LEPTOSPIROSIS: What You Need to Know!

 🚨 What is Leptospirosis?

Leptospirosis is a bacterial infection caused by the Leptospira bacteria. It’s commonly spread through floodwater contaminated with animal urine, particularly from rats. During the rainy season or after natural disasters, the risk of leptospirosis spikes—especially in low-lying areas with poor drainage.

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🧬 How is it Transmitted?

You can get leptospirosis when the bacteria enters the body through:

• Cuts or open wounds

• Mucous membranes (eyes, nose, mouth)

• Ingesting contaminated food or water

Animals such as rats, dogs, pigs, and livestock can carry and shed the bacteria in their urine. Once this urine mixes with water or soil, it becomes a potential source of infection.

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⚠️ Common Symptoms

VITAMIN D SUPPLEMENTS TO PREVENT/TREAT COVID?

I can always hear radio advertisements regarding Vitamin D3 supplementation in preventing diseases especially COVID patients. In fact, I have one patient before who had been prescribed by another doctor of Vitamin D3. I have come upon a good video in you tube wherein it discusses the merit of using vitamin D3 supplementation as a treatment for COVID and cites good, credible clinical trials and medical studies about it. (I will link the said youtube video below:)

VITAMIN D AND COVID NEW STUDIES - EVIDENCE FOR A PROTECTIVE ROLE OF VITAMIN D IN COVID BY DR. MIKE HANSEN

So regarding Vitamin D supplementation: according to studies, vitamin D insufficiency MAY INCREASE THE RISK of COVID and Covid complications BUT vitamin D supplementation IS ONLY VALUABLE TO THOSE WHO ARE VITAMIN D DEFICIENT. Meaning Vitamin D supplementation for those who are Not Vitamin D Deficient may not be of great value.

HABITS TO BREAK TO BUILD A BETTER YOU

H.A.B.I.T.s TO BREAK TO BUILD A BETTER YOU.

Health Hints by Alexandra Nicole Torres (HealthCare Magazine)

PhotoCredit: Dreamstime.com

Breaking free from an unhealthy routine to build a good one requires time, patience and commitment - it's a process. Let's face it, we all have our guilty pleasures that are really difficult to depart from.

To Guide us on our Journey, let's remember the acronym H-A-B-I-T:

1. (H)AVE A GOAL. In order for you to be successful, you must learn to KNOW WHAT YOU WANT. The key to building a solid plan is knowing yourself and knowing what you really want to do and what you want to achieve.

GROUP-A BETA HEMOLYTIC STREP (GABHS) PHARYNGITIS

Photo Credit: Dr. James Heilman from Wikipedia

PHARYNGITIS

: MC caused (30-60%) by viral infection in adults – rhinovirus

: caused by bacterial infection in adults in only in 5-10% - GABHS

: accounts for 30-40% of case in children

: prevents rheumatic fever – by starting antibiotics 10 days after onset of symptoms

: SORE THROAT from Epstein-Barr virus (82%) – found in pxs with Infectious Mononucleosis –

• Tx mostly consist of

1. Supportive care

2. Rest

3. Antipyretics

4. Analgesics

 

GABHS-PHARYNGITIS

: MC pathogen responsible for most case of bacterial pharyingitis – BUT accounts only 10% of adult cases

            : Symptoms – usually rapid onset:

- Severe sore throat

- Odynophagia

- Cervical lymphadenopathy

- Fever

- Chills

- Malaise

- Headache

- Mild neck stiffness

- Anorexia

Alternative Ways of Continuing Professional Development (CPD) Compliance during the COVID-19 Pandemic

Abolish CPD Call of Certain Sectors of Society

About 4 years after the Republic Act 10912 or the "Continuing Professional Development (CPD) Act" became law, the presidential son, Rep. Paolo Duterte recently said that he will be proposing a bill to repeal the law authored by former Senator Antonio Trillanes, IV. 

