Saturday, April 30, 2016

INTERNAL MEDICINE RESIDENCY IN Ciudad Medical Zamboanga

We would like to extend our invitation to all interested in applying for INTERNAL MEDICINE RESIDENCY TRAINING (under the Philippine College of Physicians) here in Zamboanga City.
Be inspired by the mentorship of brilliant, dynamic and caring IM Specialists-trainors.

Chairman of the Department of Internal Medicine is Dr. Reynie Tam, a well known Gastroenterologist in the city.

Training Officer is Dr. Kristine Bantal, Cardiologist and Assistant Training Officer is Dr. Adele Espaldon-Aquino, a Pulmonologist. 

These are the following requirements:
1.  Letter of application to:
      Dr. Filipinas Rojo, Medical Director
      thru Dr. Reynie Tam, IM Department Head
2.  Updated Curriculum Vitae/ Biodata with 2 x 2 picture
3. Transcript of Records
4.  Board rating
5.  Class rating
6.  Diploma
7.  Photocopy of PRC license
8. Medical/ PE / Psychometric Exam / Internal Medicine Admission Test

Deadline for submission of requirements: May 4, 2016
Date of examination: May 5, 2016

If in case your papers are not yet complete by these dates, please call (062)992-7330 and look for Mel (Executive Secretary) or Roselle (IM Department Secretary) at CMZ Admin to signify your interest.

We do hope you would consider our invitation and be part of Zamboanga City's most dynamic hospital, with well respected Internal Medicine consultants, more than enough patient complement with varied disease cases, supported by advanced technology, and of course, the only hospital awardee for the Philippine Quality Award as of this time!


CMZ BRAngay Project 32: PNP Police Regional Office 9

April 15, 2016

This April 15, 2016, we were so excited to have our 32nd BRAngay Project at the Philippine National Police Police Regional Office 9 (PRO9) at Camp Col. Romeo Abendan, Mercedes, Zamboanga City under Regional Director PCSupt. Miguel Cabanatan Antonio Jr. 
We were welcomed by PSSupt. Atty. Sofronio Palana Ecaldre, Chief of the Regional Police Community Relation. We were touched by his story that his wife is a Breast Cancer survivor herself and, thus, he recognizes the value of ''Early Detection and Treatment save lives!"
We proceeded to the Lecture Hall where a lot of policewomen were waiting for us including the new policewomen in training.
Lecture on Breast Cancer Awareness by Dr. Filipinas Rojo

Breast Self-Examination was explained and demonstrated by Ms. Watchel Basilio, CMZ MRI Nurse




The ''I CAN SERVE" Video on Sariling Salat sa Suso (SSS or Breast Self Exam) with host: Dawn Zulueta was also presented to the participants. 

A very touching and meaningful part of the program was the sharing from the Breast Cancer Survivor who is also one of their colleagues. 
Open Forum was very lively with many queries from our participants to understand Breast Cancer better.

Group photo

After the lecture portion, we proceeded with the Breast Screening held at another part of their complex.

Registration for Breast Screening






Breast Screeners and Support Staff




We thank PNP Police Regional Office 9 for giving us the opportunity to serve them and special THANKS to Maám Rose Asaali, Maám Mercedes Saputalom Maám Rina Saldo and Maám Villalyn Taboada for helping us throughout the activity.

We hope we can serve you again in the future!

By the way, the CMZ Breast Wellness Center continues to provide free breast awareness lectures with free clinical breast examinations to private and public groups interested to learn more about BREAST AWARENESS!

Please contact us at (062) 993-7330 local 1278 and look for Nely, Beth or Nanette for your queries and your schedules!!!


Friday, April 22, 2016

NOROVIRUS OUTBREAK IN ZAMBOANGA CITY @ 2016

April 22, 2016.

This morning, I heard on the radio that City Health Officer, Dr. Rodelin Agbulos declared the Norovirus outbreak in Zamboanga City presenting as Acute Gastroenteritis (or LOOSE BOWEL MOVEMENT) with 777 in-patients in this city for part of April 2016 alone.

We sometimes go on duty at the Emergency Room and last March, we recognized the surge on the number of patients coming in for Acute Gastroenteritis or usually called AGE or LBM and even with a higher spike this April. The most common symptoms were: diarrhea, vomiting, nausea and abdominal pain.

These are representative data from one private hospital and one government hospital for AGE admissions. However, there are five other private and public hospitals in Zamboanga City who have similar data plus data from other smaller hospitals. The data also does not include out-patients, who visit doctors' clinics or the Emergency Room.


