. MESH WORDS: Artificial intelligence, ChatGPT, Prompt engineering, Diagnostic Accuracy,Pediatrics ▲ Show less

Introduction: Zamboanga City Medical Center (ZCMC) is one of the many institutions which implemented a teleconsultation service during the COVID 19 health crisis. There have been no studies done in the past to assess teleconsultation acceptability among patients. Hence, the initiative to conduct one for this could be a potential service that can be established as mainstream or adjunct to the regular healthcare Objectives: Determine the perception and acceptability of teleconsultation among adult clients. Specifically, to determine the acceptability of teleconsultation among adult clients who sought consultation at ZCMC and to determine perception on teleconsultation in the following domains: enhanced quality of care, accessibility, ease of use, usefulness, privacy and discomfort, availability, and intention to use. Methodology: The study utilized a descriptive cross-sectional design. A total of 230 respondents participated in the study. Stratified random sampling technique proportional to the size was utilized. Results: Respondents perceived that teleconsultation increases access to healthcare with a mean score of 4.41, enhances quality of care (4.27), easy to use (4.37), useful (4.35), readily available (4.25) and does not invade their privacy with a mean score of 1.78. An acceptability rate of 97% was obtained having 224 out of the 230 respondents agreeing to use teleconsultation should they have access to it. Summary/Conclusion: Providing healthcare through teleconsultation can be as effective as face-to-face visits as evidenced by the high acceptability rate among end users. This is further supported that teleconsultation is perceived positively in the different domains explored. MESH WORDS: teleconsultation, acceptability, perception on teleconsultation. ▲ Show less

Introdunction: End of life care preference must be part of the routine practice during elderly consultation. A better knowledge of these preferences can help senior citizens plan their medical care in advance while they are mentally competent. This lessens the burden among the family members in instituting decision making at end of life scenario. Similarly, the physicians will be comfortable in the medical management based on the elderly patient's wishes. This study aimed to determine the end of life preferences among the senior citizens as to medical care and places of dying. This study was a cross-sectional survey using systemic sampling method. It employed a face-to-face questionnaire guided interview of senior citizens demographic data, and end of life preferences. The data gathered were analyzed using frequency and percentages. The results showed that the respondents' end of life preferences were the following: a) a need for CPR (86%), b) instituting IV fluids (100%).c) continued needed medications (100%), and d)NGT feeding nutrition (74.15%). The majority of elderly also preferred to die in the hospital (74.8%). The instituting of intubation (48.9%) was also found to be an option if there was a need for it. Elderly patients also wanted medical care to be given despite its futility. Thus, the absence of standard directives or living will make such demands difficult in their end of life management for the physicians. The inclusion of end of life topics in early consultation should be part of the counseling process for the elderly medical management. It could clarify and simplify the different advantages and disadvantages of the different medical management. ▲ Show less

Snakebite is a potentially life-threatening disease which results from the venom released by a venomous snake following a bite, symptoms can be localized, neurotoxic, cardiotoxic, and hematoxic like tissue damage, paralysis, bleeding and necrosis that can result to limb amputation and permanent disability. It is already a major health problem especially in sub tropical and tropical countries like the Philippines The study aimed to determine the profile of snake bite patients who consulted and admitted at Zamboanga City Medical Center, this will then provide baseline data. The profile of the snake bite patients included the demographic, clinical profile, management and final outcome of patients. By determining these patients, health advocacy on snake bite will be implemented using information dissemination and education especially in communities with high incidence of snake bite. These will then aid health care providers and other concerned agencies in the awareness, control and management of snake bite. The study is a retrospective descriptive study in which cases of snakebite at Zamboanga City Medical Center from January 2015 to December 2019 were recorded and analyzed. A checklist was used in the collection of data and analyzed through frequency distribution. ▲ Show less

TITLE: THE PREVALENCE OF POSTPARTUM DEPRESSION AMONG ADOLESCENT MOTHERS WHO DELIVERED AT ZAMBOANGA CITY MEDICAL CENTER FROM MARCH-AUGUST 2025 NAME OF PRINCIPAL INVESTIGATOR: JESSIE JAMES C. CABELIN, MD, MPH NAME OF ADVISER: SOLEDAD PAMELA DAGUIO, MD, DPPS Background and Objectives: This study investigated the prevalence postpartum depression (PPD) among adolescent mothers at the Zamboanga City Medical Center (ZCMC) from March to August 2025. PPD, with a global prevalence of 25-42%, disproportionately affects young mothers, necessitating a holistic approach to understanding its complexities and developing effective solutions. This research aims to determine the prevalence of PPD in this setting. providing critical data to enhance healthcare policies for adolescent mothers. Methodology: This cross-sectional study utilized the Patient Health Questionnaire 9-item (PHQ-9) for PPD assessment. Purposive sampling was conducted among eligible participants aged 10-18 who met the inclusion criteria. Data collection included sociodemographic and obstetric histories, analyzed through descriptive statistics. Results: Eighty-two adolescent mothers participated, with a mean age of 16.20 1.17 years; fifty tree percent (53.7%) were in their late adolescence. The majority were cohabitating (64.6%), unemployed (100%), and had low household incomes, with 95.1% earning under Php 5,000 monthly. Most participants reported no family history of mental illness and experienced unplanned pregnancies. The PHQ-9 assessment showed a mean score of 2.94 and a prevalence of 6.1% (n=5) at 2 weeks, declining to a mean score of 2.27 and a prevalence of 1.2% (n-1) by 4 weeks. Conclusion: The prevalence of postpartum depressive symptoms among adolescent mothers was low and mild, with notable improvement over time. Recommendations for comprehensive screening at multiple time points and tailored support interventions are essential for enhancing mental health resources for this vulnerable population. ▲ Show less

The rapid spread of multidrug resistant (MDR) infections among common pathogenic microorganisms is a serious challenge around the world. In Zamboanga City Medical Center (ZCMC), the Infection Control Committee reported over the years a rising number of antibiotic resistant organisms. This is a cross-sectional analytical study to describe the rate of MDR infections in the medical and surgical wards of ZCMC from January 2014 to December 2016. Chart review of all admitted patients 18 years or older was done. A total of 94 charts with bacterial isolates were included. Respondents with MDR infections had a mean age of 52.3 ± 14.28 years, and BMI of 24.49 ± 2.41 kg/m². Dermatologic (40%) and pulmonary (40%) were the most common sites of MDR infections. Comorbidities included diabetes (30%) and hypertension (10%). The rate of patients with MDR infections is 21.28%. MDR pathogens involved were E. coli, A. spp., K. spp., E. spp., S. haemolyticus, P. spp., P. mirabilis, and P. alcalifaciens. The clinical outcomes included prolonged hospital stay up to 29 days. Almost a third of the respondents necessitated transfer to Intensive Care Unit (ICU) from ward admission. Sixty five percent (65%) of patients with MDR infections went home against medical advice (HAMA), commonly due to depleted resources. The case fatality rate of those who have MDR infections is 20%. E. coli, A. baumannii, K. pneumoniae (25%, 15%, and 10% respectively) were the most commonly isolated MDR pathogens. In conclusion, MDR infections are commonly encountered in the medical and surgical wards in ZCMC. Mortality and prolonged hospital stay along with depletion of financial resources comprised the poor outcomes of these patients with MDR infections. ▲ Show less

Background: Pregnancy has long been recognized as a diabetogenic state whereby insulin sensitivity decreases with advancing gestational age. Those who cannot meet the increased demands usually develop diabetes. Diabetes is the most common medical complication of pregnancy. Gestational Diabetes Mellitus is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. It has been associated with adverse outcomes such as preeclampsia, cesarean delivery, macrosomia, birth trauma and pre-term birth. Several studies have shown that the adverse effects of hyperglycemia during pregnancy may extend beyond the postpartum period in both the mother and infant. Objectives: To determine the occurrence of Gestational Diabetes Mellitus among pregnant patients seen at the Zamboanga City Medical Center from June 2014 to December 2014. Furthermore it aimed to determine the prevalence and the presence of established risk factors and clinical characteristics common among pregnant women diagnosed with GDM. Method: A descriptive cross sectional design was performed between June to December 2014 at the ZCMC. Univariate analysis and logistic regressions were used to estimate the odds ratios with 95% confidence intervals, and to control for confounding variables. Results and Discussion: A total of 85 pregnant women fulfilled the inclusion criteria and were enrolled into the study. We reported the prevalence of GDM at ZCMC to be 11.8%. The risk for GDM was significantly associated with increasing BMI, Age of > 30, Parity of >3, history of OCP use, Family history of DM and Light Physical Activity. A progressive increase in GDM risk above a BMI of 24 kg/m² was observed (5 [50%]). The present result has public health implications because of the increasing prevalence of obesity; we can also expect further rise in the prevalence of GDM in the coming years. On regression analysis, the full model did not find any significant factors in predicting GDM. However the final model found three (3) factors associated with developing GDM. These are age of >30 years (OR=8.08, CI=1.14-57.57, p=0.03), OCP use (OR=14, CI=1.90-103, p=0.001), and light physical activity (OR=11.44, CI=1.05-124, p=0.04). A significant association between the history and duration of OCP use (ranges 1-4 years and 5-8 years) was found to be significantly associated with GDM. The odds ratio was found to be 38.85. Presence of these findings may be helpful in identifying those at risk for GDM who might benefit from heightened surveillance during pregnancy. The prevalence in developing countries is related to increasing urbanization, decreasing levels of physical activity, changes in dietary patterns and increasing prevalence of obesity. In our study there is an increased risk in developing GDM among patients with light physical activity and sedentary lifestyle. With regards to ethnicity, there is a risk for GDM among Zamboanguenos 5 (50%) compared to Tausug 4 (40%) and Visayan 1 (10%). However, no significant association was observed between ethnicity and GDM; a larger population is needed to study further the prevalence of GDM among ethnicities. Conclusion: To conclude, the prevalence rate of GDM at the Zamboanga City Medical Center during the period of June to December 2014 was 11.8%. This study indicates that pre-gravid characteristics including BMI, family history of diabetes, hormonal contraceptive use, age > 30, and physical inactivity were strongly associated with GDM risk, just as these characteristics in the non-gravid state predict risk for Type 2 diabetes. These data underscore the close link between GDM and Type 2 diabetes, as well as the need to identify and address modifiable risk factors for these disorders. ▲ Show less

Pterygium, a non-cancerous growth of the clear, thin tissue over the white part of the eye, is one of the major causes of eye problems in Zamboanga City. It is the commonest finding among low-income individuals who engage in outdoor livelihood activities such as fishing, farming, building construction, and driving public transport vehicles. A double-blind randomized study was done in determining the recurrence and post-operative complication rate of 51 patients with pterygium exposed to three treatment groups after bare scleral pterygium excision. Treatment Group A (n=19) was given 0.02% mitomycin C, Group B (n=17) with 0.04% mitomycin C, and Group C (n=15) placebo group (standard care); all were followed up for 6 weeks. Results of post-operative data showed that recurrence of pterygium is highest in Treatment Group C with 40% of its subjects having sign of regrowth after the sixth week follow-up examination. Treatment Group A, on the other hand, showed no signs of recurrence; however, it has the highest number of complications with 17.6% of the subjects manifesting scleral thinning. Finally, Treatment Group B showed a better result with neither incidence of recurrence nor complications in all its subjects. Therefore, it is highly recommended to use the 0.04% mitomycin C concentration after every pterygium surgery to be done in Zamboanga City Medical Center. To study the long-term effects of this intervention, the author recommends further examination of post-operative patients several years after their surgeries. Keywords: effectivity, recurrence, pterygium, mitomycin, groups, sclera ▲ Show less

Breast cancer has been consistently the most common cancer among Filipino women, especially those who live up to 64 years. In Zamboanga City, there are limited studies and data on the treatment outcomes for breast cancer even though it is one of the leading causes of admissions and the most common surgically managed case. With these, ZCMC also seeks to improve its capability in managing breast cancer, both medically and surgically. The management of the axilla among breast cancer patients has caught the attention of experts worldwide due to the tremendous adverse effects of axillary lymph node dissection, especially the incidence of lymphedema with numbness and pain on the ipsilateral arm. A more conservative approach is to avoid ALND in pathologically negative axillary nodes. Sentinel lymph node biopsy will determine the status of the axillary lymph node involvement intraoperatively and has been the standard of care. Currently, there are recognized mapping techniques and tracers used in localization of nodes, such as the use of isosulfan blue, patent blue dye, and methylene blue dye. In a single technique, methylene blue is as good a mapping agent as isosulfan blue and is much cheaper. With limited resources, methylene blue dye has been the agent of choice for SLN mapping in this study. This study was conducted in the hope of establishing a cost-effective method of SLN localization among breast cancer patients who underwent modified radical mastectomy in ZCMC. A preliminary case cohort study was utilized by review of charts of patients who underwent sentinel lymph node biopsy during modified radical mastectomy procedure for breast cancer in Zamboanga City Medical Center for the past six (6) years, from 2013 – 2018. Official biopsy results were gathered from ZCMC Department of Pathology. This is a case cohort study involving a total of 15 cases of breast cancer patients who underwent SLNB with MRM and partial mastectomy. The identification rate was 93.3% (14/15 patients), true negative rate of 100% (5/5 patients), and a true positive rate of 75% (3/4 patients). This study concludes that methylene blue dye is a highly acceptable and safe mapping agent in localization of sentinel node among breast cancer patients. The researcher recommends applying methylene blue in node localization during SLNB in breast cancer surgery. Further recommends that additional numbers of procedures are still needed to further validate the histopathologic findings, train other surgeons in doing sentinel lymph node biopsy, and finally standardize and employ the procedure in this institution. ▲ Show less

Due to a pronounced shift in utilization from primary public health facilities to government hospitals, government hospitals end up providing the same services as primary health care facilities. Zamboanga City Medical Center (ZCMC) has a similar setting, especially the Out-Patient Department (OPD), partly because it is the only existing government-run Level 3 medical center in Zamboanga Peninsula. The study was conducted in four of the Out-Patient Departments of ZCMC and aims to determine client perception in terms of personnel, services, and facilities regarding the primary health care services of OPD in ZCMC. Purposive sampling design and convenience sampling design were used in the first and second phases of the study, respectively. A total population of 400 were included in the study. Results show that the majority (89.0%) of the personnel are knowledgeable enough in their respective fields. As to skills, 81.5% of the personnel give clear instructions, 36.5% of the physicians explain the disease well, and 32.75% do thorough physical examinations. Also, the majority (73.5%) are well-mannered. As to services, the majority (76.5%) show that the laboratory is accessible; however, other supplies are not easily accessible (6.0%). In terms of affordability, consultation fee was affordable (94.25%), as were laboratory fees (10.5%) and medicines (20.0%), except the x-ray fees (6.25%). Also, most of the respondents (66.75%) answered that the services were fast in terms of waiting time. As to the facility, the majority (56.5%) of the respondents said there are enough chairs, but 7.25% said wheelchairs are not sufficient in the OPD. In addition, 83.25% and 4.75% of the interviewees indicated that the OPD clinic and the comfort rooms were easily accessible. However, even though 71.25% stated that the environment is clean, the majority still felt uncomfortable (11.25%). In conclusion, the majority of personnel are knowledgeable in their respective fields, skilled enough, and well-mannered. As to services, the laboratory is accessible while supplies are not. Consultation fees, laboratory fees, and medicines are affordable except the x-ray fee; and the services are fast in terms of waiting time. As to the facility, there are enough chairs while wheelchairs are not sufficient in the OPD; the OPD clinic and comfort room are accessible. However, even though the environment is clean, still the majority of respondents felt uncomfortable in the OPD. This study recommends further training for personnel to develop their skills and attitudes in dealing with patients; increased medical supplies and additional wheelchairs in the OPD to make them easily accessible and available to the patients. Furthermore, another similar study should be conducted in the new OPD building for comparison and reassessment of the services in the OPD. ▲ Show less

Background: Community-acquired pneumonia (CAP) is the 4th leading cause of death in the Philippines. Pneumonia results from the proliferation of microbial pathogens at the alveolar level and the host’s response to those pathogens. Elevated red cell distribution width (RDW) has been recently shown to be associated with adverse prognosis in pro-inflammatory states such as pneumonia. Objectives: This study aims to determine the association of red cell distribution width with mortality, severity, and prolonged hospital stay. Methods: This is a cross-sectional study including all patients admitted with community-acquired pneumonia ≥ 18 years old in Zamboanga City Medical Center from January to December 2017. Primary endpoint is in-hospital mortality, with secondary endpoints of prolonged hospital stay (> 4 days), ICU admission, and use of mechanical ventilator. Results: There were 197 patient charts reviewed and analyzed. There were 50.8% males with 73.09% having moderate-risk CAP; the average length of stay was 7.42 days. The study demonstrated a correlation of increased RDW with prolonged hospital stay. An increase of the RDW change from day 1 to day 4 was correlated with longer length of stay. The specific percent change was not measured, yet 7.73% of the change in length of stay was due to RDW difference (D4-D1). There was also variable increase of RDW from day 1 to day 4 in patients with a comorbidity of tuberculosis. Conclusion: This study did not show the association of mortality, severity of pneumonia, or length of stay with the day 1 RDW. On the other hand, it demonstrated correlation of RDW variability and prolonged hospital stay. Patients with TB as comorbidity showed significant RDW variability. RDW can be used as a prognostic marker in CAP patients with TB. ▲ Show less

