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