Introduction: The coexistence of two global pandemics, COVID-19 and type 2 diabetes mellitus, has been implicated with worse prognosis. The association of diabetes and worse outcome in viral infections stems from the detrimental effect of hyperglycemia to the control of viremia and different components of the host response. This study aimed to describe the epidemiological and clinical characteristics of confirmed COVID-19 patients and establish the association of baseline glycemic status and COVID-19 outcomes among persons with type 2 diabetes. Methodology: A single center, retrospective study among adult persons with type 2 diabetes diagnosed with COVID-19 in Makati Medical Center from March 1 to August 31, 2020. A total of 156 medical records (26%) out of 584 confirmed cases were reviewed. Data were collected on diabetes status, comorbid conditions and laboratory findings. Both Cox proportional hazards models and logistic regression models were fitted. To assess the factors associated with mortality as a dichotomous endpoint (died/survived), binary logistic regression was performed. On the other hand, a time-to-mortality analysis was performed using Cox regression. For the effect estimate, we refer to hazard ratios in the Cox proportional hazards model and odds ratios in the logistic regression models. All analyses were adjusted for age and sex and two models were additionally adjusted for any presence of comorbidity. Results: A total of 156 COVID-19 patients with diabetes were analyzed. Upon admission, 13% were in diabetic ketosis, 4% were in a state of DKA, and 2% had hypoglycemia. About 5%, 33%, 26%, and 36% of patients had mild, moderate, severe, and critical COVID-19, respectively. Between non-survivors and survivors, the latter group were significantly younger in age (p<.003) and had less ICU admissions (p<.001). Although DKA status upon admission seemed to result in increased odds of non-survival (cOR 5.8 [95% CI 1.1-30.7]), no other feature in the glycemic history was significantly associated with mortality outcome after having adjusted for age and sex. Death in this study was limited to patients with severe or critical disease. Conclusion The risk of mortality is five times greater among patients admitted with diabetic ketoacidosis. The incidence of complications were also significantly greater and mortality was limited to patients with severe or critical disease.
Diabetes Mellitus ; Coronavirus

Objective: This study aims to determine the prevalence of sexual dysfunction among premenopausal Filipino women with type 2 diabetes mellitus at the outpatient department of a tertiary hospital through the use of the Female Sexual Function Index (FSFI) and identify factors that could be associated with sexual dysfunction. Methodology: Seventy-five women with type 2 diabetes mellitus, aged 38 to 49 years old, received the FSFI questionnaire. Their age, history of hypertension, smoking habit, alcohol intake, body mass index, waist circumference, fasting blood sugar, HbA1c, creatinine, lipid profile, albuminuria or proteinuria, presence of microvascular complications such as diabetic retinopathy, neuropathy and nephropathy and their association with sexual dysfunction was determined. Results: Seventy-two percent of the participants have sexual dysfunction scoring lowest in the lubrication, orgasm and pain domains. Age (p=0.016), a high body mass index (p=0.001), a fasting blood sugar above 100 mg/dl (p=0.006) and the presence of microvascular complications of diabetes mellitus namely, retinopathy (p=0.046) nephropathy (p=0.004) and neuropathy (p=0.001) were associated with sexual dysfunction. Conclusion The prevalence of sexual dysfunction is high among premenopausal Filipino women with type 2 diabetes mellitus, and is associated with age, a high body mass index, an uncontrolled fasting blood sugar and the presence of microvascular complications of diabetes mellitus.
Diabetes Mellitus, Type 2 ; Premenopause ; Diabetic Neuropathies ; Diabetic retinopathy ; Diabetic Nephropathies

BACKGROUND: Adrenal  nodules  can  either  be  non  functioning or hormone secreting. Once proven functional,
adrenalectomy is warranted. Laparoscopic adrenalectomy has been the popular intervention for these nodules. There is no local literature citing the clinical outcomes, particularly on  symptom  and  medication  reduction.  Considering  that  these tumors present with hypertension, such condition may be  under  diagnosed  in  a  population  with  a  hypertension  prevalence  of  22.3%.  This  study  reviewed  the  outcomes 
of the procedure particularly on the improvement of signs and  symptoms  and  medication  use.