Most of the patients are children



City Health Office Files: Zamboanga City Medical Center data
Most of the admitted patients are young belonging to the 0-18 age group, although, most of these are the infants and toddlers (less than 5 years old) who usually come dehydrated and who refuse to drink since this triggers vomiting. Needless to say, parents are at a loss on how to rehydrate when kids vomit after each intake!

Adults have better chance of being treated as out-patient since they can understand the option of Oral Rehydration and they themselves felt the need for pain relief but also preferred to go home.

Everyone was wondering what the source of the AGE or LBM was since they could not pinpoint specific areas or communities affected. Initially, there were talks of contaminated water from refilling stations but then again could not explain the number of patients.

Authorities did inspect water refilling stations and dealt with them accordingly, although, was not directly the source of the Norovirus infection. The source of infection was not yet identified.

Interestingly, Zamboanga City is strongly experiencing the El Niño phenomenon and lots of barangays have water shortage! This indeed may be contributory to the new illness.

Eventually, news had spread that all hospitals are full and in fact, there is a lack of rooms due to the outbreak and many patients remain in the ER until they have recovered from dehydration. 

With the initiative of Dr. Rosemarie Arciaga, a Pediatric Infectious Disease specialist, representative cases from each hospital were sent to the Research Institute for Tropical Medicine to identify the virus and NOROVIRUS was named! 

Fourteen of the seventeen representative specimens were POSITIVE for NOROVIRUS! Three of the specimens were still pending for identification. 

An emergency forum with DOH IX and CHO and the different hospitals to discuss about the present status of the Gastrointestinal outbreak in Zamboanga City, the disease, its prevention and treatment was convened at the Zamboanga Peninsula Medical Center last April 20, 2016. 

The City Health Office and physicians especially pediatricians concur that this is indeed A NEW VIRUS in Zamboanga City, thus, the rapid spread! 

We are wondering if other places in the Philippines also has a concurrent outbreak like this, as Norovirus is not a known cause of LBM in the Philippines.

But, in the United States and the United Kingdom, NOROVIRUS is a very common stomach bug and even called the "winter bug".

We used to identify fecal-oral route as the usual mode of transmission, therefore, not necessarily contagious. We have heard of Cholera or Staphylococcal Food Poisoning and it is easy to identify the source of the infection. But, NOROVIRUS is different!

So, how is the NOROVIRUS Infection spread?

Norovirus is highly contagious with several modes of transmission. The virus may shed in stool (feces) and vomitus and is depicted in this infographic, wherein Norovirus spreads when a person gets poop or vomit from an infected person in their mouth. 


Therefore, to STOP NOROVIRUS, cleanliness is of utmost importance, especially proper HAND WASHING!
Note, even if a person is well, it is suggested that you continue to stay at home for two more days after your symptoms stopped. This is a reminder for Human Resource personnel for your staff who have called in sick. Again, the workforce can come back to work two days after their symptoms have stopped!

So from the Center for Disease Control, here are infographics which summarize what we should know about NOROVIRUS and how to prevent it from spreading.



Note: Antibiotics will not help with Norovirus illness.
Prevention from dehydration is the primary goal.

What do we do? 
Hand Hygiene is one of the best ways for prevention.
What is is Right Way to Wash Your Hands?
The healthcare institutions, then, have to be aggressive on the dissemination of information regarding NOROVIRUS

Ciudad Medical Zamboanga, through the Infection Control Nurse, Ms. Kamille Alcala, then disseminated to and discussed with the Infection Control links, especially the clinical areas including the Human Resource and Administrative departments such as Dietary, Linen and Laundry and the Janitorial service about the NOROVIRUS: The Disease, Symptoms, Transmission, Prevention, Treatment and most of all, Infection Control Recommendations.
CMZ Infection Control Nurse, Ms. Kamille Alcala shares to the Infection Control committee links on the results of the meeting the night prior.
with CEO,  Medical Director, Assistant Nursing Director for Training, Infection Control Nurse and Pediatric Ward nurses 

Infection Control Links: clinical areas, ancillary units, administrative and human resource departments

Pediatric Department Head, Dr. Mary Ann To, who also attended the meeting shares more about the Norovirus infection as part of the dissemination campaign.
from ER, wards and ancillary services

CEO, Administrative Officer, Infection Control Nurse and Assistant Nursing Director-Service 

from Dietary, Janitorial, Medical Records and with Human Resource Manager also intently listen on their role during this Outbreak

Let us all understand about the NOROVIRUS and optimize CLEANLINESS through proper hygiene, hand hygiene, environmental cleaning and for Healthcare Personnel, use of Personal Preventive Equipment (PPE) such as gloves and gowns and for understanding patient cohorting.