He also emphasized that he will personally work with his colleagues in the House of Representatives, the senators in the Senate and with President Rodrigo Duterte to advocate for the abolition of the said law. He cites the undue burden that the law has imposed to hard working and selfless professionals especially during the COVID-19 Pandemic. 

It is noted that the said law has mandated that professionals has to comply with prescribed number of CPD units of their profession before they will be allowed to renew their Professional Identification Card (PIC) with the Professional Regulations Commission.

UPDATE on the Status of COVID-19 VACCINES

With the advent of fast-paced technology and media reports, we can surmise that with the COVID-19 pandemic, the development of a vaccine can also be at a record speed but reading an article by Dr. Sanjay Gupta at CNN, this reality is grim so far regarding COVID-19 Vaccine Development.

1 Revealing Point: According to the Milken Institute, although there are 254 treatments and 172 vaccines currently in development to fight COVID-19, so far, there is only 1 PUBLISHED STUDY of a vaccine which is trialed in Humans. Other vaccines/treatment in development are either press-releases or pre-print reports.

Photo Credit: European Pharmaceutical Review

For those who have no idea on the significance of a Published Study on vaccine development or any other thing basically is this - published studies are subjected to peer review, which by essence brings down the expertise of most if not all of the science disciplines to screen this studies and POINT SOME POTENTIAL ERRORS of the study that may be unintentional and also makes the study and eventually the science or the vaccine BETTER.

No Approved Therapeutic Claim!

I had always wanted to talk about this with my patients but I have not had the time to sufficiently discuss this.

As a medical doctor I cannot and will not endorse any product which has a 'No Therapeutic Use' on its label. I am for any thing herbal and natural but it does not mean that I will disregard the safety of my patients.

I have a professor in Medschool that is an advocate of herbal medicine but she is also a medical doctor. And so, while advocating for herbal medicine, she tediously explained the process and the science of preparing an herbal medicine, and so let's take some important points about it:

• Herbal medicine preparations should be an exact ....science. This simply means that exact measurements should be used. Meaning if you prepare (let's take for an example Sambong leaves) leaves, and you are instructed to take 5 leaves. You should take leaves with proportionally same size with each other. There are some preparations that prescribes the exact size of the leaves like for example (I am only hypothesizing here) Sambong leaves should have 1-inches leaves while recommendations for Malunggay leaves is only 1-cm leaves. AND there are different preparations for barks, roots, fruits, etc.
• Even the procedures in preparations should be exact. As my mentor explained, preparing a decoction is also exact meaning a certain decoction is prescribed with a 1 cup water while others are prescribed with a 1 glass water (yes a cup is different from a glass!). If you boil a decoction for 30 minutes and you start the time from the moment you pour the water into the pot, it may be a whole lot different if you start the 30-minute time on the moment that the water boils. Plus there's a difference if the instruction is like 'You boil the leaves with 2 cups water until the point that the water remaining is only 1 cup.'
• The time of the day when you pick up a leaf/root/bark matters. We had been advised that the perfect time to pick leaves is in the morning just before the sun rises as the leaves has the perfect consistency to it.

Simple Cure to the Most Common ENT (Ears, Nose, Throat) Problem: BUGs in your Ears!

Various specialties share common factors that makes them common to other specialization in the realm of the art and science of Medicine. These factors make the practice of medicine overlap with other field of specialization. There are some things though that are totally unique in one specialty of the art of healing.

Take ENT for example or for medical professionals - Otorhinolaryngology or as defined, the field of medicine specializing in the study of the (E)ars, the (N)ose, and the (T)hroat thus the word E.N.T.. But as as I've mentioned above, some specialization overlaps with another, and so the nose and the throat can also be scrutinized and studied under the field of Internal Medicine in general, the field of Surgeons specifically the Plastics and Reconstructive Surgeons and to some extent the field of Dermatologists. But while the nose and the throat can be shared commonly, the Ears are exclusively of the field of ENT. It deals exclusively of the realm wherein no other set of specialized doctors have handled.

