Journal of Medicine, University of Santo Tomas最新文献

{"title":"Double Contour Sign In Early Detection Of Gout Among Asymptomatic Hyperuricemic Filipino Patients: A Single Center Tertiary Hospital Observational Study","authors":"J. Li-Yu, Dominic Dela Cruz, Millicent Tan-Ong, L. Zamora, Richelle Joy Bayson","doi":"10.35460/2546-1621.2022-sp11","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp11","url":null,"abstract":"Objective. Double contour sign (DCS) is considered part of the new gout classification. This study aims to determine the agreement of blinded musculoskeletal sonologists in identifying the double contour sign among asymptomatic hyperuricemic patients. Methods. Participants with asymptomatic hyperuricemia (n=65) underwent a gray-scale ultrasound assessment of both of their 1st metatarsophalangeal joints (MTPJs) done on 3 positions (dorsal, medial, plantar) in longitudinal view. The static images were read by 2 independent blinded sonologists for presence of double contour sign. Results. Among the 130 1st MTPJs, the sonologists were able to positively identify DCS on 48R and 52L, negative in 10R and 10L, with discordant readings in 7R, 3L. The overall kappa agreement was statistically significant at 0.674 (substantial agreement) and 0.842 (almost perfect agreement) on the right and left respectively, (both p<0.001). Conclusion and Recommendation. There is a high proportion of positive double contour sign seen among persistently asymptomatic hyperuricemic patients. It might be prudent to perform musculoskeletal ultrasound early on to detect monosodium urate crystal deposits in similar patients. A close follow up to monitor clinical gouty arthritis may be necessary or consider utility of urate lowering drugs in crystal dissolution in prospective studies.","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130340695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The things that truly matter…","authors":"Sandra V Navarra","doi":"10.35460/2546-1621.2022-sp18","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp18","url":null,"abstract":"In the summer heat of 1966, racial tensions between African Americans and whites in Cleveland erupted into a riot that left four people dead, 30 critically injured, and 240 homes and businesses burned in the Hough community. In October, 1966, the Black Panthers, founded \" to serve the needs of the oppressed people in our communities and defend them against their oppressors (www.blackpanther.org), \" adopted their party platform and program. \" What We Want & What We Believe \" demanded housing, education, military exemption for black men, an immediate end to police brutality and murder of black people, jury trials of blacks by their peers, release of all black prisoners, and the establishment of a black colony in the United States under the auspices of the United Nations that would empower black people to determine their own national destiny societal oppression. Subsequently, its focus shifted to the creation of community programs to address poverty and improve health. The late Larry Slaughter was a Black Panther. I met him in the decade that followed the Hough riots in Cleveland at Myron T. Herrick Junior High School. He was a well-established presence in the building; I had recently arrived from an across town senior high school. He taught industrial arts; I taught English, but most importantly, we both taught children. Within weeks of my arrival in the school, Mr. Slaughter confronted me and tried to dissuade me from making home visits in the neighborhood. I was determined to contact the parents of truant/disruptive students; he was equally determined that I would not","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133786887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online Team-Based Learning in Teaching Hyponatremia Among Medical Clerks of the University of Santo Tomas Faculty of Medicine and Surgery, Philippines","authors":"M. Marcial","doi":"10.35460/2546-1621.2022-sp14","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp14","url":null,"abstract":"Objectives: To determine if online team-based learning (TBL) is effective in improving knowledge outcomes and confidence about hyponatremia in its clinical recognition, classification, diagnostic work up, and management among fourth year medical students Study design: A quantitative evaluative design. Population and Setting: Fourth year medical students (medical clerks) rotating in the Department of Medicine, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines from July to December 2020. Methodology: A modified TBL workshop is adopted in teaching fourth year medical clerks about hyponatremia. The TBL session was held with a group of medical clerks weekly from July to December 2020. As a pre-workshop preparation, the medical clerks were assigned to read ahead of time the clinical practice guidelines on the diagnosis and treatment of hyponatremia developed by the European Renal Best Practice. After reading it, they were asked to answer an Individual Readiness Assessment Test (IRAT) composed of 20 case-based multiple-choice questions (MCQ). The group was thereafter divided into 4 subgroups and asked to discuss the same MCQ-based exam