NEWS | 48th ICPC: Dissecting through the COVID-19 catastrophe, one clinical case at a time

By Jaxine Laguio and Miraflor Anacio

Photo from the Interscholastic Clinicopathologic Conference’s Facebook page

Featuring a mini-symposium discussing the current public health crisis and the highly anticipated clinical case diagnosis competition among Philippine medical schools, the University of the Philippines Medical Students’ Society (UP MSS), in cooperation with the Department of Pathology, UP College of Medicine — Philippine General Hospital (UPCM -PGH), concluded its 48th Interscholastic Clinicopathologic Conference (ICPC) on Saturday, March 20. The Davao-based Brokenshire College School of Medicine bagged the championship title, with one of its members, Maricar C. Claros, won the best speaker award.

An avenue for great minds

The ICPC is an annual, face to face, one-day event, held for over 40 by the UP MSS — a non-profit, non-stock, college-based student organization duly recognized by the UPCM. However, in the light of the public health crisis, a two-day virtual event was instead executed.

This year’s theme is hopeful as it is named “Convalescence,” a term used primarily in infectious disease to mean the period of recovery after illness. With this, the event hopes to stress the adverse effects of infections in the community and reiterate responsibility of every individual to prevent its spread.

The clinical case competition was held last March 13, 2021 in a closed Zoom conference with 13 medical schools participating. Among those who contended were: Mariano Marcos State University, Cebu Doctors University, Central Philippine University, University of Visayas, West Visayas State University, Brokenshire College, Xavier University, Ateneo School of Public Health, De Lasalle Health and Sciences Institute, Emilio Aguinaldo College, Manila Central University, Pamantasan ng Lungsod ng Maynila, and St. Luke’s College of Medicine.

Meanwhile, Dr. Jose Jonas D. Del Rosario, spokesperson of the PGH, Dr. Nina G. Gloriani, Chairperson of Department of Science and Technology (DOST) COVID-19 Vaccine Trials, and Dr. Arthur Dessi E. Roman, Assistant Professor on infectious diseases of the UPCM were the seated panelists for the brief conference regarding the nation’s prevalent healthcare issues amidst the pandemic. On the other hand, Clinical Associate Professors of the UPCM, Dr. Angela D. Salvana, Dr. Sonia S. Salamat, and Dr. Ma. Angelina L. Mirasol were the judges of this year’s clinicopathologic contest.

Dialogues and diagnosis

Prior to the contest proper, all 13 schools were tasked to study and analyze a case which involved a 54-year old female with a two-month history of intermittent fever. The scenario was, the patient was previously admitted at another hospital but went home against medical advice, with a discharge diagnosis of presumptive pulmonary tuberculosis (pTB). She had poor compliance with given medicines and was then admitted to PGH with worsened symptoms.

On her 28th day of confinement in the PGH, the patient died. The cause of death (COD), according to the General Medicine Service, was recorded to be septic shock and the antecedent COD was hospital-acquired pneumonia.

The winning team, who scored a whopping 93.3%, Brokenshire College School of Medicine’s final diagnosis was: Malignancy associated-Hemophagocytic Lymphohistiocytosis to consider Non-Hodgkin’s Lymphoma; Pulmonary Tuberculosis; and Past Hepatitis B Infection. Throughout their presentation, they explained that the immediate COD was Septic Shock, while the antecedent COD was the Hospital Acquired Pneumonia and Hemophagocytic Lymphohistiocytosis; and the underlying COD was the Non-Hodgkin’s Lymphoma.

Brokenshire’s team is composed of Claros, Daphnie Shane V. Gentapan, Ryanne Melle P. Olea and Riyany D. Sidik.

Meanwhile, sharing the first place are the De La Salle Institute of Health Sciences and Western Visayas State University. The Manila Central University and the Ateneo School of Medicine and Public Health clinched the second place.

In addition, the University of the Visayas — College of Medicine was then awarded best visual presentation.

What the doctors plea

In a panel discussion regarding the pandemic’s impact and how it looks moving forward, Dr. Roman was reminded of the initial struggle of seeing patients and colleagues suffering and dying from the virus, with no prescribed medicine to give.

“Napakahirap. We hoped that it would be similar to the MERS or Ebola outbreak that did not reach the Philippines. Nobody is prepared to face COVID. One of the challenges is that we don’t have anything to give when the patients arrive. Napakahirap no’n. ‘Yung nasa harap mo ‘yung pasyente, some of them are your colleagues, hirap huminga, ventilated. Even the timing of giving the medicine wala kaming kaalam-alam,” explained Dr. Roman.

A year after the government first imposed strict lockdown protocols, the Philippines is back at it again after recording a significant increase in daily cases. Dr. Del Rosario revealed that the number of admitted COVID-19 patients in the PGH in the last three weeks has doubled. On top of the challenge of lack of manpower, rooms were once again needed to be expanded to accommodate at least 200 patients.

To call for accountability, Filipino netizens rallied on various social media sites with the hashtag #DutertePalpak and #SolusyongMedikalHindiMilitar.

“We have a fixed number of nurses, doctors, support staff. When the COVID operation starts, demanding for more, it’s the non-covid operations that have to be de-man power. It [is] really a tight balance. We are having a hard time trying to convert back to where we were before because the non-COVID patients are here,” lamented Del Rosario.

In hopes of total recovery, medical professionals call on the government for the implementation of a fast vaccine rollout and real science-based policies. Dr. Gloriani also calls on the academe, the Department of Health, and other government agencies to conduct operational research and impact assessment, monitoring the whole vaccination program.

Furthermore, they encouraged people to follow health quarantine measures to help ease the spread of the viruses. Dr. Del Rosario then warned the public that there is really a threat of new COVID-19 variants which are more transmissible, putting their lives at risk.

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