INTRODUCTION: Congenital heart disease (CHD) is a leading cause of infant mortality. The aim of this study was to evaluate the efficacy of a neonatal screening programme for CHD before the introduction of pulse oximetry. METHODS: This was a retrospective review of live births in the period 2003-2012. Cases of CHD were detected through prenatal ultrasonography and/or postnatal examination, and confirmed using two-dimensional echocardiography. Data was rigorously checked against multiple sources. The antenatal detection rate, sensitivity, specificity, predictive values and likelihood ratios of the screening programme were analysed for all cases of CHD and critical CHD. RESULTS: The incidence of CHD was 9.7 per 1,000 live births. The commonest CHD was ventricular septal defect (54.8%). The antenatal detection rate was three times higher in the critical CHD group (64.0%) compared to the group as a whole (21.1%). The sensitivity and specificity of screening was 64.5% and 99.7% for all CHD, and 92.9% and 99.1% for the critical CHD group, respectively. The positive likelihood ratio was 215 and 103, while the negative likelihood ratio was 0.36 and 0.07 for all CHD and critical CHD, respectively. CONCLUSION The CHD screening programme had excellent specificity but limited sensitivity. The high positive likelihood ratios indicate that where sufficient risk factors for CHD are present, a positive result effectively confirms the presence of CHD. The low negative likelihood ratio for critical CHD indicates that, where prior suspicion for critical CHD is low, a negative result is reassuring.

Objective: Leptospirosis in children is one of the most common diagnostic dilemmas, hence this study was performed to determine the clinical profile, outcome and risk factors associated with mortality in patients seen at tertiary government hospitals from January 2008 to December 2012. Methods: A case-control retrospective study was done among admitted patients at UP-PGH, SLH, and RITM. Descriptive statistics and multiple logistic regressions were utilized. Results: Among the 404 leptospirosis cases included in the study, 94% were male, with 43% belonging to 16-18-year-old age group (age range 3 to 18 years old). A higher occurrence was noted during the rainy season and in Manila. Clinical findings include fever, abdominal pain, calf tenderness, vomiting and conjunctival suffusion. Significant correlation was noted in patients with jaundice (p-value 0.014; OR 6.293, CI 1.449-27.335), dyspnea (p-value 0.004; OR 7.880, CI 1.967-31.561) and cardiac abnormality (p-value 0.042; OR 15.343, CI 1.106-212.853). Abnormal laboratory findings include neutrophilia, azotemia, creatinemia, anemia, elevated bilirubin levels and thrombocytopenia. Prolonged prothrombin time was associated with poor outcome (p-value 0.004, OR 23, CI 2.79-189.67). Penicillin was the drug of choice given to 96.8%. 94.6% of cases who had oliguric renal failure were conservatively converted to non-oliguric type. 5.4% underwent peritoneal dialysis and survived. Inotropes were used in 93% of non-survivors. The case fatality rate was 3.5% with the cause of death mostly due to Weil’s disease. The average hospital stay among survivors was 6.8+3.3 days as compared with 1.8+1.9 days in non survivors. Shorter hospital stay (p-value 0.00; OR 3.514, CI 2.115-5.839), as well as inotropic support (p-value 0.035; OR 62.511, CI 1.33-2949.134), were associated with poorer outcome, but these findings can be attributed to late presentation of cases at the hospital for admission. Conclusion A5 year review of patients with leptospirosis showed that jaundice, dyspnea, cardiac abnormality and prolonged prothrombin time were predictive of mortality.
Leptospirosis

Background and Objectives: The study determined the prevalence and causes of childhood blindness and visual impairment (VI) in the hospital and determined the association between risk factors and dimensions affecting eye care utilization and VI severity. Methodology This is a retrospective cross-sectional study which included 318 records of pediatric patients who consulted at the Baguio General Hospital and Medical Center (BGHMC) in 2018.
Vision Disorders ; Blindness ; Cataract ; Refractive Errors