The Official Newsletter of Jose B. Lingad Memorial

and financial assis-tance. JBLMRH will continue to support DOH on monitoring our Dengue Vac-cine Recipients in the Region.Jose B. Lingad Memorial Regi...

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The Official Newsletter of Jose B. Lingad Memorial Regional Hospital


ISSN 2018-001


PAMAGLINGAP NEWSLETTER ▪ ISSN 2018-001 Editorial Board Editorial Consultants Monserrat S. Chichioco, MD Alfonso C. Danac, MD Misael C. Cruz, MD Emerita C. Danac, MD Editor in Chief Gertie L. Jimenez, MD

My congratulations to Jose B. Lingad Memorial Regional Hospital (JBLMRH), for putting up your very first newsletter which features the hospital and all its service provisions. Truly, this institution does not only abide by its policies and standards in healthcare management and service delivery, but also, it continuously works and makes its way to excellence by documenting all its accomplishments in this newly created hospital publication, the Pamaglingap Newsletter. This newsletter also serves as a medium in disseminating different health information to the public. It gives everyone the opportunity to increase their awareness and understanding of various health concerns . Together, let us continue the work of excellence in improving the quality of lives of every Filipino by making health information and updates easily accessible and available partnered with quality healthcare delivery. Thank you and Mabuhay!

Associate Editor Jose Erwin L. Enriquez, MD Managing Editor/ Lay-Out Artist Rechelda G. Dione, RN Staff: Abner B. Alavazo, MD Ana Kristine V. Bermudes, MD Mia D. Buendia, MD Adriane P. Carreon Christine Joy M. Castillo Kevin Catap Madelene Jezer T. Co, RND Carl Genesis G. David, MD Patrick L. David, MD Michael P. Dayrit, MD Crisle O. Dychingco, MD Sam Angelo Esteban, RN Celeste B. Palad, RND Arnold Angelo M. Pineda, MD Maureen B. Malabong , RND Genriech N. Reoyan, MD Dante Carlo V. Valenzuela, MD Contributors: Clark Steven S. Dela Paz Agnes M. Gaddi, MD Andrea M. Gaddi, MD Leslie T. Garcia, MD Janet T. Miclat, MD Sandra M. Razon, RN

I am very excited and pleased to present to you, the first issue of Jose B. Lingad Memorial Regional Hospital’s newsletter, Pamaglingap. In general, this newsletter shall serve as your source of information as to the activities of JBLMRH, health innovations, its implemented health programs in line with the Department of Health (DOH). Current public health issues, DOH interventions and initiatives to mitigate current public health concerns shall also be published through Pamaglingap. The goal of this newsletter is to keep you informed on JBLMRH’s achievements, projects, initiatives and events. I extend my compliments to the editorial team, spearheaded by the Editor in Chief Dr. Gertie L. Jimenez, for their tremendous efforts which made the creation of this newsletter possible.

The first issue of the Pamaglingap shall give you a glimpse of the roots of JBLMRH, how our institution began and how it flourished from a simple healthcare institution to one that is now recognized as a leading teaching-training hospital in Region III. Furthermore, it highlights the development of the Regional Biomarine Poisoning and Toxicology Center, one of the specialty centers that JBLMRH shall reinforce under the Philippine Health Facility Development Plan 2017-2022.

02 … Regional Director’s Message

02 … Medical Center Chief’s Message 03 … Editorial 03 … Pamaglingap Staff Attends News Writing Workshop 04 … JBLMRH Through the Years 04 … Dengue and Japanese Encephalitis 05 … DOH Service Delivery Network 06 … The Beginning… ORL-HNS 06 … Establishment of Poison Control Unit in JBLMRH 07 … Living with Dignity, Comfort and Quality of Life 08 … Focus: Cervical Cancer

You will also have a chance to glance through the numerous awards that we have received from the Central Luzon Excellence Awards 2018 such as the Excellence in ASEAN 2017 Deployment, Most Innovative Newborn Screening Facility, Mother and Baby Friendly Hospital Initiative Award among others, all of these made possible by the combined efforts of our hard-working doctors, nurses and staff. It shall also highlight the positive feedbacks that we get from our clients proving that JBLMRH is truly an excellent and competent healthcare institution. I encourage you all to take the time to read the important information enclosed regarding our institution. I hope that through Pamaglingap, which shall be published semiannually, we will be able to feel more connected, updated and informed.

09 … From A Patient’s Point of View 09 … Ketogenic Diet: A Nutritionist’s View 10 … JBLMRH Team Building 10 … COMMUNITY OUTREACH: JBLMRH conducts Surgical Caravan and Reaching the Unreached Last Mile Medical Missions 11 … Sustaining Excellence in Health 11… Make Your Hospital Proud

EdItorIal Words that echo from the deep. Words that should reflect what we are. And yes, these are what we aim to be , and what this paper will be. is the first ever newsletter of JBLMRH, the regional hospital in Central Luzon. It was conceptualized with the aim to disseminate information about health concerns of the people in the region, as reflected by most of the patients that are referred to the hospital. It also aims to bring the employees closer together with the paper as one of the media of communication.

First meeting of the Pamaglingap Editorial Team with the Chief of Medical and Professional Staff, Dr. Alfonso Danac.

may be hidden by the stress in the workload but JBLMRH has its ways to dilute the stress for one to be able to focus on the work for our patients. Pamaglingap will feature stories reflecting the hospital’s response and actions to the healthcare needs of the people in the region.

