THE WVSGH DIABETES AND HYPERTENSION CLINIC CONSULTATION KICKS-OFF

 

March 26, 2025

March 14, 2025 marks the calendar to be the kick-off of The WVSGH Diabetes and Hypertension Clinic consultation.

For quite some time, maybe for a year or so, the dilemma of starting or initiating the diabetes and hypertension consultation was predominating the angst of the Diabetes and Hypertension Clinic staff.  There were no venues, patients cannot be scheduled for consultation for various reasons, on top of that undermanned personnel was also the problem.  The dilemma did not last so much.  If there is a will, there will always be a way. 

Creation of the new Diabetes and Hypertension Clinic members:

Last January 21, 2025, Dr. Judy Ann T. Dumayas, Medical Center Chief I of Western Visayas Sanitarium and General Hospital approved the reconstitution of the Diabetes and Hypertension Clinic by virtue of WVSGH Personnel Order No. 2025-0016.

The members were carefully chosen based on their expertise in handling diabetes and hypertension care.  They were hailed from various hospital divisions that, in one way or the other, makes an integral part in diabetes and hypertension management.

Health education is the important part of the Public Health Unit, in which the Diabetes and Hypertension Clinic is under its wing.  Health education and promotion should be at its best  The personnel qualified for this is no other than our Health Promotion Officer, Mrs. Geline Ta-ala, a nursing professional herself.  Diabetes education and to ensure correct anthropometric data is made sure by the assigned nurse, Mr. Joseph Arrius Sombong.  

Correct laboratory diagnostics, preparation and processes are the turf of our medical technologist, Ms. Arlene Archebuque, her expertise will ensure correct collection of self-glucose, cholesterol, uric acid and other point-of-care tests.  

Another important aspect in diabetes and hypertension care is how we manage our diet.  This is the expertise of our in-house dietician, Ms. Michaelle Fe Casabuena.  Patients for dietary counselling and management are referred to her for face-to-face instructions.  

Cleanliness is next to Godliness as they say, hence, provision of a clean, infection control-compliant environment is provided by Mrs Marina Flogoso and Mrs. Gemma Lusaya.  

Documentation and record keeping is also as important.  To ensure secured and correct record filing is manged by Mrs. Maureen Suizo, our Health Information System representative.

Ground management, logistics and liaisons are the arms of every organization.  They are the tentacles that make the program in constant motion.  These are made sure by our Employees Clinic staff and secretariat, Ms. Mayla Lagana and Ms. Psyraine Sontillano.

In between these busy-bees, are the medical staff. Representing as diabetes and hypertension physician is a Family Medicine graduate, Dr. Twinkle Grace Germia.  Her expertise in the management of hypertension and diabetes, good patient rapport, and quick wit is a precious gem to have in the organization.

I, and my co-coordinator, Dr. Renia Grace Salapare, herself, a brilliant and an intelligent doctor, and as a PHU head, will always committed to serve the WVSGH community through this program.

Photos courtesy of Sir Romel Precia of IT Department.

The Kick-Off:

The first-ever meeting was held last February 21, 2025.  Guidelines were formulated and introduced to the group. Procedures of registering, to consultation to discharge were discussed.  The kick-off will serve, in a way, sort of a soft opening to identify areas of improvement.  It was decided that the Diabetes and Hypertension Consultations will be every other Fridays.

During the kick-off, we served an ample number of patients yet, but soon, it will grow into big numbers as diabetes and hypertension has easily become a pandemic.

Friends from pharmaceutical industry provided simple and yet integral part of the kick-off consultation.

Medicine samples to be given freely was provided by Cathay CYDC, Pharex, Innogen, Kauffman and Labmate.

Free tasting (wet sampling) courtesy of Kalbe, the makers of Entrasol and Diabetasol; and point-of-care uric acid testing courtesy of Terramedic.

Images:

Dr. Twinkle Germia and yours truly, with patients on consultation for diabetes and hypertension.  The two metabolic conditions comprise the rising epidemic among Filipinos.

Maam Geline, gets the data and registration, also provides Diabetes and Hypertension OPD ID's for use during follow-up of patients. As a Health Promotion Officer, she also distributes IEC materials on diabetes and hypertension.

Anthropometric data like height, weight, and all four extremities blood pressure is taken.  This will be the bases for dietary calculations and looking for evidence of arterial diseases, such measurement is known as the Ankle-Brachial Index.

Our enthusiastic members taking part in the wet sampling of diabetes meal supplementation formula from Kalbe (above photo); and taking part in the point-of-care uric acid determination courtesy of Terramedic (bottom photo).

