Objectives: Transitioning from the home to a new environment exposes university students to unhealthy eating behaviors, which may impact their body mass index (BMI). The purpose of this study was to determine the frequency of these abnormal eating behaviors among the students of the Malaysian Allied Health Sciences Academy (MAHSA) University, Malaysia, gender difference in eating behaviors, and to explore the association of such behaviors with body mass index (BMI), waist circumference, and waist-to-height ratio. Methods: In this cross-sectional study, 300 students from MAHSA University were evaluated for eating habits using the Eating Attitude Test 26 (EAT-26) questionnaire. Their height, weight, and waist circumference were measured, and their BMI and waist-to-height ratio was calculated. Data were analyzed using Statistical Package for the Social Sciences (SPSS), Version 24. Results: Of the 300 students enrolled in the study, 6% scored >20 on the EAT26, therefore appearing to have abnormal eating behaviors. Most of the students (62.0%) were found to be in the “normal” weight category according to their BMI measurements. A significant positive correlation was found between EAT-26 score and BMI, and between EAT-26 score and waist-to-height ratio. Female students had higher EAT-26 scores compared to the male students (p=0.01). Conclusions: Female students are at higher risk of developing abnormal eating behaviors than male students, according to this study. Among Malaysian students, the higher the risk of abnormal eating behaviors, the greater the likelihood of having a higher BMI and waist-to-height ratio.
Extrapulmonary tuberculosis (EPTB) is a complex disease; diagnosis is often difficult due to the paucibacillary status and the invasive procedures required to obtain an adequate sample. Culture testing remains the gold standard for diagnosis, but low bacterial count in EPTB may lead to a negative culture; therefore, a combination of tests is often required for confirmation of diagnosis. Microbiological tests are combined with clinical signs and symptoms, in addition to imaging techniques to improve diagnostic accuracy. Molecular tests have improved time-to-detection for disease and drug sensitivity testing; however, they cannot replace culture testing at present. Though specificity of molecular testing is high, sensitivity varies in samples from different sites, being low for TB meningitis. For genital TB, a combination of tests must be used for timely diagnosis, as disease progression leads to irreversible damage of the reproductive organs. Newer techniques, like whole genome sequencing and next-generation sequencing, are being introduced to improve diagnosis and detect drug resistance. Currently, no single diagnostic test can be considered a ‘point of care’ test. Early and accurate diagnosis is urgently needed to prevent the associated morbidity and mortality.
1. Department of Endocrinology, Center for Endocrinology Diabetes Arthritis & Rheumatism (CEDAR) Superspecialty Clinics, New Delhi, India; 2. Department of Medicine, Institute of Post Graduate Medical Education & Research (IPGMER), Kolkata, India; 3. Department of Endocrinology, Bharti Hospital, Karmal, India; 4. Department of Endocrinology, RG Kar Medical College, Kolkata, India; 5. Department of Rheumatology, CEDAR Superspecialty Clinics, New Delhi, India
1. University of Arizona College of Medicine, Phoenix, AZ, USA; 2. Division of Endocrinology, Barrow Neurological Institute at Phoenix Children’s Hospital, Phoenix, AZ, USA; 3. Department of Neurology and Neuro-Oncology, Barrow Neurological Institute/Ivy Brain Center at Phoenix, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA; 4. Department of Neuroendocrinology and Neurosurgery, Barrow Neurological Institute, University of Arizona College of Medicine and Creighton School of Medicine, Phoenix, AZ, USA
Serum cortisol is a measure of underlying disease severity The more severe the disease, the higher the circulating cortisol levels and the greater the chances of poor prognosis/mortality Not surprisingly, a recent study found that higher serum cortisol was associated with poor prognosis in patients with coronavirus disease 2019 (COVID-19) Nevertheless, the study did not take into consideration the confounding effect of COVID-19 severity;hence, the results could not be regarded as being fully adjusted Besides, guiding glucocorticoid therapy based on serum cortisol levels is an impractical proposition, and to date is not backed by robust evidence Therefore, routine measurement of serum cortisol in patients with COVID-19 is a futile endeavor and should not be encouraged © Touch Medical Media 2020
McCune–Albright syndrome (MAS) is characterized by polyostotic fibrous dysplasia, café-au-lait hyperpigmentation of the skin, and acromegaly. Ablative therapy in affected patients must target the entire pituitary gland, making medical management the preferred therapy. Targeted medical therapies, including somatostatin and growth hormone (GH) receptor blockade, have shown promise in achievement of biochemical remission. We present the case of a 15-year-old girl with MAS who was discovered to have pituitary enlargement on computed tomography scan. She presented with café-au-lait spots, fibrous dysplasia of the sphenoid bone, and elevated insulin-like growth factor 1 and GH levels that failed to suppress on oral glucose tolerance testing. Treatment with a somatostatin analog was shown to be a safe and effective long-term management strategy of acromegaly that provides advantages over surgical resection.
Objective: Estimate the costs associated with a flash continuous glucose monitoring system as a replacement for self-monitoring of blood glucose (SMBG) for people using intensive insulin to manage diabetes, from a US private payer perspective. Methods: The base case used SMBG at 8 tests/day, the mid-point of the range recommended by the American Diabetes Association for intensive insulin users. Scenario analyses used SMBG at 3, 6 and 10 tests/day. Estimated costs of glucose monitoring and severe hypoglycemic events were assessed. Results: For the base case, the annual cost of SMBG was $4,380 for a patient with type 1 diabetes mellitus (T1DM) compared with $1,712 for flash monitoring, a reduction of $2,667 (61%). The cost of flash monitoring was also lower than SMBG at 6 and 10 tests/day. With SMBG at 3 tests/day the cost was comparable. Similar results were obtained for patients with T2DM using intensive insulin. The annual cost of severe hypoglycemia was approximately 50% less for flash monitoring than for SMBG for both patients with T1DM and those with T2DM. Conclusions: For US private payers, the flash monitoring system provides cost savings compared with SMBG for people with diabetes using intensive insulin. Cost savings with flash glucose monitoring may be realized through a reduction in severe hypoglycemia. Further study of budget impact is needed to include changes in behavior leading to improved adherence.
Therapeutic administration of steroids (or corticosteroids) in patients with coronavirus disease (COVID-19) is controversial owing to risk of adrenal insufficiency or immunosuppression from prolonged use A recent clinical trial report presenting preliminary data suggested survival benefits of low-dose dexamethasone in patients with severe COVID-19 Additionally, there is evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-mediated pathogenetic mechanisms can involve the adrenal gland, and can therefore influence endogenous production of steroids, mainly cortisol Cortisol is an output hormone of the hypothalamic–pituitary–adrenal axis—the chief endocrine axis maintaining physiological homeostasis Despite the known dangers of possible endocrine disruption, there has been very little discussion in the literature regarding monitoring of serum cortisol concentrations in patients with COVID-19 In this article, we briefly discuss existing and emerging empirical evidence in favor of monitoring serum cortisol concentrations in patients with severe COVID-19 in terms of improving survival outcomes as well as facilitating better therapeutic management © Touch Medical Media 2020
1. Faculty of Medicine, Universiti Teknologi MARA (UiTM), Malaysia; 2. Institute for Pathology, Laboratory and Forensic Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia; 3. Department of Paediatrics, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia; 4. Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
