This editorial reflects on the author’s experiences as a mentor in a private community hospital, highlighting the responsibilities, rewards, and challenges of guiding interns with diverse educational backgrounds.

To analyze the ethical and legal principles governing the formation, maintenance, and termination of the physician-patient relationship, clarify the circumstances under which a physician may refuse or withdraw from care, and emphasize the responsibilities required to prevent abandonment while ensuring patient rights and welfare are upheld.
 

Four years ago, the Hepatology Society of the Philippines published the 2014 Consensus Statements on the Diagnosis and Treatment of Hepatitis C. Since then, a number of direct-acting antivirals (DAA) have been made available in the country. These agents have significantly improved the viral response rates of drug therapy for chronic hepatitis C and the resulting outcomes and prognosis of patients with chronic hepatitis C. Therefore, this document updates the consensus statements of the 2014 guidelines to include the scientific evidence supporting DAAs currently available in the Philippines.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that is severely debilitating with a prevalence in the Philippines of 0.17-0.4%. This study aims to determine rate of methotrexate (MTX) toxicity, identify risk factors and comorbid conditions predisposing to toxicity and describe management of MTX toxicity.

Febrile neutropenia (FN) is a common complication of immunocompromised patients – whether due to infection, cancer, drug-induced, or other bone marrow failure states. With the incidence of patients with immunocompromised states on the rise, this life threatening complication is also increasing. The importance of initiating the appropriate empiric antibiotic therapy can prove to be lifesaving, thus we examined how the initial choice of antibiotics influenced patient outcomes. This study aims to determine the effect of adherence to guideline-based antimicrobial therapy for adult febrile neutropenia patients in terms of patient outcomes.

Acute myocardial infarction (AMI) is rare in “very young” patients and studies among Filipinos are scarce. The objective of this study is to determine the prevalence, clinical, echocardiographic and angiographic features, and outcome of this population.

Malnutrition is a widespread condition that impacts millions of people across the world annually. The World Health Organization defines malnutrition as the deficiency, excess or imbalance in a person’s intake of energy and/or nutrients. It has been highly prevalent in hospitalized patients and is often overlooked as it continues to be an unrecognized problem. It is also associated with increased risk of complications, higher mortality rate, longer hospital stay, and higher hospitalization costs. The researchers aim to determine in-patients’ nutritional status using the Subjective Global Assessment (SGA) and their outcomes in a tertiary hospital.

In 2017, the American Diabetes Association (ADA) have introduced and recommended a Diabetes Risk Test for immediate detection of diabetes mellitus. Given the growing number of diabetics worldwide and in our country, early diagnosis and control of diabetes is vital. This study aimed to validate the modified filipino version of the ADA Diabetes Risk Test and the SLIM (St. Luke’s Internal Medicine) Diabetes Risk Test.

Performance on cardiopulmonary exercise test (CPET) is influenced by genetic, racial and environmental factors. It is important to establish a set of reference values for the Filipino population. This study aimed to establish the maximum working capacity, peak oxygen uptake (VO2), peak carbon dioxide output (VCO2), tidal volume (TV) for normal Filipinos during exercise; determine the median perceived rate of exertion using the Borg Scale; and derive prediction equation models for maximum working capacity, peak VO2, peak VCO2 and maximum attained TV.

The special needs of cancer patients offer unique challenges in treating them for venous thromboembolism (VTE). Dabigatran is a novel oral anticoagulant (NOAC) that may be comparable to warfarin in clinical benefit and risks of bleeding. A meta-analysis and systematic review was performed to compare efficacy of prevention of VTE recurrence and risks of bleeding with dabigatran compared to warfarin.

Acute paraquat (PQ) poisoning is associated with high case fatality rate. Following a report of 108 cases of poisoning from 2011 to 2013, the distribution, sale, and use of PQ was recently prohibited in the Philippines. However, there still is a need to gather additional information on the manifestations of PQ poisoning in the Philippines. Hence, this study aimed to identify the clinical presentation and outcomes of cases of PQ poisoning seen in a hospital at northern Philippines.

Coronary anomalies are rare congenital anatomic patterns affecting approximately one percent of the general population. Most of the cases may be asymptomatic and are never detected. Rarely, they result in severe life threatening consequences, thus, the diagnostic challenge is recognizing the abnormality early. Cardiac imaging modalities such as echocardiography, coronary computed tomography angiography (CTA), and coronary angiography can help us in the diagnosis. This is a case of a 49-year-old female who initially presented with dyspnea and managed as rheumatic heart disease and hypertension.