Abstract Background: Dengue fever continues to spread worldwide, particularly in tropical regions. Some patients with dengue fever may progress to severe dengue, which is associated with significantly higher morbidity and mortality. Despite this, no definitive treatment has been found to prevent its progression. Montelukast, a leukotriene receptor antagonist, has shown potential in reducing plasma leakage, a key factor in the pathophysiology of severe dengue. Therefore, this study aimed to evaluate the effectiveness of montelukast in reducing the risk of severe dengue. Methods: A systematic literature search was conducted on April 16, 2025, using keywords related to montelukast and dengue across four databases, which included PubMed, Taylor and Francis, Cochrane Library, and ScienceDirect. A critical appraisal was performed using the Oxford Centre for Evidence-Based Medicine framework, evaluating the validity, importance, and applicability of each study. The primary outcomes were the incidence of dengue shock syndrome and dengue with warning signs. The secondary outcomes included mortality rate and hospitalization duration. Results: This study included three studies involving a total of 1057 patients. Montelukast is associated with a reduced incidence of dengue shock syndrome and shorter duration of hospitalization. However, the effect of montelukast on dengue with warning signs and mortality rate was inconclusive. Conclusion: Montelukast shows potential as an adjuvant therapy in preventing the progression of dengue fever to severe dengue. However, further research is required before montelukast can be widely recommended for dengue fever patients in daily clinical practice and possibly integrated into dengue fever clinical guidelines.
evidence-based case report ; severe dengue ; dengue fever ; leukotriene receptor antagonist ; montelukast

Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.

Cardiac Catheterization ; instrumentation ; methods ; Cardiac Output ; Confidence Intervals ; Female ; Hemodynamics ; Humans ; Middle Aged ; Mitral Valve Stenosis ; pathology ; Pulmonary Artery ; physiology ; Statistics as Topic

The purpose of this study was to evaluate predictors of change in physical function in individuals diagnosed with chronic fatigue syndrome (CFS) following participation in nurse delivered, non-pharmacologic interventions. Participants diagnosed with CFS were randomly assigned to one of four, 6-month interventions including cognitive behavior therapy, cognitive therapy, anaerobic exercise, or a relaxation control group. Baseline measures including immune function, actigraphy, time logs, sleep status, and past psychiatric diagnosis significantly differentiated those participants who demonstrated positive change over time from those who did not. Understanding how patient subgroups differentially respond to non-pharmacologic interventions might provide insights into the pathophysiology of this illness.

Endemic malaria still exists in the Republic of Vanuatu, an 80-island archipelago that sits astride the southeast margin of the Southeast Asian-Melanesian malaria band (Buxton Line 170 degrees E, 20 degrees S). The annual parasite incidence has decreased dramatically over the past decade, which has been attributed to an intensive insecticide-treated bednet distribution program and implementation of a revised Plasmodium falciparum treatment policy that employs combination chloroquine + sulfadoxinelpyrimethamine as a first-line therapy. Standard malariometric surveys were conducted at 10 locations in 2 provinces, screening 2351 adults and children towards the end of the peak transmission season. Spleen rates were consistent with mesoendemic malaria. Examination of blood slides revealed a mean slide-positive rate of 22% (range 4% to 33%). P. falciparum predominated, accounting for 73% of infections, followed by P. vivax (25%). Among 396 individuals with P. falciparum, the gametocyte rate was 54%, with 37% presenting gametocytes alone without asexual stages. Only 8% and 4% of persons with asexual stage P. falciparum and P. vivax parasitaemia, respectively, were symptomatic. These data suggest that malaria transmission has increased in some locations in Vanuatu over the past decade and this report underscores the importance of appropriate bednet use and vector control in this setting as well as the impact of adding sulfadoxine/pyrimethamine and removing primaquine from the national malaria treatment formulary.
Malaria ; upper case pea ; Vanuatu ; control ; asexual