There are many afflictions that involves the Ears, but no other more common than the most simple problem - creeping bugs crawling inside your ears. This is not just a nightmare to some arachnophobes or entomophobes but also strikes fear to the ordinary patient who imagines a creepy crawling insect inside your ear canals. If this thought bothers a 'brave' adult patient, just imagine how a child with a bug in his/her ear would feel.

What would you feel?

 So first things first, how would you know that a bug or insect is really inside your ears? Your ear canal actually hosts several cranial nerves that renders it super sensitive to a variety of sensations. Tenderness may be felt due to weather changes or some kind of allergy.

Some signs and symptoms of insects inside the ear canal presents as pain, swelling, crackling or buzzing sounds but the most common symptom is severe pain especially if you keep on poking the insect down your ear canal. In some instances, some biting or stinging sensations may also be experienced. Some may also report certain levels of hearing loss or dizziness.

Bakit Nga Ba Tinutubo ang Pasyente? (Indications for Intubation for the Layperson)

By: Viktoria Ines Matibag, MD

Siguro naman nakakita na kayo ng mga pasyenteng nakatubo sa mga drama. Maraming maling konsepto na tinuturo katulad na lamang ng: 

1. Nagtutubo lamang ang pasyente kapag wala nang pulso, 
2. Hindi nakakapag salita ang may tubo dahil nga nasa daluyan ito ng hangin,
3. Hindi makakahinga ang pasyente kapag may tubo.

Translation: Don't mistake medical drama series in TV for the real thing. Often times, there are specific important details that is missed out in TV that if you missed it out in real life could result to patients getting harmed. These are the common misconceptions about Intubation: 

1. We only intubate patient if they are already dead or has no pulse 
2. The patient can't express himself if a patient is intubated 
3. The patient can't breathe if he/she is intubated because a TUBE is inserted down his THROAT!

Hanging by a Thread: Tips on Reviewing for the Physician's Licensure Exam

As much as I wanted to update this blog as often I can, unfortunately I cannot. I am currently reviewing for the August 2014 Medical Board Exam and it's officially about 60+ days to go... so I would like to personally apologize and at the same time thank everyone who are avidly checking the site and using the site...

As a stress buster in a way, I'll be updating the site and at the same time providing you with insights on my experience reviewing for the boards. As you all know, reviewing can cause burnout fastet than any training there is... as advised by my peers I came up with these time needed tips in conquering the Physician's Licensure Exam.

Tip #1: Read a little, Master a lot.

One common feedback I get from those who conduct reviews and those who took the boards and PASSED! is you don't have to read every book in medschool cover to cover. I mean if you haven't done that during medschool, it's certainly not advisable to do it during review where TIME is literally GOLD and should be spent wisely. The key is RECALL and it's certainly reasonable advise, I mean what's the use of having read Harper's, Guyton, Schwartz or even Solis if you can't even recall the answer during your exams? There's a study out there conducted to find out what's the most effective way to recall something you read and they found out that REPEATITION is the key. They say you more likely to remember something if you read it twice, thrice or even 4x. So read those review handouts as often as you can.

Tip #2: Read, Read and Read.

Tip #3: Treat leisure time as REWARD not as INCENTIVES.

I can't understand this at first but upon explanation, I totally get the point. You ever have moments where you are suppose to finish something but you take a look at your laptop, your tablet or your tv and you say, ok "I will finish what I'm suppose to finish after this episode or after playing Clash of Clans or Candy Crush." (Sounds familiar?) Eventually after the night is through, you end up not finishing what you are suppose to do or worse, you have not even started. This is where the tip comes in, treating your leisure time as reward simply means, you can have your leisure time AFTER finishing what you're supposed to do. Meaning, "I can watch this episode of Game of Thrones if I finish reading 10 pages of my handouts, as a REWARD".

Tip #4: Read, read and read.

