Factors affecting medication adherence of hypertension and diabetes club members in the District Health Centers in the City of Baguio

Background@#Medication adherence is important to mitigate complications of NCDs. Hypertension and diabetes clubs were intended to make essential medications accessible to club members. Despite these efforts, patients avail treatment and management in acute care with noted complications. To address this problem, it is important to identify factors that affect patients’ adherence medication.@*Objectives@#This study aimed to determine the factors affecting adherence to medications of members enrolled in the Hypertension and Diabetes Club in the district health centers in the city of Baguio.@*Methods@#This is a cross-sectional study with a total of 374 respondents from the 16 different district health centers in the City of Baguio, obtained through random sampling. A validated questionnaire was utilized for the collection of data and was presented using percentage and frequency tables. A chi-square test was used to find the association of clinic-demographic data with respondents’ medication adherence.@*Results@#Hypertension and Diabetic Club members overall reported good adherence to medication. Majority of the respondents are female and are older than 61 years old while comorbidities show significant association with level of adherence. On the other hand, lack of finances, feeling that the drug is not effective, multiple medications, taking medications for many years, interference with meal plan, feeling the dose is too high, and complexity of drug regimen are noted to be associated factors for non-adherence.@*Conclusion@#Hypertension and Diabetes Club a community-based management in the City of Baguio shows a good impact on patients’ medication adherence. Comorbidities, chronicity, good family support as well as good physician-patient relationship can positively affect adherence to medications. On the other hand, factors affecting medications non-adherence are: complexity of medications, subjective report that medication is too high, interference to meal, having medications for many years and having multiple medications. Identifying factors affecting adherence and nonadherence are important to decrease further complications of the common NCDs.

Telemedicine use and perspectives of municipal health officers in the Cordillera Administrative Region during the COVID-19 pandemic

Background@#Telemedicine has proven essential during COVID-19. However, concerns remain about the rural municipalities in the country such as those from the Cordillera Administrative Region (CAR), wherein perceived barriers by Municipal Health Officers (MHOs) include poor internet connectivity and inadequacy of the current telemedicine service.@*Objective@#This study aimed to assess the extent of Telemedicine use and perspectives in terms of perception, attitudes and perceived barriers among MHOs in CAR during COVID-19.@*Methods@#This is an analytical cross-sectional study that used a validated online questionnaire to 62 MHOs and DTTBs in CAR. Logistic regression analysis was employed to determine the effect of sociodemographic factors and physician perceptions and attitudes on the extent of Telemedicine use.@*Results@#Most MHOs use Telemedicine frequently in their practice for 0-1 year during COVID-19. There is no significant effect of sociodemographic factors to the extent of Telemedicine use except for IT expertise which had a negative influence on the extent of use [prevalence (p=0.011), frequency (p=0.013), length of use (p=0.044)]. Generally, MHOs agree that telemedicine is beneficial for them in performing consults with a positive effect on frequency (p=0.004) and length of use (p=0.009). There is positive attitude towards telemedicine, however, with no significant effect on extent of use (p=0.352, p=1.00, p=0.484). Compromised decision-making and network issues are the most prevalent perceived barriers that limit MHOs to practice Telemedicine. @*Conclusion and Recommendation@#This study showed that during COVID-19, there is good utilization of Telemedicine among MHOs in CAR. MHOs perceive Telemedicine as beneficial in their work and positive attitude remains. However, presence of barriers makes them apprehensive to fully incorporate it in their practice. Study results can contribute to policy-making on telemedicine as it is a key player in e- health to improve access to healthcare services in the attainment of the goal of Universal Healthcare.

COVID-19 vaccine hesitancy among healthcare workers in two general hospitals in Benguet: A cross-sectional study

Background@#Baguio General Hospital and Medical Center (BGHMC) and Benguet General Hospital (BeGH) started COVID-19 vaccination among its employees in March 2021. Although there was an observed substantial increase in vaccine acceptance, a better understanding on the factors associated with hesitancy toward COVID-19 vaccine is necessary to further strengthen efforts and focus on the caveats regarding vaccine acceptance.@*Objective@#The study aimed to determine the factors influencing COVID-19 vaccine hesitancy among healthcare workers (HCW) in two general hospitals in Benguet.@*Methods@#A cross-sectional study was conducted among HCW in BGHMC and BeGH for 1 month. Total enumeration sampling was used which included 222 participants but only 85 responded. A modified questionnaire was used to describe the factors influencing COVID-19 vaccine hesitancy. Categorical variables were presented as frequencies and percentages. Pearson’s Chisquare test was used to observe the association between clinicodemographic factors and COVID-19 vaccine hesitancy among the HCW in BGHMC and BeGH.@*Results@#The results showed that young, female, non-clinical workers with direct contact with COVID-19 patients, previous COVID-19 infection, and without comorbidities were more likely to be hesitant. The study identified various internal, external, and vaccination-specific factors that influenced vaccine hesitancy, such as concerns about adverse effects, their impending risk in contracting COVID-19 at workplace, and thoughts about yearly booster dose. These findings suggest that vaccine hesitancy among healthcare workers in the Philippines is complex and influenced by a range of factors.@*Conclusion@#The study can be used to develop targeted interventions to address concerns about vaccine hesitancy and improve vaccine uptake among healthcare workers. The development of an equitable approach such as an effective and inclusive vaccine policy that does not feel mandatory for this population will foster trust in the healthcare system.