and present it as a Team Readiness Assessment Test (TRAT). As each subgroup presented their IRAT, the facilitator discussed the underlying concepts for each question and its application in actual cases of hyponatremia. The facilitator then summarized the learning outcomes at the end of the TBL workshop. For team application (TAPP), the students created a concept map and formulated admitting orders. The medical clerks were then surveyed on their confidence in hyponatremia diagnosis and management during pre-TBL workshop, after IRAT, after TRAT, and after discussion with the facilitator. Statistical Design: Descriptive statistics were used to summarize the study variables and included the mean, standard deviation, frequency, and percentage. Within-group comparisons of different outcomes across the different timeframes were conducted using one-way multivariate analysis of variance (one-way MANOVA). Cognizant that the study has multiple outcomes or dependent variables which were compared at four different timeframes, multivariate analysis was utilized to minimize the inflation of family-wise errors (FWE). Results: Comparative analysis indicated that the mean readiness scores of the respondents after TRAT was significantly higher (t=–91.61, p=0.001) compared to the mean readiness scores after IRAT. Comparative analysis using paired t-test indicated that the mean confidence scores of the respondents in the recognition, diagnosis, and treatment of hyponatremia were significantly higher among the respondents after the IRAT (t=–24.26, p=0.001), TRAT (t=–34.58, p=0.001), and facilitator discussion (t=–42.72, p=0.001) approaches compared to the mean pre-TBL confidence score. The mean knowledge score of the respondents on the creation of a concept map and the formulation of admission orders of patients w","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123487833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Combined Flipped and Classroom-based Instruction in Teaching Pulmonary Ultrasound to First-year Medical Students","authors":"J. Visperas","doi":"10.35460/2546-1621.2022-sp12","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp12","url":null,"abstract":"Background and Objectives of the Study The study aimed to determine the effectiveness of combining flipped classroom on pulmonary ultrasound instruction in first-year medical students with traditional classroom-based instruction and compared it to traditional classroom-based instruction alone. The insights of the teachers and the students on the implementation of both interventions were also evaluated. Research Methodology This is a mixed qualitative (concurrent triangulated) and quantitative research. Baseline procedural knowledge and skills of a total of 282 students on the lung ultrasound scanning using pre-test 20-item summative test, multiple-choice question type of examination, and a pre-test narrative test on lung ultrasound were obtained. A post-intervention summative assessment and narrative test were administered. Statistical analyses were done to compare the scores. A thematic analysis was done to evaluate the responses to the survey. Results 138 students were randomly assigned to the classroom-based instruction group, while 144 students in the combined flipped and classroom-based instruction group. The number of students who passed the summative (MCQ) test and were given flipped classroom and classroom-based instruction increased (6.3% to 79.9%; p<0.001) and the number of students given classroom-based instruction only, significantly increased (4.3% to 79.9%; p<0.001). The number of students who passed the narrative test and were given flipped classroom and classroom-based instructions increased (2.1% to 84.0%; p<0.001) and the number of students given the classroom-based instruction only, also significantly increased (3.6% to 84.2%; p<0.001). The students appreciated the classroom-based instruction because of the knowledgeable facilitators, the very concise approach, that is understandable and done in real-time. In addition, the flipped classroom was likewise helpful and a good introduction before the classroom-based instruction. The facilitators have noticed that the ease in instruction was influenced by the student’s enthusiasm and willingness to learn. Conclusion Flipped classroom in addition to classroom-based instruction, and classroom based instruction were effective in teaching pulmonary ultrasound to First-year medical students Key words: flipped classroom, lung ultrasound, pulmonary ultrasound, medical school, medical students, medical education, blended classroom, classroom-based instruction, ultrasound, ultrasound medical education, video-based instruction","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130468491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare: Is it a Business or a Profession?","authors":"Maria Graciela Garayblas-Gonzaga","doi":"10.35460/2546-1621.2022-sp09","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp09","url":null,"abstract":"","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134156918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Online Learning In The Internal Medicine Rotation Among Medical Clerks During The Covid 19 Pandemic