Introduction. Gestational diabetes mellitus (GDM) approximately affects 14% of pregnant women in the Philippines. It has been linked to several maternal and neonatal adverse outcomes. Objective. This study aimed at determining the association of the clinical profile of patients with GDM to maternal and neonatal outcomes. Methodology. This single-center, retrospective, descriptive, cross-sectional chart review was conducted in a tertiary hospital in Cebu City to 229 patients with GDM admitted from January 2021 to December 2022. Results. The study revealed several significant associations. Hypertension was strongly linked with primary cesarean section (OR: 4.32, P-value 0.004); and severe pre-eclampsia (OR: 16.97, P-value: 0.000). Gravidity showed significant correlations with Ballard’s score (P-value: 0.013), birthweight (P-value: 0.045) and 5-minute APGAR score (P-value: 0.001). Parity was associated with birthweight (P-value: 0.011) and 5-minute APGAR score (P-value: 0.001). Weight gain during pregnancy was linked to birthweight (P-value: 0.004) and occurrence of congenital anomalies (OR: 1.26, P-Value: 0.032). Additionally, prenatal smoking was associated with 5-minute APGAR score (P-value: 0.006). Moreover, having a Small for Gestational Age (SGA) fetal growth status is associated with insulin-requiring mothers, (OR: 4.79, P-Value: 0.049); and a family history of diabetes was significantly associated with insulin therapy (OR: 5.38, P-value: 0.021). Conclusion. Patients' clinical profile affect maternal and neonatal outcomes among patients with GDM. Careful consideration of these factors during the perinatal period may help reduce maternal and fetal risks. Keywords. Gestational Diabetes Mellitus, association, clinical profile, outcome, pregnancy, maternal health

Introduction. Neurolisteriosis is caused by Listeria monocytogenes, a gram-positive microorganism. It usually affects vulnerable population including pregnant women, neonates, immunocompromised individuals, and elderly persons. This report describes a case of neurolisteriosis in a 31-year-old immunocompetent man. Case Summary. This case involves a 31-year-old Filipino male who presented with decrease sensorium. A lumbar puncture was performed, and polymerase chain reaction (PCR) testing of the cerebrospinal fluid confirmed the presence of Listeria monocytogenes. On the fifth day of hospitalization, the patient developed unilateral sixth cranial nerve palsy and facial nerve palsy. He was treated with intravenous ampicillin for 21 days, resulting in significant improvement in the cranial nerve deficits. Conclusion. It is the first neurolisteriosis case in this institution. There is only one published neurolisteriosis case in the Philippines which presented with brain abscess. Neurolisteriosis, although uncommon, is one of the differential diagnoses in patients presenting with fever, headache, and nuchal rigidity. Isolation of Listeria monocytogenes in the cerebrospinal fluid and blood culture is diagnostic. Neurolisteriosis is an invasive disease which can result in neurologic sequalae such as cranial nerve palsies. Targeted treatment aids in good clinical outcomes. Keywords: Neurolisteriosis, Listeria monocytogenes, rhombencephalitis, case report

Intestinal Tuberculosis (ITB) presents a significant diagnostic challenge due to its nonspecific clinical presentation and the lack of comprehensive local data to guide diagnostic strategies. This study aims to fill the gap by conducting a twelve-year retrospective cross-sectional analysis at a tertiary hospital in Cebu, Philippines. Electronic records of 209 patients aged 18 years old and above were first reviewed, focusing on clinical features, laboratory results, endoscopic findings, and CT scan of the abdomen. Initial screening identified 54 patients meeting the predefined criteria for gastrointestinal tuberculosis (GITB). In addition, statistical analyses, including logistic regression models, were employed to identify significant predictors of ITB which can further enhance the ITB diagnosis and management in the region. Clinical manifestations observed include: symptoms and signs resembling those observed in malignancies and inflammatory bowel diseases, such as abdominal pain (92.6%), ascites (57.4%), fever (51.9%), hematochezia (25.9%), abdominal mass (24.1%) and intestinal obstruction (5.6%). The findings from CT scans of the abdomen were consistent with other studies, including the presence of matted mesenteric lymph nodes (79.6%), concentric mural thickening (57.4%), ileocecal involvement (44.4%). However, dilated bowel loops (20.4%), intestinal perforation (5.4%) and strictures (3.7%) were observed in only a few cases. Ileocecal involvement was found to be a dependable predictor among all the variables when logistic regression analysis was employed, emphasizing its diagnostic utility. Our findings highlight the importance of local epidemiological insights in improving diagnostic strategies and patient outcomes. Consolidating the clinical profiles and diagnostic markers contributes to evidence-based strategies tailored to the Philippine context. This localized approach can further help medical professionals in making more informed decisions. Future studies could validate these findings to develop region-specific predictive tools, for a more time sensitive management of ITB. Keywords. Intestinal Tuberculosis, Clinical features, Indicators, Ileocecal involvement.

