Mariel Grace Andrada Diokno MD

21/08/2024

From Dr Inday Dans of HPAAC: Today Recto gets another 10 BILLION of our Philhealth Funds. (sad) Dami ng palusot para maguluhan lahat tayo at ang taong bayan. So Friends, puede patulong maglinaw sa mga ka- chat, kaibigan at kamag-anak?

In gist, Philhealth, a social health insurance covers the whole population and is intended to guarantee financial health protection to the whole population. Such financial protection has three essential features: 100% coverage of the population, increasing the coverage of benefits and services (a continuing task) and reducing to the maximum the out-of-pocket expenditures. How is all this done? By pooling the members. risks and resources of all its members. All members thus contribute to the pooling of resources. But since a part of the population does not have the capacity to pay, it’s taxpayers’ money (like the revenues from sin taxes) that subsidizes the premium of the poor. In short, all are contributing premiums. And thus not even government can take away the contributions of members.

The above explanation is the basis why the UHC law is very explicit in saying that excess funds must be used to increase benefits and to reduce contribution s and that all PhilHealth funds and income CANNOT be transferred to the national government and its instrumentalities.

20/02/2024

The “rail sign”: an ultrasound finding in placenta accreta spectrum indicating deep villous invasion and adverse outcomes
Incremental angiogenesis of placenta accreta spectrum and the rail sign
A–B, Color Doppler ultrasound examination for a patient with placenta previa creta. A, In this patient, only subplacental hypervascularity (indicated by “1”) existed at 30 weeks’ gestation. B, The uterovesical hypervascularity (indicated by “2”) appeared only after 33 weeks’ gestation; C–D, Color Doppler interrogation for a patient with placenta previa percreta and bladder invasion at 34 weeks’ gestation. C, Numerous newly formed, coral-shaped vessels (indicated by “3”) extended perpendicularly from the placenta to the bladder mucosa (so-called bridging vessels). D, The subplacental and uterovesical hypervascularity merged (indicated by an asterisk) and even progressed into an aneurysm (Video 2). The parallel subplacental or uterovesical hypervascularity and neovascularization of the bladder mucosa (indicated by a short arrow), together with interconnected bridging vessels (indicated by “3”), constitute the “rail sign” in (D). (E) and (F) were the corresponding images from cystoscopy and surgical findings of the patients in (C) and (D).
http://ow.ly/kwQQ50MXmOi

20/01/2024

https://youtu.be/8msfDgSs2DQ

Watch Prof. Asma Khalil discuss the new ISUOG Practice Guidelines on the performance of a third-trimester obstetric ultrasound scan. The guideline is free to...

13/12/2023

AJOG Expert Review in Labor: Abnormal fetal heart rate patterns caused by pathophysiologic processes other than fetal acidemia - FHR tracing of a case of hematogenous fetal infection because of Listeria monocytogenes: This patient was at 35 weeks and 5 days gestation in active labor; on admission, there were frequent uterine contractions accompanied by late FHR decelerations (arrows) (A); 60 min after admission, persistent and frequent late decelerations (arrows) with absent FHR variability were noted, resulting in an undulating FHR pattern (B); 90 min after admission, persistent fetal tachycardia, absent variability, and subtle late decelerations (arrows) were noted (C). At cesarean delivery, 90 min after admission, foul smelling amniotic fluid was noted; Apgar scores were 1, 6, and 7 at 1, 5, and 10 minutes, respectively; cord artery pH=7.18, cord vein pH=7.21; neonatal blood cultures were positive for Listeria monocytogenes; the female neonate was treated for neonatal sepsis with gentamycin and ampicillin for 2 weeks. Paper speed 3 cm/min http://ow.ly/Ivga50NFLaE

05/12/2023

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02/12/2023

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16/11/2023

05/09/2023

27/08/2023

AJOG Expert Review in Labor: Uterine-sparing surgical procedures to control postpartum hemorrhage - Tsirulnikov’s triple ligation
Ligation of: (1) uterine arteries, (2) the round ligament, and (3) the utero-ovarian ligaments. https://ow.ly/shmc50PCNhT

27/08/2023

AJOG Expert Review in Labor: Uterine-sparing surgical procedures to control postpartum hemorrhage - B-Lynch’s technique of uterine compression by plication
A, Diagram. The technique described here begins on the left side:
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The needle crosses the anterior wall of the uterus approximately 3 cm under the still open, unsutured incision to 3 cm from the left lateral edge of the left uterus.
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It goes back through the anterior wall of the uterus and emerges 3 cm above the incision, still approximately 3 cm from the left lateral edge of the uterus. Steps (1) and (2) describe the first “passage” of the needle.
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The suture travels up the anterior wall of the uterus, crosses the top of the fundus, and descends down the left posterolateral wall.
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The needle pierces the posterior wall and enters the uterine cavity at the same level of the preceding suture point (3 cm above the incision), that is, in the superior portion of the uterine body-isthmus junction, always approximately 3 cm from the left lateral edge of the uterus.
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The needle again pierces the posterior wall at the same horizontal level as the previous suture point, but this time, at approximately 3 cm from the right lateral edge (the other side) of the uterus. Steps (4) and (5) describe the second passage of the needle.
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The suture, now on the posterior wall of the uterus, moves up toward the uterine fundus along the right lateral edge of the uterus, to descend down the right anterolateral wall.
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It returns back through the anterior wall of the uterus and emerges 3 cm above the incision, still approximately 3 cm from the right lateral edge of the uterus.
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The needle again crosses the anterior wall of the uterus, this time approximately 3 cm above the (still unsutured) incision. Steps (7) and (8) describe the third passage of the needle.
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The incision is then sutured according to the usual technique.
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Both ends of the suture (straight needle, No. 0 polyglactin 910) are then put under tension, helped by the assistant's manual compression, to be able to press one wall against the other. Both sutures are then tied at a lower level of the lower segment, under the now sutured incision.

B, Intraoperative view of myometrial brace compression by B-Lynch https://ow.ly/shmc50PCNhT

03/08/2023

Paladini et al. have developed a sonographic protocol that enables instant recognition of 20 major lethal or life-threatening congenital malformations. Read more here: https://bit.ly/451ahRt