Eosinophilia is commonly associated with parasitic infections, allergic disorders and haematological conditions. Although bleeding in patients with eosinophilia is rare, platelet dysfunction may contribute, even when platelet counts are normal. We report the case of a 7-year-old boy with glucose-6-phosphate dehydrogenase deficiency who presented with recurrent spontaneous bruising over 6 months. Physical examination revealed multiple ecchymoses over the lower limbs, with no organomegaly or lymphadenopathy. Laboratory investigations revealed a normal platelet count, marked eosinophilia and prolonged bleeding time. Platelet function testing using whole blood impedance aggregometry (Chrono-Log) demonstrated reduced aggregation in response to multiple agonists, consistent with a selective impairment of aggregation to adenosine diphosphate and collagen. The patient was treated with anthelminthics, resulting in a significant reduction in the eosinophil count and resolution of bleeding symptoms. This case highlights that eosinophilia may be associated with acquired platelet dysfunction, even in the presence of normal platelet counts. Clinicians should consider platelet function testing in patients with unexplained bleeding and eosinophilia, as timely treatment of the underlying cause can lead to clinical improvement.
Introduction:Dietary and weight control in type 2 diabetes (T2D) can place psychological strain on patients, increasing the risk of disordered eating behaviours (DEBs). This study aimed to determine the level of DEBs using the validated Eating Disorder Examination Questionnaire (EDE-Q) and its associated sociodemographic, clinical and mental health factors in adults with type 2 diabetes in Malaysia. Methods:We conducted a multicentre cross-sectional study in four government primary care clinics among 412 patients with T2D. DEBs were assessed using the Malay EDE-Q 6.0, while depression and anxiety were evaluated using the Patient Health Questionnaire-9 and Generalised Anxiety Disorder-7 (GAD-7), respectively. Multivariable linear regression was performed on the square-root transformed EDE-Q global score to identify independent associated factors. Results:The mean EDE-Q global score was 1.01±1.09, with shape concern being the highest- scoring subscale. Higher DEB levels were associated with younger age (B=-0.01, 95% confidence interval [CI]=-0.02 to -0.01, P<0.001), higher body mass index (BMI) (B=0.02, 95% CI=0.02 to 0.03, P<0.001), higher GAD-7 score (B=0.05, 95% CI=0.03 to 0.08, P<0.001) and higher educational level (secondary [B=0.21, 95% CI=0.07 to 0.35, P=0.003] and tertiary education [B=0.31, 95% CI=0.13 to 0.48, P<0.001]). The Chinese participants had lower EDE-Q scores than the Malay participants (B=-0.18, 95% CI=-0.31 to -0.04, P=0.012). Conclusion:Overall DEB level is low, however, risks are higher among patients who are younger, are more educated, have a higher BMI and have greater anxiety. Targeted identification of these high-risk groups facilitates early interventions to prevent adverse complications.
Introduction:University education is a stressful period in young adults' lives, and the emergence of disordered eating during this time adds to the psychological morbidity that university students often experience and may need early identification and appropriate management. This systematic review of relevant Malaysian studies aimed to determine the pooled prevalence of disordered eating among university and college students and assess the associated factors. Methods:A comprehensive search for Malaysian studies using the Eating Attitudes Test (EAT- 26) was conducted using several bibliographic databases (PubMed, Scopus and Google Scholar). Relevant literature was systematically selected; pertinent data were extracted; and data on disordered eating (EAT-26 score of ≥20) and its associated factors were synthesised. Results:Twenty-one Malaysian cross-sectional studies that measured disordered eating using the EAT-26 were included. The pooled prevalence of disordered eating was 16.45% (random effects model, 95% CI=13.86-19.22), with a significantly higher odds ratio in female students (1.45, 95% CI=1.28-1.65). Various body image measures were assessed in nine studies, five of which reported a positive association between disordered eating and body dissatisfaction. Conclusion:One in six Malaysian university or college students, especially female students, may be affected by disordered eating, and many of them may also have body image concerns and body dissatisfaction. Disordered eating is a rising public health concern in the student population of colleges and universities and deserves further exploration of its potential adverse health outcomes.