One of its goals is to bring out the truth in certain Pamaglingap is committed to provide the issues that need clarification, to find answers to the que- public news and feature stories that are truthful, unbiased, timeries in the minds of the employees, stakeholders, patients and ly and relevant to the current health-related events. people concerned. It will not cater to fake news. Pamaglingap intends to deliver quality artiOne of the main goals of this paper is to be able cles deserving of the time of the readers - who will be the emto provide service in whatever way it can. It will be a medium for ployees, stakeholders, patients and the public. We will make dissemination about the different health programs of the hospi- sure that reading the contents of the paper will be worthy of tal in line with the Department of Health so that the public and one’s time. employees will be made aware. Here at JBLMRH, service is what This is first issue, JBLMRH’s first newsletter. we breathe, and service is what we give and it is always a serWith TRUTH in us, may we be able to SERVE you with COMPASvice with a heart. SION, being COMMITTED to provide you with EXCELLENT outWe at JBLMRH serve with compassion. It puts. Pamaglingap is a Capampangan term meaning “care”. cannot be denied that once one is in government service, there Here in JBLMRH, we treat because is always this space in our hearts to serve the underserved. It

Gertie L. Jimenez, MD After the workshop, the staff was re-organised based on their identified skills and knowledge.

Pamaglingap Editorial Team during the workshop.

The staff of Pamaglingap, the JBLMRH Newsletter, attends a “News Writing and Feature Writing Workshop” on June 14, 2018 at the Outpatient Department (OPD) Office. The workshop was held to guide staff of Pamaglingap on how to compose news write ups and feature articles, as well as orient them on the different parts of a newsletter. The lecturer is Eric V. Jimenez, editor of the local newspaper Angeles Observer and host of Clark in Action, the radio program of Clark Development Corporation (CDC). He is a former correspondent of Philippine Daily Inquirer and Malaya and the current assistant manager, Communications Division of CDC. The lecture was followed by a news writing exercise where the participants attempted to write news article based on the event.

Consultation with Dr. Emerita Danac.





Agnes M. Gaddi, MD, FPOGS, FSGOP, FPSCPC The hospital had both private and charity services until 2003 when the Chief of Hospital Dr. Venancio Banzon closed the Pay Services. In 2012, the Republic Act No. 10355, “an act increasing the Bed capacity of JBLMRH from 250 to 500” was passed. Further improvement of the hospital has taken place such that on March 2014, JBLMRH passed ISO certification 9001:2008 for the first time. Then on March 2017, JBLMRH passed the ISO 9001:2015.

The Jose B. Lingad Memorial Regional Hospital (JBLMRH) is formerly known as the Pampanga Provincial Hospital. The hospital was built on a 2 hectare lot located at Dolores, San Fernando, Pampanga donated by the late Don Juan Teopaco in 1921. When it started, the hospital catered to emergency cases with only an eight-bed capacity. With the demands of time, it increased to 50 beds with inpatient services, then to 125, 150, then 250 beds. In January 1964, with the implementation of the integration program of the thenMinistry of Health it was designated as the Central Luzon Regional Hospital and it was in this year that the hospital became departmentalized. In 1989 its name was changed to Jose B. Lingad Memorial General Hospital in honor of a previous governor of the province. It was subsequently changed to Jose B. Lingad Memorial Regional Hospital and holds its name until now.

Accreditation of the training programs started in 1983. The Department of Surgery was the first department to be accredited for residency training. The Department of Internal Medicine was accredited for training in 1987, then the Department of Ophthalmology on November 28, 1990. The Department of Obstetrics and Gynecology came next with Level 1 Accreditation in 1990 and full level II Accreditation in 1991. The Department of Pediatrics was given accreditation in January 1991, Anesthesia in January 1995 and Family Medicine in February 2014. The Departments of Emergency Medicine, Otorhinolaryngology, Head and Neck Surgery (ORL-HNS), Pathology and Orthopedics, are the departments most recently accredited. The hospital also has an Internship Training Program duly recognized by the Association of Philippine Medical Colleges (APMC). It has also been chosen for affiliation by the Angeles University Foundation (AUF) School of Medicine for its medical clerkship program since 1987. Several schools of Nursing, Midwifery, Medical Technology, Radiation Technology and Pharmacy have also been sending their students to JBLMRH for practicum.

Sandra Lou M. Razon, RN Japanese Encephalitis Virus (JEV) is the most common vaccine-preventable cause of encephalitis in Asia (Hills, 2014). The virus belongs to a vector-borne Flaviviridae family which has high case fatality rates and often has significant neurologic sequelae among survivors. The epidemiology of JEV in the Philippines is not well defined. To have data on the prevalence of JEV in the country, JBLMRH in collaboration with the DOH through its Philippine Integrated Disease Surveillance and Response (PIDSR) program started case detection and investigation of different cases of Japanese Encephalitis in the year 2015. Japanese Encephalitis Surveillance started using standard case definition of Acute Meningitis-Encephalitis Syndrome (AMES). Cerebrospinal fluid (CSF) and serum of the enrolled patients were collected and sent to Research Institute of Tropical Medicine (RITM) for confirmatory testing. Since 2015 until May 2018, 889 patients were enrolled at the AMES Surveillance. From the enrolled AMES cases, 82 patients were positive of Japanese Encephalitis. Through the JBLMRH-PIDSR program, epidemiology of JEV was defined in the country. This resulted to increase awareness of the Filipinos in terms of the spread of the disease and its prevention. Japanese Encephalitis Forums were conducted by the DOH to increase awareness on its prevention. The World Health Organization (WHO) visited JBLMRH to study cost analysis of JEV vaccine vs hospitalization to include JEV vaccine in the Expanded Program on Immunization (EPI). Surveillance of JEV became an important tool in the detection and prevention of the disease. Surveillance is truly a backbone to disease prevention