Quality health care means doing the right thing, at the right time, in the right way to achieve the best possible results. Providing quality health care also means striking the right balance of services (Agency for Healthcare Research and Quality 2005). Clients’ perceptions of quality health care oftentimes are not congruent with the perception of the health care providers (Trigg, 2011). Clients seem to judge the level of health care they receive to be inadequate some of the time, and when these clients think that they are not receiving the care that they think they deserve, complaints usually come next. Zamboanga City Medical Center is a tertiary hospital with 500-bed capacity in Zamboanga City, Philippines. Its vision is to be a leading socially accountable medical center of choice and partner for all in Zamboanga Peninsula as well as from the island provinces of Basilan, Sulu, and Tawi-Tawi. Provision of quality services is one of its core values. The Emergency Department is the first stop for clients who require immediate medical care and who need medical advice at their most convenient time. Understanding client perceptions on quality of service is increasingly important to effectively manage healthcare services (Mejabi & Olujide, 2008). This study aimed to determine clients’ perception of quality health care in the Emergency Department of Zamboanga City Medical Center. This will serve as a guide/basis for improving their services at the Emergency Department towards the fulfillment of client-oriented care. This study utilized a descriptive cross-sectional design. This study concludes that the clients’ perception of quality health care in terms of personnel are being knowledgeable in their field, explaining the procedure to the client, and being confident in their work. With regard to services, availability of medications, prioritization of patients, and availability of supplies are important to most clients. Finally, in terms of facilities, clean stretchers and wheelchairs, adequate beds and chairs, and functional equipment in the emergency department equate to quality health care. It is recommended that further studies be done on the comparison of the perception of clients and healthcare workers on quality health care as well as satisfaction of the clients with health care delivery in ZCMC. Further studies may also look into other variables of quality health care such as universal healthcare insurance coverage and adequate human resources. ▲ Show less

Intrauterine Device (IUD) insertion has been a contraceptive method in use since the early 1960s, and it has been found to be one of the most widely used forms of reversible contraception currently. IUD insertion during cesarean section is a contemporary approach with the hope to decrease complications of insertion, most prominently perforation. However, there is no data supporting the acceptance, continuation, and complications of IUD insertion, which is the aim of this study. A cross-sectional study was done interviewing and assessing parturients who underwent intra-CS IUD insertion from October 2017 to March 2018 at the Zamboanga City Medical Center. Out of the 818 patients who underwent cesarean section, 222 opted for IUD insertion, which represented an acceptance rate of 27.14%. Out of these 222, only 171 were considered eligible because the remaining respondents were mostly either from outside Zamboanga City or had eclampsia, rendering them unable to go through the needed orientation. Out of the 171 patients, most were found to be young, between ages 20-25 years (41.52%), unmarried (55.55%), with adequate education (55.55%) – enabling them to fully understand the risks, benefits, and consequences of being part of the study – Roman Catholic (54.97%), and a housewife (86.55%). Menarche averaged 12.93 years of age, occurred mostly monthly, and most patients had 4-5 days of menstruation (48.53%) consuming 2-3 pads per day (73.10%). Dysmenorrhea was not an issue for many of the respondents (78.36%). While there were a few grandmultiparas in this study, most mothers were on their 2nd to 4th pregnancy (69.59%) at the time of the study. Almost all respondents chose IUD as a form of contraception because they knew it was long-acting. No expulsion of IUD was reported throughout the duration of the study, and no side effects such as heavy bleeding or infection were recorded. Continuation rate also yielded good results for this study at 99.12%. It can be concluded that the overall acceptance rate for IUD insertion after CS for this population was good and competitive internationally. The study also shows that continuation of IUD as contraception is very high, seeing that there have been no reports of IUD expulsion or any forms of severe complications among the respondents. Visibility of strings, which indicates that the IUD was still in place, also yielded satisfactory results among those who have followed up. Recommendations include greater additional efforts to have respondents follow up, such as free transportation expenses. Moreover, patients who have delivered vaginally with post-placental IUD insertion should also be assessed for their acceptance and continuation rate, likely the rate of missing IUD string anytime during follow-up, to compare and evaluate the results of this study. Lastly, the improvisation of the inclusion criteria of the study to include respondents outside Zamboanga City, and/or monitor their follow-up through accessible local health units in the vicinity, to improve the number of respondents. ▲ Show less

Placental abruption is considered by literature to be a rather rare complication during pregnancy but causes high mortality and morbidity among mothers and newborns alike. Worldwide, incidence of placental abruption is only 0.6%-1.0% of all pregnancies, but causes as high as 67% perinatal mortality. Other consequences of placental abruption include hemorrhage and subsequently anemia for the mother, and low birthweight, prematurity, and asphyxia in the newborn. Zamboanga City Medical Center is no stranger to placental abruption, as cases are noted frequently in the emergency room. Unfortunately, too little data exist about the characteristics and maternal and fetal outcomes of patients with placental abruption. This study then intends to identify the characteristics and maternal and fetal outcomes of patients with placental abruption admitted to the Obstetrics and Gynecology Ward of Zamboanga City Medical Center from January 1, 2011 to December 31, 2015. The study utilized a cross-sectional descriptive design and used total count of all patients with placental abruption during the said duration. Data were analyzed using frequencies and percentages. Overall prevalence rate of abruption placenta has only been recorded at a total of 0.16%, or 50 out of 31,844 patients. However, it can be noted that per calendar year from 2013-2015, the incidence was steadily rising. The majority of respondents within this study were more than 31 years old (54%), married (58%), Roman Catholic (74%), and a housewife (98%). The majority had menarche at the appropriate age of 12-15 years (78%), had regular menstruation (88%), and delivered preterm at 28-36 weeks gestational age (42%). The majority of these respondents did not have previous obstetric complications (86%), only 10 (20%) had previous hospitalization, and none had previous history of placental abruption. As noted, despite the low incidence of abruption, both maternal and neonatal mortality were very high, at 10% and 42% respectively. Management or delayed diagnosis could have been the issue, as 82% of the respondents had to stay more than three days in the hospital, with the longest staying 15 days. The condition has also been complicated by anemia for 84% of respondents, of whom 22 (44%) needed blood transfusion, which might explain the increased length of hospital stay. Most neonates were preterm (56%) and small for gestational age (48%). Cesarean section was the treatment of choice within this study (45, 90%). It can be concluded that maternal mortality and neonatal mortality are very high among patients suffering from placental abruption in ZCMC, and that there is an increase in the number of cases yearly. There is therefore a need to intensify diagnosis and improve management of the condition in order to bring down or totally eliminate neonatal and maternal mortality. ▲ Show less

Post-spinal anesthesia shivering is often an overlooked complication causing significant discomfort to patients, doctors, and nurses. Studies have looked into treatment approaches to address this complication, but little has been studied as to its prevalence. This study aimed to determine the prevalence of intraoperative shivering among patients who were induced with regional anesthesia-subarachnoid block in Zamboanga City Medical Center. Specifically, the study looked into factors that might be associated with the development of post-spinal anesthesia shivering as to age, sex, type of surgery, level of blockade, and incision site. An observational cohort study was utilized, and a total of 201 patients who underwent spinal anesthesia were followed for 20 weeks. The incidence of shivering was 47% with an incidence rate of 5.25%. In this particular sampled population exposed to spinal anesthesia, no factor was detected in contributing to the development of anesthesia. ▲ Show less

This is a descriptive retrospective study design to determine the clinical and diagnostic profile of patients admitted due to bowel obstruction secondary to post-operative adhesion in a tertiary government hospital, the Zamboanga City Medical Center (ZCMC), with the following objectives: (1) To determine the proportion of patients admitted due to bowel obstruction secondary to post-operative adhesions in the Surgery Department of ZCMC from January 2015 to December 2016. (2) To describe the clinical profile of patients admitted due to bowel obstruction secondary to post-operative adhesion in the Surgery Department of ZCMC. (3) To describe the diagnostic profiles of patients admitted due to bowel obstruction secondary to post-operative adhesion in the Surgery Department of ZCMC. The researcher utilized a convenience sampling method in identifying respondents in this study. All charts of those admitted as a case of bowel obstruction secondary to intestinal obstruction secondary to post-operative adhesion from January 1, 2015 to December 31, 2016 were reviewed and analyzed. This study aims to determine the characteristics of patients with post-operative bowel obstruction. A total of sixty (60) patients were included in the study. Clinical profile shows 80% came in with abdominal pain and the majority (48%) presented with partial intestinal obstruction upon admission. There were 57% presented with late post-operative adhesion (~6 weeks), and mostly (36%) underwent conservative management. Diagnostic profile showed mostly leukocytosis (72%) with predominance of neutrophils (100%) and with an imaging result of distal small bowel obstruction (27%). The result of this study serves as a database for future use to conduct further studies relevant to improving management outcomes. ▲ Show less

Background: Ketafol and Fentafol have been widely used as sedative-analgesics in brief surgeries, but there has been no study done comparing their effects on patients in Zamboanga City Medical Center. Objective: This study aimed to compare the effects of Ketafol (ketamine-propofol) 1:2 and fentanyl-propofol in the prevention of cardio-respiratory adverse effects among patients who undergo brief orthopedic procedures. Methods: A prospective randomized single-blind study design was utilized. Forty-eight subjects were selected based on inclusion criteria, and 24 respondents per group were obtained. Group A received Ketafol IV in a 1:2 ratio, and patients in Group B received Fentafol. Cardiorespiratory effects were noted, and adverse events were recorded. Result: There were no significant differences in terms of desaturation, bradycardia, tachycardia, changes in respiratory rate, and hypertension. The only significant difference noted in this study is the incidence of hypotension in the Fentafol group. This was significant at a p-value of 0.004. Conclusion: It can be concluded from this finding that the use of Fentafol significantly produces hypotension more than 5 minutes after induction among patients receiving it, compared to those receiving Ketafol. ▲ Show less

This study aimed to determine the incidence of intra-operative awareness among patients who underwent cesarean section under regional anesthesia at the Zamboanga City Medical Center. Eighty (80) respondents were interviewed before the cesarean section procedure. A questionnaire identifying socio-demographic characteristics (such as age, sex, marital status, occupation, etc.) and clinical characteristics (such as comorbidities and gravidity) was used. After twenty-four hours, the patients were re-interviewed for intra-operative awareness. The modified Brice Questionnaire was used to note any recall before, during, or immediately after their operation. The data gathered from the interview were analyzed using percentages. Under the sociodemographic profile, most respondents belonged to the 21-25 years old group, which is 39% of the total. As to marital status, 44 respondents (55%) were married. As to ethnicity, 34 respondents (42%) were Zamboangueno. As for the clinical profile, the majority (69%) of respondents were without medical problems. Thirty-one percent (31%) of respondents had other comorbidities like bronchial asthma, hypertension, and diabetes mellitus. Out of the eighty respondents, gravida 1, 2, and 3 accounted for the most, while multigravidas accounted for the least. The results of the study showed that all 80 respondents had no intra-operative awareness. As for intra-operative awareness using the Brice Questionnaire, 59% of respondents remembered the feeling of the oxygen mask on their faces before they were put to sleep. Thirty-two percent (32%) of the total noted being in the recovery room as the first thing they remembered after waking up. Six respondents (7%) recalled having experienced dreaming, while the remaining 74 (93%) did not dream at all. Lastly, 40 of the respondents (50%) said that the worst thing about the operation was the recovery process. ▲ Show less

“The Clinical and Biomedical Profile and Outcomes of Adult Patients Taking Sehat Badan in Zamboanga City” ¹Fatima Aminah Hussin Ibrahim, MD, ²Jerome Rebollos Barrera, MD ¹Resident in Training, Department of Internal Medicine, Zamboanga City Medical Center ²Endocrinology Consultant, Department of Internal Medicine, Zamboanga City Medical Center BACKGROUND: Statistics show that there are over 100,000 deaths and complications caused by unregulated and unsupervised administration of drugs and supplements. While administration of Sehat Badan, a Malaysian health supplement in the form of a coffee drink marketed as a supplement that improves general well-being and treats various diseases, has increased, its role in public health, specifically those which are resorted to as medication and treatment to cure, halt, or prevent disease, ease symptoms, or help in the diagnosis of certain illnesses despite lack of knowledge and awareness, has not been well established. OBJECTIVES: The primary objective of this study was to determine the clinical and biomedical profile and outcomes of adult patients on Sehat Badan in Zamboanga City. METHODS: This was a conservative cross-sectional study among adult patients who are currently or previously taking Sehat Badan. The study design used purposive sampling in the selection of subjects. Participants were identified and recruited on a voluntary basis. Demographic, biomedical profile, clinical characteristic, and outcomes were likewise included. The primary endpoint was the incidence of adverse effects of Sehat Badan, which includes Cushing’s syndrome, kidney and gastrointestinal complications among the subjects. RESULTS: Thirty-one adults who had previously or were currently taking Sehat Badan were included. The mean (±SD) age was 48 ± 15 years, and there were slightly more males than females (58% vs. 42%). Systolic blood pressures were on the higher side (median of 130 mmHg), but diastolic BP ranged from normal to high (median of 80 mmHg). Cushingoid facies, truncal obesity, and abdominal pain were noted at presentation in 42%, 33%, and 25%, respectively. More than half of patients had highly elevated morning serum cortisol (52%) and serum creatinine (52%). The majority had normal fasting blood glucose. In more than half of cases, a family member introduced Sehat Badan to the patient. Use of the supplement ranged from 4 months to 3 years, with a median duration of 1 year. Patients mostly acquired their supplement from barter purchase (48%). Others got them from family (19%), friends (13%), at the mall (16%), or online (3%). In half of respondents, Sehat Badan was taken as treatment for an illness (26%) or for general well-being (23%). CONCLUSION: Thirty-one patients with average age of 48.13 ± 14.64 years commonly presented for consultation with Cushingoid facies, truncal obesity, and abdominal pain, and with elevated serum cortisol and serum creatinine. The median duration of intake was 12 months at presentation. Three had presented with acute myocardial infarction. Sehat Badan was recommended by family and friends; 48% had purchased it via barter. It was observed in the study that individuals taking Sehat Badan presented a set of symptoms indicative of steroid usage. The conflicting aspect of this research further requires that Sehat Badan products be evaluated for the presence of steroids aside from the 3 drugs that have been earlier reported. Hence, the researcher deemed outcome significant. ▲ Show less

The study was conducted to compare the effect of early delivery and expectant management on maternal morbidity and neonatal outcomes after preterm premature rupture of membranes in Zamboanga City Medical Center. A total of 78 mothers were included in the study (39 per group). The expectant group comprised historical patients admitted previously (2015 and 2016), and the early delivery group were patients who delivered during the time of data collection. Since the patient-mothers were purposively selected, comparability tests were done using the different demographic and maternal variables, which showed non-significant differences between the two groups, implying the two groups in the study were comparable. The findings revealed that there was no significant difference in maternal morbidity and neonatal outcome between early delivery and expectant management. Neonatal outcomes in both groups were good. However, neonatal sepsis was more common in the early delivery group. There was no association between the length of PPROM and maternal morbidity or neonatal outcome, but there was a strong association between the length of PPROM and manner of delivery. Cesarean rate was higher in expectant management than early delivery but not statistically significant. ▲ Show less

The Philippines has the highest incidence of breast cancer in the continent, with 3/100 women contracting the disease before age 75. Due to this fact, the Philippines is at the forefront of combating the disease through continuously adapting treatment modalities that try to eradicate breast cancer or alleviate signs and symptoms. However, due to instances of particularly rigorous treatment, or just the course of the disease itself, what now becomes of particular interest is the Quality of Life (QoL) of these patients – health encompassing all aspects of life including social and psychological well-being. This study was conducted to assess the QoL of surgically diagnosed stage III and IV breast cancer patients in Zamboanga City Medical Center (ZCMC). This is a cross-sectional descriptive study where a total of 20 patients were interviewed. Data reveal that the mean age was 52.09, the majority were married (75%), Roman Catholic (75%), and all patients were female. Invasive ductal carcinoma was the most common diagnosis (80%), and 18 out of 20 (90%) had stage III breast cancer. Overall QoL of patients was at the lower level of the upper limit at 56.06 compared to a very high 84.6 among breast cancer patients in Japan. Despite overall QoL of patients being only “okay,” functionality was rather high. Physical functioning (78.9), role functioning (80.30), and cognitive functioning (78.79) were all rated “very much,” meaning the disease and treatment did not have much of an effect in these areas, while emotional functioning (67.42) and social functioning (67.42) were rated “quite a little,” but were still considerably high. Symptoms felt due to the disease and treatment, such as fatigue, insomnia, weight loss, hair loss, and diarrhea, were all either felt “just a little” or not at all. Considerably, insomnia (40.91) and financial difficulties (46.97) were the most commonly felt, but were not as “severe” as one would expect. This study concludes that overall QoL of breast cancer patients was good but could still be improved, while their functionality was high. The researcher recommends a similar study be done on all cancer patients in order to assess their quality of life. Moreover, QoL should be assessed prior to and after treatment, so as to give healthcare workers (HCW) the knowledge as to what extent the disease and treatment are affecting the patients. This could be an avenue for HCWs to improve communication with patients and help optimize treatment modalities given to the latter. ▲ Show less