Background. Blood pressure is an important vital sign measured not only in hypertension but also among hospitalized patients for clinical evaluation of the actual hemodynamic status. In the digital era, mercury and aneroid sphygmomanometers are being replaced by automated monitors despite lacking validation and recommendations for their use, especially in acute illness. Objective. To compare automated and manual blood pressure measurement among hospitalized medical patients with acute illness. Methods. A crossover design was used in a single tertiary hospital. Blood pressure was recorded from 216 participants, with 432 observations from an automated monitor (Omron HBP1120) and a mercury sphygmomanometer. Automated and manual BP recordings were done twice following the same arm sequential method. The average of the two recordings was used for comparison. Results. Most participants were female, elderly, obese, and had cardiac complaints. Comparing automated and manual methods, the mean difference for systolic was 1.47 ± 12.12 (p = 0.08) and 1.82 ± 10.99 (p=0.02) for diastolic. Subgroup analysis revealed that males had higher manual systolic BP than females (pairwise p-value= 0.017). Overweight and obese participants had higher automated systolic and diastolic BP (p=0.04). Overweight and obese participants had significantly higher systolic and diastolic BP regardless of the method. Significantly higher diastolic BP for different age groups and areas of admission (p=0.02) were observed from the automated method. Conclusion. Automated BP monitoring showed a significant difference in diastolic BP recordings. Automated BP monitors should be used with caution, especially in interpreting diastolic BP among hospitalized patients. Keywords. Automated blood pressure, manual blood pressure, Omron® HBP 1120

Introduction: Cardiac arrest occurs when abrupt cessation of cardiac function results in loss of effective circulation and complete cardiovascular collapse. For every minute of cardiac arrest without early intervention (cardiopulmonary resuscitation [CPR], defibrillation), chances of survival drop by 7 – 10%. It is crucial that CPR be initiated within 4 – 6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment is not readily available, resulting in poor victim outcomes. Methods: This descriptive study was done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-of-hospital cardiac arrest. Out of the total 102 cases of OHCA, 63 participants were included in the study. Descriptive statistics was used to summarize the demographic and clinical characteristics of the patients. Results: Forty-three subjects were male patients, comprising the majority at 73.02%. Hypertension was identified as the top comorbidity, followed by diabetes mellitus, heart failure, and chronic kidney disease (CKD). Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received pre-hospital intervention before ER arrival, comprising only hands-on CPR. Twenty-three of these were performed by individuals with background knowledge of CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which were noted to have no available equipment necessary to provide proper resuscitation. The average travel time from dispatch to ER arrival is 20 minutes. Conclusion: Overall survival of OHCA in our local setting remains dismal, as the return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education. Keywords: Out-of-hospital cardiac arrest, cardiopulmonary resuscitation, survival

Introduction. Chronic obstructive pulmonary disease (COPD) is the most common disease encountered in clinical settings and is one of the leading causes of death worldwide. The most recent guidelines on diagnosing and treatment can assist COPD management aimed to reduce the exacerbation of symptoms and avoiding the risk of complications. In this case report, we present the diagnosis of COPD patient according to the clinical symptoms based on the recent guidelines and treatment rationalization based on the literature review taking into account the facilities available in clinical settings. Case. A 68 years old man with previous history of hard smoker came with shortness of breath in the past 2 weeks which had been getting worse for one day. Shortness of breath are accompanied by a dry cough that aggravated the dyspnea. The patient was hospitalized with diagnosis that established through clinical examination. The patient was classified as suffering from group B COPD and received treatment Salbutamol-Ipratropium bromide nebulizer every 8 hours, intravenous corticosteroid Methylprednisolone, dyspepsia treatment with Omeprazole, analgesic Metamizole, antibiotic Azithromycin 500 mg per day, mucolytic N-Acetylcysteine 200 mg three times a day, and antihypertensive Amlodipine 10 mg per day. The patient received outpatient medication after having no complaints on the fourth day of treatment. Conclusion. Diagnosis and treatment of COPD patients according to guidelines and the patient's clinical condition can improve the conditions due to exacerbation and reduce the risk of complication. Education of smoking cessation is important to prevent the increase of incidence and prevalence of COPD. Keywords. Chronic obstructive pulmonary disease, clinical practice, diagnosis, treatment

