Resilience levels among Filipino non-medical personnel at a Tertiary Government Hospital in Metro Manial during the COVID-19 Pandemic - July 2021

Objectives@#This study aimed to measure the resilience level of non-medical personnel of the University of the Philippines Manila – Philippine General Hospital (UP-PGH) and determine whether this was associated with sociodemographic factors such as gender, length of service and job position.@*Methodology@#A cross-sectional study that included non-medical personnel using convenience sampling via email was done. Data was obtained through the 14-item Resilience Scale (RS-14) as well as a sociodemographic factors questionnaire. Descriptive and non-parametric correlational analysis of data was used.@*Results@#One hundred twenty five of the 153 respondents (81.70%) garnered a resilience score of 74-98 or moderate to high resilience level, while 28 or 18.30% had a resilience score corresponding to very low and on the low end. The mean resilience score was 81.8, corresponding to a moderate resilience level. More women than men had a resilience level of moderate to high. Respondents with greater than 5 years of work experience within the hospital had higher resilience levels than those who were less experienced. Moderate to high resilience levels were found in more administrative than non-administrative personnel. No significant association was found between resilience level and the factors analyzed. In terms of Resilience Core Characteristics, all comparisons between demographic factors of interest and Self-reliance, Purpose, Equanimity, Perseverance and Authenticity yielded insignificant results except for Self-reliance versus length of service, which showed a weak but significant relationship. Exploratory factor analysis found that the unidimensionality of the RS-14 Scale (US Version) still applied when administered to Filipinos in this particular population.@*Conclusion@#Majority of the non- medical personnel of the UP -PGH had moderate level of resilience. There was a lack of significant association between resilience level and demographic characteristics like age, length of service, and position in the study sample. In terms of Resilience Core Characteristics, comparison between length of service and self -reliance showed a weak but significant relationship.

Estimated range of cost of treatment of adult Schizophrenia patients at a tertiary government hospital as of October 2015

OBJECTIVES@#Using the patient’s perspective, the study’s objective was to estimate the economic cost of treatment for adult schizophrenia patients in a tertiary hospital using key informant interviews.@*METHODS@#A guided structured key informant interview was done to determine key practices in the treatment of adult schizophrenic patients in the charity and pay in-patient and out-patient settings of the tertiary hospital. Cost of treatment included direct (medication, room and board, professional fees, ancillaries) and indirect costs (productivity losses of both patient and caregiver) and was computed based on 1 to 4 week length of stay for inpatients and varying intervals of follow-up for outpatients. Total costs were computed depending on the treatment setting.@*RESULTS@#Twenty nine members of the Department of Psychiatry, involving 5 psychiatric nursing staff, 13 residents-in-training, 4 fellows-in-training and 7 consultants were interviewed. The cost, for charity inpatient care, may range from PhP 2332.00 to PhP 44,861.00 (USD 50.88 to 978.86). For charity outpatient care, this may range from PhP 2892.00 to PhP 21,3612.00 (USD 63.10 to 4660.96) annually. For pay patients, costs were estimated to range from PhP15347.00 to PhP 24,6831.00 (USD 334.87 to 5385.80) for inpatient care and PhP 17,292.00 to PhP 1,125,600.00 (USD 377.31 to 25681.04) for outpatient care. The factor that influenced costs the most was the choice of medication. As of October 15, 2015, 1 USD = 45.83 PhP.@*CONCLUSION@#Schizophrenia is a chronic psychiatric illness that places a significant financial burden on patients and their caregivers. Based on the data gathered, patients’ and their families could spend from as low as 2332 to as high as 1,125,600 pesos depending on the treatment setting.

Lethal midline granuloma in a 15-year-old girl: A diagnostic dilemma

Objective@#To report a case of lethal midline granuloma and discuss the diagnostic and treatment dilemma, and management. @*Methods@#Design: Case Report. Setting: Tertiary Government Hospital. Patient: One.@*Results@#A 15-year-old girl under treatment for pulmonary tuberculosis presented to the Emergency Room for epistaxis and a nasopalatine lesion. She was managed as a case of nasopalatine osteomyelitis for one month and discharged on antibiotics. She returned due to bleeding after being lost to follow up for 3 more months. Hemostasis, debridement and biopsy yielded atypical cells, possibly lymphoma. Immunohistochemistry confirmed the diagnosis of NK-cell lymphoma. Unfortunately, she expired prior to initiation of chemotherapy. @*Conclusion@#Clinicians must have a high index of suspicion for lethal midline granuloma in chronic, non-healing midline lesions. Multiple biopsies confirm the diagnosis, and earlier initiation of treatment may improve prognosis.