Maam Michaelle of the Department of Dietetics explaining to the patient proper diet to further control diabetes and hypertension.  Maam Michaelle also receive referrals from the OPD for dietary counselling specially for our GDM, or gestational diabetes patients.

Flanked by our community patients, the members of the WVSGH Diabetes and Hypertension Clinic during the Kick-off consultation last March 14, 2025. (L-R: Dr. Germia, Maam Gemma, Maam Michaelle, Maam Psy, Sir Joseph, and yours truly-Dr. Owen Poral).

The gift of sustaining the program will always be in our prayers.  This is to ensure continuity of service to our patients with diabetes and hypertension and its related conditions.  

See you in our next sessions.

Fight Diabetes! Fight Hypertension! Onwards to life with ease!.

41st DP Annual Convention 2024

 November 22, 2024

ACQUIRING NEW SETS OF KNOWLEDGE TO FIGHT DIABETES: THE 41ST DP ANNUAL CONVENTION, NOVEMBER 20-22, 2024, EDSA SHANGRI-LA, MANILA

Diabetes has become a deadly disease in this century.  It has surpassed mortality caused by hypertension and myocardial infarction, pneumonia, COPD and tuberculosis. It has become a pandemic that affects in a global scale.  No wonder, the study of diabetes has produced myriad of researches and trials resulting to the production of diabetes medicines and more coming in the pipeline.  Diabetes also become a burden, not only to the patients but also to their families and caregivers.  It has also generated millions of pesos in healthcare needs.

This convention provide many insights or facets that is with diabetes: how diabetes is related to cancers, to pneumopathy, to the new syndrome the CKM or cardio-kidney and metabolic syndrome and everything in between.  Nutrition therapy and diabetic emergency management were also discussed. The drug of the event is the SGLT2-i (sodium-glucose co-transport) its efficiency not only for diabetes but for cardiorenal protection as well.

On the lighter side, the Diabetes Philippines ILOGA Chapter (Iloilo-Guimaras-Antique) Chapter won 3rd in the Best Chapter.  Congratulations to the team, headed by Dr. Rosanna Subade-Junio.  I, myself, had won a Littmann Cardiac Stethoscope courtesy of booth raffle from JustRight Pharmaceuticals, and a DP Jacket from the convention pre-lecture raffles.  Importantly, these knowledge will be used for the face-to-face diabetes (and hypertension) consultation at the out-patient department in-line with the opening of the BUCAS Center.

The Diabetes and Hypertension Clinic (DHC) is under the flagship of the Hospital's Public Health Unit. Currently, the program gives lectures and free screening to patients and clients but with sans consultations.  However, for the patients to have the optimal services, the DHC will implement face-to-face consultations on diabetes and hypertension.  Expectedly, there would be birth pains or rather "teenage angsts". Our birth pains were experienced during the introduction of the program.  We have started as little as we can, hence, implementing the clinic will entail another set of problems: making of guidelines and protocols, review of committee members, hiring of specialty personnel like diabetes educators, external liaisons and much more.

The implementation of the clinic will result to a more clientele being served, maximizing potential for diabetes and hypertension management, serve as platform for the skills in diabetes and hypertension management can be put into use specially for the learning residents.

Continuous medical education is still the key to an efficient medical practice. I'm thankful for the management of Western Visayas Sanitarium and General Hospital for the privilege to attend various CME events that can be useful in medical practice.  It is beneficial not only to the medical practitioner but also to his or her patients as well.  What a better way to serve, but to serve with diligence, honesty and confidently.  

Snippets:

The DP banner, ILOGA Chapter (Iloilo-Guimaras-Antique), the 3rd place winner for the 2024 BEST CHAPTER

The DP ILOGA President, Dr. Rosanna Subade-Junio, along with other presidents of various chapters, represented the chapter during the 41st DP Annual Convention in EDSA Shangri-la, Manila.  Bohol Chapter ultimately bagged the No. 1 BEST CHAPTER.

Conventions does not only give you a chance for continuing education but also a chance to reunite and get together with friends and colleagues. Dr. Joveno Galvez, Jr. Of Masbate, a graduate of Internal Medicine at Western Visayas Medical Center.

Winning something from convention raffles provide further excitement during conventions.  Thank you JustRight Pharmaceutical for the chance to win this. And I did!

Owen Erle P. Portal, MD

Medical Officer IV

Western Visayas Sanitarium

And General Hospital

WESTERN VISAYAS SANITARIUM AND GENERAL HOSPITAL DIABETES AND HYPERTENSION CLINIC HOLDS LECTURE ON SKIN CARE FOR DIABETES AND HYPERTENSION CLUB

 

October 22, 2024

THE WESTERN VISAYAS SANITARIUM AND GENERAL HOSPITAL DIABETES AND HYPERTENSION CLINIC HOLDS A LECTURE ON SKIN CARE FOR DIABETES AND HYPERTENSION CLUB

October 22, 2024 marks the day for this event in which the WVSGH Diabetes and Hypertension Clinic once again hold its quarterly lectures in everything that is diabetes and hypertension.  In this case, it was on taking care of the skin and vigilance on skin manifestations of diabetes and hypertension.

