Haemophagocytic lymphohistiocytosis (HLH) is a potentially fatal disorder resulting from uncontrolled hyperinflammatory response. There had been increase in cases of one of the secondary form of HLH, i.e., infectionassociated haemophagocytic syndrome (IAHS) in severe dengue in recent years. However, the condition remains under diagnosed due to lack of awareness compounded by the lack of validated diagnostic criteria. Severe hepatitis with prolonged cytopenias, severe hyperferritinemia, hypofibrinogenemia and persistent fever were evident in all four cases reported. All the subjects survived with supportive care and adjuvant steroid therapy. Prospective controlled studies are needed to develop diagnostic criteria and management protocol for IAHS in severe dengue.
Severe Dengue

Background: Dengue, a mosquito-borne flavivirus, is hyperendemic in the Philippines. One of its rare complication is dengue encephalitis, characterized by altered sensorium, elevated liver enzymes, and high dengue-specific antibody titers. Previously known as non-neurotropic, dengue presents with an increasing incidence of neurologic manifestations. Objective: To describe the clinico-demographic profile and outcome of laboratory-confirmed dengue encephalitis patients. Methods: This is a retrospective study that used purposive sampling to describe laboratory-confirmed dengue encephalitis cases aged 0-18 years. The clinico-demographic profiles and outcomes were collected using chart review, and variables were analyzed using descriptive statistics. Results: 14 laboratory-confirmed cases were reviewed. Most (57%) were males aged 3 days-15 years. Fever lasted 3-11 days. Following nonspecific signs and symptoms, neurological manifestations developed within 1-5 days, the most common being seizures (71%). Majority (57%) had anemia. All, except one, exhibited leukopenia and thrombocytopenia. Elevated liver enzymes, bleeding parameter derangements, electrolyte, and glucose imbalances were noted. All were seropositive for dengue IgM, and 5 dengue IgM in the CSF. Most common EEG findings showed generalized slowing. Neuroimaging reports were normal in some or showed cerebral edema in the others. Half of the patients recovered fully, 3 showing partial recovery from neurologic changes, and 3 others had neurologic sequelae. One infant expired. Conclusions and Recommendations Dengue encephalitis should be considered in patients living in an endemic country, presenting with fever with neurologic changes or elevated liver enzymes, with a risk for developing neurologic sequelae or death.
Severe Dengue

No abstract availalbe.
Severe Acute Respiratory Syndrome*

No abstract available.
Severe Acute Respiratory Syndrome*

No abstract availalbe.
Severe Acute Respiratory Syndrome*

INTRODUCTION: Dengue is one of the causes of morbidity and mortality among pediatric patients. Calcium has been shown to play a role in the myocardial function of the patient and is a potential cause of mortality among dengue patients. This study aimed to determine the accuracy of hypocalcemia in predicting the severity of dengue among pediatric patients. METHODS: This is a systematic review and meta-analysis of published studies identified through an electronic literature search using PubMed/Medline, Cochrane Library, Herdin, Google Scholar, and hand search. Validity was assessed using the Cochrane risk of bias tool. Statistical analysis of the diagnostic test accuracy review was done using Review Manager 5.4.1 with the random effects model. Results showed sensitivity and specificity of hypocalcemia in severe dengue with a 95% confidence interval. The predictive values and likelihood ratios were also computed. RESULTS: Four studies were analyzed. The mean serum total and ionized calcium levels of patients were decreased among the severe dengue group. Data showed that there is a 74% sensitivity (95% CI = 0.58, 0.84) and 75% specificity (95% CI = 0.67, 0.81) with a positive predictive value of 67% and a negative predictive value of 90.7%. CONCLUSION This systematic review and meta-analysis showed that hypocalcemia may be a useful tool to predict severe dengue fever. However, further analysis is needed to strengthen the the diagnostic accuracy of hypocalcemia.
Severe Dengue ; Hypocalcemia

Dengue ; Humans ; Severe Dengue

Severe ; Staphylococcal Infections

Dengue infection is epidemic but ocular complications of dengue are less reported. We report a case of dengueinfected patient with disturbing ocular symptoms. He was admitted for severe dengue. Subsequently, he presented with symptoms of bilateral central scotoma with metamorphosia. Fundus examination revealed cotton wool spots and flame-shaped haemorrhages at the macula, with dull foveal light reflex. He was diagnosed with bilateral dengue maculopathy. The patient was managed conservatively with surveillance. One week later, his eye symptoms improved and were resolved six months later. Early recognition and close monitoring remains the key to successful management and interventions are rarely needed.
Severe Dengue ; Eye Diseases

Objective: To determine the pregnancy rate after intrauterine insemination using samples with. processed total motile count of 1.0 x 106 and less and describe the semen quality profile of Filipino males with severe male factor infertility in both the raw and processed semen samples. Design: Retrospective descriptive study. Setting: Andrology Laboratory, St. Luke's Medical Center. Patients: 307 infertile Filipino couples who underwent 426 IUI cycles. Main Outcome Measures: Pregnancy rate (PR) after intrauterine insemination. Results: A total of 10 pregnancies were obtained out of 426 IUI cycles, for a pregnancy rate per cycle of 2.4%. Seven of these eventually delivered to term, for a live birth rate of 1.6%. Among those who did not get pregnant with IUI, 8 had spontaneous pregnancies within 1 to 5 year period of follow-up for a spontaneous pregnancy rate of 1.9%. As expected, all the semen parameters analysed showed improvement after semen processing in all subjects. However, these improvements failed to result in a more acceptable pregnancy rate. Among the parameters, morphology was notably better among those who had pregnancies. Conclusion: The chance of pregnancy with IUI using semen samples with processed total motile count of 1.0 x 106 or less is relatively low. For these couples, it may be more prudent to proceed directly to IVF-ICSI than to try several cycles of IUI in futility.
INTRAUTERINE INSEMINATION ; SEVERE OLIGOSPERMIA