Correlation on the level of adherence to self-care activities and blood glucose control of adult patients with type 2 diabetes mellitus seen in the Outpatient Department of a tertiary hospital in Baguio City – A cross-sectional study

Introduction@#Type 2 Diabetes Mellitus (T2DM) remains one of the leading causes of mortality in the Philippines. Studies have reported that good adherence to self-care activities significantly aid in glycemic control. However, previous studies revealed a low adherence to diabetes self-care activities. Moreover, only few studies were done in the local setting assessing the level of adherence to self-care activities and correlating the two; hence, the immense need for the assessment of level of adherence to self-care activities among patients with T2DM.@*Objective@#This study aims to determine the level of adherence to self-care activities and correlate it with the glycemic control among T2DM patients seen in the outpatient department in a tertiary hospital in Baguio City.@*Methods@#This cross-sectional study was done using a survey questionnaire adapted from the Summary Diabetes Self-Care Activities Questionnaire version 2000. Glycemic control was determined using the latest valid HbA1c results. One hundred adult diabetic patients were included in the study. Participants were selected in the Family Medicine and Internal Medicine OPD Clinics through systematic random sampling method. Data collected were analyzed using descriptive and inferential statistics.@*Results@#Results revealed that majority of the sample population had undesirable self-care activity (69%), and poor glycemic control (69%). Statistical analysis revealed that proper adherence to either exercise (0.003) or compliance to medications (0.012) both have a significant relationship with glycemic control. Overall score (0.003) on one hand revealed a highly significant relationship with glycemic control.@*Conclusion@#Incorporating the different self-care activities namely diet, exercise, blood sugar testing, foot care, smoking cessation, and compliance to medication all together has a significant relationship with glycemic control among diabetic patients. Clinicians must emphasize proper adherence to self-care activities because of the high number of patients with undesirable self-care activities.

A portal quadrad with triple hepatic arteries / 대한해부학회지

The arterial support of the liver is most commonly from the celiac trunk via the proper hepatic artery (PHA). The PHA divides into left and right branches: the right hepatic artery (RHA) supplies the right and caudate lobes while the left hepatic artery (LHA) supplies the left and quadrate lobes. Aberrant hepatic arteries are relatively common, and the most frequent contributors are the superior mesenteric artery and left gastric artery. Herein we present findings from postmortem dissection of an abdominal cavity that revealed a rare combination of reported variations. Specifically, this subject had three extrahepatic arteries - a replaced LHA (rLHA), a PHA, and a replaced RHA (rRHA). The rLHA originated from the left gastric and the rRHA originated from the superior mesenteric artery. Knowledge of these variations is important for surgical and radiological procedures to avoid complications during treatment and improve patient outcomes.

Genotoxic effect induced by hydrogen peroxide in human hepatoma cells using comet assay

Hydrogen peroxide [H2O2] is a common reactive oxygen intermediate generated by various forms of oxidative stress. The aim of this study was to investigate the DNA damage capacity of H[2]O[2] in HepG2 cells. Cells were treated with H2O2 at concentrations of 25 micro M or 50 micro M for 5 min, 30 min, 40 min, 1 h, or 24 h in parallel. The extent of DNA damage was assessed by the comet assay. Compared to the control, DNA damage by 25 and 50 micro M H[2]O[2] increased significantly with increasing incubation time up to 1 h, but it was not increased at 24 h. Our findings confirm that H[2]O[2] is a typical DNA damage-inducing agent and thus is a good model system to study the effects of oxidative stress. DNA damage in HepG2 cells increased significantly with H2O2 concentration and time of incubation but later decreased likely due to DNA repair mechanisms and antioxidant enzymes

An effective integrated learning programme in the first year of the medical course.

BACKGROUND: An integrated approach to teaching medical subjects is an effective educational strategy. Yet, this has not become popular in medical colleges in India. We describe an integrated learning programme to teach the gastrointestinal system in the first year of the medical course. METHODS: The integrated learning programme was conducted for 3 years (2003-2005). It incorporated elements of problem-based learning, early clinical exposure, lectures and small group laboratory work. Student assessment was formative (for problem-based learning sessions) and summative (using problem-based learning and knowledge tests). Evaluation of the programme was based on feedback from the students and faculty members. RESULTS: Ninety-six per cent of the students obtained more than 60% marks in the problem-based learning test. The mean (SD) score in the knowledge test was 62 (0.89)%. The majority of students received satisfactory and more than satisfactory grades for their performance in the problem-based learning sessions. The feedback from faculty members and students was positive, which highlighted benefits such as integrated learning of the basic sciences, their application to clinical cases and active student learning. The challenges encountered included the higher input required from faculty members. Most of the faculty members and students recommended that the integrated programme should be continued and extended to other parts of the curriculum. CONCLUSION: An integrated learning programme is feasible within a conventional medical curriculum of an Indian medical college.