For the COMMUNITY, here are more infographics to help prevent further illness:
HOW DO WE HELP PREVENT THE SPREAD OF NOROVIRUS, if Norovirus is affecting your community?
HOW DO WE CLEAN UP AND DISINFECT FOR NOROVIRUS if someone had a vomiting and diarrhea accident?
***anything that has been in contact with vomit and diarrhea should be thrown away or disinfected!
Routine cleaning and disinfection on frequently touched surfaces with sodium hypochlorite 1:10 for those who use the metric system.

During this El Niño season, this is such a great challenge since how can we do hand washing, if we do not even have water in the first place! Somehow, we need strong government support and prioritization for water services and transport to improve the water supply to the different barangays in Zamboanga City! This WATER SHORTAGE must be the triggering factor!

Another challenge that the hospitals face is the lack of rooms. One contributing factor is the updated 2016 PhilHealth regulation that Acute Gastroenteritis (AGE) can only be compensated (paid) by PhilHealth if the patient stays for 72 hours or 3 days! We would want PhilHealth to be more flexible in times of outbreaks but I guess this needs further discussion with them!

Everyone needs to do extra effort for understanding the disease to help stop further spread! We do hope that very soon, this ACUTE GASTROENTERITIS (AGE)  outbreak will be controlled!!!

Since this diarrhea problem cropped up in Zamboanga City, we would like to ask again if other places in the Philippines also experienced an Acute Gastroenteritis (AGE) Outbreak, too?
~ * ~ ~ * ~ ~ * ~ ~ * ~

P.S. UPDATES
1) April 25, 2016
Mayor Isabel Climaco declared a Gastrointestinal outbreak in Zamboanga City through Executive Order No. BC 174-2016 signed April 25, 2016.
Executive Order signed by the City Mayor: 813 Gastrointestinal patients with three Pediatric deaths (March 28-April 18, 2016)


City Health Office files
City Health Office files
2) April 23, 2016
A multi-center collaborative study among Zamboanga City hospitals spearheaded by Dr. Rosemarie Arciaga, Pediatric Infectious Disease specialist (Zamboanga Peninsula Medical Center)  will conduct a medical research to delve more deeply into the Gastrointestinal Outbreak in Zamboanga City. 

For Ciudad Medical Zamboanga, Dr. Mary Ann To (CMZ Pediatrics Department Head), Dr. Bernadette Chua-Macrohon, ICN Kamille Alcala and Pedia Ward Head Nurse, Kris Encarnacion are among the participants in this research.

3) We also have epidemiologists from DOH looking into the problem since there seems to be a "cocktail" of viruses as cause of the AGE such as Rotavirus, Adenovirus and even the bacteria, Escherichia Coli. Could this be because the Zamboanga City water problem is more complicated than it looks? 

Let us bid them well in this research and their other studies for the better understanding of the ongoing Gastrointestinal outbreak --- especially on the disease, its presentation, course and pattern, modes of spread and most of all, the underlying environmental and social factors to better foster its prevention and treatment.

Saturday, April 16, 2016

CMZ BRAngay Project 31: FOURTH BWC ANNIVERSARY

March 20, 2016 is the FOURTH ANNIVERSARY OF THE CMZ BREAST WELLNESS CENTER.

We had a simple fourth anniversary with a Free Breast Screening last Monday, March 21, 2016.




For the Fourth Anniverary, we offered free Clinical Breast Examinations at the CMZ Breast Wellness Center and for those with possible palpable masses, they will be given free Breast Ultrasound.

Preparations:
Decorating the Mammography Room which will also be used for Breast Screening





Biscocho from Crumbs N Buns for the participants for the free Breast Screening
Distribution of Flyers for invitation: Flyers for information were distributed to those in  the registration area, doctors' clinics, shared to friends, Facebook and also through the E-Media radio station. 
B.R.A. (Bra to Raise Awareness) Exhibit:
the Giant embellished BRA from Crumbs N Buns by Nora Javonitalla









Registration:




Breast Screening: There were 50 women served for the free Clinic Breast Examination. 

Giveaways: We gave away Biscocho from our ever strong supporter, Crumbs N Buns by Nora to all who participated.


Group Photos:


Thanks to our CMZ Breast Wellness Center Team for the continuing service. More Power to you!!!

Within the CMZ BWC is the first digital mammography in Western Mindanao, the Siemens Mammomat Inspiration.

As we celebrate, the fourth anniversary of the CMZ BWC, we would like to share with the public, that for 2016, the lectures and free Clinical Breast Examination (screening) are still offered to private and public groups who are interested to learn more about Breast Cancer Awareness.

P.S. 
Here are some of them who received the free Breast Ultrasound using the very new Siemens Acuson S2000 HELX which arrived early this year!!!