BACKGROUND: Most characteristics and common signs and symptoms of hyperthyroidism are the effects of thyroid  hormones  on  the heart and cardiovascular system. With the advent of echocardiography, characterizing the effects of  hyperthyroidism on the heart has been described mainly for overt hyperthyroidism. Data on subclinical hyperthyroidism  are still conflicting.
OBJECTIVE: To describe and compare the cardiac morphology and function of Filipino patients with uncontrolled overt and subclinical hyperthyroidism through echocardiogram, admitted at De La Salle University Medical Center (DLSUMC) for a period  of  five years and six months. 
METHODOLOGY: This is a retrospective descriptive study that utilized review of medical records. Seventy-five  hyperthyroid patients were included; 56%  with overt hyperthyroidism and 44% with subclinical hyperthyroidism. Cardiac morphology and systolic and diastolic functions were determined in the population and compared  between overt and subclinical hyperthyroidism using 2-dimensional echocardiogram.  
RESULTS: Cardiac morphology was slightly  compromised due to slight thickening of interventricular septum (IVSTd) and left ventricular posterior wall thickness at diastole (LVPWTd). There was also an increase in left ventricular mass (LVM), more pronounced in overt hyperthyroidism. Systolic function parameters such as fractional shortening (FS) and ejection fraction (EF) were normal. Impaired left ventricular myocardial relaxation manifested as low early mitral peak flow velocity, low E/A ratio and prolonged isovolumetricrelaxation time (IVRT) was observed in most patients, particularly in overt hyperthyroidism.
CONCLUSION: Abnormalities noted were comparable between the two groups of hyperthyroidism. With cardiac  parameters affected even in subclinical hyperthyroidism, treatment might be indicated regardless if hyperthyroidism is  overt or subclinical.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Young Adult ; Academic Medical Centers ; Diastole ; Echocardiography ; Heart ; Hyperthyroidism ; Medical Records ; Retrospective Studies ; Systole

Abstract: This current study aims to report the clinical profiles and characteristics of diabetic patients who had been admitted for hyperglycemic crises from 2007 to 2017 at our institution. Methodology: We conducted a retrospective study in a tertiary care university hospital outside Metro Manila. The data gathered were divided into three categories: clinical data, biochemical data and precipitating factors. Results: A total of 3,120 adult patients with diabetes mellitus were admitted for various reasons, and 71 cases presented with DKA or HHS over the 10-year period of review which is equivalent to 2% of all diabetes mellitus cases admitted. Forty-six (64.79%) of the patients with hyperglycemic crises were known diabetics with a duration of 7-13 years. Majority of patients were not taking anti diabetic medications upon admission. Most patients with hyperglycemic crises were tachycardic and hypertensive upon admission. Majority were discharged and improved. Majority of the cases 53 (81.69%) had DKA. The most common precipitating factor in DKA and HHS was infection. Conclusion In conclusion, the biochemical profiles in our series did not significantly differ from the past study by Gatbonton et.al (1998). Despite the advent of new therapies for diabetes mellitus control, mortality among the patients with hyperglycemic crises was slightly higher in our study at 11% compared to the global reported data of 2-10%. One of the reasons could be the minimal improvements in our health care delivery system that is still unable to cater to the needs of diabetic Filipinos. Early screening programs should be done for patients beginning age 40 years and even earlier for those with risk factors for prompt detection and treatment of diabetes mellitus. Education and awareness should be strengthened for patients with diabetes mellitus to avoid the crises by emphasizing the importance of regular follow-up, monitoring and compliance with a diabetic regimen, especially with insulin and multiple OADs (oral anti- diabetic drugs) since the disease is progressive, and timely intensification of therapy is needed.
Diabetes Mellitus, Type 2

OBJECTIVES: To determine cut-off levels of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) for overweight/obesity associated with cardiometabolic diseases (CMDs) among adult Filipinos in a rural community.
METHODOLOGY: This community-based cross-sectional observational study utilized data from our Phase II of Diabetes Self-Management Education Program in San Juan, Batangas, Philippines. It included 332 Filipino adults with no known illnesses and residing for at least 6 months in the rural communities. Optimal cut-offs were determined by the intersection of sensitivity and specificity curves of having at least 1 or 2 CMDs.
RESULTS: The study population included 332 participants (72.3% females). Mean BMI, WC and WHR were 23.5 kg/m2, 79.5 cm and 0.87 respectively. Twenty eight percent, 11.1%, 78.3% and 85.8% of the participants have hypertension, diabetes, dyslipidemia, and at least 1 CMD respectively. The optimal cut-off for overweight/obesity and central obesity in males and females are BMI of 24 and 23 kg/m2, WC of 84 and 77 cm, and WHR 0.91 and 0.85 respectively.
CONCLUSION: Similar to other Asian countries, cut-off levels for overweight, obesity, and central obesity associated with CMDs are lower than the currently recommended cut-offs among Filipino adults in rural communities, particularly for WC in both sexes.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Body Mass Index ; Obesity ; Overweight ; Waist Circumference ; Adult ; Hypertension ; Diabetes Mellitus ; Dyslipidemias

Preoperative preparation of the hyperthyroid patient for thyroidectomy is imperative to avoid perioperative complications due to severe thyrotoxicosis. The mainstay of preparation is the administration of anti-thyroid drugs (ATD). When ATDs cause adverse reactions, an alternative regimen to prepare the patient for definitive management is crucial. We present the case of a 35-year-old Filipino female with Graves’ disease who developed methimazole-induced agranulocytosis. She refused to undergo radioactive iodine (RAI) therapy. She was admitted for thyroidectomy with elevated thyroid hormone levels. She was rapidly prepared for thyroidectomy using high-dose steroid, beta-adrenergic blocker, propylthiouracil (PTU) and Lugol’s solution. The patient’s free thyroxine level decreased after 8 days of treatment, without complications. She then underwent an uneventful subtotal thyroidectomy. In conditions with very limited options, although contraindicated, administration of another ATD may be the last alternative for patients who developed agranulocytosis.
Hyperthyroidism ; Thyroidectomy ; Agranulocytosis ; Iodine