INTRODUCTION: Advance directives are documents by which a person makes provisions for health care decisions in the event that, in the future, that person becomes unable to make those decisions. There is a lack of studies on the knowledge and understanding towards advance directives among patients and their families. The purpose of this study is to address this lack of research regarding advance directives by measuring the level of knowledge and attitudes of families of hospitalized patients. METHODS: A descriptive, cross-sectional study design was used to describe the attitudes and the level of knowledge on advance directives of the families of patients. Data were collected directly by the researchers via assisted questionnaires. Descriptive statistics and frequencies were reported. RESULTS: A total of 79 participants consisting of immediate family members of patients from UERMMMCI were enrolled. Only 24% reported having discussed advance directives with the patient's physician. Those respondents whose families had no discussion with their physician about advance directives had the same score as those who had. Overall, 61% of participants have only medium to low knowledge of advance directives, while 70% have positive attitudes regarding advance directives. CONCLUSION The study showed that the family members of patients had a reasonable understanding of advance directives in terms of basic knowledge, and positive attitudes on advance directives. Those who denied having discussed advance directives were comparable in the knowledge of advance directives with those who did.

INTRODUCTION: Metro Manila is at risk from “the big one”, a magnitude 7.2 earthquake caused by the movement of the West Valley Fault, thus awareness and preparedness of the people are very important. The study compared the levels of earthquake awareness and preparedness of households in a high-risk area and a low risk area. METHODS: This was a cross-sectional study among 376 households each from a high- and a low-risk barangay in Metro Manila using a self-administered household-based survey questionnaire consisting of questions on awareness and preparedness. The prevalence of households classified as aware and wellprepared was computed; the significance of differences between the high- and low risk barangays was determined through Fisher’s exact test. RESULTS: There were fewer households classified as aware in the high-risk barangay compared with the low risk barangay, but the difference was not significant (PR = 0.98, 95% CI 0.84, 1.01, p = 0.078, Fisher’s exact test). Less than half of households were classified as well-prepared in both high- and low risk barangays (49.7 vs 46.5%) and the difference was not significant (PR = 1.07, 95% CI 0.92, 1.24, p = 0.422, Fisher’s exact test). Television was the most common source of information in both barangays. Households in the high-risk barangay were more likely to be well-prepared when a member was at least a high school graduate (PR = 2.54, 95% CI 1.24, 5.22, p = 0.001, Fisher’s exact test). CONCLUSION There was no difference in the levels of awareness and preparedness between high and low risk barangays. Television was the most common source of information in both high and low risk barangays. The presence of at least one high school graduate in the household from a high-risk barangay was associated with preparedness but not awareness.
environment ; earthquake ;

INTRODUCTION: In the face of unchanging high rates of stunting among 12-23 months old Filipino babies, sustaining exclusive breastfeeding up to 6 months old remains a challenge. This study determined the effect of a breastfeeding reminder system on breastfeeding. METHODS: This is a quasi-experimental study. Mothers were regularly given breastfeeding reminders by SMS and phone call. The weight, body length, episodes of upper respiratory tract infection and diarrhea were compared between the babies who were given exclusive breastfeeding and those whose exclusive breastfeeding was not sustained. Pearson Chi – square test and t-test at p=0.05 determined significance of differences of variables. RESULTS: From March- October 2020, there were 450 babies included in the study. Of these babies, 44.8% were given exclusive breastfeeding up to 6 months. Timely initiation of breastfeeding was practiced by 91.95% of the mothers in the study. Babies who did not receive exclusive breastfeeding were shorter than those who received exclusive breastfeeding at 1 year old (70.11cm +2.78 vs.75.47cm +1.41, p<0.001) and at 2 years old (80.89 cm +2.30 vs. 87.29cm +1.47, p<0.001). At 2 years old, babies who received exclusive breastfeeding had no episodes of diarrhea and minimal (2%, p<0.001) episodes of acute respiratory infections. CONCLUSION Due to the implementation of the reminder system, the percentage of babies exclusively breastfed up to 6 months of age increased to 44%. This is a significant improvement compared to a previous study where only 29% of the babies were exclusively breastfed.At one and two years old, babies who were not exclusively breastfed had stunting, weighed less and had more infections (diarrhea and URTI).
exclusive breastfeeding ; infants ; stunting

