It is now 10 years since the world was faced with the first severe and readily transmissible new disease of the 21st century – severe acute respiratory syndrome (SARS). Unknown and unrecognized, it emerged in late 2002 as the probable cause of an outbreak of atypical pneumonia in Guangdong Province, southern China. It then spread to Hong Kong Special Administrative Region (China) via an infected traveller who arrived at his hotel on 21 February 2003 where he infected 15 other guests. They, in turn, travelled to other countries carrying the new disease and initiating outbreaks in Viet Nam, Singapore and Canada. Three weeks later, with increasing numbers of cases among hospital staff in Hong Kong Special Administrative Region (China) and Viet Nam, the World Health Organization (WHO) issued a global alert on 12 March 2003 about this new acute respiratory syndrome of unknown etiology. However, the disease was spreading rapidly along major air routes, prompting WHO to issue an emergency travel advisory on 15 March, as well as naming the new disease “severe acute respiratory syndrome” and providing the first surveillance case definition.

Beckwith-Wiedemann Syndrome (BWS) is a rare congenital overgrowth disorder due to alterations in specific genes in chromosome 11p15. It has a variable clinical picture. Infants may exhibit a combination of the following characteristics: macroglossia, macrosomia, abdominal wall defects, ear creases or posterior helical pits, hypoglycemia, polyhydramnios and prematurity. Presented is a case of a 24-year-old gravida 3 para 2 (2002) who manifested with preterm labor and polyhydramnios. She delivered a preterm live baby girl who was diagnosed to have Beckwith-Wiedemann syndrome. The rarity of this condition, as well as the significant maternal and perinatal complications associated with it, is discussed in this paper.

Human ; Female ; Adult ; Infant Newborn ; Pregnancy ; Congenital Macroglossia ; Macroglossia ; Beckwith-wiedemann Syndrome ; Polyhydramnios ; Abdominal Wall ; Fetal Macrosomia ; Hypertrophy ; Chromosomes ; Hypoglycemia

Swyer Syndrome is a pure form of gonadal dysgenesis that although rare, should not be disregarded in the differential diagnosis of patients who present with primary amenorrhea and abdominopelvic mass. The dysgenetic gonads fail to produce antimullerian hormone in an individual with Swyer Syndrome who is genetically male, resulting in feminization and absence of virilization. Phenotypically female, they usually seek consult at a later time during their teenage years due to primary amenorrhea. Our index patient consulted due to a large abdominopelvic mass and primary amenorrhea. Hormonal assay showed a hypergonadotropic hypogonadism endocrinologic milieu, and on karyotyping, showed a genetically male individual. This paper shall discuss an in-depth pre-operative, surgical and post-operative management of patients diagnosed with Swyer Syndrome.

Human ; Female ; Adolescent ; Anti-mullerian Hormone ; Amenorrhea ; Feminization ; Diagnosis, Differential ; Gonadal Dysgenesis, 46,xy ; Turner Syndrome ; Gonadal Dysgenesis ; Karyotyping ; Virilism ; Hypogonadism ; Gonads

Malaria is suspected in pregnant women with fever of unknown origin who come from areas with high transmission of the disease. Pregnant women are at greater risk of infection due to a weakened immune response and higher parasite burden because of placental sequestration. A 26-year-old Sudanese primigravid 23 6/7 weeks of gestation presented at our institution with mixed infection of malaria, with severe features (hypotension and anemia). Malaria was highly suspected due to her country of origin, which was highly endemic and has high transmission of the disease. Fetal surveillance to monitor fetal well-being was done since malaria is known to cause perinatal adverse outcomes. Intrauterine growth restriction, preterm labor and stillbirth are the most common perinatal morbidity from malaria. These are not present in the patient due to the prompt initiation of artemisinin-based combination therapy, which significantly decreased the parasite load, leading to successful outcome.