and Lockdown","authors":"M. Marcial","doi":"10.35460/2546-1621.2022-sp07","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp07","url":null,"abstract":"Background: The impact of online learning during internal medicine rotation among graduating medical students was evaluated during COVID 19 pandemic. Objectives: The study aimed to gauge acceptability of a self-directed learning, recognize frustrations, identify coping mechanisms, assess rate of learning, evaluate study habits and appraise level of readiness in handling actual patients later in practice among graduating medical clerks. Methodology: An ambispective cohort design study involving both retrospective and prospective follow-up of respondents. The retrospective component involved blended learners with clinical experience (Group 1). The prospective component included online learner with clinical experience (Group 2) and online learner without clinical experience. Results: Group 1 showed that they favor pure traditional learning over pure online learning in contrast to the other 2 groups which rated acceptability of online learning high. All groups had high levels of frustration with their inability to experience actual patient exposure, had moderate to high level of coping mechanisms, and rated high the traditional learning and blended learning methodologies. In contrary, all groups rated low to moderate contributions of online learning to their learning. Group 3 had a significantly higher mean overall readiness score compared to the two other groups. Conclusion: The study showed the different levels of impact of online learning to the different population of medical clerks in terms of its acceptability as an alternative way of learning. Actual patient exposure is of main concern while different coping mechanisms maximize knowledge acquisition. Key words: Online learning, self directed, COVID 19 pandemic, Medical clerks","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130329704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The University of Santo Tomas Hospital (USTH) 2022 Institutional Chest Pain Pathway: Approach to Diagnosis, Risk Stratification, and Management","authors":"J. L. Tarranza, Christine Joy Bongon, Maria Monica Valdez, John Paul Tiopianco, Alexander Reyes, John Patrick Ona, Don Robespierre Reyes, M. Ramirez, Aileen Cynthia De Lara, C. Mendoza, Wilson Tan de Guzman, Manuel B. Zacarias, E. S. Caguioa, Milagros E. Yamamoto","doi":"10.35460/2546-1621.2022-sp03","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp03","url":null,"abstract":"This clinical pathway for the diagnosis and risk stratification of patients presenting with acute chest pain, including acute coronary syndromes, provides recommendations and algorithms for clinicians to diagnose, risk stratify, and manage acute chest pain in adult patients. The writing committee reviewed existing international and local guidelines. Modifications to the algorithm following face-to-face and virtual meetings resulted in expert decisions written as recommendations and presented in a flow diagram format. The USTH Chest Pain Pathway provides guidance based on current guidelines and recommendations on assessing and evaluating acute chest pain, tailored to local needs and institution-specific facilities. We recommend its use to ensure quality patient care in the hospital. Key Words: angina pectoris, acute chest pain, acute coronary syndrome, clinical decision pathway, diagnostic pathway, risk stratification, emergency care","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128894482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Target-Oriented Clinical Skill Enhancement (TOCSE) Builds Up Confi dence of Fourth-Year Medical Students During First-Time Patient Encounter: An Effective Bridging Tool After Online Didactic Undergraduate Classes During the COVID-19 Pandemic","authors":"Maria Faye Anne S Gomez, Leonid D Zamora, Paul John Ablaza, M. Marcial, L. Mercado-Asis","doi":"10.35460/2546-1621.2022-sp15","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp15","url":null,"abstract":"Background and Objective: Teaching clinical skills to undergraduate medical students has brought significant challenges during the COVID-19 pandemic. Patient discussion utilized hypothetical cases from history taking to diagnosis and management. Further, everything was delivered online. Target-Oriented Clinical Skill Enhancement (TOCSE) is a teaching and learning tool that integrates the basic medical sciences, such as anatomy, physiology, pathology, microbiology, and pharmacology, at the clinical level. TOCSE has been proven to improve the clinical performance of fourth-year medical students. However, clinical confidence remains an issue, especially for medical students on pure online mode of learning during the pandemic. Therefore, this study was undertaken to determine if TOCSE also facilitates the development of confidence in the clinical performance of 4th-year medical students during the first-time patient encounter after online undergraduate classes. Methods: Eight-item Clinical Performance Confidence Scale survey was performed at three (3) time points of fourth-year medical student’s rotation in the Department of Medicine: (1) prior to