OBJECTIVE: This study aimed to evaluate the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of a handheld Near Infrared Spectroscopy (NIRS) device (Infrascanner 2000®) in detecting intracranial hemorrhage in mild, closed traumatic brain injury patients in the emergency room setting. METHODS: This prospective study evaluated the diagnostic validity of a NIRS device in hemodynamically stable patients with mild, closed traumatic brain injury. The authors included patients aged 15 to 65 years who were consecutively admitted to the Emergency Department of the Philippine General Hospital from June 2017 to September 2017. Patients were scanned by a trained research assistant with the NIRS device in the frontal, temporal, parietal, and occipital areas of the brain bilaterally. A cranial computed tomography scan was used as a reference standard for comparison. RESULTS: A total of 83 participants with mild, closed traumatic brain injury were included in the final analysis. There were 68 (82%) males, and the mean age was 29.52 years old. Of the 83 participants, 41 had intracranial hemorrhages (23 subdural, 13 epidural, 5 intraprenchymal). The NIRS device exhibited a sensitivity, 85.37% [55-96.19%]; specificity, 92.86% [85.07-100.00%]; PPV, 92.12% [83.53-100.00%]; NPV, 86.67% [76.74-96.60%]; PLR, 11.96 [3.99- 35.82]; and NLR, 0.16 [0.07-0.33]. CONCLUSION The NIRS device can reliably screen for hemorrhages in patients with mild, closed traumatic brain injury using CT scan results as the gold standard. These diagnostic values suggest the potential role of the NIRS device in the early evaluation of patients with traumatic brain injury requiring urgent care.

Rationale/Objective: The competency of surgical trainees is measured by, among other things, summative examinations and operative experience. There is little literature on general surgery training in the Philippines. This study examines the trends in operative case load and variety in training institutions accredited by the Philippine Society of General Surgeons (PSGS) from 2009-2018. Methods: This is an observational cross-sectional study of the surgical outputs of PSGS accredited training institutions as reflected in their annual reports. The study determined the trends in general surgical case load and variety and their distribution across the different training institution types from 2009 to 2018. Results: In the study period, there is a trend to an increasing number of operations across all categories/procedures except for trauma surgeries. Overall, the average number of cases credited to residents meets the requirements set by the PSGS. The distribution of cases, however, is not equal among residents of the different institutiontypes. Changes in scope and differences in interpretation of index operations contributed to significant changes in trends. Conclusion Recommendations include a review of definitions of index operations and strict compliance to changes, the utilization of an annual computerized database and the addition of patient outcome measures in the assessment of resident competencies.