Human ; Female ; Adult (a Person 19-44 Years Of Age) ; Pregnancy ; Artemisinine ; Artemisinins ; Parasites ; Coinfection ; Malaria ; Prenatal Care ; Parasite Load ; Gravidity ; Obstetric Labor, Premature ; Anemia ; Hypotension

Polycystic ovary syndrome (PCOS) is a heterogenous condition with signs and symptoms including menstrual dysfunction, weight disorders, hirsutism, diabetes mellitus, dyslipidemia and metabolic disorders. As such, diagnosis is controversial and differs between countries and communities. This study was done to identify and construct a registry of women with polycystic ovary syndrome being seen at the Out-Patient Department of Philippine General Hospital and obtain their demographic and anthropometric characteristics as well as their hormonal profile to be able to examine the best available evidence on the diagnosis and clinical management of PCOS in the Philippine setting. Results of the study showed comparable baseline characteristics and hormonal profile among Filipino women with PCOS. These data suggest that diagnostic and therapeutic modalities applied in other groups of women may be applicable and cost-effective in the Philippine setting.
Human ; Female ; Adult ; Young Adult ; POLYCYSTIC OVARY SYNDROME ;

Adult ; Comorbidity ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza, Human ; diagnosis ; drug therapy ; physiopathology ; Inpatients ; Male ; Pneumococcal Infections ; diagnosis ; drug therapy ; physiopathology ; Streptococcus pneumoniae ; isolation & purification ; Treatment Outcome

Current evidence suggests that understanding coronary artery disease extends beyond identifying and treating traditional risk factors. Progression of coronary plaque contributes to the development of acute coronary syndrome (ACS). In this article, we reviewed current literature for modalities to image coronary plaque as well as discussed the role of emerging techniques that can improve our understanding of the pathophysiology of ACS.
Acute Coronary Syndrome ; diagnostic imaging ; Coronary Stenosis ; diagnostic imaging ; Humans ; Magnetic Resonance Angiography ; Tomography, Optical Coherence ; Tomography, X-Ray Computed ; Tunica Intima ; diagnostic imaging ; Tunica Media ; diagnostic imaging ; Ultrasonography

OBJECTIVE: To report a case of frosted-branch angiitis. METHOD: This is a case report of frosted-branch angiitis seen at the University of the Philippines-Philippine General Hospital. RESULTS: A 42 year-old male presented with progressive blurring of vision of the left eye. Indirect funduscopy showed dilated retinal veins with perivascular sheathing, giving the appearance of frosted-branches of a tree. CONCLUSION: Frosted-branch angiitis is a rare form of retinal vasculitis with various etiologies. Despite the severe retinal appearance, the prognosis is usually good, with rapid recovery of visual acuity after prompt steroid treatment.
Male ; Middle Aged ; RETINAL VASCULITIS ; VASCULITIS ; CASE REPORTS

Absenteeism ; Emergency Service, Hospital ; Hospitals, General ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; epidemiology ; Personnel, Hospital ; Sentinel Surveillance ; Singapore ; epidemiology

BACKGROUND

Accurate diagnosis of onychomycosis is important because its treatment is long-term, costly, and sometimes with complications. KOH test is quick and cheap but has low sensitivity. Hence, the need for additional tests such as culture and/or PAS. However, these two tests are not readily available and expensive. Dermoscopy is an emerging tool for the diagnosis of nail conditions.

OBJECTIVE

This study aims to evaluate the accuracy of dermoscopy as a point-of-care tool in diagnosing distal subungual onychomycosis (DSO).

METHODS

This is a prospective, cross-sectional study of 22 clinically diagnosed DSO patients selected via convenience sampling in a tertiary hospital from November 2019 to March 2021. Participants had gross nail examination, dermoscopy, KOH and PAS tests. Measures of diagnostic accuracy for the different dermoscopic patterns were obtained, with KOH and PAS results as reference standard.

RESULTS

Fifty-one nail samples were submitted for processing with only 49 nails accepted for analysis. The most common pattern was jagged edge with spikes (65.3%). Combining all 5 dermoscopic patterns increased the sensitivity to 91.2% (95% CI: 76.3, 98.1).

CONCLUSIONS

Dermoscopy may be used as a first-step, point-of-care tool in the diagnosis of DSO. Addition of mycological and histopathological tests is still warranted for confirmation.

Dermoscopy ; Onychomycosis ; Potassium Hydroxide