Tip #5: Exercise

Someone can easily fall into the trap of neglecting your health and your body when your routine is: Sleep-Eat-Read-Eat-Read-Eat-Read-Sleep. Burnout and stress can easily creap in once you don't take time to stretch, smell the flowers and shake your butt alittle. Exercise   releases endorphins that makes you feel good and at the same time facilitates easy retention when you read. So do take time to exercise.

Tip #6: Read, read and read.

Tip #7: Sleep!!!

No matter what anyone says, take time to sleep. Sleep gives your body a chance to rejuvenate and at the same time gifes your brain cells a breathing room to convert what you read into memory. One can easily read whole day and not sleep thinking that sleeping is a waste of time but studies show that a person who have ample sleep can recall mire compared to those who have little or no sleep at all.

Choosing a Specialty

My favorite part of my job is teaching. There, I’ve said it. Yeah, it’s cool picking apart diseases and mix-n-matching treatment regimens for the optimal balance of cure and side effect. I love hand-holding people through concepts that are far beyond their educational level and helping patients and families make impossible decisions with uncertain data.

But give me a new third-year medical student who’s been dropped in the middle of the hospital for her First Real Rotation Ever, and I am just in heaven. I love teaching med students.

One of the things I love the most is helping them figure out what flavor of doctor they want to be. Third year is all about sampling it all, and experiencing what actually happens in the various medical specialties. You rotate through Surgery. You rotate through Internal Medicine. You rotate through Family Practice. You rotate through Anaesthesia. You rotate through Psychiatry. In fourth year, you’re supposed to be narrowing it down to your most likely options for residency.

Tips on Excelling on Rotations

I know that my performance on clinical rotations is important for how I will be assessed. How can I distinguish myself?

Response from Sheila M. Bigelow, DO Resident Physician -- Pediatrics, UH Rainbow Babies and Children's Hospital, Cleveland, Ohio

Clinical rotations can be very challenging. For the first time, you're expected to follow patients, present on rounds, show your medical knowledge, and work well in a team environment with people who are new to you, knowing that you'll be moving on before long. Not only are you expected to meet the basic requirements, you are expected to do well enough to earn an honors grade or a strong letter of recommendation from the attending.

Fortunately, there are some "must know" tricks that can help you distinguish yourself and help get the grade or letter that you want.

Thinking of Quitting

Question:

Medical school and residency can be tough physically, mentally, and socially. What's the best way to get through those tough times when all I want to do is quit?

Response from Sheila M. Bigelow, DO
Resident Physician - Pediatrics, UH Rainbow Babies and Children's Hospital, Cleveland, Ohio




Depression in Medical Students

Medical school and residency are some of the biggest challenges of our careers. Along with the good, exciting times come the hard, rough times. Long hours, little sleep, and a high-stress environment all create the perfect storm. These feelings can fall anywhere in the spectrum from burnout and depression to suicidal thoughts and suicide attempts.

Deep Tendon Reflex

In a normal person, when a muscle tendon is tapped briskly, the muscle immediately contracts due to a two-neuron reflex arc involving the spinal or brainstem segment that innervates the muscle. The afferent neuron whose cell body lies in a dorsal root ganglion innervates the muscle or Golgi tendon organ associated with the muscles; the efferent neuron is an alpha motoneuron in the anterior horn of the cord. The cerebral cortex and a number of brainstem nuclei exert influence over the sensory input of the muscle spindles by means of the gamma motoneurons that are located in the anterior horn; these neurons supply a set of muscle fibers that control the length of the muscle spindle itself.

Hyporeflexia is an absent or diminished response to tapping. It usually indicates a disease that involves one or more of the components of the two-neuron reflex arc itself.

Hyperreflexia refers to hyperactive or repeating (clonic) reflexes. These usually indicate an interruption of corticospinal and other descending pathways that influence the reflex arc due to a suprasegmental lesion, that is, a lesion above the level of the spinal reflex pathways.

Ins and Outs of Being an Intern

Question

How will things change as I transition from medical student to intern?