On November 29, 2017, Sanofi Pasteur announced the results of new clinical data analysis, which found that Dengvaxia is riskier for people not previously infected by the virus. Following the said announcement, the DOH halted the Dengvaxia Immunization. Enhanced monitoring of dengue vaccine recipient through surveillance was implemented. In collaboration with the DOH, JBLMRH responded through the release of Hospital Memorandum No. 2018-01 entitled Implementing Guidelines on the Management of Dengue Vaccine Recipients which includes establishment of dengue fastlane at the ER, health education and counselling of parents and vaccinees, autopsy team for mortalities, enhanced dengue surveillance, and designation of dengue room for in-patients. In January 19, 2018, Health Secretary Francisco T. Duque III visited JBLMRH to personally check admitted dengue patients. As of June 2018, JBLMRH responded to a total of 427 outpatient and 296 inpatient cases with history of dengvaxia immunization by providing medical and financial assistance. JBLMRH will continue to support DOH on monitoring our Dengue VacThe Secretary of Health, Francisco T. Duque III visits cine Recipients in the Region. Jose B. Lingad Memorial Regional Hospital.

Janet T. Miclat, MD

Family Health Cluster Head, DOH-RO3 With recent events of different sensationalized A BEmONC Facility is able to : 1. Give Parenteral (IV or IM) administration of emergency/lifehealthcare complications, it is not a wonder that many would saving drugs: oxytocin, anticonvulsants, antibiotics, and care to know what the Department of Health (DOH) is doing to dexamethasone; prevent further health related problems. It was determined 2. Perform manual removal of the placenta; that part of the solution should start from the grassroots then 3. Removal of retained products of conception; up to the proper channels, hence, the birth of Service Delivery 4. Assist in imminent breech deliveries; Network ( SDN) 5. Provide Essential Newborn Care; and SDN is defined as a network of organizations that makes arrangements to provide good quality health services that are equitable, comprehensive, integrated, and continuous, with minimum duplications and inefficiencies. To institutionalize a peoplecentered SDN is one of the strategic foci of the DOH agenda. It shall include the follow-


Provide Basic Newborn Resuscitation.

ing:  Engage the healthy as a means of promoting and preventing health.

 Engage the sick by providing services that are curative, rehabilitative, and palliative.

A CEmONC Facility is able to provide all BEmONC services  Engage affected populations to include preparedness and plus:

response during armed conflicts and disasters. 1. Emergency surgery (ex. Cesarean section, Hysterectomy);  Engage special groups where health services are focused 2. Blood transfusion; and and customized to the poor and vulnerable populations in3. Advanced Newborn Resuscitation. cluding those in geographically isolated and disadvantaged areas (GIDA), those of the Indigenous People (IP) community, JBLMRH is categorized as a CEmONC Facility along and migrant workers. with BGH and PJGMRMC in the region. Level 1 and BEmONC

Facilities are to handle Low Risk Pregnancies while CEmONC The model of care of a network shall be based on the or Level 3 Facilities are to handle High Risk Pregnancies. Primary Health Care approach that emphasizes Primary Care through strong gatekeeping. To ensure delivery of compre- High Risk Pregnancies include the following: hensive, integrated, and continuous health services, networks  Maternal age below 19 years old or above 35 years old are to have a broad range of health facilities from Primary  First pregnancy regardless of age Care Service Facilities to End-referral Hospitals, which are  Multiple pregnancy (e.g. twins and triplets) usually Level 3 facilities, or termed Apex Hospitals.  Multipara - >5 pregnancies  Placental abnormality (e.g. placenta previa) Central Luzon is fortunate to have four DOH Hospitals,  Abnormal fetal presentation (e.g. breech) three of which are Apex Hospitals, Bataan General Hospital,  History of (three) 3 or more miscarriages/abortion or 1 stillbirth (BGH), in Balanga City, Bataan, Dr. Paulino J. Garcia Memorial  History of previous CS Research and Medical Center, (PJGMRMC), in Cabanatuan  History of Pre term labor City, Nueva Ecija, and Jose B. Lingad Memorial Regional Hos History of Pre-eclampsia/eclampsia pital, (JBLMRH), in the City of San Fernando, Pampan Ovarian or cyst abnormality (e.g. myoma or ovarian cyst) ga. JBLMRH not only caters the province of Pampanga but  History of major obstetric and/or gynecologic operation (e.g. cesarean section, uterine myomectomy) surrounding provinces as well due to the wide range of services and sub-specialties that they offer. An established FP-MNCHN Service Providers AgreeThe Family Planning – Maternal, Newborn, Child, ment has allowed for a more efficient referral system espeHealth and Nutrition, (FP-MNCHN) Service Providers Agree- cially in preventing delay of services and management for ment, is a prime example of an established Service Delivery obstetric complications and emergencies. The effectiveness Network in the region, focused mainly on maternal and new- of this network is critical in addressing and preventing materborn care services, in which JBLMRH plays a vital role in the nal deaths, where in its impact is evident when analyzing manetwork. The MNCHN SDN includes three levels of health ternal health indicators such as but not limited to the declinfacilities and providers offering integrated MNCHN services in ing maternal mortality ratio in the region. a coordinated manner as depicted below. Although the MNCHN SDN is just Emergency Obstetric and Newborn Care facilities are one of many networks based on various either Basic (BEmONC) or Comprehensive (CEmONC) faciliDOH programs, it is evident that a functional SDN geared towards giving quality ties based on the level of care and services they can provide. health services upholds the DOH’s misBEmONC facilities may include Barangay Health Stasion in developing a people-centered, tions, Rural Health Units with Birthing Stations, District Hospiresilient, and equitable health system. tals, and Privately-owned Lying in Clinics.






Jose Erwin L. Enriquez, MD

In early 2016, Jose B. Lingad Memorial Regional Hospital (JBLMRH) Ear-Nose-Throat (ENT) consultant Dr. Godofredo Jose Hizon, together with a handful of young ENT specialists, spearheaded the idea of establishing a separate ENT Department. This was favorably supported by the hospital’s administration in order to cater to the increasing number of ENT cases seen in the hospital but are subsequently referred to other government institutions for management. Aiming to open an ENT training program accredited by the Philippine Board of Otorhinolaryngology-Head and Neck Surgery (PBOHNS), the department accepted its first set of residents. Having extensive support from Dr. Monserrat Chichioco, Medical Center Chief (MCC) and Dr. Alfonso Danac, Chief of the Medical and Professional Staff (COMPS) , state-of-the-art equipment and operating instruments were provided along with an office, an ENT ward, an OPD section and a dedicated operating room.

Upper Blepharoplasty

In October of 2017, the Department of Otorhinolaryngology and Head and Neck Surgery (ORL-HNS), having satisfied all requirements, was granted a 4-year accredited training program by the PBOHNS. Since its establishment the department has catered to around 6,200 patients and has surgically managed around 260 patients for 2017 alone. Today, children with swallowed coins, grandmothers with head and neck cancers, newborns with cleft lips and other community members requiring various ear, nose and throat surgeries, need not go to Manila for treatment.


Massive Thyroid Tumor Removal

Leslie T. Garcia, MD

My ultimate dream for our second home, With all the ongoing developments such as the JBLMRH, is for the establishment of the Regional Bio- planning of the infrastructure that will house the poison marine and Poison Control Unit. This will cater to differ- control unit as well as the continuous training of hospient poisoning cases in the region. The Department of tal personnel, no poisoning patient will die unnecesHealth, through the efforts of the management of JBLMRH, allotted a huge budget for this specialty service. What makes me more excited is the creation of the Poison Information Service (PIS). During my residency training, poisoning cases seen at the emergency room need to be referred to the National Poison Management and Control Center (NPMCC) located at Philippine General Hospital (PGH). With the establishment of the PIS, all hospitals from Region III can refer Dr. Leslie Garcia during the lay forum on Poison Prevention Week their poisoning cases at JBLMRH. at the Outpatient Department

In 2017, JBLMRH was able to successfully manage 375 different cases of poisoning. Youngest case that was handled was 14 years old and the oldest was sarily. 79 years old.

Ana Kristine V. Bermudez, MD Palliative Care is defined by the World Health Organization (WHO) as “…an approach that improves the quality of life of patients and their families facing the problems associated with lifethreatening illness, through the prevention and relief of suffering … affirming life and regards dying as normal process.”

“There is nothing more we can do!” This is the statement everyone dreads to hear from a healthcare professional when dealing with an illness. It makes one feel hopeless, words that seem harsh, connoting finality and death. Dying Dr. Jose Antonio U. Martin oftentimes includes pain Family Medicine Department and suffering not only on the part of the patients, but also on their families and loved ones. Pope John Paul II himself recognized that dying with dignity is a basic human right hence care and comfort is due to all. However, demand and supply for palliative care in the Philippines is not at par with one another. In fact, according to the 2015 Quality of Death Index conducted to determine which country provides good end-of-life care, the Philippines ranked 78 out of 80. The WHO has increased its reach to rally more countries towards a more holistic health care system. As response to the need for a holistic health care system in the Philippines, JBLMRH initiated the creation of a

Ms. Irene Santiago, RND Palliative Nutritionist

Ms. Cherrylyn Adolfo, R.N., Palliative Care Nurse

champion this cause, thus, the “Integrated Networking & Referral System for Palliative and Hospice Care” was created. This is a pilot project for palliative care as part of the Universal Health Care (UHC) in the province of Pampanga. The goal is to develop a referral system to improve identification and early referral of patients with palliative care needs including pain and symptom management as well as nutrition support and terminal care at home. It also aims to build capacity and sustainability within the district hospital and community setting by helping to train and educate community health providers leading to a greater number of staff with a level of competency in palliative care. The execution of the project takes place on July 2018 starting with a three-part

Dr. Ann Bermudez, Palliative Fellow, and Dr. Garcia during a Family Meeting .

Palliative and Supportive Care Unit (PASCU). Since January 2015, this unit has grown from eight to more than fifteen medical practitioners including a nurse specialized in palliative care. An Interdisciplinary and multidisciplinary approach of care was applied with Nutrition and Dietitics Service, Social Service and Pharmacy being part of the unit and referrals to other services for assistance and use of their expertise. From 200 referred and admitted patients on its first year, the unit has helped around 1000 patients for the past 3 years. Its services also grew from just accepting referrals from other departments to having its own ward for admitted patients as well as providing home care services. Discharged palliative patients need regular follows ups at home which can only be addressed if both health care providers and the local government will

Dr. Agnes Bausa-Claudio, Head of PASCU during the Palliative Care Summit, December 2017

training workshops for district and community doctors, nurses and barangay health workers (BHW). Indeed, everyone hopes for a happy death – a death free from suffering and pain, a death with dignity. Hence, the need for everyone to realize the importance of an effective palliative and hospice care system. Increasing the awareness and understanding of the benefits of palliative care for the patients and his/her family will certainly address those who claim, “There is nothing more we can do.”