Background: Pregnancy-related acute kidney injury (PR-AKI) is an underdiagnosed yet serious public health obstetric complication with high risk of maternal and fetal morbidity and mortality. Several studies have varied reports as to its incidence since there is no validated diagnostic criteria. As of date, there is a lack in published studies on the prevalence and clinical profiles of PR-AKI in the Philippines. Objective: To determine the prevalence of PR-AKI and investigate their clinical profiles and outcomes in a tertiary hospital Methods: This single-center, cross-sectional, retrospective study included all admitted patients with PR-AKI from January 2019 to December 2021. Prevalence was determined and clinical data and outcomes were obtained and analyzed through review of electronic records. Results: A total of 49 out of 1374 patients had PR-AKI with a prevalence of 3.57% while prevalence of AKI with underlying CKD was 0.22%. The mean age was at 30 ± 6 years and most were primigravid (51.02%). Most of the patients affected had no pre-existing comorbidities (57.14%) and no known maternal comorbidities (59.18%) prior to the admission. The top causes of PR-AKI were pre-eclampsia/eclampsia (53.06%), blood loss (24.48%) and sepsis/septic shock (22.45%) mostly occurring during the third trimester (69.39%). The mean highest creatinine level was at 1.99 ± 2.01 mg/dL. Only 18.37% had oliguria while hemodialysis was done in only 6.12%. ICU admission rates were at 26.53%. Intrauterine fetal demise was seen in 12.24% of cases. PR-AKI had a 6.12% mortality rate. However, most were discharged with normal creatinine (89.8%). Conclusion: PR-AKI is a serious complication with significant burden even in previously healthy individuals. Prompt diagnosis is essential for a more favorable maternal and fetal outcome as well as improvement of kidney function to baseline. Keywords: Acute Kidney Injury, Pregnancy, Maternal and Fetal Morbidity and Mortality

Objectives. As the population ages, the likelihood of cancer increases. Aging-related deficits that eventually manifest as frailty may be associated with poor emotional health in older patients with advanced cancer. This study aimed to determine whether frailty was strongly associated with emotional distress, particularly anxiety and depression. Method. This is a single center, cross-sectional, descriptive study using the Geriatric 8 (G8) Frailty Screening Scale and the Hospital Anxiety and Depression Scoring (HADS) Scale. Results. One hundred five patients (105) were included in the study. Over-all, 86 (81.9%) were frail. Majority of them were female (50, 47.6%), married (57, 54.3%), and were able to graduate college (62, 59.0%). Hypertension (70, 66.7%) and diabetes mellitus (33, 31.4%) were the most common co-morbidities. There was significant association between the patients’ functional status (ECOG score) and frailty (p = 0.001). Our results showed that the likelihood of being frail increased by 30% per unit increase in the ECOG score (OR 3.685, CI 1.623 – 8.366). More so, our results showed strong association between frailty, depression & anxiety (p = 0.000 & 0.001, respectively). We also found that the likelihood of being anxious & depressed was 7-times as much for those patients who were frail (OR 7.000, CI 2.132 – 22.981; OR 7.150 (CI 2.406 – 21.246, respectively). Conclusion. Frailty had a strong association with both anxiety and depression. Frailty, in addition, had a good predictive value for emotional distress. Those who were frail had a 7-time likelihood of being anxious and depressed. Frailty was also associated with functional status. The chances of being frail increased by 30% for every unit increase in the ECOG score. Keywords: Frailty, Elderly, Depression, Anxiety, Advanced Cancer

