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.