“Comparative Study on the Knowledge of Diabetes and Non-Diabetes Patients in Zamboanga City Medical Center-Out Patient Department on Diabetes Mellitus using the Visayan Version of the Simplified Michigan Diabetes Knowledge Test” ¹Merry Ann S. Teus, MD, MPH and ²Melchor Alan L. Siriban, MD, FPCP, FPRA ¹Resident Physician and ²Research Adviser/Consultant Department of Internal Medicine Zamboanga City Medical Center Diabetes Mellitus is becoming a major health concern in terms of morbidity and mortality worldwide. One of the major causes for this is poor adherence to treatment plans. According to studies, there are different reasons for a diabetic patient to be poorly compliant, and one of the identified causes is lack of adequate knowledge about Diabetes Mellitus, especially in developing countries. Thus it is a must, especially for a tertiary institution like Zamboanga City Medical Center, to have quantitative data on the knowledge of its patients about diabetes. For this study, the objective is to assess the knowledge of diabetic and non-diabetic patients about Diabetes Mellitus using the Simplified Michigan Diabetes Knowledge Test (Visayan Version), compare the knowledge of both groups, and identify knowledge gaps. The assumption is that diabetic patients have more knowledge about Diabetes Mellitus compared with non-diabetic patients. It was a cross-sectional survey study, and participants included were Visayan-literate patients of the ZCMC-IM OPD who are at least 18 years old with no severe health problems or cognitive impairment. The actual data collection was done from January to April 2017. It has a sample size of 341, of which 114 were diabetic and 227 were non-diabetic. The Simplified Michigan Diabetes Knowledge Test (Visayan Version) is a 20-item questionnaire; each item was given 5 points. Scores were then categorized as Highly Sufficient if the score is 80-100; Sufficient for a score of 55-75; Insufficient for a score of 30-50; and Highly Insufficient for a score of 0-25. Results showed that in the diabetic group, 48 (42%) respondents have Sufficient knowledge and 66 (58%) have Insufficient knowledge. In the non-diabetic group, 93 (41%) respondents have Sufficient knowledge and 134 (59%) have Insufficient knowledge about Diabetes Mellitus. There was no respondent who got Highly Sufficient or Highly Insufficient in both groups. Using Fisher’s Exact Test, comparison of knowledge between the diabetes and non-diabetes groups was done, which gave a p-value of 0.09, which is not significant. Thus, this study showed that the knowledge of diabetes and non-diabetes patients in ZCMC-OPD has no significant difference. Knowledge gaps identified are knowledge pertaining to HbA1c, sugar and fat content in certain kinds of food, proper footwear, proper glucose monitoring, importance of exercise, management of hypoglycemia, and the relationship between regular check-up and the possibility of developing diabetes complications. Health teachings and other measures should thus be employed to improve the knowledge of patients in ZCMC, especially diabetic patients, about Diabetes Mellitus. ▲ Show less

Introduction: Neutrophil to lymphocyte ratio (NLR) has been used in the diagnosis and assessment of patient outcomes in a variety of diseases in recent years. This study aims to establish the diagnostic accuracy of preoperative NLR in detecting complicated acute appendicitis to guide surgeons on which appropriate abdominal incision to perform. Method: Medical charts of patients diagnosed with acute appendicitis who underwent appendectomy at Zamboanga City Medical Center from January 2015 to December 2015 were reviewed. Patients were grouped into complicated and non-complicated acute appendicitis. An independent t-test was used to compare these two groups. The NLR cut-off value was determined using the ROC curve. Results: A total of 144 patients’ charts were reviewed. The NLR of patients with complicated acute appendicitis was increased at 11.66 compared to 6.01 in patients with non-complicated acute appendicitis at a p-value of <0.0001. Cut-off points predictive of complicated acute appendicitis based on the area under the curve of the ROC curve revealed a significant test (AUC is equal to 0.733, 95% CI (0.697-0.850), p = <0.0001). At a cut-off point of </>7.5, the sensitivity is 100%, specificity 80.23%, and negative predictive value is 100%. Conclusion: The NLR of patients diagnosed with complicated acute appendicitis was significantly higher compared to patients diagnosed with non-complicated appendicitis. NLR </>7.5 was remarkably sensitive and predictive of complicated acute appendicitis. Keywords: Neutrophil to Lymphocyte Ratio, NLR, Acute appendicitis, AP ▲ Show less

Burn injuries remain hypothetically fatal. They are dissimilar from any disease known in the medical field. The condition tends to require a different or multiple types of treatment, which makes it more difficult to manage in terms of providing additional health care based on the status of the individual affected, standard method of care, availability of treatment regimens, and usual practices. Injuries can vary from small wounds easily managed in a mobile clinic to complex and extensive injuries resulting in admission and prolonged hospital course, long-term functional and psychosocial disturbances, or, worst, multiple organ system failure. The objective of this study was to determine the profile of all burn patients admitted to the Department of Surgery of Zamboanga City Medical Center from January 1, 2014 to December 31, 2014. This retrospective hospital-based study was planned with the aim of identifying the socio-demographic factors of patients admitted for burn injury, identifying the types of burn incurred, and identifying surgical procedures done, length of hospital stay, and clinical outcomes of admitted burn patients in the burn unit. Seventy cases of burns were noted for the year 2014. Most patients were male (47, 67%), making it a 2:1 male-to-female ratio. Most were children (33, 47%), and most patients were admitted due to less than 15% TBSA burn (49 or 70%). Thermal burns were the most common at 48 (68.57%), while chemical burn only accounted for 3%. Two patients (3%) had inhalation injury, which necessitated intubation as part of management. Treatment was considered optimal as 87% and 83% were treated with topical and intravenous antibiotics, respectively. Finally, it was noted that 65 (92%) of patients were discharged improved, while only 2 (3%) patients succumbed to death due to multiple organ failure and sepsis ▲ Show less

Introduction: Stroke is becoming a global burden and is often a catastrophic event affecting all aspects of an individual’s life as well as their carers’. Hence, interventions to combat this public health issue are warranted. However, health-related quality of life (HRQOL) of post-stroke patients is not evaluated, which may help in tailoring the needs of each individual. No published local data was found. The demand for a local study arose to determine the HRQOL of post-stroke patients at Zamboanga City Medical Center using the Stroke-Specific Quality of Life Scale (SSQOL) by Dr. Linda S. Williams and to determine the most affected domains of SSQOL. Objective: To determine the Health-Related Quality of Life (HR-QOL) of post-stroke patients at the Zamboanga City Medical Center. Hypothesis: SSQOL of post-stroke patients is significant. Methodology: This study utilized a descriptive cross-sectional method. Stroke patients older than 18 years old, diagnosed with stroke through imaging, with Modified Rankin Scale of 3 and below, and able to read and understand the English or Tagalog version of the validated SSQOL were enrolled in the study. A total of 172 respondents were included based on the computed sample size, and the results gathered were analyzed using Cronbach’s α (a measure of internal consistency), frequencies, and percentages. The study showed that among the 12 subscales in the SSQOL tool employed, mobility was greatly affected (mean ± SD 17.069 ± 7.388, out of a maximal attainable score of 30), whereas vision was the least affected (mean ± SD 12.442 ± 2.3753, out of a maximal attainable score of 15). Therefore, intervention to address the problem of mobility is highly recommended. Once a stroke club is created, members will be encouraged to enroll and participate in regular physical therapy sessions at Tzu Chi rehab center. Moreover, privileges are also recommended for stroke club members in availing their maintenance medications at ZCMC pharmacy to resolve non-compliance to medications. ▲ Show less

This descriptive cross-sectional study was undertaken to determine the prevalence of behavioural problems and their subscales among elementary school children from Panglima Sugala, Tawi-Tawi. This elementary school has witnessed several armed conflicts in the area for the last 10 years. A total count of all elementary students studying in this school was involved in this study. They were assessed both by their parents and their respective class advisers using the Strengths and Difficulties Questionnaire by Goodman. A total of 183 pupils were enrolled in this study. Results showed a contrasting prevalence of 43.1% as reported by their parents, while the class advisers reported 25.1% - giving an average prevalence of 34.17% for behavioural problems. As to the subscale of these behavioural problems, close to half (43.2%) had emotional problems, followed by peer problems, conduct problems, and subsequently hyperactivity problems. This finding shows a 2x higher prevalence in contrast to a similar study done in 5 major private schools in Zamboanga City where Conduct Problem was instead the predominant behavioural problem. This study underscores the impact of chronic exposure of students to fear-provoking armed conflict incidents and the need to develop educational and behavioural intervention programs to assist pupils in coping with their emotional distress while averting their mental health symptoms from becoming full-blown adult mental health disorders. ▲ Show less

The Montreal Cognitive Assessment (MoCA) test is a brief screening test that examines orientation, word recall, language abilities, attention, calculation, and visuospatial ability of patients to determine cognitive impairment in patients at higher risk for dementia. Objective: This research aimed to determine the validity of the Montreal Cognitive Assessment (MoCA) test translated into the Tausug version among elderly patients in the Zamboanga City Medical Center. Methods: The Montreal Cognitive Assessment (MoCA) test underwent a classic forward-backward translation method in accordance with guidelines for cross-cultural adaptation to produce the Tausug version of the MoCA. A cross-sectional study was conducted at the Internal Medicine Outpatient Clinic Room 1 at the Zamboanga City Medical Center (ZCMC). A purposive sample of 30 patients who are 60 years old and above, able to read and communicate in the Tausug dialect, were identified during the research period. The MoCA Tausug version was then tested for its face and content validity. The internal consistency and inter-rater reliability of the MoCA-Tausug version were also determined. Results: In the testing for the validity of the MoCA test-Tausug version, a Cronbach’s alpha score of 0.747 was noted, and during the re-test, an almost unchanged Cronbach’s alpha of 0.789 was seen, indicating good internal consistency. The test-retest reliability value using the paired T-test was not statistically significant (p value=0.096). Conclusion: From this study, it has been shown that the MoCA-Tausug version is a reliable and valid instrument in determining dementia among elderly patients of the Zamboanga City Medical Center. ▲ Show less

Aim: This study aims to compare fentanyl and IV lidocaine in attenuating hemodynamic response evoked by direct laryngoscopy and endotracheal intubation in ASA 1 and 2 patients undergoing General Endotracheal Anesthesia at Zamboanga City Medical Center from January 2013-June 2013. Specifically, the cardiovascular parameters of Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Mean Blood Pressure (MAP) are compared at the following time durations: Baseline Vital Signs, 0 minutes before induction, 1 minute after induction, 2 minutes after induction, 3 minutes after induction (onset of intubation), 4 minutes after induction, 5 minutes after induction, and 10 minutes after induction. Methods: This study is a prospective, double-blind, randomized, equivalence study design to compare the efficacy of single bolus dose of fentanyl (2-4 ug/kg) and intravenous lidocaine (1-2 mg/kg) for attenuation of hemodynamic response during direct laryngoscopy and endotracheal intubation (ETI) among American Association of Anesthesiologists Physical Status (ASA PS I and II) patients undergoing General Endotracheal Anesthesia (GETA) in Zamboanga City Medical Center from January 2013 to June 2013. Results: The results of the present study show that fentanyl (2 ug/kg) is superior to lidocaine 2% (1 mg/kg) for attenuation of hemodynamic response to direct laryngoscopy and endotracheal intubation. There were no significant differences between the two groups in age, body weight, gender, and ASA grading. Before induction of anesthesia, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were not statistically significant (p>0.05) in both groups. One minute after induction, these parameters were significantly decreased (p<0.05) in both groups. Our study demonstrated a highly significant reduction in HR in both groups (p<0.03) at 2 and 4 minutes. SBP reduction was statistically significant (p<0.03) in both groups at 1, 2, 4, and 5 minutes after induction. DBP reduced in both groups at 2, 3, 4, and 5 minutes, which was statistically significant (p<0.02). MAP in both groups was statistically significantly reduced (p<0.01) at 5 minutes. In the fentanyl group, these reductions were greater than those in the lidocaine group. Four minutes after induction, HR, SBP, DBP, and MAP were lower than baseline values in the fentanyl group. These findings are in agreement with Ugur B, Ogurlu M, et al., who showed attenuated hemodynamic response due to sympathetic stimulation associated with tracheal intubation. The study also shows that fentanyl could reliably offer protection against increases in both HR and SBP. Low dose fentanyl (2 micrograms/kg) prevented hypertension and tachycardia. Various studies have shown that intravenous lidocaine administration prior to induction of anesthesia is effective in preventing or attenuating the arterial hypertension and tachycardia in response to endotracheal intubation. In this study within the lidocaine group, 2 mg/kg lidocaine also had an effect to blunt adverse hemodynamic responses, especially HR, SBP, DBP, and MAP at 3 minutes during laryngoscopy and tracheal intubation, but these were slightly increased compared to the fentanyl group. Conclusion: The results of the present study show that fentanyl (2 ug/kg) is superior to lidocaine 2% (1 mg/kg) for attenuation of hemodynamic response to direct laryngoscopy and endotracheal intubation. There were no significant differences between the two groups in age, body weight, gender, and ASA grading. Fentanyl and lidocaine can both attenuate the rise in pulse rate, though fentanyl was better. Lidocaine attenuated the rise in blood pressure with intubation, whereas fentanyl prevented it totally. ▲ Show less

Objective: To describe the demographic and clinical profile of patients admitted with acute gastroenteritis at the Pediatric ward of Zamboanga City Medical Center (ZCMC) during the declaration of a gastroenteritis outbreak in Zamboanga City. Methods: A descriptive cohort design was utilized. Six hundred twenty-six pediatric patients aged 0-17 years old, admitted to the pediatric ward of Zamboanga City Medical Center, were included in the study. The outcome measures were the demographic and clinical characteristics of the patients admitted with AGE. The demographic characteristics included age, sex, address, and water sanitation practices. Clinical characteristics were day of illness on admission, signs and symptoms present on admission, physical examination findings, and lab results. Descriptive statistics were used for this study. Results: Six hundred twenty-six pediatric patients from different areas in Zamboanga City were admitted with AGE at ZCMC during an outbreak of acute gastroenteritis. Males 0 to 2 years old were the most affected. The majority of patients came from Barangay Santa Catalina, which also had the most number of AGE cases overall during the outbreak. The earliest time of admission from the onset of symptoms was day one. Diarrhea was the most common symptom followed by vomiting and fever, while sunken eyes was the most common physical examination finding. Rotavirus was isolated in 71% of the stool samples sent for testing. The majority of patients improved, while the mortality rate was 2%. Conclusion: Six hundred twenty-six pediatric patients from different areas in Zamboanga City were admitted with AGE at the time of an AGE outbreak. Males 0 to 2 years old were the most affected. Rotavirus was isolated in 71% of the total stool samples sent for testing, and there was an absence of rotavirus vaccination in all patients, all of which suggests that rotavirus was the cause of the outbreak. ▲ Show less

The aim of this study was to compare the efficacy of tramadol versus nalbuphine in the control of shivering after spinal anesthesia in pregnant patients for cesarean section. Forty patients of American Society of Anesthesiologists Grade I and II aged 18 to 40 were allocated by closed envelope technique into two equal groups. Group 0 (n=20) received tramadol 0.5 mg/kg via intravenous route, while Group 1 (n=20) received nalbuphine 0.1 mg/kg also via intravenous route. Blood pressure, heart rate, temperature, and peripheral oxygen saturation were recorded at five-minute intervals after spinal anesthesia in both groups. The time in minutes in which shivering started, the severity of shivering, and time of disappearance of shivering were recorded. Side effects were recorded and properly treated. No major hemodynamic changes were observed in both groups except that systolic blood pressure was higher in the nalbuphine group compared to the tramadol group. No drug showed any statistical advantage over the other in controlling shivering after spinal anesthesia. Both tramadol at 0.5 mg/kg IV and nalbuphine at 0.1 mg/kg IV were effective in the control of shivering. ▲ Show less

This descriptive cross-sectional study sought to determine the outcome of the Epidural Test Dose Fluid Movement Method Technique as a predictor of epidural catheter placement in patients undergoing gynecologic abdominal surgery in Zamboanga City Medical Center. A purposive sampling design was utilized. A survey questionnaire was used which is divided into three phases: pre-induction, induction, and post-induction. Out of the total 30 respondents, the mean age was 43 years old, and the majority belonged to the middle-aged group. Results showed that 83% of the patients lost their pain, touch, and motor activity. The majority of fluid test dose movement ranges were 3 to 4 cm in height, which is 60 percent or 18 out of 30 patients before induction. This shows that the lower the fluid movement reaches, the lesser the probability that the epidural catheter is placed correctly in the epidural space for the induction of anesthesia; the greater the height reaches (to 5 cm), the higher the percentage that the catheter placement is in the epidural space. Out of 30 patients, 25 also experienced motor blockade, where 84 percent had motor loss after 5 minutes of induction and only 16 percent had an onset of 4 to 5 minutes. No motor loss was noted less than 3 minutes post-induction. There were no complications noted, but there were changes seen in patients’ vital signs. Temperature became slightly elevated in the majority of patients post-induction. Blood pressure also decreased, signifying that the catheter was in the epidural space, but heart rate and respiration remained constant. The Loss of Resistance technique should be supported with the fluid test dose movement technique as its outcome gives a good predictor of epidural catheter placement. ▲ Show less

