SPMC Journal of Health Care Services

Southern Philippines Medical Center Journal of Health Care Services (SPMC JHCS) is the official journal of SPMC. It is a multi-disciplinary, peer reviewed, Open Access journal that showcases the written works of SPMC employees and other submitting authors. The goal of the publication is to contribute to local and international efforts to broaden the knowledge base of health care services.

SPMC JHCS accepts submissions and commissions articles on a year-round basis. Individual articles are published online immediately upon completion of peer review, editorial processing, and copyediting to ensure the timely dissemination of new health care knowledge. Published articles are subsequently consolidated into two formal issues, released annually in June and December.

SPMC JHCS is owned and published by SPMC. The owner grants editorial freedom to the editors of this publication.

Information contained in SPMC JHCS is intended for professionals and students of health care disciplines. Contents made available in this publication are contributions of individuals or organizations. SPMC is not responsible for the accuracy of any data used in coming up with the contents reported in the articles.

The views and opinions expressed by the authors of individual articles in SPMC JHCS are their own and do not reflect the official position of SPMC. Contents in this publication shall not be used to disregard or replace the advice of a qualified medical professional. SPMC shall not be held liable for any damages resulting from the use or inability to use the contents of SPMC JHCS.

Editor in Chief
Alvin S Concha

Southern Philippines Medical Center

Associate editors
Christine May Perandos-Astudillo

Southern Philippines Medical Center

Rodel C Roño

Southern Philippines Medical Center

Managing editor
Clarence Xlasi D Ladrero

Southern Philippines Medical Center

Layout editor
Clarence Xlasi D Ladrero

Southern Philippines Medical Center

Fitzgerald Cabahug Arancel

Chief of Medical Professional Staff, Southern Philippines Medical Center

Maria Elinore Alba-Concha

Chief Training Officer, Southern Philippines Medical Center

Vicente Belizario Jr

College of Public Health, University of the Philippines Manila
SEAMEO TROPMED Regional Centre for Public Health, Hospital Administration, Environmental and Occupational Health

Noel Espallardo

Board of Trustee, Philippine Academy of Familly Physicians
Editor-in-chief, The Filipino Family Physician
Chair, Research Committee, PAFP
Chair, Publication Committee, PAFP

Noel Juban

University of the Philippines Manila

Jose Florencio Lapeña

University of the Philippines Manila
College of Medicine - Philippine General Hospital
Professor of Otorhinolaryngology, UP College of Medicine
University Scientist III, University of the Philippines System
Editor, Philipp J Otolaryngol Head Neck Surg
Charter President, Philippine Association of Medical Journal Editors (PAMJE)
Secretary, World Association of Medical Editors (WAME)

Lynette Lu Lasala

Southern Philippines Medical Center

Zorayda Leopando

University of the Philippines – Philippine General Hospital

Anthony Sales

Regional Director, Department of Science and Technology XI

Leopoldo Vega

Former Medical Center Chief, Southern Philippines Medical Center

The overall quality of this journal greatly relies on the comments and recommendations of peer reviewers. We would like to acknowledge the following peer reviewers for their invaluable contribution in the article selection process of the SPMC Journal of Health Care Services.

Mary Jane Ayco Southern Philippines Medical Center	Maria Elinore Alba-Concha Southern Philippines Medical Center	Robert Bandolon Southern Philippines Medical Center
Vergel Bautista Southern Philippines Medical Center	Mary Jo Kristine Bunagan Southern Philippines Medical Center	Claire Angela Canda Southern Philippines Medical Center
Antonietta Rolida Cañedo Southern Philippines Medical Center	Bernard Chiew Davao Doctor's Hospital	Wenelito Clapano San Perdo Hospital
Katrina Cecilia Cruz Southern Philippines Medical Center	Rae Dapitanon-Solis Southern Philippines Medical Center	Henry Derla San Pedro Hospital
Madelle Anne Dumlao Diliman Doctor's Hospital	Je-Ann Faith Fabian-Tan Davao Doctor's Hospital	Laricelle Feliciano-Paguican Southern Philippines Medical Center
Reece Feliciano-Paguican Brokenshire Integrated Health Ministries	Rodel Migue Flores Davao Regional Medical Center	Ernesto Guadalupe Southern Philippines Medical Center
Ruby Jane Sahid Guerrero St Louis Hospital Tacurong	Bryan Edgar Ko Guevara Southern Philippines Medical Center	Victoria Guillano Southern Philippines Medical Center
Michelle Harun Southern Philippines Medical Center	Ann Marie Tabucan Isaga Davao Medical School Foundation	Maria Lourdes Lacanilao Southern Philippines Medical Center
Crystal Lademora Southern Philippines Medical Center	Evelyn Lao Southern Philippines Medical Center	Annabelle Lao-Reyes Southern Philippines Medical Center
Peter Paul Lim Avera Medical Group	Ria Fortugaliza Luengas Southern Philippines Medical Center	Lynnette Lu-Lasala Southern Philippines Medical Center
Donnah Bless Lumanlan-Mosqueda Southern Philippines Medical Center	Leandro Manalaysay Cardinal Santos Medical Center	Julaidah Mastura-Glang Southern Philippines Medical Center
Armand Merton Southern Philippines Medical Center	Bryan Norico Family Eye Care	Loida Michelle Ong Southern Philippines Medical Center
Mark Anthony Paderanga Southern Philippines Medical Center	Agnes Padilla San Pedro Hospital	Noel Peñaranda Davao Doctor's Hospital
Ella Joy Nogas Southern Philippines Medical Center	Jay Karlou Piedad Sanchez-Regondola Davao Doctor's Hospital	Paolo Alan Tabar Friendly Care Foundation Incorporated
Mark Anthony Paderanga Southern Philippines Medical Center	Agnes Padilla San Pedro Hospital	Noel Peñaranda Davao Doctor's Hospital
Peter Ian Tabar St Elizabeth Hospital Inc	Ronald Tangente Davao Doctor's Hospital	Mark Anthony Tom Davao Doctor's Hospital
May Uyking-Naranjo Davao Doctor's Hospital	Delfin Valdez Jr Brokenshire Memorial Hospital	Gabriel Anthony Villa Cebu Doctors' University Hospital
Maria Vinna Nicodemus Crisostomo Southern Philippines Medical Center	Margaret Stephanie L Jimenez Southern Philippines Medical Center	Hester Lim Bueser Chong Hua Hospital
Seurinane Sean Española Southern Philippines Medical Center	Marie Applelyn M Fabian Southern Philippines Medical Center	Aura Rhea Lanaban Southern Philippines Medical Center
Rozalyn D Reyes-Mauro Southern Philippines Medical Center	Enrico Ian Deliso Southern Philippines Medical Center	John Michael B Hega Southern Philippines Medical Center
Stephen Matthew B Santos Southern Philippines Medical Center	Jesse Jay Baula Southern Philippines Medical Center	Ma. Theresa A Fedoc-Minguito Southern Philippines Medical Center
Hannah Grace Segocio Southern Philippines Medical Center	Cheryl Lyn A Diez Southern Philippines Medical Center	Kirk Llew V Quijote Southern Philippines Medical Center
Ace Gabriel Culas Department of Health	Jacqueline B Javier Department of Health	Fercy Cavan Fixstat Research and Consultation Services

and the peer reviewers who wish to remain anonymous. Many thanks for your participation!

- SPMC JHCS Editorial Staff

SPMC Journal of Health Care Services