Introduction: In the realm of education and professional licensure, the assessment of individuals’ competencies is pivotal in determining eligibility for entry into various fields of practice. Medical school assessments encompass cognitive and non-cognitive measures. The Philippines’ Physician Licensure Examination (PLE) relies solely on cognitive assessment. This study explored the predictive power of cognitive assessment in the passing the Physician Licensure Examinations. Methods: A case-control study design was done. Cognitive examination grade was defined as the average cumulative grade of written examinations in specific subjects, while the dependent variable was PLE scores. Results: The study revealed a positive association between failing written examinations and failing the Physician Licensure Examination. In all subjects, there is an observed association, but only Pharmacology reached statistical significance (OR: 2.30 CI:1.01,5.24). For the remaining subjects, although there is an association, it did not reach statistical significance (Biochemistry OR:1.42, CI: 0.43, 4.72; Medicine 3 OR:1.56, CI: 0.81, 3.0; Surgery 3 OR:1.28 CI: 0.63, 2.58). There was no association seen between failing the written examination and failing the PLE in Obstetrics (OR:0.98 CI: 0.47, 2.03). Furthermore, there was a weak positive correlation (0.18-0.31) between written examination grades and corresponding board exam subject grades for all subjects, highlighting the importance of cognitive assessments in predicting success. The research also found a statistically significant difference in PLE grades between those who failed the written examinations and those who passed. Conclusion These findings emphasized the crucial role of cognitive assessments in predicting success in the PLE and its associated board subjects. The study underscored the need for medical institutions to focus on strengthening cognitive competencies and to align the content and rigor of written examinations with the PLE. Addressing these issues would better prepare students for the licensure examination and enhance the quality of healthcare professionals entering the workforce. The results may contribute to the ongoing discussion on the effectiveness of assessment methods in medical education and licensure examinations.
Association

INTRODUCTION: Lockdowns and quarantine measures during the pandemic have led to increased media consumption among students worldwide. This study aimed to determine the association between the status of the psychological well-being of medical students in a private tertiary institution and social media use during the pandemic. METHODS: This is cross-sectional analytical study which included medical students in a private tertiary institution. SONTUS was used to measure social media usage, while Ryff’s Scales of Psychological Well- Being was used to assess the psychological well-being. PRR and Chi-square test were used for data analysis. RESULTS: There were 317 respondents in the study. Based on the results of SONTUS, there are 114 respondents who have high usage. For the Ryff’s scale, there were 76 respondents who have low well- being scores. The computed Pearson Chi-square has an associated probability (p-value) of 0.855 which is more than the set significance level of 0.05. For the PRR, the computed value was 1.04. CONCLUSION There was no association found between the psychological well-being status of medical students in a private tertiary institution and social media use during the pandemic.
social media use ; well-being ; pandemic

INTRODUCTION: Okra is reported to have anti-diabetic effects, but the literature shows conflicting results. The experiment aimed to determine the efficacy of three doses of okra seed powder suspension as a glucose lowering agent on streptozotocin-induced diabetic rats and its cellular effects on the liver and pancreas. METHODS: Twenty-five Sprague Dawley rats that were given streptozotocin 60 mg/kg intraperitoneally were randomly allocated to one of five treatment groups: okra seed powder at 100 mg/kg, 150 mg/kg and 200 mg/kg, acarbose (positive control) and vehicle only (negative control). The treatments were given as a 1.5 mL oral gavage daily for 21 days. Significant differences in blood glucose were determined between treatment groups in terms of relative change from baseline, using One-Way ANOVA with Dunnett’s method with acarbose as the referent group. Repeated measures ANOVA was used to analyze the blood glucose levels across the time point collections (baseline, T1 and T2). Histopathologic changes on the liver and pancreas were described using counts and proportions. RESULTS: Mean blood glucose values increased from baseline to T2 in all treatment groups. Increasing trend was observed only up to T1 in the 150 mg/kg and the 200 mg/kg okra seed treatment groups. Comparing okra treatment groups to acarbose, the percentage increase of mean blood glucose from baseline to T2 was lowest in the 200 mg/kg okra group (p = 0.040). The okra-treated rats had no fatty change and a dose-dependent decrease in cellular degeneration in the liver and none for the 200 mg/ kg treatment group. CONCLUSION The 200 mg/kg okra suspension has a potential lowering effect on blood glucose and a hepatoprotective effect. A longer period of observation with higher doses of okra suspension is recommended to study these effects further.