ABSTRACT Title: A Preliminary Study on the Neurological Status of Patients Treated with Brain Derived Peptide (Cerebrolysin): A Case Series Study in Zamboanga City Author’s Name: Ofelia M. Dammang, MD Department of Pediatrics, Zamboanga City Medical Center Background / Objectives: The use of brain derived peptide in the treatment of brain injury has become frequently used in European and Asian countries in the management of CNS infection. This research describes the use of brain derived peptide (Cerebrolysin) in children with neurologic conditions in Zamboanga City. Study design: This is a retrospective descriptive case series of admitted pediatric patients with neurologic conditions in different Medical Centers in Zamboanga City. Respondents: The study includes patients less than 18 years old with neurologic conditions such as trauma and infections who were confined in the hospital and treated with Cerebrolysin. Results: Patients treated with Cerebrolysin in this research were discharged with improvement as to cognition, level of consciousness, and movement. Four out of the nine (44%) patients, despite the neurologic condition upon admission, were discharged with no permanent disability. Patients with complicated neurologic conditions like Generalized Status Epilepticus; Hypoxic Ischemic Encephalopathy, Tuberculous Meningitis and Suppurative Meningitis with Concomitant Pneumonia were discharged with spastic quadriplegia. One patient died due to Nosocomial Pneumonia in the course of his 1-month stay in the hospital. Conclusion / Recommendation: The research had a total of 9 pediatric patients with neurologic conditions namely infection, trauma, and hypoxic ischemic encephalopathy. All patients included in the research with neurologic conditions like Suppurative Meningitis, TB Meningitis, and trauma related to fall showed neurologic effects and improvement in terms of level of consciousness, movement, and cognition after the use of Cerebrolysin. Cerebrolysin may be effective in the management of neurologic cases, principally Traumatic Brain Injury, among the pediatric population. Early initiation of Cerebrolysin as treatment showed earlier improvement and benefits. Based on the results of the retrospective study, it is recommended that more extensive research on Cerebrolysin use among pediatric patients with neurologic conditions be conducted. ▲ Show less

TITLE: COMPETENCY OF POST ANESTHESIA CARE UNIT (PACU) STAFF NURSES: BASIS FOR STAFF DEVELOPMENT PLAN INSTITUTION: ZAMBOANGA CITY MEDICAL CENTER AUTHOR: MARGA JANE C. CIRCULADO The study is a descriptive survey to determine the level of competency of the PACU nurses on the PACU Standards. The study was conducted in the Post Anaesthesia Care Unit of Zamboanga City Medical Center, where all 6 (six) nurses served as respondents. The study adopted an instrument based on the Core Competencies for Post-Anesthesia Care by The Association of Anesthetists of Great Britain and Ireland (2013). Simple percentage and mean scores were used in the study. The level of competency of PACU nurses on the following major competencies is at the level of an expert, namely: communication, assessment of level of consciousness. They are experts in both fields as a product of constant experience in communication and assessment. On the other hand, they are proficient in the following areas: professional development, clinical governance, assessment and management of airway; assessment and management of breathing, assessment and management of circulation, monitoring during recovery, intravenous access and fluid balance, applied knowledge of pharmacology in perioperative care, management of postoperative pain, nausea and vomiting, recovery emergencies, and post surgical care. Lastly, they are at an average level on a single competency which is clinical leadership. Overall, the PACU nurses are proficient in all of the competencies with a grand mean score of 4.15. The study affirmed Patricia Benner’s Stages of Clinical Competence. In all occasions in the different competencies of the PACU Standards, the PACU nurses were in different levels of competency and they pass through the different levels of being a novice, advance beginner, competent or average, proficient, and expert. In the study, being professionals already, the PACU nurses were at the levels of being an advance beginner in some competencies but are mostly proficient in the competencies. Moreover, they were experts in a certain number of competencies which only goes to show that they are progressing from one stage to another. ▲ Show less

Introduction. Fine needle aspiration cytology (FNAC) is a simple and fast diagnostic tool for breast masses. This study aimed to determine the diagnostic accuracy of FNAC in the detection of malignancy of breast specimens seen at Zamboanga City Medical Center (ZCMC). Methodology. Official histopathologic reports of female adult patients who underwent FNAC of palpable breast mass at our institution were retrieved and compared with the cytopathological diagnosis of FNAC. Slides and blocks of cases included in the study were also retrieved and reviewed. Measures of diagnostic accuracy using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio (LR) were done to compare the FNAC diagnosis to the tissue diagnosis as the reference standard of the diagnosis. Results. A total of 55 records of women with palpable breast mass were included in the study. Fifteen (27.27%) of these were diagnosed by FNAC as benign, 11 (20%) were diagnosed as malignant, 13 (23.64%) were atypical, 8 (14.55%) were diagnosed as suspicious, and 8 (14.55%) were nondiagnostic. Overall diagnostic accuracy of FNAC is 78.95% with a sensitivity of 57.89%, specificity of 100%, PPV of 100% and NPV of 46.67%. Conclusion. The overall diagnostic accuracy of fine-needle aspiration cytology in the detection of breast cancer is unsatisfactory at 78.95%. The sensitivity is low at 57.89% and specificity is markedly high at 100%. PPV is likewise high at 100% and NPV is decreased at 46.67%. Key Words: Fine-needle aspiration cytology, FNAC, breast cancer, diagnostic accuracy ▲ Show less

Background: Geriatric Depression is a mental and emotional disorder affecting senior citizens and is associated with a higher risk of morbidity and mortality. Comorbidities and multiple medications are often seen among the elderly population, making diagnosis more complicated. Objective: This study determined the prevalence of depression and associated socio-demographic and clinical conditions among Senior Citizens in the Out-Patient Department of Zamboanga City Medical Center. Methods: A descriptive and analytical cross-sectional design was used and included persons 60 years old and above who availed of first time out-patient consultation with good cognitive function. The Geriatric Depression Scale (GDS-15) was applied to 246 subjects along with a questionnaire that included socio-demographic factors (age, sex, occupation, living arrangement, economic profile, religion), history of death in the family within one year, clinical conditions, and activities of daily living. The data were analyzed employing Chi-square to measure the association of Geriatric Depression with the risk factors and Measures of Central Tendency using Mean in determining the prevalence of depression and its risk factors. Results: Out of 246 respondents, 57 had possible Geriatric Depression in the Out-Patient Department who sought consultation at the Zamboanga City Medical Center. Risk factors for high prevalence of Geriatric Depression were: female, 60-74 years old, Catholics, blue-collared jobs, living with children and relatives, low income strata, hypertension as a clinical condition, and activities of daily living (can do independently). As to significant association with Geriatric Depression, risk factors are 60-74 years old, living with children and relatives, history of death in the family within one year, clinical condition, and activities of daily living. Conclusion: Screening the elderly population for possible depression is important to improve the quality of life for this age group. ▲ Show less

Post-operative nausea and vomiting (PONV) remains one of the most common complications after laparoscopic cholecystectomy. PONV is a clinical issue that should be addressed by physicians because it does not only prolong the patient’s stay at the PACU, but it also lengthens hospital stay, thereby increasing hospital costs. Moreover, it may also increase morbidity rate, adversely affect recovery, and sense of well-being post-operatively. This study determined the overall incidence of PONV and its rate according to established variables such as age, sex, BMI, smoking history, and intra-abdominal pressure. Patients who underwent laparoscopic cholecystectomy (N=43) were evaluated. Thirty percent (30%) of patients developed PONV, which is consistent with the findings of Mustafa (2011). Among those who developed PONV, 62% were females, 84% belonged to the middle-aged group (36-55 years old); 62% were overweight (BMI 25-29.9), and 77% were non-smokers. In the study, intra-abdominal pressure was maintained at a desirable limit of less than 15 mmHg. ▲ Show less

Background: The commonly used combination for sedation in this institution is Ketamine-Propofol in a 1:1 ratio; however, there has been no study in this institution that can attest that the 1:1 ratio of Ketamine-Propofol provides lesser cardio-respiratory effects to patients who underwent General Intravenous Anesthesia. Methods: 100 patients undergoing Closed Reduction surgeries were included in the study. Patient’s blood pressure (BP), heart rate (HR), oxygen saturation (SPO2), and respiratory rate (RR) were all recorded using the American Society of Anesthesiologist (ASA) chart sheet at 3 minutes, 6 minutes, and 9 minutes after induction. The recording of the patient’s vital signs was continued until the patient woke up or until after the closed reduction procedure, which ended approximately 5 minutes after induction. All charts were collected and reviewed for any cardio-respiratory effects soon after induction such as hypotension or hypertension and respiratory depression or a decrease in respiratory rate and SPO2. Hypotension was considered when the mean arterial pressure (MAP) decreased by 20% of the baseline MAP. A decrease or increase in heart rate was considered when the heart rate was less than 60 beats/minute or more than 100 beats/minute. Any patient that needed to be induced again after the first drug combination wore off due to prolonged surgical time (needing an additional dose) was excluded from the study. Results: Data showed that the values were within the normal range for both genders at three minutes, six minutes, and nine minutes. Although there were slight differences in values between each gender, the discrepancies were not significant. Conclusion: It is concluded that there were no adverse cardio-respiratory effects of Ketamine-Propofol 1:1 used as general intravenous anesthesia for closed reductions. ▲ Show less

The co-existence of Human Immunodeficiency Virus (HIV) and Pulmonary Tuberculosis (PTB) is known to be a deadly syndemic, that is, it acts synergistically to magnify the burden of the disease. Objective: To determine the prevalence of HIV co-infection in cases of Pulmonary Tuberculosis (PTB) patients in ZCMC. Methodology: This study utilized an analytical, univariate, cross-sectional method to identify the prevalence of HIV co-infection in cases of PTB patients in ZCMC. Respondents diagnosed with PTB who were enrolled in the ZCMC TB-DOTS underwent HIV screening by Rapid HIV Antibody Test. They were given questionnaires, and analysis involved simple percentage, frequency distribution, and Fisher-Exact Test in order to determine the clinical profile and risk factors for HIV. Results: A total of 153 respondents were included in this study. Four were reactive to HIV screening, with a prevalence rate of 2.61% (95%CI = 0.49% – 5.72%). All were males belonging to age 31-40, with multiple sexual partners, and sexual contact with males. Of the demographic variables, age 31-40 years (p=0.032), being employed (p=0.036), and higher educational background (p=0.004) were noted to be predictive risks for HIV. For the clinical profile, only recent travel was predictive of HIV (p=0.022). Among classical TB symptoms, generalized weakness, weight loss, and back pain were noted to be predictive risks. Those with positive Sputum AFB results were noted to have greater predisposition for HIV. Conclusion: This study showed that the prevalence of HIV co-infection among PTB patients in ZCMC is 2.61% (95%CI = 0.49% – 5.72%). The established risk factors reported by the DOH-NEC 2014 are the same as the findings in this study, that is, those having high-risk behaviors. Moreover, predictive risks for HIV are young age group, higher literacy level, being employed, and recent travel to regions with high rate of HIV. Most importantly, having a positive Sputum AFB is considered a risk. Recommendation: Furthermore, it is recommended that a larger sample size be gathered to broaden the scope of variables. Also, re-testing of those HIV seronegative after 6 months, with a subsequent confirmatory test. ▲ Show less

Post-anesthetic shivering among spinal anesthesia patients may be thermoregulatory shivering in response to core hypothermia or due to cytokines from the surgical procedure. The second type of shivering is non-thermoregulatory shivering and may occur in normothermic patients in response to certain anesthetics or postoperative pain. It can trigger deleterious complications such as hypoxemia, raised oxygen consumption, lactic acidosis, increased intracerebral and intraocular pressure, and raised carbon dioxide production. Moreover, it may also induce pain secondary to muscular contractions at the operative site and can lead to interference with monitoring of ECG and blood pressure. Several drugs are used for prophylaxis and therapy of post-anesthetic shivering: meperidine, tramadol, clonidine, and nalbuphine. Ketamine, which is a competitive N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to be effective in the prophylaxis of postoperative shivering in previous studies as shown in the related literature. However, the ideal dose of ketamine in the treatment of shivering has not been determined. The aim of this study was to investigate the minimum effective dose of ketamine in the treatment of post-anesthetic shivering and determine the mean body temperature at which shivering resolves after the administration of ketamine among patients undergoing spinal anesthesia. This paper endeavored to provide a readily available and cost-effective substitute as an addition to commonly marketed anti-shivering drugs with lesser side effects and cost. ▲ Show less

Despite the dangers of pregnancy, women have various reasons for becoming pregnant regardless of age, religion, socio-economic status, etc. The birth of a firstborn child almost always marks a significant event in a woman’s life. Given the unique and diverse culture and beliefs of our local constituents, not to mention the increased rate of malnutrition brought about by poverty and poor socio-economic status of our underdeveloped country which is more pronounced in the provinces, this study aimed to determine the association of maternal age on maternal and fetal outcomes among adolescent primigravid mothers ages 19 years old and below, optimal age primigravid mothers ages 20-34 years old, and elderly primigravid mothers more than or equal to 35 years old. A total of 110 respondents were employed in this study. Thirty-eight were aged 13-19 (adolescent group), forty-seven were aged 20-34 (optimum-aged mothers), and twenty-five were aged 35 years and over (elderly or advanced age). This study revealed that overall, the majority of patients were mostly Roman Catholic (63, 57.27%), were housewives (58, 52.73%), reached college level for their education (24, 21.82%), and had two pre-natal visits (43, 39.09%). Results also suggested that while the majority of respondents had cumulatively good maternal outcomes such as being term at delivery (107, 97.27%), did not have any obstetric and medical comorbidities or complications such as PROM (92, 83.63%), PPROM (108, 98.18%), hypertension (89, 80.90%), and diabetes mellitus (103, 93.63%), there were some aspects where poor pregnancy outcomes were seen. Among those of note were prevalence of PROM which was seen mostly among mothers of optimum age; prevalences of hypertension in pregnancy, acute cystitis, anemia, need for cesarean section, and anemia as a post-partum complication were highest among mothers of advanced maternal age. Fetal outcome was also observed, where good outcomes such as being term at delivery (106, 96.36%), being term on Ballard scoring (106, 96.36%), having normal weight of 2,500-3,999 grams (95, 86.36%), and no congenital anomaly (109, 99%) were noted. APGAR scores were also generally good. Prevalence was high in terms of neonates being born preterm or post-term, having poorer APGAR scores at 1st and 5th minute of life, being born either prematurely or post-term in terms of Ballard score, and being born with anomalies among elderly mothers. For both maternal and fetal outcomes, the difference was not significant between adolescent mothers and optimum-aged mothers, with p-values at 0.909 and 0.106 respectively, while the difference was statistically significant between elderly mothers and optimum-aged mothers in terms of poor maternal outcomes (p-value of 0.000006) and poor fetal outcomes (p-value 0.024). Risk of developing poor maternal outcomes was 4.85 times higher, and poor fetal outcomes were 3.008 times higher among elderly mothers compared to optimum-aged mothers. Conclusions that could be drawn from the results are that most mothers had a good educational level, were more likely to be Roman Catholic, a housewife, and had 2 prenatal visits. Maternal and fetal outcomes were generally good, with the exception of maternal outcomes among elderly women which were seen to be poor, where 17 patients (68%) had poor maternal outcomes. From the comparison that was made, it could be noted that the only statistically significant difference was in terms of maternal and fetal outcomes between elderly mothers and mothers of optimum age, which pointed out that indeed, being an elderly primigravida entails more risks of having poor maternal and poor fetal outcomes. Also of significance is that there is a higher risk of developing poor fetal outcomes (3.008 times higher) and poor maternal outcomes among elderly mothers. ▲ Show less

The study was carried out for the following reasons: First, to have a descriptive epidemiology of dengue fever outbreak in Zamboanga City. Second, to plan for control measures based on the information gathered. Third, to implement the control measures with efficient social mobilization. An increase in the cases of Dengue Hemorrhagic Fever was noted based on the hospital admissions at the Zamboanga City Medical Center and other private hospitals. Age incidence of dengue hemorrhagic fever predominantly affected 1-10 years old, 11-20 years old, and 21-30 years old. Aedes Aegypti showed a preferential habitat for: flower vases (27.9%); tin cans (26.27%); jars (13%); discarded tires (13%); drums (17%); banana axils (5.9%); bottles (3.9%); water tanks (3.6%); bamboo internodes (0.06%). Fogging was done in schools and offices with 70% coverage. Public dissemination was done through TV talk shows, radio broadcasts, and printed media, especially during the first month of the intervention. Lectures were done mostly in schools, offices, and health centers with 70% coverage. There was a significant drop in the cases of dengue hemorrhagic fever on the 52nd morbidity week after the said intervention. ▲ Show less