Andrea M. Gaddi, MD, FPOGS, FSGOP, FPSCPC tially pre cancerous and cancerous processes. It is now recommended locally that screening be done annually and started at the age of 21 up to the age of 65 or until 70 years old if there is history of precancerous lesions. WHAT SHOULD WE WATCH OUT FOR?

“DID YOU EVER EXPERIENCE BLEEDING AFTER SEXUAL CONTACT?” This is one of the common questions gynecologists ask their patients and probably one of the common complaints of patients with cervical cancer. Cervical cancer has long been a burden borne by women worldwide. It is the third most common cancer in women and the second top cause of cancer deaths in the same category. Here at JBLMRH, it is the most common gynecologic cancer seen and managed. Cervical cancer has been found to be associated with the Human Papillomavirus (HPV). HPV is the most common sexually transmitted infection globally. Since cervical cancer is strongly linked to a sexually transmitted disease (STD), sexual promiscuity is a big RISK FACTOR. Other minor risk factors include early age at onset of sexual activity, prolonged duration of oral contraceptive pills (OCP) use, smoking, having more than 4 children and lack of proper screening. Immunocompromised individuals, like people living with HIV, are also at risk for developing cervical cancer.

The SIGNS AND SYMPTOMS of cervical cancer are nonspecific and, unfortunately, often times occur once disease is already advanced. We should be concerned when one experiences the following: post coital vaginal bleeding, vaginal spotting outside of menses, foul smelling discharge, pelvic/abdominal/flank pain, urinary disturbances like dysuria or hematuria, and leg pain or leg edema. If and when the following are detected, immediate visit to your Ob-Gyn is warranted. Once cervical carcinoma is considered, a biopsy should be taken to confirm the diagnosis. IS THERE TREATMENT FOR CERVICAL CANCER? YES, THERE IS. The standard treatment for cervical carcinoma of any stage is concurrent chemotherapy with pelvic external beam radiation therapy (EBRT) and vaginal brachytherapy. For early stages, surgery may be an option. The important thing is early detection and immediate treatment. Fortunately, in Pampanga we have two centers with pelvic EBRT, one center for brachytherapy and several local government and private hospitals with the capability of giving chemotherapy. WHAT DOES THE GOVERNMENT DO ABOUT CERVICAL CANCER? The government along with Cervical Cancer Prevention (CECAP), Philippine Society Cervical Pathology and Colposcopy

HOW DO WE PREVENT CERVICAL CANCER? There are several ways to prevent cervical cancer. One is through VACCINATION. There are currently three available vaccines: the bivalent, quadrivalent and nonavalent vaccines. The vaccine is highly recommended to be given to children from the age of 11 or 12 as this usually ensures that the drug is given when kids are not yet sexually active. Males and females alike can be given the vaccine, as males are the carriers of HPV. Adults who have already had sexual relations can also be given the vaccine although it should be understood that the efficacy may not be as effective HOW ELSE CAN WE PREVENT CERVICAL CANCER? OTHER WAYS ARE:

■ ■ ■ ■ ■ ■ ■

Delaying sexual debut Sexual abstinence Being involved in a mutually monogamous relationship Correct and consistent use of barrier methods Decreasing number of planned (and unplanned) children Quitting smoking Male circumcision Adequate screening

IS SCREENING AVAILABLE FOR CERVICAL CANCER? Screening is very much available in our country, especially in JBLMRH. The PAPANICOLAOU (PAP) SMEAR has been around since the 1920’s and has been used ever since in detecting poten-

Dr. Sheena G. Sicat during the lay forum on Cervical Cancer Awareness at the OB-Outpatient Department. (PSCPC) and other non-profit organizations, have taken several steps to help reduce the burden of this disease in our country. Recently, the PSCPC has launched the National Visual Inspection with Ascetic Acid (VIA) Day last May 23, 2018 in line with May being the Cervical Cancer Awareness month. Several hospitals participated in this activity including our institution. We performed VIA on 50 patients, gave lay lectures on Cervical Cancer and distributed the ANITA comics. SO WHAT SHOULD YOU DO? PLEASE SEE YOUR OB-GYN AT JBLMRH FOR ANY QUESTIONS ON VACCINES, SCREENING AND IF YOU HAVE ANY OF THE SIGNS AND SYMPTOMS OF CERVICAL CANCER.

