Patient X is a 13 year old client from a remote area in Bgy. San Vicente, Ocampo, Camarines Sur.

Wherein she lives with her family in a non concrete house mainly made of bamboo and nipa materials. The structure is in close proximity with their other relatives and surrounded by vast area of agricultural lands and a river at the back of it. His father is a laborer with no permanent job paid in a day to day basis with a minimum income of 150 pesos. Her mother serves as the manager of the house taking care of its operations. She has 5 siblings namely. One of her brother died due to a fall accident way back three years ago which caused the depression of her mother and aggravated by her present condition. Her father brought her mother in the psychiatric department of BMC to seek medical attention and is given home medications but not rigidly followed. So the condition still exists and suffered by the family with periods of relapse and exacerbation. When her mother conceives of patient x, she regularly visits the health center, with an estimation of 2 kilometers distance from their house, and taking some medications like ferrous sulfate. Her mother doesnt have vices and neither took any harmful medications during pregnancy. Patient X was delivered in their house with the assistance of a partera and not seen by a pediatrician to check for any congenital anomalies. She grew up normally like any other children not until she reached the age of 9 when she was brought to the hospital for the first time and diagnosed with ventricular septal defect. Since then, her complaints were difficulty of breathing, epistaxis, and body malaise. Her recent admission last April 16, was again due to epistaxis