This study examined the nature, magnitude, scope, and patterns of wastage of laboratory examinations in the context of billing policy shifts/changes at the Zamboanga City Medical Center Integrated Clinical Laboratory from the period of July 2005 to July 2006. It involved three sections: Hematology, Clinical Microscopy, and Clinical Chemistry, and three clinical departments: Internal Medicine, Obstetrics and Gynecology, and Pediatrics. Key Informant Interviews were conducted involving the patients' relatives, medical technologists, and the Budget Officer of the hospital. Questionnaires were administered to the residents and post-graduate interns of the three clinical departments. Focus Group Discussions involving the doctors in the three clinical departments and nurses were conducted. Analysis of data revealed that although a small percentage comprised the unclaimed results which led to wastage of laboratory resources, the equivalent costs were substantial and a management concern. The impact of the change in billing policy was evident in the Hematology section, which incurred the highest number of unclaimed results. The Department of Internal Medicine topped other clinical departments with the most number of unclaimed results. The study revealed that the high number of unclaimed results is attributable to the lack of dissemination of laboratory policy and rates, certain physicians' and nurses' practices, and inadequate Medical Social Services. A more in-depth study involving all stakeholders should, therefore, be conducted to establish causality in relation to the pattern of wastage. ▲ Show less

An ideal screening test is inexpensive, easy to administer, poses little risk, and causes minimal discomfort to the patient. In addition, results of the screening test must be valid, reliable, and reproducible (Gaeta, 2005). For screening blood donors, the Copper Sulfate Test, also known as the float test or copper sulfate screening test, is commonly used for hemoglobin screening. It is a method used to determine whether the specific gravity of a donor's blood is above or below that of a known specific gravity (that of the Copper Sulfate solution), which corresponds to normal hemoglobin level. The Blood Bank Center of Zamboanga City Medical Center (ZCMC) uses the Copper Sulfate solution test for differentiating normal from abnormal hemoglobin levels among blood donors. This study was done to determine the validity of the Copper Sulfate Solution in determining the hemoglobin level at the Zamboanga City Medical Center. There were 40 consented male respondents enrolled in the study selected through convenience sampling. Each respondent was initially interviewed prior to blood extraction through venipuncture using a syringe. One drop of blood was dropped into the Copper Sulfate solution. The rest of the collected blood samples were stored in an EDTA tube and were analyzed using the fully automated hematology analyzer machine at the laboratory department of the Zamboanga City Medical Center. The result of the test was read as normal if blood sank to the bottom of Copper Sulfate solution but retained its normal shape, ambiguous if blood sank to the bottom of the Copper Sulfate solution but formed a ring or donut shape, and below normal or abnormal if blood floated in the Copper Sulfate solution. Sensitivity, specificity, positive predictive value, and negative predictive value were used for measures of validity. Results of this study show that the specificity and positive predictive values remain high all throughout the 40 tests, while the sensitivity and negative predictive value start to decline at 35 individual tests. In conclusion, the Copper Sulfate solution enables us to obtain only the qualitative estimate of hemoglobin level. The sensitivity and negative predictive value of Copper Sulfate solution start to decline at 35 individual tests. Therefore, it is recommended to keep the Copper Sulfate solution to a maximum of 30 tests to maintain optimum validity of the test. ▲ Show less

The study was undertaken to determine the most common indications that led to cesarean section births in the tertiary hospitals of Zamboanga City. Moreover, it specifically sought to find out which among the common indications have more complications and what causes the complications. Two hundred post-cesarean mothers admitted at the three tertiary hospitals in Zamboanga City were taken as respondents. Their respective OB-Gyne surgeons and nurses were also considered as respondents since they were also interviewed on the indications and complications of cesarean section operation. The results showed that the most common indications that led to cesarean section delivery can be categorized into three major factors, namely maternal factors, fetal factors, and placental factors. Among the maternal factors, the most common indication was prolonged labor and failure to progress due to cephalopelvic disproportion, accounting for 62 or 31 percent of the 200 respondents. This can be attributed to the primigravid respondents. The second most common maternal factor was previous cesarean section, which accounted for 58 or 29 percent of the total respondents. This was because of fear of uterine rupture. The third most common maternal factor that led to cesarean section delivery was grand multiparity, accounting for 13 percent of the 200 respondents. For the fetal factors, fetal distress ranked the highest with 21.5 percent, followed by mal-presentation or mal-position which accounted for 18 percent. The third fetal factor was due to cord coil neck (single cord coil and double cord coil neck), 9.5 percent. On the other hand, the most common placental factor that led to cesarean section delivery was placenta previa with a 5.5 percent rate. The study also showed that among the common indications that led to cesarean section delivery, placenta previa has more complications. Finally, the study found that low socio-economic status and nutritional deficiencies are the major causes of complications after cesarean section operations. It is hoped that the findings of this study could serve as a reference material in coming up with programs related to perinatal care. This further implies that obstetricians, nurses, and midwives must also develop a high level of awareness of prenatal care for them to be able to come up with a continuous Health Education Program which is essential for the prevention of further obstetrical complications. ▲ Show less

Background/Purpose: The World Health Organization (WHO) has proposed that treatment outcome is an important indicator of tuberculosis control. This study investigated the outcome of tuberculosis treatment in the 15 different districts of Zamboanga City. Methods: A total of 4,355 pulmonary tuberculosis patients enrolled at the 15 districts of Zamboanga City in 2008 and 2009 were included in this study. Treatment outcome data were collected from the official TB registry of each district and categorized according to WHO recommendations as cured, treatment completed, failed, died, defaulted, or transferred out. Data were interpreted according to gender, age, location, history of treatment, smear results, and chest radiograph. Co-morbidities were not computed since data were inadequate. Results: Of the 4,355 patients, outcomes were classified according to WHO classification as cured in 1,917 (44.0%), treatment completed in 2,086 (47.9%), death in 109 (2.5%), failed in 24 (0.55%), defaulted in 139 (3.19%), and transferred in 80 (1.84%). Females were more successfully treated than males (92.5% vs. 91.6%), as there were fewer deaths (2.0% vs. 2.8%), default (3.1% vs. 3.2%), and transferred out (1.3% vs. 2.1%). Patients older than 64 years old had the highest death rate (7.3%) compared to other age groups, while patients less than 24 years old had the highest rate of treatment success (95.1%). The majority of subjects were successfully treated in both negative AFB smear and positive smear results (92.7% and 91.2%). Patients with a history of tuberculosis were more likely to die (5.8%), to default (1.1%), to fail (5.3%), or to transfer (3.7%) than new patients (2.3%, 0.4%, 3.2%, 1.8% respectively), thus with a lower rate of successfully treated (92.3% vs. 84.1%). The proportions of subjects with cavitary lesions on radiographs were less likely to attain successful treatment in relation to the proportion of subjects with non-cavitary infiltrates (78.18% vs. 88.18%). The frequency of pulmonary tuberculosis among the different districts was noted to be highest in Ayala district (486 patients) and lowest in Labuan district (135 patients). Among all the different 15 districts, Curuan district demonstrated the highest successfully treated rate (99.3%) while Baliwasan had the lowest rate (79.7%). Conclusion: The study suggests that age, gender, history of tuberculosis treatment, smear results, and chest radiographic lesions influenced the treatment outcome of pulmonary tuberculosis. ▲ Show less

This study aims to compare the effectiveness of laryngotracheal lidocaine spray versus intravenous lidocaine in blunting the cardiovascular responses during endotracheal intubation. The study design used is the Randomized Control Trial. This was conducted at the Operating Room Complex of the Zamboanga City Medical Center. All patients within the age range of 18 to 60 years old, ASA 1 and 2, who were scheduled for elective surgery and who were under General Endotracheal Anesthesia were randomly selected to be included in the study. Forty-five (45) patients were randomly chosen to be under the lidocaine spray group, forty-five (45) patients were randomly chosen to be under the intravenous lidocaine group, and another forty-five (45) patients were randomly chosen to be under the group who did not receive any lidocaine prior to intubation (Control Group). Patients who fell under the lidocaine spray group were sprayed with lidocaine 10% in their laryngotracheal area prior to intubation, while patients who fell under the intravenous lidocaine group were given intravenous lidocaine 2% (at a dose of 2mg/kg) prior to intubation. Changes in heart rate and mean arterial pressures (MAP) were recorded using a specialized data collection sheet. The data gathered were treated using T-test statistical analysis and One Way ANOVA. The result of this study showed that there was an increase in the mean heart rate and MAP from the baseline values during endotracheal intubation for all three groups. There was a significant change in heart rate and MAP from the baseline values during endotracheal intubation after intravenous lidocaine and after laryngotracheal spray. Finally, this study concludes that laryngotracheal lidocaine spray is more effective than intravenous lidocaine in blunting the cardiovascular responses during endotracheal intubation. ▲ Show less

OBJECTIVE: Cervical Cancer is one of the top leading causes of cancer in the country with an incidence rate of 20.4 per 100,000 population and an increase of 17,000 cases annually. Since cervical cancer has been proven to be curable when treated early in its course, it is believed that promoting cancer awareness will prevent a significant number of Filipinas from dying because of having their illness detected late in its course. This paper seeks to determine the profile, prevalence, signs and symptoms, modalities, and outcome of Cervical Cancer patients in Zamboanga City Medical Center (ZCMC) for the purpose of increasing cancer prevention awareness and provision of cervical cancer baseline data in the Region. METHODS: The study utilized an observational, cross-sectional study design. A chart review of admissions with a final diagnosis of Cervical Cancer from 2005 to 2009 was done. Demographic, clinical, and laboratory characteristics were obtained and analyzed. RESULTS: The most common type of cervical carcinoma is squamous (81.05%). Patients are usually admitted at stage III of the disease. The typical demographic profile of patients with cervical carcinoma seen in ZCMC includes the following characteristics: middle adulthood between 36-49 years of age (45.35%), married (74.7%), Roman Catholic (57%), of either Chavacano or Tausug ethnicity (35% each), and a housewife (94%). Moreover, they characteristically have finished either elementary school (38%) or high school (40%). In regards to their exposure to factors identified as associated with cervical carcinoma, most of the patients are multigravida (45%), had their first sexual intercourse between 19 to 25 years old (44.68%), have never had a pap smear done (92%), have not used contraception, and were non-smokers. Regarding the number of sexual partners, about sixty-nine percent have only one (1) sexual partner. Thirty-one percent have multiple sexual partners. The most common sign or symptom that the patients presented with was vaginal bleeding (89%), while 79% of the patients admitted having anemia at one point before or after being diagnosed. The most frequent type of treatment received by the patients was blood transfusion (78.13%), followed by chemotherapy (15.9%), cobalt therapy (7.37%), surgery (4.3%), and radiotherapy (1.05%). Mortality rate was 3.57% among those who received blood transfusion alone, 25% among those who had surgery alone, and 0% among those with mixed or combined treatment modalities. DISCUSSION: Squamous carcinoma is the most common type of cervical cancer, the same result as with other studies. The demographic profile is similar to other research, only with discrepancies in the data on contraception and smoking. Second-hand smoke can be a contributory factor in the development of cervical cancer. Bleeding is the usual presenting symptom noted because the patients admitted are usually at Stage III. Thus, blood transfusion is seen as the most common treatment given, while surgery is instituted in only a number of patients. Surgery is only applicable in early-stage cervical cancer. Poor financial capability and knowledge can contribute to seeking medical help at a late stage of disease, thus resulting in poor prognosis. CONCLUSION: The demographic profile of cervical cancer patients in ZCMC is almost the same as in other studies, though with different results on contraception use and smoking. ▲ Show less

BACKGROUND: Hospital-acquired pneumonia is an important cause of morbidity and mortality in ZCMC. Most studies on hospital-acquired pneumonia have been done on intensive care patients, and very little data exist on hospital-acquired pneumonia occurring in the wards. Recognizing the clinical profile of patients developing HAP in our setting allows the physician to intervene earlier and possibly decrease the morbidity, mortality, and cost caused by this disease. METHOD: This is a descriptive, retrospective study. Data were collected by records review. Hospital-acquired infections are monitored by the Infectious Disease Committee of Zamboanga City Medical Center. The list of patients with a diagnosis of HAP was obtained, and their charts were retrieved and reviewed. Those that fulfilled the American Thoracic Society definition of HAP were included in the study. The clinical profile of patients diagnosed with hospital-acquired pneumonia was analyzed in terms of age, gender, length of hospital stay, admitting diagnosis, previous antibiotic treatment for infections other than pneumonia, enteral feeding, blood transfusion, and glucose control. RESULT: 36 cases fulfilled the inclusion criteria. The incidence of hospital-acquired pneumonia from July 2010 to December 2011 in the medical ward of ZCMC is 7.2 per 1000 admissions as compared to 3 cases per 1000 reported in the literature (Sopena, 2005). The mean age was 51.69 years old (SD=19.674), with most patients coming from the 45-55 age group. Most patients were male (57.2%; n=19). The mean duration of hospital stay was 12 days; however, most patients developing HAP were observed to have stayed between 5 and 10 days. The most common primary admitting diagnosis was cerebrovascular disease (22%; n=8). Hypotension was seen in 55% (n=20) of patients. The mean random blood glucose on admission was 177 mg/dL. Twenty-seven percent of the population was given enteral feeding. Of the 12 cases given antibiotics for non-pulmonary infections, 6 patients were given ceftriaxone. Six out of the 12 patients given antibiotics did not complete the course. Only 3 patients received blood products during their confinement, with a maximum of 3 units transfused. CONCLUSION: The incidence of Non-ICU Patients Developing Hospital Acquired Pneumonia in Zamboanga City Medical Center was more than twice the figure reported in the literature. This study suggests that the following factors may increase the risk for the development of HAP: male gender, 45-55 age group, duration of confinement of 5 to 10 days, enteral feeding, and an incomplete antibiotic course. ▲ Show less

Title: THE DEVELOPMENT OF A CLINICAL TOOL TO PREDICT SERUM POTASSIUM LEVEL AMONG SUSPECTED HYPOKALEMIC PEDIATRIC PATIENTS WITH ACUTE GASTROENTERITIS SEEN IN THE ZAMBOANGA CITY MEDICAL CENTER. Author's Name: Ezrah-Dino S. Hailil, Zamboanga City Medical Center, Zamboanga City, Philippines Background: In severe cases of acute gastroenteritis where electrolyte replacement may be essential, the need to establish serum potassium level as an aid to guide fluid and electrolyte replacement can be life-saving. Serum assay remains the gold standard for establishing serum potassium level; however, this is not readily available in most Philippine provincial settings. Objective: This study seeks to correlate the clinical and ECG signs and symptoms of hypokalemia. Specifically, it aims to develop a clinical tool that can be used to predict the serum potassium level of hypokalemic patients with acute gastroenteritis. Design: A cross-sectional study was used in this research. Setting: The study was conducted in the Department of Pediatrics of Zamboanga City Medical Center, the only tertiary government hospital in the city. Participants: A total of 126 patients aged 5 months to 13 years old with acute gastroenteritis were invited to participate in the study. Methodology: A purposive consecutive sampling method was used. Patients were examined for signs and symptoms of hypokalemia. ECG long lead II was read by a single pediatric cardiologist. Univariate analysis and subsequent logistic regression were employed using plotted residuals vs. fitted values to come up with a best-fit model. The variables that remained statistically significant were used in the final model for the development of a clinical tool for predicting serum potassium level among patients with acute gastroenteritis. Results: The factors found to predict serum hypokalemia in patients with acute gastroenteritis are severe wasting, head lag, abdominal distention, prolonged PR interval, flat T wave, prominent U wave, prolonged PR interval with flat T wave, prolonged PR interval with prominent U wave, and a combination of prolonged PR interval, flat T wave, and prominent U wave. A tool was subsequently developed using scores of 1 and 0 multiplied by the assigned coefficient to predict serum hypokalemia. Conclusions: A clinical tool to predict serum potassium level among suspected hypokalemic pediatric patients with acute gastroenteritis was developed. This tool was used in a small field study and was found to correlate with true serum value. Keywords: Clinical tool, hypokalemia, acute gastroenteritis, serum potassium level, pediatric patients ▲ Show less