Clark Steven S. Dela Paz To get a sneak peek on how we are doing in terms of the services that we provide, I visited random patients to ask about their overall experience in our hospital and their suggestions on how to improve our services. As soon as I entered one of the wards and introduced myself, I was reciprocated with a smile. It was really heart warming to hear what they have to say which only proves that JBLMRH has really gone a long way in providing great patient service.

man of facilities, excellent naman po dahil well provided yung mga supplies at medicine, unless out of stock, otherwise, binibigay naman. Very cautious sila sa procedure. Sobrang ingat sila sa mga pasyente. Ok naman po, wala ng masyadong suggestions. Sa mga Windows, nakikita ko na napaprioritize naman po sila at understandable na madami patients pero nabibigyan pa rin ng priority yung nagchechemo. May window na nakalaan sa mga kailangan ng priority. Sana lang magkaroon ng parking dahil hirap sa mga I feel more proud to be part of this institution. I could not naghihintay. “- LALAINE LIBUT (OPD Chemotherapy) forget this particular patient who was teary eyed while saying ¨Kahit walang bantay, nakakakain po ako¨ (the patient was refer“Napakalaki ng improvement lalo na sa quality ng serring to our Nutrition and Dietetic Services in distributing daily bisyo ng doctors at facilities. Kahit public hospital, hindi mo meals on time). There were other scenarios like patient laughing mararamdaman na mahirap ka. Parang nasa semi-private ka at our nurse’s jokes, establishing good relationships and positive at magandang bumalik balik dito. Malaki yung pinagbago vibes. After a few days of interviewing patients, here are some nya mula nung una akong nanggaling dito. Taga Arayat po words I got from them: ako, kahit malayo ay worth naman ang pagbalik dito. Suggestion ko ay sana mas maging mahigpit sa pagdidisiplina “Maserbisyo po sila. Kapag may emergency, agad sa ibang patients tulad ng pagtapon ng basura nila. Ok nanatutulungan. Dati na kaming patient dito. Ok naman dito. man at kumportable ang set up sa OPD.” - ANONYMOUS Sana magkaroon ng sariling Dialysis ang JBL para maayos (OPD - OB Gyne) ang serbisyo.” - ANONYMOUS (Medicine Ward) “Unang una, sa mga doctors at nurses mababait sila “Ok naman po, mababait ang mga nurses at doctors. at maasikaso. Malinis ang clinic nila at may laging naglilinis. Dapat magpapa-discharge na po ako kaso di pa maayos Maraming mga clinics na ang JBL OPD may sariling CR na. kundisyon ko at may laboratory pa na kailangang ipagawa. Mas maging maayos pa yung mga pasilidad at sana ibalik Mas kampante ako sa decision ni doctor. Dito kumpleto at yung Lingap sa Masa.”- ANONYMOUS (OPD - Chemotherapy may CR bawat kwarto. At kahit walang bantay, nakakain po Unit) ako. Wala naman na akong maisip na improvement pa dahil ok naman po lahat.” - ANONYMOUS (Medicine Ward) “Ok lang naman. Ok naman mga doctors at nurses. Madaling lapitan. Agad agad lumalapit pag tinawag, pwera “Pasyente ko ay ang anak ko. In terms of services, accom- na lang pag sobrang dami ng pasyente. Ok yung facilities.” modating yung mga health personnel natin at skilled yung ANONYMOUS (Pediatric Ward) mga doctors at trained, assisted by our long time doctors. Competent po yung mga doctors and nurses. In terms na-

Maureen B. Malabong, RND Losing weight is a never-ending struggle for many. It has high fat foods and would cut out on carb sources like grains and been the goal of most but its success rate is low. Several of bread. those who are trying to lose weight may gain back their previous Here is my view as a nutritionist. In trying to lose weight, weight after some time. as in any other aspect of life, shortcuts usually do not have longA few, if not maybe most of those trying to lose weight are term positive outcomes. So it is still best to follow a traditional following diets that are trendy, or the fad diets like the ketogenic healthy diet that includes a lot of whole foods and has an allotdiet. Ketogenic Diet has been around for nearly a century in the ment of 65 % carbohydrates, 15 % proteins and 20 % fats. Whole 1920s. It has been used to treat epilepsy. Researchers found foods are those that are still “fresh from the farm” and are not that increased amount of ketones—the byproduct of the break- processed or are refined as little as possible. In this busy world down of fatty acids—in epileptics resulted in fewer seizures. though, we can not do away with food processing since it offers convenience. But here is a tip I can give you: the less processed, Just how does a ketogenic diet work? Ketosis, which is the better and unprocessed food is best because it still has its the burning of stored fats when the body does not have enough nutrients intact . glucose to use for energy, is the main process involved. In this diet, people eat a low-carbohydrate and a high-fat diet trying to deprive the body of glucose—the primary source of energy. Therefore the body consumes fat for energy. The ketogenic diet is basically super high in fat (about 6070 % of calories), super low in carbohydrates (about 5-10 %) and moderate in protein (about 15-30 % of calories). The percentage distribution varies but essentially, the fat and carbohydrate ratio is sort of reversed because a typical diet has 55-70 % carbohydrates, 10-15 % proteins and 20-30 % fats. The diet then is composed mainly of high fat dairy like butter, cheese, heavy cream, non-lean meat, fried foods, high fat sauces and the like. It is like “keto loading”. People on this diet would load up moderate to







Employees of JBLMRH attended the annual JBLMRH teams, and battled it out in games of wit and strategy starting Gender And Development (GAD) Orientation, Stress with a cheering competition, basket building and ball shoot-out, Management, Values Formation and Team Building activity held dress-me-up game, and human bingo. in Baguio City in batches from April to May 2018. Day one of each batch ended with some rest and For the first day, invited speakers from the Civil Service recreation activities kicking-off with a fellowship night highlighted Commission, Dir. Maria Cristina R. Gonzales (Director of CSC by videoke singing and BBQ. Tarlac Field Office), and Randy C. Tababa (Head Human Day two was about the life changing talk of esteemed life Resource Specialist, CSC Regional Office 3) discussed the coach Ning B. Tadena on finding an individual’s inner beauty importance of work-life balance and how it affects productivity through a “mindset make-over” and rounded up by a power and work values of government employees. dressing talk by Kristianne Joy F. Sombillo teaching employees to Meanwhile, Teresita B. Biteng and Adoraline B. Marigza dress the way they want to be addressed in a professional world. from CSC-CAR oriented employees on basic Gender and Before leaving the cool Baguio weather, employees were Development concepts as well as how this affects company treated to a visit at the La Trinidad Strawberry farm and shopping planning and customer satisfaction. for souvenirs and pasalubong at the Baguio Public Market. The JBLMRH Employee Association, headed by its president Ma. Luisa M. Gopez, organized the Team Building activities held in the afternoon. Participants were divided into

