ABSTRACT
Ivermectin is an antiparasitic drug that has been used as an alternative for prophylaxis and treatment of COVID-19 infection. The adverse effects from supratherapeutic doses of ivermectin can include non-neurological and neurological symptoms. In this study, we report the case of a 52-year-old Filipino male with newly diagnosed diabetes mellitus who developed a subacute history of fever, cough, and generalized weakness, causing him to self-medicate with supratherapeutic doses of ivermectin and thereafter subsequently developed a decrease in sensorium, restlessness, and complex visual hallucinations. Significant laboratory examinations showed hyperglycemia, mild hyponatremia, positive SARS-CoV2 reverse transcriptase polymerase chain reaction test, and bilateral pneumonia on chest radiograph. He was subsequently started on antibiotics, a high-flow nasal cannula, and given two doses of activated charcoal. During the first 24 hours of hospital admission, there was a significant improvement in the patient's sensorium with a resolution of restlessness and visual hallucinations. During the rest of the hospitalization, his respiratory symptoms improved, and he was subsequently discharged. Clinical outcome in our patient after administration of activated charcoal and completion of antibiotics showed an overall improvement in symptoms and without any neurologic sequelae.
ABSTRACT
INTRODUCTION: Mild cognitive impairment (MCI) is a dynamic state, which has evolved into a highly defined condition due to its association with dementia syndromes. There are no published data on the demographic and clinical characteristics of MCI in the Philippines. These data will help in defining the population at risk for the condition and in modifying the factors for its prevention. METHODS: From 2010 to 2019, 434 subjects were diagnosed with MCI based on the criteria published by the International Working Group on MCI last 2004. The demographic profile, vascular risk factors, and levels of Vitamin B12, Vitamin D, and homocysteine were reviewed. Results of neuropsychological tests, such as Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), Mini-Mental State Exam (MMSE), and Montreal Cognitive Assessment (MoCA), were collected. The Fazekas score of the cranial magnetic resonance imaging of patients was also considered. RESULTS: The median age was 72 years [34-97] with 58.3% females. The median years of education were 14 [4-28]. Median ADAS-Cog, MMSE, and MoCA scores were 11.3 [0-27.67], 27 [13-30], and 21 [7-30], respectively. Hypertension and dyslipidemia were present in 66.8% and 64.1%, respectively. Normal homocysteine, Vitamin B12, and Vitamin D levels were found in 64.2%, 59.8%, and 48.8%, respectively. The median Fazekas score was 1 (59.4%). CONCLUSION: This is the first study to document the demographic and clinical profile of Filipinos with MCI in a clinical setting. This review serves as a foundation for increased understanding of MCI with the ultimate goal of controlling the factors which may impact its prevention.