METHODOLOGY: This  is  a  retrospective  review  describing  the  post-operative  outcomes  of  patients  who  underwent  laparoscopic  adrenalectomy  conducted  in  a  tertiary 
medical  center  from  2010  -  2015. 

RESULTS: Twenty-three  (23)  patients  were  categorized  according  to  pathology  -  primary  hyperaldosteronism 
-(17),   pheochromocytoma   -   four  (4)  and  Cushing's  syndrome - two (2). Post-operatively, there was a reduction in  the  systolic  blood  pressure  of  patients  with  primary  hyperaldosteronism  (p  =  0.156).  A  mean  reduction  of  20-30  mmHg  in  the  blood  pressure  was  documented  in patients  who  had  pheochromocytoma  (p  =  0.625).  There  was  a  reduction  in  the  number  and  dosages  of  anti-hypertensive  medications  (primary  hyperaldosteronism  p=
Human ; Male ; Female ; Aged 80 And Over ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Adult (a Perso ; Adrenalectomy ; Antihypertensive Agents ; Pheochromocytoma ; Hydrocortisone ; Hyperaldosteronism ; Hypertension ; Cushing Syndrome ; Blood Pressure Determination

BACKGROUND: Various studies have shown that papillary thyroid microcarcinoma (PTMC) has a favorable prognosis but has the capacity to be aggressive; thereby, requiring effective treatment.

OBJECTIVES: To determine the clinical characteristics and outcomes of PTMC in Filipino patients diagnosed and treated at Makati Medical Center.

STUDY DESIGN: This is a retrospective, descriptive study.

SUBJECTS AND METHODS: Medical and clinical records of twenty two patients diagnosed and treated for papillary thyroid microcarcinoma from 1993-2004 were reviewed. Statistical means and percentages were used.

RESULTS: The patients' age ranged from 19-73 years old with a mean of 46years. There was a female predominance at 95.45%. One patient (4.5%) had papillary microcarcinoma by fine needle aspiration biopsy (FNAB). Another patient had lymph node and distant metastases (bone) at presentation after near total thyroidectomy without ablation in another medical center and later received 200mCi of radioactive iodine therapy but was lost to follow up. Multifocality was seen in two patients (9%). Five patients (22.7%) had lobectomy while one (4.5%) underwent subtotal thyroidectomy. Near total thyroidectomy was done in five patients (22.7%) while 11 (50%) had total thyroidectomy. Only 12 patients (54.5%) received radiation remnant ablation therapy. One patient who had lobectomy was noted to have nodule recurrence in the remaining lobe while another patient who underwent total thyroidectomy with no radioactive iodine treatment had elevated thyroglobulin (Tg) on follow up. Follow up period ranged from one to 11 years (mean of six years). All patients have survived and were asymptomatic but in some of the patients the cancer activity could not be accurately assessed due to absence of thyroglobulin and thyroid ultrasound determinations.

CONCLUSIONS/RECOMMENDATIONS: Our study compared to foreign studies had a smaller population. Multifocality considered as a predictor of poor prognosis was seen in only two patients. PTMC may have latent/ indolent course and favorable outcomes but may be persistent/ metastatic in some. Combination therapy of near total/ total thyroidectomy with radiation remnant ablation offered greater benefit. Thyroglobulin served as a powerful prognostic factor of persistent/ recurrent disease. Repeat thyroid ultrasound/ biopsy were necessary to document thyroid cancer activity in patients not amenable to thyroglobulin determinations.

Human ; Male ; Female ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Adult (a Person 19-44 Years Of ; Biopsy ; Radiation ; Thyroglobulin ; Thyroidectomy ; Philippines ; Patients