ADRIANE P. CARREON As a response to the continuing program of the DOH under the flagship of “ B oost ing Univers a l Healthcare via FOURmula One for Health Plus”, JBLMRH conducted a series of Surgical Caravan and R ea chi ng t he Unreached Last Mile Medical Missions at Kainoma yan Primary Hospital in Botolan Zambales last March 21, and at Ipo Elementary School in Norzagaray, Bulacan last May 24.

providing free medical checkups to the Dumagat people residing around Ipo Dam in Norzagaray, Bulacan.

On the day of the mission, pre-listed patients were checked for vital signs and triaged to different clinics such as Family Medicine, Pediatrics, Dermatology, Internal Medicine, Ophthalmology, Ob-Gyn and Family Planning, General Surgery, Orthopedics, and Head and Neck Surgery. Basic diagnostics for surgery clearances were also administered by the Department of Pathology and Laboratory Services and the The Surgical Caravan is a program aimed to bring Surgical Radiology Department. JBLMRH also deployed its Dental bus Services to far away communities who are in need of surgical equipped with resident dentists to provide oral health services from operations and rarely have the opportunity to avail these services prophylaxis to tooth extraction. due to geographical challenges and/or financial difficulties. Minor surgeries screened Kainomayan Primary were conducted on site at the Hospital, being an adopted host hospital. Cases operated hospital of JBLMRH, is a regular included excisions, cautery, beneficiary of the Surgical ligation, and circumcisions while Caravan Mission providing free major surgeries such as surgical services through the herniorrhaphy, Cholecystectomy, combined efforts of the thyroidectomy, Cataract cases, Philippine Health Insurance and pterygium cases were Corporation, DOH Reginal Office scheduled for operation at 3, and the Local Government of JBLMRH. Botolan, Zambales. Take home medicines were also dispensed to beneficiaries in On the otherhand , Reaching the Unreached Last Mile order to render complete medical services for all patients catered. Medical Mission conducted in Ipo Elementary School focuses on

Sam Angelo Esteban, RN

Department of OB-Gyne

2nd place, 24th PMA Resident's Research Competition (Case Report) Dr. Karen Grace L. Plurad Dr. Andrea M. Gaddi, Adviser

1st Place, POGS CLC 2018 Interesting Case Contest Dr. Michael Dayrit

2nd Place, POGS CLC 2018 Interesting Case Contest Dr. Zhyra Gail Catli

Department of Internal Medicine

From left to right:J.M. Manlutac, Dr. C. Canlas, L. Macabulos, Dr. L. Mangulabnan, ARD R. Siapno, RD. L.P. Gorgolon, Dr. M. S. Chichioco, L.M. Chiong, S.A. Esteban, J. M. Buan, S. M. Razon, and C. L. Rivera.

It was a great yet challenging 2017 in the health sector. One issue that made the greatest buzz was the Dengvaxia scare. Despite controversies like these, there are many things to be grateful for. To name a few JBLMRH received numerous awards from the recently concluded 6th Central Luzon Excellence Awards for Health 2017 (CLExAH) of the Department of Health (DOH) Regional Office 3 held at Royce Hotel in Clark Freeport Zone. The event aims to award health programs of the DOH with exemplary health service and recognize institutions who created an impact in providing the best health services. With and without these additional feathers in our hats, JBLMRH vows to continually improve its quality management system for the satisfaction of its clientele and stakeholders, to achieve the Philippine Health Agenda. With the theme of CLExAH namely, "Sustaining Excellence in Health in 2017 and Beyond", we are positive we can reach this goal. As stated by Assistant Health Secretary Leonita P. Gorgolon, "we are here to serve with passion and commitment." Among the different institutions all throughout Region III that received awards and recognitions, JBLMRH was able to bag the following:  Best Hospital Disease Reporting Unit  Mother and Baby Friendly Hospital Initiative (MBFHI/COC) Award  Most Innovative Newborn Screening Facility  Most Number of Reported Acute Flaccid Paralysis  Excellence Award in ASEAN 2017 Deployment  Pulang Laso Excellence Award for being the Model Treatment Center for Service and Outreach Services  Pulang Laso Excellence Award to Ing Mamalakaya Support Group for being the Model Support Group for Innovative Strategies and Outreach Services  Pulang Laso Excellence Award for HIV Program Implementation with token of appreciation worth Php50,000.00 advocacy activities and LED screen television  Certificate of Recognition for being the Lead Blood Service Facility in Region III  Certificate of Recognition as Hospital Implementer in Family Planning  Special Award for Health Emergency Referral System of Avian Flu Cullers  Special Citation to Dr. Alfonso C. Danac for his unwavering support and selfless service as an Incident Commander during the 31st ASEAN Summit

4th Place, Philippine Society of Nephrology, Central Luzon Nephrology Quiz Show Dr. Noel Gomez Dr. Carmela Maminta Dr. Khassmeen Aradani

