Armpit Furuncle and Folliculitis

Inflammation and infection of hairs in the armpit leads to armpit furuncle (singe hair follicle is involved) and armpit folliculitis (multiple hair follicles are involved).

Most women remove their armpit hairs.  Regardless of types of methods of armpit hair removal (shaving, plucking, depilators, waxing, laser removal, etc.), there is a risk for armpit furuncles and folliculitis to develop.  Hygiene is the key to preventionWashing with bland soap and water is the mainstay in the treatment of furuncles and folliculitis until the inflammation and infection subside.  Antibiotics and drainage of pus may be added when indicated.

Below are some pictures of armpit furuncles and folliculitis I sorted from the Internet (courtesy of the owners):

Armpit Furunculosis

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Armpit Folliculitis (different degrees and extent)

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Ringworms-in-armpit-may-cause-underarm-rash

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After drainage of folliculitis

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ROJ@18may26;18jun17

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Sample of Prescription with Legible Handwriting

prescription_legible_roj_17jan24

 

ROJ@18may25

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Surface Body Mass – An Algorithm – ROJoson

Retrieved this old file – circa 1994

Still apt.

18may25 – Addition: An ill-defined margin of a non-bony surface mass can be used as a basis for suspecting malignancy.

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ROJ@18may25

Posted in Mass and "Bukol", Surgeons | Leave a comment

Usual Schedule of Professional Fees of HMOs in the Philippines – 2018

Professional fees for outpatient services:

Consultation Fee – P350 / visit



Professional Fees for surgical and gynecologic cases:

These fees will be based on the Relative Unit Value (R.U.V.) published by the Philippine College of Surgeons (2009)

OPD Ward                                                           110 x RUV

Semi-Private Room                                         115 x RUV

Private Room                                                     120 x RUV

Suite Room                                                         125 x RUV


Professional Fees for Anesthesiologists: 1/3 of the surgeon’s fee.



Professional fees for Inpatient Services

Ward                                                                     600.00 / day

Semi-private                                                       750.00 / day

Private                                                                  850.00 / day

Suite                                                                      1,200.00/ day

ICU                                                                         1,400.00 / day




PCS RVS 2009

rvs2009


ROJ@2018may24

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Use of Probability in Clinical Diagnosis

I am happy to see this note from the website of John Hopkins Breast Cancer.  In particular, I am happy to see the word “probability.”  It jibes with my usual practice of giving estimates of probability or certainty of clinical diagnosis (most of the time, using subjective probability based on objective clinical findings, prevalence and experience).  See sample of a medical record  below.

“At the Johns Hopkins Breast Center, our team of breast cancer specialists is incredibly sensitive to the anxiety a possible diagnosis of breast cancer creates for our patients. Therefore, we follow strict guidelines for evaluation, biopsies and pathology reports. On the day of your breast biopsy, you will be given the probability that the biopsy is a fibroadenoma. Firm confirmation will follow within 24 hours.

https://www.hopkinsmedicine.org/breast_center/breast_cancers_other_conditions/fibroadenoma.html


Sample of ROJoson’s Medical Record – Note the estimates of probability of clinical diagnosis. Depending on the clinical findings and my judgement, I usually give 60-40; 70-30; 80-20; 90-10; 95-5; 98-99-2-1.  I don’t give an estimate of 50-50.

informed_consent_thyroid_1_roj_17jul13a

Concerning this statement: “At the Johns Hopkins Breast Center, our team of breast cancer specialists is incredibly sensitive to the anxiety a possible diagnosis of breast cancer creates for our patients. ”  This is true.  If the clinical diagnosis has a high probability of a benign condition, by telling the patient so, rather than saying 50-50 or no estimate, it instantly will offer great relief to the anxiety of the patient.



ROJoson’s TPOR (Thoughts, Perceptions, Opinions, and Recommendations)

ROJoson’s RRR (Re-study, Refine, and Reaffirm)



rojoson_way


ROJ@18may23

Posted in Clinical Diagnosis, Probabilistic Medical Reasoning and Clinical Decision-making | Leave a comment

One way of patients’ keeping their outpatient medical records from ROJoson Medical Clinic

Below is a way of how a patient kept her outpatient medical records from ROJoson Medical Clinic.  She placed them inside a folder that fitted the size of the outpatient medical records.

See illustrations below:

medical_recors_patients_roj_17mar2 (1)medical_recors_patients_roj_17mar2 (2)nipple_discharge_antibiotics_prescription_pad_roj_16dec30roj_explanation_thyroid_roj_17feb2

Note: the above illustrations also show the contents of the medical records of ROJoson with informed consent.


ROJ@18may4

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Breast Cancer Survivor Sharon Belveder – 11 Years in Remission

2018 May 2

Eleven years ago (2007), I operated on Sharon Belveder in Ospital ng Maynila Medical Center.  I did a partial mastectomy with axillary dissection.  The axillary lymph nodes were negative for metastasis.  She did not have any additional treatment afterwards.  She just had regular check-up with me.  We both thank God for this long remission.

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ROJ@18may2

Posted in Breast Cancer Survivors, Cancer Survivors | Leave a comment