INTRODUCTION: In clinical practice, hernioplasty (repair of hernia) and appendectomy (removal of appendix) are commonly done by a single-shot spinal anesthesia with 20 mg of hyperbaric bupivacaine 0.5%, which gives a 1-2 hour surgical anesthesia effect. The use of isobaric bupivacaine 20 mg has also been performed as a single-shot intrathecal application with observed prolonged effect. This leads to ideas of possible advantages of isobaric over hyperbaric bupivacaine solutions. It is the aim of this study to compare the anesthetic effects of isobaric bupivacaine versus hyperbaric bupivacaine in the performance of lower abdominal surgery for patients diagnosed with Acute Appendicitis and Inguinal Hernia. METHOD: An experimental, two-group parallel study was conducted. Sample size was calculated using standard statistical assumptions (n=60). The target population was divided into isobaric (n=30) and hyperbaric (n=30) groups. Selection of samples was done through standard criteria. Patient pre-anesthetic data was gathered. Patients were cases from Zamboanga City Medical Center. Epinephrine version 7 of CDC was used in the analysis. RESULTS: T4 was the highest sensory level attained for the isobaric group (20 minutes). This was the same as the hyperbaric group. The two groups attained the same sensory level at 5th, 10th, and 20th minutes post-intrathecal. However, the difference between the sensory levels of the two groups at 3 minutes was insignificant. The maximal degree of motor block achieved was Bromage III (unable to move hip, knee, ankle; able to move toes) in both groups. There were no observed differences between the two groups after 3rd, 5th, 10th, or 20th minutes post-intrathecal. The hyperbaric group showed more drop in blood pressure at 3rd, 5th, 10th, and 20th minutes post-intrathecal. The difference at the 10th minute between the two groups was significant (P value=0.005); however, the differences at 3rd, 5th, and 20th minutes were not (p value=0.541; p value=0.33; p value=0.733). ▲ Show less

Objective: To determine the hemodynamic effects of oxytocin given as slow IV bolus compared to IV drip among women undergoing Caesarean section under spinal anesthesia. Methods: A randomized double-blind controlled study was undertaken in 60 parturients undergoing cesarean section under spinal anesthesia. They were randomly allocated either to receive 5 u of oxytocin as slow IV bolus (bolus group) or IV drip at 1:100 dilution (drip group). Baseline heart rate and blood pressure were obtained prior to administration of oxytocin. Immediately after extraction of the baby and administration of oxytocin, heart rate and blood pressure were recorded every 5 minutes for the first 10 minutes, then every 10 minutes for the next 20 minutes, then every 15 minutes for the next 30 minutes for a total of 1 hour. The hemodynamic data, along with the estimated blood loss and hematocrit changes preoperatively and 48 hours after cesarean delivery, were compared between the two groups. Results: There were 4 out of 30 (13.3%) in the bolus group and 3 out of 30 (10%) in the drip group who had hypotension. Tachycardia occurred in 11 out of 30 (36.7%) patients in the bolus group and 12 out of 30 (40%) patients in the drip group. There were statistically significant differences in estimated blood loss and onset of effective uterine contraction between the two groups, with both p-values at 0.00 as analyzed by independent sample t-test and Wilcoxon rank-sum test for data which did not fulfill assumptions for an independent sample t-test. There was a significant statistical difference between the two groups regarding the need for an additional uterotonic drug, with a p-value of 0.0005 as analyzed by chi-square test. Conclusion: Therefore, slow IV bolus of 5 units oxytocin showed better outcome in terms of the need for an additional uterotonic drug, onset of good uterine contraction, and estimated operative blood loss without hemodynamic compromise. ▲ Show less

Cerebrovascular disease or stroke is one of the most common causes of death in the Philippines. However, there is little research being done. This study aims to determine the presence of established risk factors among adult stroke patients seen at Zamboanga City Medical Center Training Hospital from January to December 2011. Established risk factors for stroke (Stroke Society of the Philippines) were reviewed and obtained from medical registries, histories, and hospital records. Results showed that increased stroke occurrence was in males (55%), and female stroke patients were older than males (p-value=0.001). There were more men than women in the 46-55 and 56-65 age groups (p=0.008). The increased occurrence of hypertension in males was significantly higher than in females (p=0.021); however, females (p=0.0463) had long-standing hypertension (>10 years) more than males. Males were more likely to be smokers (p=0.001) and alcoholic beverage drinkers (p=0.000) than females, while females were more likely to be diabetic (p=0.032) and had previous stroke events (p=0.003). Females were more likely to have the infarct type of stroke (p=0.025). Hypotension was found to be one of the most significant risk factors among the patients (p=0.021). This data reveals that hypertension can be prevented through early consultation with medications. ▲ Show less

The study was conducted to determine the socio-demographic profile and the obstetric and neonatal outcomes of teenage mothers ages 13-19 years old admitted in Ward 1 and Birthing Center of Zamboanga City Medical Center. A total of three hundred twenty-five respondents were included in the study. Sixty-three percent of the respondents were ages 18-19 years old, 31% belonged to the 16-17 age group, and the rest were 13-14 years old. The study utilized a checklist which was analyzed using mean scores and percentages. Relative risk (RR) was used to determine the association between probable risk factors in teenage mothers and their obstetrical and neonatal outcomes using Epi-Info version 7. The study showed that most of the teenage mothers seeking medical care in Zamboanga City Medical Center (ZCMC) were single, inhabitants of this city (70%), and high school undergraduates (57%). Most (24%) have at least 6 prenatal check-ups during their whole duration of pregnancy. Two hundred eighty-two (282) or 86% were primigravid, 37 respondents got pregnant for the second time, 4 respondents for the third time, and one respondent each got pregnant for the 4th and 5th time. Two hundred twenty-eight respondents or 70% of the total population did not know anything about contraception. Risk factor analysis showed that smoking (RR=3.3; CI=1.8 to 6.29; P value=0.0007) teenage mothers are 3 times more likely to have babies with poor APGAR scores; however, the association found between smoking and hypertension among teenage mothers was not significant (RR=2; P value=0.75; CI=0.76-38). Alcohol drinking was not shown to be a risk factor in this study. On mode of delivery, the majority (92%) delivered via NSVD with very minimal hypertensive events (90%), and complications with little chance of having PROM (90%). Regarding birth outcomes, the majority (81%) of the babies were of normal weight (2500-3999g) and with good APGAR scores (73%). Although results of the study showed good obstetric and fetal outcomes in pregnancies among teenage mothers, it is recommended that efforts should still be made to develop a comprehensive health care program for teenagers aimed at reducing the incidence of unplanned teenage pregnancy and improving support for pregnant teenagers. ▲ Show less

Background: The health benefits that can be derived from practicing exclusive breastfeeding (BF) are well-established. International recommendations promote exclusive breastfeeding as the optimal method of infant feeding for the first six months of life. However, despite various programs on BF advocacy, the use of milk formula is still a common practice among mothers in the region. Objective: This study aims to determine the perceived barriers to the successful implementation of hospital policy on breastfeeding at the Zamboanga City Medical Center. Design: A qualitative ethnographic method study based on Grounded Theory principles. Participants: There were a total of 68 respondents included in this study, divided into four groups representing the various stakeholders – hospital administrators, residents, nurses and midwives, and the postpartum mothers who are the recipients of the BF policy program. Methodology: The study was conducted at Zamboanga City Medical Center, a tertiary hospital. The qualitative data were derived from seven focus group discussions which included four groups with mothers, two groups with residents, and one with nurses and midwives, while in-depth interviews were conducted with the administrators. Using the same validated four trigger questions, the researcher investigated the respondents' perceived barriers to the successful implementation of the BF policy program. Results: The themes that emerged from the FGD and in-depth interviews were centered more on issues around promotion/advocacy strategies and on the breastfeeding policy implementation process. The barriers that emerged from these two major themes were further polarized into two categories: individual/personal and institutional issues. Summary/Conclusion: The results of the study disclosed that the failure of the breastfeeding program is likely due to a mismatch between the stakeholders' promotional advocacy strategies for implementation of the breastfeeding program and clientele (mothers) perceptions. Keywords: breastfeeding, barriers, stakeholders, mothers, perceptions ▲ Show less

This case study focused on women who had induced abortion outside of hospitals and were admitted to the Zamboanga City Medical Center in November and December 2011 for medical treatment. It used the case analysis method involving six participants. Interviews using guide questions were used in the gathering of data for this study. The findings indicated that the women who had induced abortion outside of hospitals and consequently admitted at the Zamboanga City Medical Center were generally in their: 1) mid-twenties and mid-thirties, Roman Catholic, employed with minimal income, and with a live-in partner; 2) Their reasons for induced abortion were: financial difficulty, quarrel with the live-in partner, did not want to take responsibility on the part of the man, fear of civil changes by the first husband, and fear of the parents; and 3) they believed that their act of having induced abortion was against their belief and culture. It was concluded that: 1.The women who had induced abortion outside of hospitals and admitted at the Zamboanga City Medical Center for medical treatment are in their mid-twenties and mid-thirties, of legal age, Roman Catholic, with live-in partners, and with minimal income. 2.The women who had induced abortion outside of hospitals and admitted at the ZCMC have different reasons for undergoing abortion. 3.The women who had induced abortion outside of hospitals and consequently admitted at the ZCMC indicated that the abortion they underwent was against their belief and culture. It was recommended that: 1.Women should be oriented on the criminal offense under Articles 256, 258, and 259 of the Penal Code of the Philippines to lessen the number of women who commit induced abortion. 2.Women should also be briefed on their moral and legal accountability in committing induced abortion. 3.Men and women should be oriented on the importance of human life – especially the life in the womb of the mother. ▲ Show less

Background: It is now a requirement that patients' satisfaction with the services obtained from outpatient and inpatient services should be surveyed. Aim: The aim of the study was to produce a standard, reliable, and valid patient satisfaction questionnaire that could be used in outpatient and inpatient sections of the Pediatric Department of the Zamboanga City Medical Center. Method: Items were originally derived from patients' responses to focus group discussions. The resulting 18-item and 41-item Likert-scale questionnaires for both outpatient and inpatient were formulated. General satisfaction items were removed from the set, and responses to remaining items underwent factor analysis. Subscales were produced from items representing each factor. Reliability and internal consistency of each subscale were examined. Results: Both outpatient and inpatient questionnaires were internally reliable (Cronbach's alpha coefficient of 0.85 and 0.88 respectively), and initial tests of validity suggested that all subscales were valid. Conclusion: The study has resulted in an 18-item and a 41-item scale that have been found to be reliable and valid after initial tests. ▲ Show less

BACKGROUND: Clinical breast examination (CBE) seeks to detect breast abnormalities or evaluate patient reports of symptoms to find palpable breast cancers at an earlier stage of disease when treatment is more effective and greater options are available. Health care personnel with the proper skills are vital in examining patients and enabling them to detect breast cancer early. OBJECTIVE: To gauge the perceived adequacy of knowledge versus actual skill in performing Clinical Breast Examination among surveyed Health Care Personnel in Zamboanga City Medical Center. METHOD: This is a two-part descriptive study. In the first part, selected Health Care Personnel at Zamboanga City Medical Center answered a survey questionnaire to gauge their perceived importance of clinical breast examination and their awareness about it. This was followed by a practical examination using a mannequin to evaluate their skills in both the visual inspection and palpation parts of Clinical Breast Examination. The results were reviewed by an expert panel based on WHO guidelines for Clinical Breast Examination. RESULTS: Fifty-three (53) health care personnel agreed to participate: 15 resident physicians, 30 nurses, and 8 midwives. All fifty-three health care personnel know what clinical breast examination is and agree that it is important. Fifty (50) or 91% of the health care personnel believe that they know how to perform clinical breast examination. However, only thirty-five (35) or 66% actually practice it. Thirty-six (36) or 67.9% of the health care personnel say that they are confident in performing Clinical Breast Examination. All of the 53 health care personnel are able to identify asymmetry, breast contour, changes in shape, changes in color, and nipple discharges. 50/53 or (95%) are able to identify inversion of the nipple. Fewer than 7% execute the following important maneuvers: clinical breast examination in both seated and supine positions is performed by only 3/53 or (6%). Applying three levels of pressure: 2/53 (4%); the vertical strip technique and adequate examination duration (at least five minutes per breast) are performed by only one respondent (2%). None of the respondents examined with hands pressed firmly on the waist and leaning forward. These maneuvers most often missed by the health care personnel should be paid more attention to and need to be emphasized. CONCLUSION: This study demonstrates that surveyed health care personnel at Zamboanga City Medical Center had adequate knowledge of Clinical Breast Examination, which is consistent with their visual inspection skills on CBE. However, proper positioning and palpation skills showed that the following important maneuvers: clinical breast examination with the patient in both seated and supine position, application of three levels of pressure, the vertical strip technique, and adequate examination duration (at least five minutes per breast), were missed by almost all of the respondents. Changes in the position of the arms which include arms pressed firmly on the waist and leaning forward were missed by all of the respondents. Greater focus and training should be given to these important maneuvers that are often missed by health care personnel. Based on the results of this study, health care professionals need additional training in Clinical Breast Examination to improve detection of breast cancer. ▲ Show less

Background: Trauma has plagued mankind since the time man learned to roam in the beginning for food and shelter and then as part of his activities. The World Health Organization reports that injuries, whether unintentional or intentional, constitute a major public health problem, killing more than 5 million people worldwide each year and causing more cases of disability. Unfortunately, statistics from the Zamboanga City Health Office on trauma do not depict the actual picture of trauma cases in the city. The community will greatly benefit if the Zamboanga City Medical Center could gather accurate trauma statistics and the risk profiles of trauma patients treated in this hospital. Accurate data for local health authorities are important tools in order to recommend to the local government appropriate trauma prevention strategies, as well as improvement of the emergency response team and emergency room physicians in handling common trauma cases seen in the institution, and assist the hospital in instituting financing policies and appropriate health packages. Method: This is a 6-month retrospective study of all trauma patients treated at the Zamboanga City Medical Center. The respondents included all trauma patients treated at the emergency room of the Zamboanga City Medical Center from July 1, 2012 to December 31, 2012. The study included population demographics, mechanism of injury, type of injury, place of incident, date and time of incident (for seasonal variation of cases), time frame from injury to consult at the emergency room, and patient outcome. All results were presented in percentages, mean/median values, and graphs. Secular trends were also included. Results: Out of the 3504 total number of trauma cases treated at Zamboanga City Medical Center, only 3501 charts were recovered. Of these, 66% were male, while the rest were female. Twenty-five percent of trauma cases were seen in the 20-29 year old age bracket with a gradual decline as age increased. Mauling (1009 cases or 28.8%) and vehicular accidents (1008 cases or 28.7%) accounted for the more common mechanisms of injury. Injuries occurring between 12 noon and 6 PM registered the most number of cases at 1140 patients (or 32%), mostly from vehicular accidents (311 cases or 8.8%), while 1052 cases (or 30%) happening during the 6 PM to 12 MN shift were mainly mauling victims (453 cases or 13%). Most of the victims sustained injuries in Barangays Canelar (10.5%), Sta. Catalina (10.5%), and Ayala (8.6%). Mauling was mainly the mechanism of injury in Barangays Canelar and Sta. Catalina, while in Barangay Ayala, vehicular accidents were more common. Of the 3501 patients seen in the emergency room, 88.8% were treated and discharged. Nineteen patients (or 0.54%) from all trauma cases seen at the emergency room during the time period were either dead on arrival or emergency room mortality. Around 9.8% were admitted for further work-up and treatment. Admitted patients had a 2.8% mortality rate. Conclusion: With this study, the institution is now equipped with an initial study on the profile of trauma patients seen and treated at the Zamboanga City Medical Center Emergency Room. Certain factors can now isolate and categorize individuals as high risk for trauma. Risk profiles of patients involved in specific mechanisms of injury and for admitted trauma patients were presented thoroughly. With the new information above, improvements can be made in the delivery of patient care, helping to direct research efforts, target staff education programs, and guide injury prevention activities. ▲ Show less

Title: THE EFFECT OF THE TIME OF CORD CLAMPING ON THE OUTCOMES AMONG TERM (ETIC-COAT) NEONATES DELIVERED AT THE ZAMBOANGA CITY MEDICAL CENTER: A RANDOMIZED CONTROLLED TRIAL Objectives: This study aims to determine and compare the effect of Early Cord Clamping (ECC) and Delayed Cord Clamping (DCC) on the outcomes among term neonates delivered at Zamboanga City Medical Center. Design: A Prospective Single-blinded Randomized Controlled Trial. Setting: Respondents were recruited on admission. Actual cord clamping for neonates was done in the Delivery Room, Birthing Clinic, and Operating Room. Respondents: A total of 199 newly delivered neonates were included in the study and divided into two groups: ECC and DCC. Methodology: Using computer-generated randomization, expecting mothers of neonates were pre-assigned to either ECC or DCC group. The assigned cord clamping time counting began from the time of delivery of both shoulders. Initial data were entered into Observation Sheets, kept confidential, and disclosed to the pediatrician-observer only after data collection had ended. Only one blinded pediatrician-observer did the outcome assessment. Main Outcome Measures: The study focused on the assessment of the following neonatal outcomes: 1. Respiratory Rate (at birth, 6 hours, 12 hours, and 24 hours of life), 2. Plethora (at 6 hours, 12 hours, and 24 hours of life), 3. Jaundice (at 24 hours of life), 4. Central hematocrit (at 6 hours of life), 5. Number of admissions to NICU/SNU. Results: The majority were delivered via NSVD with cephalic presentation. Low hematocrit levels were noted among ECC (p=0.011). High hematocrit levels were noted among cord clamping at 2 to 3 minutes (p=0.013). Neonatal outcomes like plethora and jaundice were found in the DCC group (p=0.000). Tachypnea at birth was also noted among DCC (p=0.013). More neonates were admitted to NICU/SNU in the DCC group for IV hydration (p=0.005). Conclusions: Anemia was significant in the ECC group, while polycythemia, plethora, jaundice, and admissions were significant in DCC2 (2 minutes) and DCC3 (3 minutes). The optimum time for cord clamping was found to be one minute from the delivery of both shoulders. Recommendation: It is recommended to use DCC at one minute for optimum cord clamping time from the delivery of shoulders, barring all undesirable outcomes attendant to cord clamping time. Keywords: early cord clamping, delayed cord clamping, polycythemia, plethora, jaundice ▲ Show less