Background. Chronic illnesses such as Type 2 diabetes mellitus (T2DM) and obesity have been implicated as risk factors in the development of cognitive impairment (CI), but despite this, definite association between the two conditions in increasing cognitive impairment risk is not well defined. Objective. This study aims to examine the association between body mass index (BMI) and cognitive impairment (CI) in elderly patients with Type 2 diabetes mellitus. Methods. This is a cross-sectional study conducted in the outpatient clinics of a private hospital in Manila which included elderly patients with Type 2 diabetes. BMI categories of the subjects were determined using the Asia-Pacific criteria and the Montreal Cognitive Assessment – Philippines (MOCA-P) was administered to subjects who fulfilled the inclusion criteria. Descriptive statistics were used to determine the prevalence of impaired cognition among subjects while risk ratio analysis was used to determine the correlation between BMI and CI. Correlation analysis and linear regression analysis were used to determine the presence of association between cognition (measured by MOCA-P scores) and BMI. For all analysis, a 95% level of significance was used. Results. A total of 109 subjects from the outpatient clinics were included in the study. A high percentage of the study population (90.83%) had CI based on MOCA-P scores. Subjects that belonged to the extremes of BMI- underweight and obese class 2 had higher incidence of CI compared to the other groups. Underweight subjects had 1.103 (95% CI: 1.038 to 1.172) times likelihood of having impaired cognition (p-value 0.0016), while obese 2 subjects had 1.110 (95% CI: 1.040 to 1.184) times likelihood of having impaired cognition (p-value 0.0016). Regression analysis revealed that in subjects with diabetes of less than 10 years, cognition scores were negatively correlated to BMI (p-value 0.0454). Correlation analysis revealed that at the general population level, regardless of the external factors, increasing or decreasing BMI did not have significant effect on cognition scores. Conclusion. Subjects who belonged to the extremes of BMI- underweight and obese class 2 – had higher incidence of CI compared to the other BMI groups. Among subjects with T2DM duration of less than 10 years, cognition scores tend to be negatively correlated to BMI. Keywords. Type 2 diabetes mellitus, cognitive impairment, BMI

Background. COVID-19 pandemic led to a dramatic loss of human life worldwide and presented an unprecedented challenge to public health. One of the solutions in addressing the problem was mass vaccination in order to attain herd immunity. However, most people were hesitant to be vaccinated particularly due to their fear of the adverse events; hence the goal of this study was to determine the possible adverse events (AEs) experienced during administration of CoronaVac™ COVID-19 Vaccine. Objective. The objective of the study was to monitor the occurrence of adverse events within one hour, two to 24 hours, and 25 to 72 hours after administration of the first and second dose of CoronaVac™ COVID-19 Vaccine in a tertiary government hospital in Pangasinan. Methodology. This cross-sectional study was done from February to April 2021 at Region 1 Medical Center. Employees who received the two doses of Sinovac-CoronaVac™ vaccine and gave their informed consent were included in the study. Participants were monitored closely for adverse events within 30 minutes following administration of the vaccine and were instructed to report any local and systemic AEs to the Hospital Epidemiology Center Office. Individuals were also followed up through telephone to investigate the occurrence of any complaints after 24 to 72 hours. Results. A total of 353 participants who received the complete doses of CoronaVac™ were included in the study. The incidence of AEs was higher after the first dose compared with the second dose. After the first dose of CoronaVac™ 12.5% reported AEs after the 1st hour, 14.2% two to 24 hours after the vaccine, and 1.4% on the 25th hour up to the 72nd hour. Pain on injection site was the most common adverse event during the first hour (8.2%). On the 2nd hour up to 24 hours, headache, and myalgia (14.2%) were more evident. Headache was reported in 1.1% of the participants after 25-72 hours of vaccination. After the second dose, only one participant reported multiple AEs such as fatigue, headache, rash and retroorbital pain (1, 0.7%). Conclusion. In this study, 28.1% of the participants experienced adverse events after the first dose of CoronaVac™ vaccine. AEs were higher after the first dose (28.1%) compared with the second dose (0.3%). Injection site pain was the most common adverse event during the first hour, then headache and myalgia during the 2nd hour up to 24 hours, and headache on the 25th – 72nd hour after vaccination. Only one participant reported several AEs after the 2nd dose of the vaccine Keywords: CoronaVac™, COVID-19 vaccination, Adverse Events