the deployment to the outpatient department (Pre-OPD), (2) after the first-time patient encounter without TOCSE workshop (Post-OPD no TOCSE), and (3) after the patient encounter with TOCSE workshop (Post-OPD with TOCSE). Mean and standard deviations were used to summarize the confidence level of the 4th-year medical students, based on the 10-point differential scale being 0 as not confident at all and 10 as very confident. Wilcoxon Signed Rank assessed improvements of confidence level from Pre-OPD to Post-OPD. Effect sizes were also calculated to compare the improvement in the items. All statistical tests were performed in SPSS version 26.0. P-values less than 0.05 indicate a significant increase in the confidence level of 4th-year medical students. Results: There is a significant increase in the clinical confidence of 4th-year medical students from Pre-OPD to Post-OPD no TOCSE (mean ± SD: 6.32 ± 1.02 to 7.06 ± 0.95, p<0.001). Comparing the eight items between Pre-OPD and Post-OPD with no TOCSE, performing a complete physical examination has the most remarkable improvement. Further, there is a significant increase in the clinical confidence of 4th-year medical students from Post-OPD no TOCSE to Post-OPD with TOCSE (mean ± SD: 7.06 ± 0.95 to 7.51 ± 0.89, p<0.001). The performance of a complete history-taking has the most considerable improvement (7.29 + 1.03 to 7.89 + 1.01, p<0.001). Correspondingly, the most significant increase in the clinical confidence of 4th-year medical students was seen among the Post-OPD with TOCSE compared to their Pre- OPD confidence scores (mean ± SD: 6.32 ± 1.02 to 7.51 ± 0.89, p<0.001). Among the eight items between Pre-OPD and Post-OPD with TOCSE confidence scores, the item on performing a complete physical examination has the most remarkable improvement (5.67 ± 1.37 to 7.20 ± ","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117248960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Development of Physical Diagnosis: Historical Perspectives","authors":"Isaias A. Lanzona","doi":"10.35460/2546-1621.2022-sp04","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-sp04","url":null,"abstract":"The history of physical diagnosis started with Hippocrates and his school. History taking, inspection, palpation, and sometimes immediate auscultation and examination of the urine are fundamental diagnostic tools. The Hippocratic Corpus and Galen’s authoritative theoretical writings dominate medical thinking for over 1000 years. Clinical examination advances through Vesalius and Morgagni’s discoveries of human dissection (1543) and pathologic anatomy (1761) respectively. The Vienna school through Auenbrugger introduces percussion in 1760. The Paris school formally establishes physical diagnosis with the invention of the stethoscope by Laennec in 1816.","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126597325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Myo-inositol in Improving Pregnancy Rate and Regulation of Menstrual Cycle for Patients With Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis","authors":"Ruela Joyce L. Sigue, D. Decena","doi":"10.35460/2546-1621.2021-0141","DOIUrl":"https://doi.org/10.35460/2546-1621.2021-0141","url":null,"abstract":"Background: Polycystic ovarian syndrome (PCOS) is a common, reproductive endocrinopathy associated with ovarian dysfunction, cardiovascular disorders, obesity, and infertility. Myo-inositol is a novel treatment for women with PCOS that claimed to have improved fertility rate in this population. This systematic review and meta-analysis examined the effect of myo-inositol on pregnancy rate, menstrual cycle, and adverse effects from randomized controlled trials (RCTs). Methods: RCTs that evaluated the efficacy of myo-inositol in improving pregnancy rate and regulation of menstrual cycle in women with PCOS. Electronic databases were searched and studies published up to October 24, 2021 were included in the systematic review and meta-analysis. Study selection and assessment of quality were conducted independently by two review authors. Results: Seven studies with 729 patients treated with myo-inositol and 677 patients treated with placebo and/or metformin were included in the analysis. The research groups did not diverge significantly in terms of basic characteristics, such as age, adnexal or uterine pathology, body mass index, and duration of infertility. In the myo-inositol group, regulation of the normal menstrual cycle is at 20%, significantly higher than the metformin group at 12%, (p<0.001). However, there is no significant difference in the pregnancy rate between myoinositol and placebo (p=0.42) and/or metformin (p=0.17). Conclusion: This systematic review and meta-analysis showed that myo-inositol can be an alternative treatment for PCOS in terms of regulation of menses and may improve the success of spontaneous pregnancies. However, additional randomized, double-blind controlled trials with larger sample sizes, low heterogeneity, and uniform inclusion criteria are recommended to establish the effects of myo-inositol on PCOS treatment and pregnancy rate.","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134575697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}