A descriptive study was conducted in March 1997 at Zamboanga City Medical Center, Zamboanga City which aims to assess the feasibility of establishing a Hospice Care Program in that area. SPECIFIC OBJECTIVES: To determine the acceptability of Hospice Palliative Care Program among the patients, the patient's families, physicians, nurses, dietitians, social workers, and spiritual representatives. To determine what resources are needed to provide necessary home care. To determine if there exists a market for Hospice Care. To design a Hospice Palliative Care Program at Zamboanga City Medical Center suitable to the Philippine setting should the market exist. This study will serve as an enlightenment at this point in time when the Hospice Palliative Care Program is slowly moving in its implementation and acceptance. The physicians, upon knowing the desire of cancer patients and their families as well, will remove the obstacle and hopefully even help disseminate the idea/concept. To the hospital administrators, they can maximize hospital utilization so that more patients can be accommodated who may need hospitalization and increase the chance of effective cost management of the hospital. Decision makers of the local health facilities can provide and deliver quality patient care at a lower cost. To the nurse, this can be an opportunity for them to enhance their practice as independent nursing practitioners. It will serve as a guide to hospitals, both government and private, or even entrepreneurs who have plans of putting up a HOSPICE PALLIATIVE CARE PROGRAM. Lastly, but also important if not more significant, is its economic impact. Hospital rates and charges have become prohibitive which the majority of our citizenry can ill afford. It is an alternative health care service which is equally, if not more, effective and comprehensive as in-patient hospital care. It is also financially less prohibitive and burdensome to the patient and to the family. This study on HOSPICE PALLIATIVE CARE PROGRAM will surely usher in further research on this topic. It will therefore serve as a reference to students who have an interest in this topic. The findings of the study revealed that the majority of patients and family members accept the HOSPICE PALLIATIVE CARE PROGRAM. The physicians, nurses, dietitians, social workers, and spiritual representatives have a favorable attitude towards HOSPICE PALLIATIVE CARE PROGRAM. Zamboanga City Medical Center can provide medical care regimens for terminally ill patients, but it needs a multidisciplinary team to care for patients after discharge from the hospital. The existing HOSPICE PALLIATIVE CARE PROGRAMS studied were very comprehensive. CONCLUSIONS: HOSPICE PALLIATIVE CARE PROGRAM is acceptable to patients and family members, and they would like to avail of it. The physicians, nurses, dietitians, social workers, and spiritual representatives have a favorable attitude towards HOSPICE PALLIATIVE CARE PROGRAM because they do not see it as a threat to their practice and it has so many advantages. Zamboanga City Medical Center can provide medical care regimens for terminally ill patients, but it needs other coordinating personnel to give direct care and supervise patients after discharge from the hospital, such as independent nurse practitioners. There is a market for HOSPICE PALLIATIVE CARE PROGRAM since the different types of respondents who are needed for its acceptance and growth in the country all have favorable answers, and the existing HOSPICE PALLIATIVE CARE PROGRAMS studied were very comprehensive, which set the pattern for the development of the project proposal for indigent terminally ill cancer patients of Zamboanga City. RECOMMENDATIONS: Doctors must learn the difference between curing and caring, to palliate when curing is no longer feasible. It is a waste to continue maintaining life at all cost with machines and equipment, thus draining all resources and leaving the family with large debts. There is a need to educate the citizenry. HOSPICE PALLIATIVE CARE PROGRAM must be included in the medical, nursing, midwifery, social service, and psychology curriculum. Education also includes the public, and the Department of Health can make use of tri-media regarding the advantages of HOSPICE PALLIATIVE CARE PROGRAM and its cost effectiveness. The government should get involved in the training of personnel and should also encourage research in the field of palliative medicine. The author hopes that the project proposal (Please see Appendix VIII), which is the result of this comprehensive study, will be a worthy project for our lawmakers and the government, and its adoption particularly in Zamboanga City. It is also hoped that this program will be legislated and included under the Medicare program as they are now in Europe and the United States. ▲ Show less

This study was conducted primarily to determine the factors affecting the quality of life of resident physicians in Zamboanga City Medical Center. It involved 46 of 56 resident physicians who consented to participate from all departments, specifically Internal Medicine (9 or 19.6%), Pediatrics (11 or 23.9%), Surgery (10 or 21.7%), OB-Gyne (5 or 10.9%), Anesthesia (6 or 13.0%), Ophthalmology (2 or 4.3%), Family Medicine (2 or 4.3%), and Pathology (1 or 2.2%). The standardized instrument on quality of life from the World Health Organization was adapted. Weighted mean, standard deviation, frequency, percentage, and multiple regression were used in the analysis of data. In general, the QOL of resident physicians was between a scale of 3 (more or less) and 4 (very much) across physical, psychological, social, and environmental domains. The findings indicate that resident physicians are much satisfied with their social relationships (Mean 3.99), psychological health (Mean 3.69), environment (Mean 3.56), and physical health (Mean 3.32). Exercise significantly improves resident physicians' social relationships (p=0.000), psychological health (p=0.005), environment (p=0.007), and physical health (p=0.43). Increasing age significantly affected psychological health (p=0.042) and social relationships (p=0.043). Also, fifth-year resident physicians showed better quality of life compared to lower year levels. Among the departments, the resident from the Pathology department had the highest QOL score. In conclusion, age, exercise, and living accommodation are the factors that greatly affected the quality of life, and resident physicians have not attained the highest level of quality of life. ▲ Show less

Based on the Health Belief Model (HBM), a theoretical framework commonly applied to health behavior research (Harisson, 1992), this study attempted to determine the effects of video-based and written information as interventions in enhancing HPV vaccination intention among pregnant teenagers at the Zamboanga City Medical Center. It adopted a randomized comparative design involving two groups of pregnant teenagers exposed to video-based and written information. The data were analyzed using frequency, percentage, and paired t-test. This study revealed that the majority of participants in both groups expressed willingness to avail of HPV vaccination, with a small percentage of participants manifesting unwillingness. Furthermore, it was indicated that there was no significant difference in HPV vaccination intention among pregnant teenagers at the Zamboanga City Medical Center exposed to video-based versus written information. It was concluded that video-based information was similar in level of effectiveness to written information in enhancing HPV vaccination intention. It was recommended that written and video-based information may be used to provide knowledge among pregnant women, specifically teenagers, and enhance HPV vaccination intention, and that similar studies may be conducted to validate/refute the findings of the present investigation. ▲ Show less

Background: Aside from being expensive, hemodialysis imposes a considerable burden in terms of chores to complete and time taken for the procedure on top of the inherent impaired Health-Related Quality of Life (HRQoL) among CKD patients. HRQoL has become a topic of interest among researchers with studies associating this parameter with a variety of clinical conditions. While there is a wealth of international studies, there is a scarcity of Philippine data in general and Zamboanga City in particular. The Factors Affecting the Health-Related Quality of Life (FAST-QoL) study sought to identify the factors associated with the health-related quality of life among dialysis patients at the Renal Center for Western Mindanao, Zamboanga City. Methods: This is a cross-sectional analytical study utilizing a researcher-formulated questionnaire and the Medical Outcomes Study Short Form-36 (SF-36). Outcomes measured are the factors associated with Health-Related Quality of Life of Dialysis Patients at the Renal Center for Western Mindanao. Results and Conclusions: A total of 54 respondents fulfilled the inclusion criteria and were enrolled into the study. The study population was noted to have an overall poor HRQoL, with the majority of patients having mean scores below the cut-off of <43 for Physical Component Score (PCS) and <51 for Mental Component Score (MCS). The factors investigated included the following: Age; Educational Attainment; Employment Status; Monthly Income; Co-Morbid Conditions; Dialysis Sessions per week; Dialysis-Related Expenses; Years on Dialysis; Cost in Initiating Dialysis; Initial Dialysis Access Modality; and Health Insurance. The results show that the presence of Health Insurance Coverage under the PHIC is associated with improved HRQoL in both the PCS and MCS domains. On the other hand, Low Educational Attainment, Unemployment, and Low Monthly Income show an association with poor HRQoL scores. High Dialysis-related expenses and Initial Dialysis access using a modality other than an AVF were associated with low MCS. On the other hand, being on Dialysis for >1 year is associated with low PCS. The rest of the factors investigated did not show a clear association with HRQoL. ▲ Show less

Background: Hypertension is a major public health concern that, according to the World Health Organization (WHO) 2013, already affects one billion people worldwide. Physicians have an immense role especially in the control of blood pressure and health education. Nowadays, Complementary and Alternative Medicine (CAM) is commonly promoted in all forms of media and endorsed by popular personalities, which can greatly affect the course of treatment and management of certain diseases, specifically hypertension. This study investigates the perception and attitude of General Practitioners (GP) in Zamboanga City towards the use of CAM among hypertensive patients, since GPs are basically on the frontlines in managing hypertension. Methods: This is a questionnaire-based cross-sectional study on the perception and attitude of GPs, and prevalence of CAM use among GPs in Zamboanga City for the treatment of hypertension. Results: The prevalence of CAM used among GPs is only 5% (5 out of 100) combined with conventional medicine, and the majority are influenced by TV/Internet and other family members using CAM. Ninety percent (95 out of 100) of GPs do not recommend CAM in the treatment of hypertension for the reason that they consider the danger it may cause, particularly that it may hinder patients from getting the right treatment and may decrease adherence to conventional medicine. Conclusion: The majority of GPs in Zamboanga City had negative perception and attitude on the use of CAM for treatment of hypertension. Only a few GPs used CAM combined with conventional medicine for the treatment of hypertension. ▲ Show less

Background: Inadequate blood pressure control can lead to increased cardiovascular events or mortality. Given the fixed income of most Filipino patients, does the added cost of taking CAM have an impact on the adherence of patients to conventional treatment? This study also investigates other factors that may affect medical adherence. Methods: This is a questionnaire-based cross-sectional study on the prevalence of CAM use among hypertensive patients and its impact on adherence to conventional treatment in Zamboanga City Medical Center. Results: A total of 203 respondents participated in the study. A statistically significant decrease in adherence was found among patients who combined CAM and conventional treatment (p=0.0000). The majority [124 (61%)] of the respondents used combined conventional and CAM for the treatment of hypertension. The following factors were associated with good adherence: age 51-60 years old, Islam religion, Tausug ethnicity, duration of hypertension of 6 months to 1 year, duration of treatment of less than 6 months, and not using CAM. Conclusion: The majority of hypertensive patients in this institution use combined complementary and alternative medicine with conventional treatment. This behavior is identified as a significant risk factor for poor adherence to treatment. ▲ Show less

Introduction: Cervical cancer is the most common cause of cancer-related mortality among Filipino women, and screening program uptake is low. This study aims to conduct a lecture and determine the knowledge and acceptance by the number of patients who will submit themselves for Visual Inspection with Acetic Acid (VIA). Methods: This study utilized a one-group pretest-post-test with a lecture adapted from the Department of Health (DOH) as an intervention among reproductive-aged women seeking consultation at the Zamboanga City Medical Center (ZCMC) OBGYNE Outpatient department between October to December 2019. The researcher secured informed consent before the commencement of data collection. The sampling method used in this study was purposive sampling. The survey questionnaire served as a tool for data gathering. Data were computerized and analyzed using Epi-info. Results: There were a total of 150 individuals who participated in this study. The majority were Tausug (46%), married (76%), and aged 27 years (SD=4.93), with income of Php 2,664/month (range: Php 0.00 to Php 8,500). The participants experienced at least two pregnancies (33%, range 1-6), had two sexual partners (49%, range 1 to 5), were 18 years old at first sexual debut (range 13-23 years), with no previous knowledge and no screening of Visual Inspection with Acetic Acid (VIA) at the time of the study. After the lecture, 130 or 87% accepted and subjected themselves to VIA, and participants were able to identify answers correctly and developed a good attitude toward screening. Despite this, knowledge was rated to be poor because of respondents' failure to identify that VIA was only used for screening and not for treatment. This poor knowledge can be attributed to the poor educational status of the respondents. Conclusion: There was an increase from 0 to 87% of Visual Inspection with Acetic Acid (VIA) acceptance among the participants in the study. However, general knowledge on cervical cancer remained poor as almost all respondents mistook VIA as a cure for cervical cancer. Recommendation: The lecture from the Department of Health (DOH) can be used in this category of patients to increase Visual Inspection with Acetic Acid (VIA) acceptance and knowledge. Word count: 330 MESH: VIA, cervical cancer, reproductive women, acceptance ▲ Show less

Laparoscopic cholecystectomy (LC) has been the gold standard for the surgical treatment of diseases of the gallbladder; however, conversion to open cholecystectomy (OC) is still inevitable in a minority of cases. Objective: The study aims to determine the factors that are related to conversion of LC to OC based on the sociodemographic and medical profile. Methodology: The study utilized a cross-sectional study in reviewing the patient charts that underwent LC and LC converted to OC from January 2011 to December 2021. Results: A total of 954 patient charts were reviewed. Out of these, 76 had undergone conversion, a 7.9% prevalence rate and 80:1 conversion ratio. Factors identified to be related to conversion include: male gender (16.04), ages 60-64 (25.58%), BMI >30 (38.23%), diabetes mellitus (53.03%), elevated ALP (15.99%). Significant perioperative notes identified to cause conversion include: previous surgery (55.26%), gallbladder empyema (65.79%), scleroatrophic gallbladder (47.36%), adhesions (53.95%), and increased common bile duct diameter (67.10%). Conclusion: The conversion rate is average, showing increasing expertise in laparoscopy and amends consideration of the risk factors that result in conversion. The identification of factors associated with conversion specific to the demographic profile of Zamboanga City will support the judgment of difficulty of the procedure and permit the surgeon to better apprise patients of conversion risks. KEYWORDS: Laparoscopic Cholecystectomy, Open Cholecystectomy, Conversion ▲ Show less

Acute appendicitis is the most common cause of emergent abdominal surgery globally. Although acute appendicitis can be straightforwardly diagnosed by history and physical examination, atypical presentations and other factors might lead to misdiagnosis. Negative appendectomy is a relatively common surgical issue worldwide. It causes patients to experience unnecessary anesthesia, surgical complications, physical stress, and financial burden. Hence, it is deemed important to determine the negative appendectomy rates as well as its predictive factors in order to devise strategies that can decrease its incidence at Zamboanga City Medical Center (ZCMC). This is a retrospective cohort study to determine the prevalence and predictive factors of negative appendectomy at ZCMC by using medical records for chart review. The charts of 105 patients who underwent appendectomy in ZCMC from January 2018 to December 2020 were reviewed in the study. Results revealed that 24.76% of the patients underwent negative appendectomy. This study concludes that the cases of negative appendectomies in this institution are existent. Six predictive factors were identified to be significant; these were the patient's sex, presence of fever, vaginal discharge, vomiting, duration of symptoms, and leukocytosis on complete blood count. In a low-resource institution, it is important to emphasize the importance of having diagnostic tools that could improve our decision-making to arrive at a correct diagnosis and treatment as well. ▲ Show less

Background: Palliative care is needed for various diseases like cancer, HIV/AIDS, and cerebrovascular disease, among others. The growing need for hospice and palliative care has recently added to the challenges faced by the service. Objective: This study was conducted to determine the knowledge, attitude, and practices on hospice and palliative care among resident physicians at Zamboanga City Medical Center (ZCMC). Methods: The study utilized a descriptive cross-sectional design. Total population sampling among resident physicians at ZCMC was utilized. A validated questionnaire was adapted for this study. Mean scores, frequency, and percentage distribution were used in presenting the gathered data. Results: A total of 69 resident physicians participated in the study. They were predominantly female, mainly from the Internal Medicine department, first-year residents, and with 3-5 years of medical experience. Among them, the mean score of Knowledge on hospice and palliative care was 0.73 (Good), whereas the attitude was 3.81 (Very Good). Sixty-two percent (62%) referred a patient to hospice and palliative care services. The reasons for referral include counseling (76%) and home care (44%). Non-referrals were because residents were unaware of the hospice and palliative care service and referral process. Conclusion: The overall knowledge of residents on hospice and palliative care is a "Good" rating, and their attitude is "Very Good" rating, but they revealed poor referral practices mainly limited to cancer patients despite encountering a wide range of terminal illnesses that necessitate referral to hospice and palliative care service. The author recommends further study to explore the incongruence between the respondents' knowledge, attitude, and practices. It is also highly recommended that further studies like the Health Needs Assessment for Hospice and Palliative Care be done to identify the facility's human resources and logistics needs. MESH WORDS: Palliative Medicine, Knowledge, Attitude, and Practices ▲ Show less

