Dr. Marvin L. Manzanero

18/07/2025

Ketchup & nutritional values?

From a clinician perspective, I have to acknowledge that we are never really taught how to read food labels and as a clinician we do have a duty and a responsibility to educate our patients in this regard.

And while I don't intend to add to any debate in the current context, it is prudent for me to signal facts that we tend to overlook in regard to - ketchup!

A typical tablespoon of ketchup a high content of both sugar and salt!

A single tablespoon can contain up to 3 grs of added sugar which is around 7% of the daily recommended value for an adult (higher percentage for children!)

A single tablespoon can carry up to 180 mgs of sodium - about 8% of the daily recommended dose for an adult (higher percentage for children or for adults on sodium restrictive diets - kidney patients or those who have hypertension).

A single tablespoon has about 20 calories - that translates into 5 minutes of brisk walking in order to burn those calories!

Those are the glaring facts and something to consider perhaps, as it seems we consume significant amounts of ketchup in our diet!

Let's strive to read food labels if we aim to be healthier!

07/07/2025

Generic medications an option?

This is a question that patients ask often, especially in a context of increasing prices of pharmaceuticals.

Generic medications, provided they have met and passed quality review processes that determine a similar bioequivalence could be used in lieu of the 'brand name drugs'.

This discussion is rather important as lately, patients have not been able to adhere when placed on brand name drugs as in some instances a tablet/capsule of a given drug can cost (as an example) $3.50 whereas the generic one costs $0.50 (as an example). Patients therefore will sometimes go a month without treatment given the affordability and accessibility and this is especially relevant with those seeking care abroad.

As always, talk to your doctor about the options available to you as daily adherence to medications, especially chronic diseases, is very important to avoid complications.

24/06/2025

Evolving health issues.

Many things continue to evolve in health and it is important that we keep abreast of evolving information and ask the relevant questions from your health providers.

And so it is with COVID-19 and the evolving variants, the latest data indicating that there are at least 6 variants being monitored currently. One of these latest variants, NB 1.8.1 has been nicknamed 'Nimbus' and although not a producer of more severe disease than previous variants, it strikes out given that it seems to be spreading quicker as it seems to infect more efficiently.

While each patient may experience different symptoms with different severity, the common characteristic seems to be a 'razor blade' type of soreness in the throat area. The scientific explanation for this is that this variant is replicating in the throat lining causing cellular damage given rise to this particular symptom.

As with other viral infections, hydration and NSAIDs may work in most cases as well as using lozenges with xylitol or pectin to lubricate the throat area. If the symptoms are not improving and your clinical case is worsened by underlying chronic conditions, talk to your doctor about the best management for your case.

As always, prevention is always better!

15/06/2025

World blood donor day is being observed today, June 14th!

The day has a 2-fold purpose:

1. To thank all those VOLUNTARY and UNPAID blood donors for their life saving gestures! Your support to those in need is to be always appreciated!

2. Raise awareness about the ongoing need for blood and blood products!

This year’s theme: “Give blood, give life - together we save lives”

Become a blood donor today!

05/06/2025

World Environment Day.

WED is being observed today, June 5th under the theme - .

The theme is timely in relation to human health as the science indicates that the impact on human health is significant and is now linked to many health problems.

Microplastics have for example, been found in multiple human tissues and are now linked to inflammatory processes, oxidative stress and eventually cardiovascular diseases. There is also a link to reproductive, immunological, developmental and even immune disorders.

We all have an individual and collective responsibility to combat plastic pollution!

Our health and the environment demand it!

25/05/2025

Unnecessary and excessive lab exams!

Much like medical imaging, lately, I am noticing two things being done more frequently: 1. Excessive number of laboratory exams being ordered by colleagues and 2. Patients themselves ordering or getting exams done on their own before going to the doctor. In both instances, there are unnecessary costs being generated

in both instances, adequate communication with your treating doctor is key! You have all the right to query every single exam being ordered on you and your clinician should explain the why!

In the second situation (and as I always tell my patients) - the doctor should see you first and you should be only taking “doctor ordered exams”!

After all, a true clinician will only seek exams to confirm the diagnosis!

Talk to your doctor about any and all laboratory exams!

21/05/2025

Unnecessary procedures!

A cardinal duty we have to our patients is educating them on the many aspects of medicine. This is especially important when patienta demand unnecessary procedures, medications or laboratory exams!

We also have a cardinal responsibility in ensuring that we are NOT requesting/ordering unnecessary exams and procedures. This is particularly important when resources are limited and because everything has a risk.

For example, what may simple like an innocuous procedure - a CT scan - exposes patient to radiation so it should be done only when needed! A headline story on Medscape indicates that CT scans could be collectively responsible for up to 5% of cancers!

As always, talk to your doctor and ask the questions!

18/05/2025

On World Hypertension Day…

❣️1.3 billion people live with hypertension, but only 1 in 5 meet Blood Pressure goals.
⚡️Hypertension silently drives stroke, heart & kidney failure—and 57% of global deaths.

What are your numbers?

120/80 is normal; anything above that and you are hypertensive!

Check with your doctor today!

18/05/2025

A word I keep stressing to my students…

But we can’t teach empathy? Or can we?

The patient is always first!

07/05/2025

Nurse’s week!

Beyond the usual calls of good wishes to nurses for a period of the year, my call is more in the line of appreciation and thankfulness for all you do.

A thank you on behalf of all the patients and the families of patients that also need to be factored in.

Beyond that, a personal thank you for all that you have taught me and for all that you have done accompanying through my growth as a professional.

Eternally grateful - gracias totales!

Because you deserve all good things - and not just this week!

06/05/2025

Please take note.

Slots will surely be filled up quickly.

We’re blessed to have a surgical group from Riverside Korean SDA Church coming to our hospital from June 10-13. Spots are very limited. If you know anyone who could benefit, please share and have them contact the La Loma Luz WhatsApp (635-0678) to get on the list and for more information.

03/05/2025

Obesity is a rather complex disease beyond just adding and taking calories away.

Obesity beyond a “risk factor” is a disease as the patient is always in a “pro-inflammatory” state!

Being obese increases your risk for cardiovascular diseases, some cancers, osteoporosis and overall poor quality of life. Even if you have no other risk factor; just by being obese you have an increased morbidity and mortality rate!

What are you doing to control your weight?!