Objective. To determine the Disability Adjusted Life Year (DALY) weights of road traffic injuries and use the DALY weights in determining the total DALYs lost in Metro Manila using available data. Methods. Consensus on DALY weights for each of the 31 International Classification of Diseases (ICD)10 codes related to road traffic injuries was done using Delphi Process. Experts from different fields were invited to participate in 2 rounds of discussion-and-scoring were done to obtain consensus were obtained for each DALY weight. Philippine Health Insurance Corporation (PHIC) data on the counts of the 31 ICD 10 coded claims for the years 2011, 2012, and 2013 were obtained and used to calculate the total DALY lost due to vehicular injuries for Metro-Manila. Results. Road traffic related injuries affected mostly young people (mean 34 yo + 15) and affected mostly men (81%). There were a total of 3,199 injuries seen in 2,573 patients. 98.1% of the patients had a < 1 year type of injury with an average disability weight of 0.34154 and a total DALYs lost of 300.4. 0.5% of the patients had a ≥ 1 year type of injury with an average disability weight of 0.2726 and a total DALYs lost of 218.08.1.4% of the patients most likely died from their injuries earning a total DALYs lost of 1,440.The sum of DALYs lost is equivalent to a total of 1,958.12. Conclusion. The Metro Manila loses roughly Php 76.6 Million per year due to road traffic injuries and accidents. These events are highly preventable. Without proper interventions, road traffic injuries may lead to impoverishment of the young families who pick up the pieces, or are left behind.

Introduction Allergic rhinitis is a common disease entity that may be easily misdiagnosed and mistreated. It is a global concern, affecting 10% to 25% of the population worldwide, that has to be controlled since it can be disabling affecting the quality of life of patients. The Philippine Society of OtolaryngologyHead and Neck Surgery is currently updating its 2006 guideline on Allergic Rhinitis. The Section of Rhinology, Department of Otorhinolaryngology together with the Section of Allergy and Immunology, Departments of Pediatrics and Internal Medicine, came up with practice parameters in the diagnosis and management of adult and pediatric patients suspected to have allergic rhinitis to guide clinicians in managing these patients. Locally, it is the first collaboration of otorhinolaryngologists and allergists. Scope of the Guideline This practice parameter was developed to guide general physicians, otorhinolaryngologists and allergists in the diagnosis and management of adult and pediatric patients with allergic rhinitis in an ambulatory care setting. Objectives This guideline aims to (1) assist general physicians, otorhinolaryngologists and allergists diagnose true allergic rhinitis; (2) evaluate current techniques and practices in diagnosing allergic rhinitis; and (3) describe treatment and management options for allergic rhinitis. Development process The Section of Rhinology of the Department of Otorhinolaryngology and Section of Allergy and Immunology of the Departments of Pediatrics and Internal Medicine of the UP-Philippine General Hospital convened a working group to create a consensus document to be used primarily for the Allergic Rhinitis Clinic, a joint clinic of the aforementioned sections in the Out-Patient Department of the UP-PGH, and to serve as a guide to general physicians, otorhinolaryngologists and allergists. The working group agreed to come up with an algorithm for the diagnosis and management of a patient with allergic rhinitis. Clinical questions were subsequently formulated based on the algorithm. The members then searched for relevant literature (including clinical practice guidelines, systematic reviews) in the National Library of Medicine’s PubMed database, Herdin database and unpublished local articles on allergic rhinitis. Appraisal of literature was done by an epidemiologist and evidence was presented and discussed within the working group. Applicability and availability of the diagnostic tests and therapeutic interventions were considered. All materials were assessed for relevance and further classified according to levels of evidence and grades of evidence based on guidelines. Recommendations were based on nominal approval of the working group. The document was then presented to stakeholders--consultants and residents of four clinical departments (Family Medicine, Internal Medicine, Otorhinolaryngology, Pediatrics), medical interns, medical students, nurses and patients. The opinions of the stakeholders were considered in the final draft.

Objective. To describe outcomes of two simulation teaching methods in developing intubation skills of year level six medical students (clinical clerks). Methods. Students were shown a 6-minute video on intubation. Students were exposed to video-assisted learning, videoassisted learning with instructor-guided simulation, and videoassisted learning with experiential learning. Each student was assessed by a non-graded 11 point objective structured clinical examination. Results and Discussion. The three learning strategies: 1. Videoassisted learning, 2. Video-assisted learning with instructorguided simulation, 3. Video-assisted learning with experiential learning (self-discovery learning) simulation showed OSCE mean scores (standard deviations) of 5.76 (2.16), 7.21 (2.35) and 7.60 (1.72), respectively. Failure of intubation was 21% (8/38), 2% (1/40) and 0% (0/36), respectively. There is an absolute risk reduction of 27-30% in failure of intubation when either VGL or VEL is used. Students recognized the contribution of the simulation-based activities to the development of their intubation skills. They appreciated the opportunity to actually perform intubation in a rehearsal setting before doing the procedure on real patients. Conclusion. Medical simulation enhanced student skills development. Experiential learning or self-discovery learning method may be as effective as instructor guided simulation.