TITLE OF PROTOCOL: EVALUATING THE ACCURACY AND APPLICABILITY OF PHONE-BASED LIDAR SCANNER FOR THE FABRICATION OF MAXILLARY OBTURATOR PROSTHESES NAME OF PRINCIPAL INVESTIGATOR: MARIA MONIQUE THERESITA M. SOLIVEN, MD NAME OF ADVISER: JUSTIN ELFRED LAN B. PABER, MD Introduction: Maxillofacial prostheses are used to rehabilitate patients with congenital or acquired facial defects or deformities to improve the patient's quality of life, both in terms of function and cosmetic outcome. Conventional methods in the production of maxillofacial prostheses are often challenging, complex, costly, and time-consuming. Advancements in the use of digital scanning technologies have addressed the limitations of conventional methods; however, this form of data acquisition remains an expensive option. Apple's integration of Light Detection and Ranging (LiDAR) in their two products since 2020 is mainly used to enrich the user's experience with the aid of 3D mapping of environments. Another particular potential of this portable and relatively low-cost technology is its use in medicine and dentistry, such as 3D scanning of anatomical parts. However, whether smartphone-integrated LiDAR scanning could be sufficiently accurate to reconstruct craniomaxillofacial parts remains to be unanswered at the time of writing. This paper aims to investigate whether phone-based LiDAR scanning may be applied in the virtual reconstruction of maxillary prostheses in terms of accuracy. Methodology: Six maxillary stone models representing varying degrees of tooth loss ranging from dentate to edentulous models were scanned with a professional laser scanner (Zeiss) set on default settings and are used as the reference scan. An iPhone 13 Pro smartphone was utilized to scan the same models using the free Scaniverse application based on the recommended instructions. Surface area, virtual volume, and surface point deviations represented by color maps were acquired and statistical analyses with independent t-tests were performed. Results and Discussion: The present study did not find favorable accuracy and precision for smartphone-based LiDAR-scanned models in comparison with those generated by a professional-grade laser scanner. Although the virtual volume showed no significant differences between the LiDAR-scanned models, the surface area showed substantially large differences which suggest variations in surface contour. This may be from the overrepresentation or underrepresentation of the surface as shown on the surface point deviation color maps. Conclusion: The varying levels of point mismatches for dentate models are substantial. This indicates that at its present technology, the phone-based LiDAR scanning method may not be favorable to produce an accurate maxillary obturator prosthesis. However, the integration of phone-based LiDAR scanning technology as a dimensional measurement device could be used as an affordable, portable, and accessible addition in the digital workflow for the fabrication of maxillofacial prostheses. Although the accuracy of the iPhone LiDAR models does not reach the laser scanning standards, its capability to realistically represent the model, particularly for edentulous cast models, shows that the majority of surface points accurately represent the reference laser scans. Improvements in raw point cloud export, maximum scan size, and range are only a matter of time for the still-novel software applications. With its field of application, it offers advantages in accessibility, usability, and integrated data processing. MESH WORDS: Maxillary obturator prosthesis, 3D scanning, Laser Scanning, Phone-based LiDaR Scanning ▲ Show less

Post-dural puncture headache (PDPH) is a common complication after intentional and unintentional dural puncture, with risk factors including: female sex, young age, low body mass index, needle size, needle design, and technique. This cross-sectional study focused on the incidence of PDPH among obstetric patients following spinal anesthesia in Zamboanga City Medical Center (ZCMC). All patients who underwent spinal anesthesia were asked for consent and assured confidentiality in the conduct of this study. Questionnaires were used to evaluate the incidence of PDPH. The different criteria include: 1) Time of onset of headache (within 24 to 72 hours); and 2) Severity of headache using the ICHD-II (International Classification of Headache Disorders diagnostic criteria) Visual Analog Scale (VAS). Other signs and symptoms accompanying PDPH were also noted. This study included respondents who underwent cesarean section under spinal anesthesia at ZCMC. All respondents were American Society of Anesthesiologist classification 2 (100%), with the majority having a history of previous spinal anesthesia (75%), multiparous (75%), and multigravid (75%). Respondents on average were aged 26.9 years old, weighing 66.5 kg. The majority of respondents also did not have normal body mass index, with 6 respondents (25%) classified as obese. Some studies have shown that above-normal BMI and use of smaller gauge spinal needles tend to decrease the incidence of PDPH, which may be the case among the respondents in this study. Since no respondent reported headache, assessment of severity of headache was not feasible. Moreover, since no other symptoms were observed among these respondents, discussion was primarily limited to the sociodemographic and clinical profile of the respondents. ▲ Show less

Background: Palliative care is needed for various diseases like cancer, HIV/AIDS, and cerebrovascular disease, among others. The growing need for hospice and palliative care has recently added to the challenges faced by the service. Objective: This study was conducted to determine the knowledge, attitude, and practices on hospice and palliative care among resident physicians at Zamboanga City Medical Center (ZCMC). Methods: The study utilized a descriptive cross-sectional design. Total population sampling among resident physicians at ZCMC was utilized. A validated questionnaire was adapted for this study. Mean scores, frequency, and percentage distribution were used in presenting the gathered data. Results: A total of 69 resident physicians participated in the study. They were predominantly female, mainly from the Internal Medicine department, first-year residents, and with 3-5 years of medical experience. Among them, the mean score of Knowledge on hospice and palliative care was 0.73 (Good), whereas the attitude was 3.81 (Very Good). Sixty-two percent (62%) referred a patient to hospice and palliative care services. The reasons for referral include counseling (76%) and home care (44%). Non-referrals were because residents were unaware of the hospice and palliative care service and referral process. Conclusion: The overall knowledge of residents on hospice and palliative care is a "Good" rating, and their attitude is "Very Good" rating, but they revealed poor referral practices mainly limited to cancer patients despite encountering a wide range of terminal illnesses that necessitate referral to hospice and palliative care service. The author recommends further study to explore the incongruence between the respondents' knowledge, attitude, and practices. It is also highly recommended that further studies like the Health Needs Assessment for Hospice and Palliative Care be done to identify the facility's human resources and logistics needs. MESH WORDS: Palliative Medicine, Knowledge, Attitude, and Practices ▲ Show less

This study looks at pediatric research in the Zamboanga Peninsula and nearby provinces (Basilan, Sulu, and Tawi-Tawi), focusing on what pediatricians are doing and the challenges they face with research after completing their training. The goal was to understand past and present research efforts and to identify what helps or hinders pediatricians in pursuing research. A cross-sectional mixed-methods design was employed utilizing results of the survey completed by 47 pediatricians—some members and some non-members of the Philippine Pediatric Society - Southwestern Mindanao Chapter (PPS-SWM), alongside qualitative focus group discussions. The findings indicate a low level of research engagement among pediatricians in this region, with only 6.7% of respondents actively participating in research activities. While many pediatricians had done research during their training, few continue to do so during clinical practice. Key enablers for research involvement include peer support, training in research methods and statistics, and financial assistance. On the other hand, barriers include a lack of skills in technical writing, limited funding, and a general disinterest in research. Discussions revealed that many pediatricians find research to be an added burden, often prioritizing their clinical work instead due to financial concerns. The study suggests that to boost pediatric research in the region, it is essential to spark more interest in research and provide targeted training opportunities and holistic support for individuals who exhibit a genuine interest in research instead of targeting pediatricians in general. This research underscores the need for a supportive environment that encourages pediatricians to engage in research, leading to better healthcare delivery and informed decision-making for children. ▲ Show less

Introduction: Tuberculosis (TB) remains a significant global health challenge, with HIV co-infection substantially increasing the risk of poor clinical outcomes. In the Philippines, the integration of provider-initiated HIV testing and counseling (PITC) into TB care is essential for early diagnosis and treatment. However, various socioeconomic and perceptual barriers continue to influence the level of acceptance and hesitancy among patients. Understanding these specific determinants is crucial for optimizing TB-HIV collaborative services and improving patient survival rates. Objectives: This study identified the factors associated with the acceptance and hesitancy of provider-initiated HIV screening among patients diagnosed with pulmonary tuberculosis (PTB) at Zamboanga City Medical Center (ZCMC). Methods: A cross-sectional study was conducted among 117 patients diagnosed with PTB at ZCMC. Data were collected using a structured questionnaire covering sociodemographic, patient-related, and health-related factors. Data analysis was performed using STATA version 17. Bivariate logistic regression was first utilized to screen for significant associations, followed by multiple logistic regression to identify independent predictors of screening behavior. Statistical significance was set at p < 0.05, and the model's goodness of fit was assessed. Results: The final explanatory model revealed that male gender and employment status were the strongest demographic predictors of screening uptake, with male patients being 1.27 times more likely (p = 0.038) and employed individuals being 7.51 times more likely (p < 0.05) to accept testing. Additionally, patient perception played a critical role; those who believed HIV testing should be a routine part of TB care demonstrated significantly higher acceptance (p = 0.006). Factors such as health insurance coverage and HIV-related knowledge also contributed to the model. The final multivariate model demonstrated a statistically reliable fit (Prob > chi2 = 0.0013). Conclusion: Most TB patients in this study population demonstrated a higher likelihood of accepting HIV screening when they possessed socioeconomic stability and viewed the test as a normalized component of clinical care. Male gender and employment emerged as key facilitators of uptake, while the perception of screening as "routine" served as a primary driver for overcoming hesitancy. These findings suggest that while individual characteristics influence behavior, the systemic integration and normalization of PITC within the TB diagnostic pathway are essential for increasing screening coverage and strengthening integrated TB-HIV care. Keywords: Provider-Initiated HIV Testing and Counseling (PITC), Tuberculosis (PTB), Screening Hesitancy ▲ Show less

Introduction: Upper gastrointestinal bleeding (UGIB) remains a significant cause of hospital admission worldwide, frequently associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs). In patients with chronic musculoskeletal conditions, such as poorly controlled arthritis, the reliance on NSAIDs for pain management often leads to severe gastrointestinal complications. In the Philippines, particularly in regional centers like Zamboanga City, the clinical profile and the specific proportion of UGIB cases attributable to arthritis-related NSAID use remain under-documented. Objectives: This study aimed to determine the proportion of UGIB cases associated with NSAID use for poorly controlled arthritis among patients admitted to Zamboanga City Medical Center (ZCMC) and to describe their sociodemographic profiles, clinical characteristics, and health outcomes. Methods: A retrospective cross-sectional study was conducted involving 106 adult patients diagnosed with UGIB at ZCMC over a one-year period (June 2024 – June 2025). Using purposive and total population sampling, patients were screened to identify those whose bleeding was associated with NSAID therapy for arthritis. Data were extracted from electronic medical records (EMR) using a standardized form. Categorical data were summarized using frequencies and percentages, while clinical outcomes were analyzed through descriptive summary measures. Results: Out of 106 UGIB cases, 20 (18.9%) were associated with NSAID use, and 7 (6.6%) were specifically attributed to the management of poorly controlled arthritis. The arthritis cohort had a mean age of 59 years and was predominantly male (71.4%). The universal presenting symptom was melena (100%), and 85.7% of patients reported concurrent smoking and alcohol use. Clinical findings revealed profound anemia (mean Hb 7.14 g/dL) in all patients, requiring blood transfusions. Endoscopic evaluations identified gastric and duodenal ulcers as the primary sources of bleeding, with severities ranging from Forrest Class Ia (spurting hemorrhage) to Class III (clean-based ulcers). While 85.7% of the patients were successfully discharged, one mortality (14.3%) was recorded. Conclusion: NSAID-induced UGIB represents a significant, yet largely preventable, clinical burden at ZCMC. Although the proportion of cases specifically linked to poorly controlled arthritis is relatively low, the clinical impact is severe, characterized by life-threatening anemia and the need for intensive intervention. The findings highlight a critical lack of gastroprotective prophylaxis and a prevalence of unsupervised medication use among these patients. There is an urgent need for improved risk stratification, patient education, and the implementation of standardized prescribing guidelines to mitigate these risks. ▲ Show less

Postoperative pain remains grossly undertreated, with up to 70% of patients reporting moderate to severe pain following surgery. The insufficient control of postoperative pain has adverse physiologic effects that can contribute to significant morbidity and mortality. This is a double-blind randomized study comparing the effects of epidural morphine and combined epidural bupivacaine-morphine as postoperative analgesia among patients operated for abdominal gynecologic cases using the Visual Analogue Scale pain assessment tool. A positive treatment outcome would provide a cost-effective option or alternative for pain control that could as well give optimum care among postoperative patients in Zamboanga City Medical Center. Respondents were patients admitted at ZCMC for abdominal gynecologic surgery, categorized as ASA 1 and 2, age bracket between 20 to 60 years old, and with minimal risk cardiopulmonary clearance for those aged 40 and above. Blinding technique was utilized, and randomization was done through the use of a computer-generated random table. Subjects were categorized into Morphine group (Experimental group) with 89 subjects and bupivacaine-morphine group (Control group) with 87 subjects. Postoperatively, patients were given epidural analgesia every 12 hours for 4 doses. Each patient in the Morphine group received 10 ml epidural solution containing morphine 0.2 mg/ml. In the Bupivacaine-Morphine group, patients individually received 10 ml epidural solution containing 0.01% per ml of bupivacaine and morphine 0.2 mg/ml. VAS scores were determined at 12 and 24 hours postoperative period. Out of 89 Morphine subjects (experimental group), 81 (91%) did not experience pain during pain assessment at 12 hours postoperative period while resting or not in motion. In the Bupivacaine-Morphine group (control group), 83 (95.40%) of 87 subjects also had no pain experience (p-value 0.26). Then at 24 hours postoperative period, 85 (95.5%) of the 89 morphine subjects did not experience pain at rest. In comparison, the Bupivacaine-morphine group had 80 (91.95%) subjects who did not experience pain as well (p-value 0.53). Upon assessment of pain during movement, 85 (95.50%) out of 89 Morphine subjects (experimental group) experienced mild pain (VAS 1-3) at 12 hours postoperative period. In the Bupivacaine-Morphine subjects, there were 85 (95.55%) subjects who also experienced mild pain (p-value undefined). After 24 hours, 78 (87.64%) of 89 Morphine subjects experienced mild pain when asked to move, and the remaining 11 (12.36%) subjects no longer experienced pain. In the Bupivacaine-Morphine group, 74 (85.06%) of 87 subjects had mild pain and 13 (14.94%) other subjects no longer experienced pain (p-value 0.77). The pain experienced by the respondents is dependent upon whether they are resting or moving. Although there are slight statistical differences between the two groups, such minor disparities are considered insignificant, thus leading to the conclusion that morphine alone as a form of epidural analgesic for abdominal gynecologic surgery is comparable to combined bupivacaine and morphine in terms of its analgesic effect. ▲ Show less

TITLE:CLINICAL OUTCOMES OF NON-INVASIVE VENTILATION IN PEDIATRIC PATIENTS AGES 1 MONTH TO 10 YEARS OLD WITH SEVERE COMMUNITY ACQUIRED PNEUMONIA ADMITTED AT THE PEDIATRIC INTENSIVE CARE UNIT OF ZAMBOANGA CITY MEDICAL CENTER FROM JANUARY 2021 TO DECEMBER 2023 NAME OF PRINCIPAL INVESTIGATOR:SHERLEY VER M.SALADAGA, MD NAME OF ADVISER: ERVINA JASTIH, MD, DPPS, DSPCCMP Background and 0bjectives: Respiratory diseases are a leading cause of morbidity and mortality, espeCially in children under 5years of age, for whom the most frequent cause of death is pneumonia and bronchiolitis. In these settings, acute respiratory distresS Syndrome most often occurs leading to respiratory failure. Immediate intervention for acute respiratory failure is needed, and among the available interventions, mechanical ventilation with endotracheal intubation is the most widely used therapeutic modality Non-invasive ventilation (NIV), however, has become an important tool over the years. Initially introduced in the adult and neonatal population, NIV has been increasingly used in the management of pediatric respiratory failure This study airs to describe the clinical outcomes of non-invasive ventilation in pediatric patients aged 1 month to 10 years old with severe community acquiredpneumonia admitted at the Pediatric lntensive Care Unit of Zamboanga City Medical Center. Methodology: This is a descriptive retrospective cross-sectional study, The study population included chldren age 1 month to 10 years old with severe communityy acquired pneumonia who received NIV as the first therapeutic choice. Results:A total of 81 participants were included in this study, Majority of the participants were male (6l.796) with ages less than 1year old (61.796). Among the NIV modalities utilized, NIPPV was the most commonly used accounting tor 51 cases (62.996). While NIV demonstrated a high success rate (65.496) a considerable proportion ofparticjpants (34.696) still had unfavorable outcomes (intubation, mortality and discharge against medicaladvice) Most particijpants hadla PICU stay of47 days 43296) Conclusion: Non-invasive ventilation demonstrated'generally favorable clinical outcomes among pediatric patients with severe community-acquired pneumonia. ▲ Show less