The lecture was attended by representatives from the hospital employees and some invited individuals from the community who are interested to know how diabetes and hypertension affects the skin and how these metabolic conditions increase the risks for diabetes and hypertension.

Collectively, about 80% of metabolic diseases like diabetes and hypertension have cutaneous or dermal manifestations and some are forebears for these diseases.  Many skin manifestations are neglected in a way because many people thought that skin illnesses or conditions are not related to other diseases. However, many of the disease entities will have skin conditions as concomitant signs or is indicative of a future diabetes and/or hypertension.

Acanthosis negricans, a darkening of the skin on the nape, axillae, breasts or arms and legs cannot be overemphasized that they are the important manifestations of pre-diabetes commonly found among pre-teens and teenagers.  This helps us realize that diabetes prevention starts at a young age.

Lipodystrophy was also tackled in the lecture especially those undergoing insulin treatment. Correct insulin injection practices were fairly mentioned to avoid such complications.  Recurrent skin infections from bacteria, fungi and viruses were also emphasized to the audience.  Other skin lesions like psoriasis, necrobiosis, hyper-/hypo-pigmentations, nail and hair problems, and on how to take care of the skin were discussed.

The greater understanding on how diabetes and hypertension affects our lives is one of the thrusts of the WVSGH Diabetes and Hypertension Clinic.  We aim to slowly make the general public understand that treatment of diabetes and hypertension does not end with medicines or at the clinic, but with taking care of the rest of the body, skin included.

Presenting the common signs of skin illness and conditions that are related to diabetes and hypertension.

Attended by hospital employees and the community, the WVSGH Diabetes and Hypertension Clinic aims to make the people understand the impact of these diseases.

This activity was made possible with the help of our PHU head, Dr. Elvira Sinoro and her office staff, Miss Psyraine Sontillano.  Mrs. Eloisa Penado, Head of the Diabetes and Hypertension Club for her dedication to the compliance to diabetes treatment of our patients, Dr. Renia Salapare, taking care of our diabetic and hypertensive clients in the Employee's Clinic.  

Also, with the help of some pharmaceutical company partners: Natrapharm, Pascual, Ajanta Pharma and Kalbe, Inc.  for our freebies, snacks and samples.

Our appreciation to our IT team represented by Sir Romel Precia, and to keep our venue clean and tidy, Mrs Elvie Sano.

And to Dr. Judy Ann Dumayas, our Medical Center Chief, Dr. Ronar Silao and Dr. Gemma Monserate-Suelo, our top management, who are always there to give us their support.

Owen Erle P. Poral, MD

Internal Medicine

Coordinator, Diabetes and Hypertension Clinic

WVSGH ANTIMICROBIAL STEWARDSHIP PROGRAM

WVSGH ANTIMICROBIAL SURVEILLANCE AND UTILIZATION PROGRAM AMR ACTIVITIES 

Antimicrobial utilization is an important factor in the prevention of antimicrobial resistance.  This mantra was, and will always be, the thrust of the Western Visayas Sanitarium and General Hospital (WVSGH) to fight antimicrobial resistance.  This brought the creation of WVSGH ANTIMICROBIAL SURVEILLANCE AND UTILIZATION AND PROGRAM.

The Western Visayas Sanitarium and General Hospital first sent its representatives for training and workshop for the Antimicrobial Stewardship Program last 2019 which was held in Bacolod City.  That event triggered the sentiment to fight animicrobial resistance and its dire effects in a person combating the infection and in general its over-all impact in the community.  This led to the creation of the WVSGH ANTIMICROBIAL UTILIZATION AND STEWARDSHIP PROGRAM or WVSGH AMSUP.

As a primary level healthcare facility, this would entail a painful, vigorous and challenging feat to start a what would be an important aspect in healthcare.  There were barriers like lack of manpower, budget constraints, and the most challenging of all is to influence medical practitioners to practice appropriate antimicrobial use.  Lobbying for the creation of the team, finding and assigning members, making the guidelines and protocols on antimicrobial use, and orientation of the hospital staff, all has its own unique challenges and barriers.  Barriers or none, the WVSGH AMSUP will stop at nothing just to give birth to this wonderful baby.

