<p style="text-align: justify;">INTRODUCTION: Tourniquet test has been widely used locally and internationally as the cheapest, fastest and most efficient way of diagnosing dengue infection. This is so efficient that the World Health Organization has been active in promoting this as a diagnostic tool for tropical countries like the Philippines.
OBJECTIVE: To determine the accuracy of the tourniquet test in the diagnosis of dengue infection among patients aged
METHODOLOGY: The retrospective research design was utilized. These variables were included: the socio-demographic and clinical variables as to the patients' age, gender, body mass index and the presence of co-morbid conditions, clinical manifestations (duration of fever, headache, abdominal pain, rashes and bleeding episodes, hemoglobin level, WBC, Platelets, NS1, IgG, IgM and Hematocri values). Once these were noted, the researcher coded the results. Coding was done in Microsoft Excel.
RESULTS: Patients were mostly in the 12 to 17 years age group, males (54.1%), in the normal weight category (88.1%) and had no co-morbid conditions (77.1%). Clinical manifestations of dengue included fever of ? 4 days (56%); abdominal pain (61.5%); and gum bleeding (56.4%). As regards laboratory profile of patients, low hemoglobin levels were observed (77.5%); low WBC count (78.9%); low platelet counts (100%); positive for NS1 (71.1%); positive for Immunoglobulin G (82.6%) and Immunoglobulin M (85.3%). There was a 65% accuracy of cases when tourniquet test was performed among patients with dengue. There was a strong correlation between dengue infection and WBC (r=0.915; p=0.028); platelets (r=0.663; p=0.003); hematocrit (r=0.57; p<0.01); Non-Structural Protein 1 (r=.753; p=.031); IgG (r=0.566;p=0.002); IgM (r=0.510; p=0.009) and Tourniquet test (r=0.513; p=0.045). No significant correlation was observed for cases of dengue infection and hemoglobin (r=0.026; p=0.702) and platelets (r=0.026; p=0.702).
CONCLUSIONS: The dengue infection was found mostly to be in the 12 to 17 years of age; predominantly males. BMI was not found to be significant factor for dengue infection since most cases were in the normal weight category. Clinical presentations of dengue infection commonly observed in this research were fever with a duration of 4 days and above, headache, abdominal pain and gum bleeding. Majority had abnormal levels of hemoglobin, low WBC, and low platelet count. Biomarkers for dengue infection noted in the study were positive NS1, presence of IgG and IgM. Tourniquet test yielded 655 accuracy if the number of petechiae cases is considered. This could indicate that as an initial tool foe diagnostics, presence of it could be considered for dengue infection. Strong correlation with tourniquet test, and laboratory parameters like WBC, platelets, hematocrit, NS1, IgG and IgM were found which are indicative that these variables have strong association to possible infection of dengue. Any abnormalities found within these laboratory parameters must be considered for dengue evaluation.p>
Human ; Male ; Female ; Adolescent ; Immunoglobulin M ; Immunoglobulin G ; Tourniquets ; Gingiva ; Hematocrit ; Dengue ; Hemorrhage ; Hemoglobin P ; Hemoglobins ; Headache

BACKGROUND: High on-treatment platelet reactivity (HTPR) has been suggested as a risk factor for patients with ischemic vascular disease. We explored a predictive model of platelet reactivity to clopidogrel and the relationship with clinical outcomes. METHODS: A total of 441 patients were included. Platelet reactivity was measured by light transmittance aggregometry after receiving dual antiplatelet therapy. HTPR was defined by the consensus cutoff of maximal platelet aggregation >46% by light transmittance aggregometry. CYP2C19 loss-of-function polymorphisms were identified by DNA microarray analysis. The data were compared by binary logistic regression to find the risk factors. The primary endpoint was major adverse clinical events (MACEs), and patients were followed for a median time of 29 months. Survival curves were constructed with Kaplan-Meier estimates and compared by log-rank tests between the patients with HTPR and non-HTPR. RESULTS: The rate of HTPR was 17.2%. Logistic regression identified the following predictors of HTPR: age, therapy regimen, body mass index, diabetes history, CYP2C192, or CYP2C193 variant. The area under the curve of receiver operating characteristic for the HTPR predictive model was 0.793 (95% confidence interval: 0.738-0.848). Kaplan-Meier analysis showed that patients with HTPR had a higher incidence of MACE than those with non-HTPR (21.1% vs. 9.9%; χ = 7.572, P = 0.010). CONCLUSIONS Our results suggest that advanced age, higher body mass index, treatment with regular dual antiplatelet therapy, diabetes, and CYP2C192 or CYP2C193 carriers are significantly associated with HTPR to clopidogrel. The predictive model of HTPR has useful discrimination and good calibration and may predict long-term MACE.
Aged ; Blood Platelets ; drug effects ; Clopidogrel ; pharmacology ; therapeutic use ; Coronary Artery Disease ; metabolism ; prevention & control ; Cytochrome P-450 CYP2C19 ; metabolism ; Female ; Genotype ; Glycated Hemoglobin A ; metabolism ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Ischemia ; metabolism ; prevention & control ; Regression Analysis