Introduction: The demanding nature of medical school causes students to experience stress, anxiety, and depressive episodes that may cause students to gain or lose weight. This study aimed to determine the association of weight changes and stress levels among a private medical school students. Methods: Data were collected two times with an interval of 30 days through on-site measurement of the students’ anthropometrics using a stadiometer and utilization of online survey questionnaires accessed via QR code. Demographics and disease states were identified in the first round of data collection while the Perceived Stress Scale-10 (PSS-10) and identification of stressors was integrated in the second round of data collection. Results: Among the 212 individuals, 69.8% were categorized into having perceived moderate stress levels, 22.2% with high stress, and 8% with low stress. Of the 212 cases, 86 gained weight, 91 lost weight, and 35 had no change in weight. Fear of failure, poor motivation, and difficulty understanding lectures are among the top overall stressors. The study noted that there is a moderate association between stress and weight changes but it is not enough to reach statistical significance (0.161), as the sample size was not reached. The study revealed that the prevailing diseases were Polycystic Ovarian Syndrome, Hypothyroidism, and Hypertension, which have varying degrees of impact on weight change. Conclusion There is an association between weight changes and stress levels among first to fourth year medical students of a private medical school from A.Y. 2023-2024.
Weight Gain ; Weight Loss ; Students, Medical

Executive Summary Leptospirosis is a disease prevalent mostly in tropical and subtropical countries. Its potential to be a concerning problem emerges with the onset of the rainy season, as flooding and heavy rainfall facilitate disease epidemics. Among those at risk of contracting the disease are field workers, veterinarians, sewer workers, military personnel and those who swim or wade in contaminated waters. In the absence of an existing evidence-based guideline for the pediatric age group, this first edition hopes to standardize approach to diagnosis, antibiotic management, and prevention of leptospirosis. The intended users are primary care physicians, family medicine physicians, pediatricians, and other healthcare workers involved in the management of leptospirosis in children. Ten priority questions were identified by a group of experts composed of an oversight committee, a guideline writing panel, and a technical review committee. The GRADE methodology was used to determine the quality of evidence of each recommendation. The draft recommendations (summarized below) were finalized after these were presented to and voted on by a panel of stakeholders.

INTRODUCTION: In the Philippines, several health policies have been tailored to promote breastfeeding. Statistics show that despite efforts, breastfeeding prevalence remains low. This study aims to determine the demographics and associated barriers and enablers of breastfeeding among mothers living in Metro Manila. METHODS: The study used a cross-sectional analytical design through an online self-administered questionnaire on barriers and enablers answered by mothers between 15-49 years old, residing in Metro Manila. RESULTS: A total of 761 responses were included in the fnal analysis. Only age was found to be signifcantly associated with the practice of breastfeeding. Barriers identifed were 1) seeing breastfeeding as timeconsuming, 2) development of sore or tender nipples, 3) previously failed breastfeeding attempts, 4) poor latching on, and 5) not enough breastmilk production. Enablers identifed were 1) seeing the practice as a good way to bond with the child, 2) presence of breastfeeding areas at work or school, 3) previous success in breastfeeding experience, 4) support from hospital staff or midwives, 5) having knowledge on whom to contact when challenged with breastfeeding, and 6) knowledge of the benefts of breastfeeding on infant and maternal health. CONCLUSION Barriers and enablers towards breastfeeding may be target points for improvement of interventions aiming to increase prevalence of breastfeeding among mothers in Metro Manila.