Response from Graham Walker, MD
Chief Resident, St. Luke's-Roosevelt Hospital Center, New York, New York

As an intern, you are the primary patient data collector. It's probably the most important part of the team. Welcome to the role.

Your first days as an intern may seem like just another medical school rotation; you're still writing notes, but what you write matters much more now. Your team will rely on you to know your patients and their numbers inside out, so if you say the creatinine is trending down, it better be.

Transitioning to INTERNSHIP

In less than 60 days, I will be going into internship and most of my posts will also be transitioning about internship and hospital duty. Thanks for your continued support.

MedicalStudent soon to be MedicalIntern... Hopefully...

Post-Exam Remorse and Realizations

PhotoCredit: Well.Blogs.Nytimes.com

I just made it out of an Exam this day and I just woke up right now. Being in Medical School, the stress of taking an exam and the usual remorse of not studying enough is not an unusual feeling. You can say that it's a cycle that will repeat over and over again and nothing will ever make you become immune of it. It's become of this that I realized a few things that I'd like to share to everyone that you may not or may have realized already:

1. Things don't always work out as you planned in Med School. I've realized this lesson each time I do things and in fact I can fairly conclude that it should be part of a Medical Student's life. It is the norm rather than the exception. There are far too numerous factors that can be in play that will make our lives as uncertain as it's already is ranging from self-deserving consultants, toxic-bringing residents, inconsiderate professors, unsupportive classmates, uncooperative family or your own lazy self. 
2. You cannot give up. After a disappointing exam, you pick yourself up and move on. There is basically nothing you could do about it anyway that you should have done before the exams. It's already too late to undo things that have past and energies are better spent on preparing for things to come. So stop moping, eat your comfort food or have a satisfying sleep, then get over it.

Accepting the Inevitable

All are in the mood of merrymaking, decorations are everywhere, I hear carols on the radio, even the TV is singing Merry Christmas, and yet here I am, with my handy dandy notebook, notes, highlighter and ballpen - STUDYING for my exams on the day our vacation ends.


It's not uncommon I guess for medical students to miss out on important events, be late on occasions or having no idea at all of happenings all around them. With the constant wave of exams and lectures, with the unending reports and case studies, it's easy to say that medical students cannot afford to care for anything else than studies. It may be depressing to think about it but it's the reality of being and wanting to be a doctor. In fact, it can safely be concluded that it would be terribly worse during internships, residency or even after practicing as consultants. 

The Art of Expectations in the Emergency Room

This article caught my attention as an intern once relayed to me his experience in the Emergency Room wherein the patient, after all that had been done for them, complained and maligned the interns and the staff of the ER. As unfair as it may seem, the disconnect between patient's expectations against hospital protocol may well be the very reason of this incidences. Or I may be wrong... nevertheless, this article is worth reading...


The Art of (Emergency) Medicine

Jeffrey Wonoprabowo, Medical Student

I had seen the patient. I had come up with my assessment and plan. I discussed it with a senior resident and now it was time to present it to the attending. As I wrapped up what I thought was a fairly decent patient presentation, my attending asked me what the patient wanted. I stammered. What the patient wanted? Wasn’t that obvious? They come in to the Emergency Department with a chief complaint and we’re supposed to fix it. Right?

Pre-Clerkship Exposure Duty Rotations

PhotoCredit: MedObserver.Com

          Our exposure duty this year had been extended to 6 months instead of the usual 3 months as a result, I presume, of the first ever student consultation spearheaded by our first alumni dean of the college. The purpose of which is suppose to orient us and make us be prepared for our upcoming internship duties in a few months to come.
          One thing I learned about these duties are they are basically WORTHLESS. Basically we don't do anything and instead we answer to the whims of the residents on duty. We do whatever they say in the absence of real work that may prepare us for the grueling work we will do as interns. It's good for those like me who had hospital experiences during our pre-medical course but for those who haven't, it's totally a purposeless.
          For the benefit of those who would otherwise learn from these experiences, I will try to give out some tips to make it a rewarding and a learning one: