Introduction: Malnutrition is a widespread condition that impacts millions of people across the world annually. The World Health Organization defines malnutrition as the deficiency, excess or imbalance in a person’s intake of energy and/or nutrients. It has been highly prevalent in hospitalized patients and is often overlooked as it continues to be an unrecognized problem. It is also associated with increased risk of complications, higher mortality rate, longer hospital stay, and higher hospitalization costs. The researchers aim to determine in-patients’ nutritional status using the Subjective Global Assessment (SGA) and their outcomes in a tertiary hospital. Methods: A cross-sectional study was conducted in a tertiary hospital in Cebu city for three months. A total of 453 patients were selected through simple random sampling from those assessed to be at risk for malnutrition. The nutritional status was obtained using the SGA tool and correlated with the demographic, nutritional and clinical profiles. Results: In the study, the mean age was 54 years with a female predominance (54.1%). A larger percentage belonged to the obese 1 category (34.9%). Fifty-eight percent had moderate risk for malnutrition and 57.2% had an SGA grade of B which corresponded to moderate malnutrition. The most common reason of admission was due to respiratory causes (25%) and the leading comorbidities were hypertension (48.79%), diabetes mellitus (36.42%) and chronic kidney disease (10.38%). The mean number of hospital stay was 6.8 days (98.9%) were discharged improved with a mortality rate of only one percent. The following factors had a positive relationship with the SGA grade: those in the older age group (p=0.000), those with more comorbidities (p=0.000), patients with diabetes (p=0.027) and chronic kidney diseases (0.001), those with higher nutritional risk on screening (p=0.000), those with pulmonologic (p=0.035) and oncologic cases (p=0.012) upon admission. The study results showed that the higher the SGA grade, the longer hospital stay (p=0.000). Conclusion In this study, the prevalence of malnutrition was 86% wherein 57.2% of the study population had moderate malnutrition, 28.9% had severe malnutrition and 13.9% had no malnutrition. The degree of malnutrition was associated with longer hospital stay, but not with mortality.
Malnutrition ; Nutritional Status

Adrenocortical carcinoma (ACC) accounts for 0.05-2% of all malignant tumors. Forty-five percent of ACCs with secretory function have excess glucocorticoids alone and only less than 1% secrete aldosterone.

This is a case of a 44-year-old Filipino female with hypertension and a 12-year-history of an incidentaloma of the left adrenal gland, with recent-onset complaints of increasing abdominal girth, purple striae, amenorrhea, moon facies and a dorsocervical fat pad. Laboratory findings revealed low potassium levels, non-suppressed cortisol on dexamethasone test suggesting Cushing’s syndrome and elevated aldosterone-renin ratio and plasma aldosterone concentration pointing to primary hyperaldosteronism. A computed tomography scan revealed a left-sided adrenal mass measuring approximately 23 cm in largest diameter suggestive of carcinoma without metastasis or lymph node involvement. Complete resection via open adrenalectomy was performed and histopathologic assessment revealed Adrenocortical Carcinoma with Weiss score of 4. The Ki-67 proliferative index was found to be >20%. Radiotherapy was done as an adjuvant treatment.

Although rare, co-secretion of cortisol and aldosterone can occur in functional tumors of adrenocortical carcinoma. Malignancy should always be considered in patients who present with a history of a unilateral adrenal mass and/ or in those with signs and symptoms of adrenal hormone excess. Thus, a proper assessment derived from a thorough medical history, physical examination and laboratory work-up is warranted in patients with an adrenal mass to ascertain the diagnosis and provide adequate management.

Human ; Female ; Adult: 25-44 Yrs Old ; Adrenocortical Carcinoma ; Primary Hyperaldosteronism ; Hyperaldosteronism ; Aldosterone