Appropriate utilization of antimicrobials is an important factor in health.  Mortality due to antimicrobial resistance could lead to about 50 million deaths in 2050 with 1 person every 3 seconds dying due to antimicrobial resistance; it is also a threat to national security, the lesson that we learned during the COVID pandemic resulting to a rise of resistance to many macrolides, among them azithromycin; tuberculosis treatment is undergoing a big leap in its management because of resistance to many anti-tuberculosis regimen; community resistance is also a rising threat and a contributor to our growing resistance by consuming meat and meat products laden with veterinary and industrial medicines that can give rise to future antimicrobial resistance.  There are few antimicrobials in the pipeline today. We need yet to see a new antimicrobial compound not in the near future.  These are just few of the notorieties that antimicrobial resistance can bring to our healthcare.

The WVSGH AMSUP, in its infancy has already started antimicrobial resistance (AMR) practices suited to our level of healthcare:

    1. Implementation of the "Automatic Stop Order" policy among the medical staff.

    2. Implementation of pre-authorization for restricted antimicrobials and 7th day-extension using                  prescribed forms.

    3. Appropriate use of antimicrobials: Correct form, indication, dose, route.

    4. Compliance to approved CPG's

    5. Correct filling-up of prescriptions.

    6. Implementation of "Step-Down" and "Switch" protocols.

    7. Surveillance and interpolation of culture and sensitivity studies.

The WVSGH AMSUP also participates in different programs of the hospitals in coordination with different units like the Infection Control, Hospital Surveillance, Therapeutic Committee and also joins program by the DOH like AMR Week and Infection Control Week to name a few.

Last 2023, the WVSGH AMSUP joined the Philippine Antimicrobial Week. Invited guests from DOH delivered lectures on proper antimicrobial usage and the importance of AMR.  It was attended by representatives from other hospital units, both medical and non-medical.  Out-patient lectures on AMR was done at the OPD for patients while waiting for their consultations.  

The following images highlight our activities and responsibilities:

A screenshot of the WVSGH AMSUP guidelines.  The basis of AMR practices and regulations are always based on this document.

Restrictive antimicrobial pre-authorization and 7th-day authorization are important tools to monitor appropriate antimicrobial use.  Along with "automatic stop orders" and assessment for "Step-Down" and "Shift-to-PO" protocols ensure further appropriate antibiotic use.

One of the responsibilities of AMS is to do analyses and interpretations of the culture and sensitivity studies and assessment of cultures referred from different hospital areas.

 

Regina Maris A. Sabado-Baylon and Charmaine Rose S. Samorro, both pharmacists from DOH came to talk on topics pertaining to antimicrobial resistance.

Antimicrobial resistance (AMR) should be introduced and taught to hospital employees and staff both for medical and non-medical personnel for better and wider dissemination on its significance in wide variety of healthcare.

A glimpse of the source of knowledge for AMS is joining different seminars and workshops.  These are the best grounds to reap ideas as well as listening and learn from the experts.

For every activity that WVSGH AMSUP joins or participates, we are always thankful for our colleagues and co-workers at WESTERN VISYAS SANITARIUM AND GENERAL HOSPITAL for their cooperation and enthusiasm.  Top honchoes headed by DR. JUDY ANN DUMAYAS, our medical center chief, heads from different areas, DR. GEMMA M SUELO, DR. RONAR SILAO and DR. ELVIRA SINORO for their inputs and encouragements.  And, the most hard-working, resilient, multifaceted nursing staff ICN/surveillance officer, Ms. APRYL JONTARCIEGO, the brain, the spirit, and the muscle of AMS, HICU, and Hospital Surveillance of WVSGH.

The WVSGH AMSUP still has a long way to go. Challenges and barriers are still at the horizon, but with coordination, shared efforts, and a strong political will to fight against antimicrobial resistance the strength to fight is incessantly fueled. The emergence and re-emergence of new and old infectious diseases, the practice of appropriate antimicrobial use is even more emphasized. AMR should be the way from the institutions to the communities.  

Let us fight AMR and save the world.  Make yourself count.

OWEN ERLE P. PORAL, MD

Internal Medicine

Medical Officer IV, WVSGH

Chair, WVSGH AMSUP/HICU

A Date To Remember

 

Hunting For A Place

 

July 29, 2024.

The Western Visayas Sanitarium and General Hospital will soon open its new OPD complex cum BUCAS center.

This gave me a chance to look for venues to implement diabetes and hypertension consultations complete with nursing and medical nutrition education.

The place is very conducive to consultations and wet clinics.  It's exciting to think of the interior designs and logistics for these wonderful room.  Hopefully, some pictures will be posted along the way.

Stay tuned.

Philippine Lipid and Atherosclerosis Society and The Medical City Iloilo: Lipid Instruct Series, July 27, 2024