4th runner up, PCP Dr. Adrian C. Peña Medical Quiz Contest Dr. Charles Eryll Sy Dr. Ainah Pamela Cunanan Dr. Ma. Carmela Maminta Dr. Florence Maliwat

Department of Family and Community Medicine

National Finalist at 57th Annual PAFP Family Case Contest Dr. Jose Antonio U. Martin

1st Place Poster Exhibit Contest – Professional Category during the Central Luzon Health Research Forum Dr. Manuel Jose B. Credo

Emergency Medicine and ER Services

 

1st Emergency Medicine Training accredited in Northern Luzon 2nd place winner in “Interesting Case Poster Presentation 2018” of Philippine College of Emergency Medicine Annual Convention 2018. Dr. Christian Jerome Carreon

Department of Orthopaedics

Residency Training Program Accredited

Department of Pediatrics

 

Residency Training Program Level II Accredited under PPS PPS Written Exam Passers (March 2018) Dr. Norma Rusella S. Baltazar Dr. Lorielyn P. Bagang Dr. April Joy G. Galang

Department of Pathology, Laboratories and Blood Transfusion Service

 

Most Outstanding Sentinel Site for the year 2017

Accreditation of Residency Training in Anatomic and Clinical Pathology from January-December 2018 given by Philippine Society of Pathologists, Inc.

Excellent Performance Result in the External Quality Assessment Schemes (EQAS) conducted by the National Reference Laboratory / STD AIDS Cooperative Central Laboratory for the year 2017

Nursing Service Office

Top one on Critical Care Course at Philippine Heart Center Rudgin Kevin Lucero

Graduated Magna Cum laude MAN at La Consolacion College George Anthony Usi

Graduated Magna Cumlaude MAN Major in Nursing Administration at La Consolacion University Philippines David Saplad

Nurse’s Certification Program by National Children’s Hospital Level 3- 18 nurses Level 4- 4 nurses








Mikrobyong “leptospira”

Dengue Virus

Paano Nakukuha:

Paano Nakukuha:

Sa pamamagitan ng pagpasok ng mikrobyo sa balat na may sugat mula sa tubig-baha, basang lupa, o halamang may ihi ng kontaminadong daga.

Mula sa kagat ng lamok na may dalang dengue virus

Mga Palalatandaan:

 Lagnat  Panginginig ng katawan o “chills”  Pananakit ng binti, kalamnan, kasukasuan at ulo

    

Pamumula ng mga mata Paninilaw ng balat Ihing kulay tsaa Kakaunti ang iniihi Sobrang pananakit ng ulo

Pag-iwas at Pagsugpo:  Iwasang lumangoy o lumusong sa kontaminadong baha at maruming tubig.

 Gumamit ng bota kung kailangang lumusong sa baha

 Sugpuin ang mga daga sa bahay  Panatilihing malinis ang buong bahay

Mga Palatandaan:

INFLUENZA Sanhi: Virus ng trangkaso

Paano Nakukuha:

 Pag-ubo  Pagbahing  Paghawak ng kontaminadong bagay o gamit mula sa taong nagdadala ng virus

 Mataas na lagnat sa loob ng 2-7 na araw

     

Pananakit ng kasukasuan at kalamnan Panghihina

Pagkawala ng ganang kumain Pamumula ng balat Pananakit ng tiyan at pagsusuka Pagdurugo ng ilong at gilagid

Pag-iwas at pagsugpo:

 Linisin at takpan ang mga dram at iba pang imbakan ng tubig.

 Itaob ang mga bote, lata at iba pang maaring mapag-ipunan ng tubig at mapangitlugan ng mga lamok.

 Magsuot ng mahahabang kasuotan upang hindi madaling makagat ng lamok.

 Maaari ding gumamit ng insect repel-

Mga Palatandaan:

     

Mataas na lagnat

Masakit ang ulo Sinisipon Namamagang lalamunan Ubo Pananakit ng kasukasuan at kalamnan

Pag-iwas at pagsugpo:

 Bakuna laban

sa influenza isang beses isang taon.

 Takpan ang bibig at ilong kapag uubo at babahing upang maiwasan ang pagkalat ng virus.

 Palagian at wastong paghugas ng kamay



Pag-iwas at Pagsugpo:         

Uminom lamang ng ligtas at malinis na tubig. Kapag hindi sigurado, pakuluan ang inuming tubig higit sa tatlong minuto. Siguraduhing na-chlorinate bago gamitin ang tubig. Takpan ang pagkain upang hindi dapuan ng insekto o daga. Hugasan at lutuing mabuti ang mga pagkain. Kumain lamang ng lutong pagkain. Hugasan ang prutas at gulay bago ito kainin o lutuin. Lutuing mabuti ang talaba o mga lamang-dagat ng hanggang 4 na minuto. Iwasang kumain ng mga pagkain binebenta sa tabing kalsada. Ugaliin ang tamang paghawak at pag-iimbak ng pagkain at inuming tubig. Gumamit ng kubeta at laging linisin araw-araw. Maghugas ng kamay gamit ang sabon at malinis na tubig bago hawakan ang pagkain. Panatilihing malinis ang paligid upang maiwasan ang langaw at ibang insekto o mga peste.

Isang paalala mula sa Jose B. Lingad Memorial Regional Hospital. Para sa karagdagang impormasyon ukol dito, makipag-ugnayan sa Health Promotion and Wellness Services, 4th Floor, OPD Building, JBLMRH