A 49-year old patient presented with symptoms of adrenal suppression following an attempt to
withdraw Depo-Provera or Depot Medroxyprogesterone Acetate (DMPA) injection. She had
been receiving DMPA injections for the past 16 years for contraception. She was initially
prescribed DMPA by her gynaecologist but later on began obtaining the medication directly
from a private pharmacy without prior consultation from her gynaecologist. Clinically, she had
been experiencing significant weight gain and appeared cushingoid. Blood investigations
confirmed partial adrenal suppression with presence of an adrenal incidentaloma. This case
reports a known side effect of DMPA but occurring at a much lower dose than previously
described. It also highlights the need to increase the awareness of the insidious side effect of
DMPA and to avoid unsupervised use of the drug.
Binge eating (BE) behaviour is associated with obesity and eating disorders. This cross-sectional study investigates BE behaviour and its relationship with nutrition-related factors among university students. A total of 170 (69% females) university students in Malaysia aged 19 to 24 years participated in this study. BE behaviour was assessed with the use of Binge Eating Scale (BES) questionnaire. Socio-demographic background and nutritional status (anthropometric measurements, body mass index (BMI) and dietary intake) were also measured. BE behaviour reported by 10% percent of the participants. BE behaviour was associated with increased energy intake, elevated BMI and sex (Adjusted R2 = 0.116, p < 0.001). Differences in sex-specific factors in predicting the risk of BE behaviour were evident. In male participants, an increased in energy intake, elevated BMI and had a higher waist circumference associated with the risk of BE behaviour (Adjusted R2 = 0.411, p < 0.001). In female participants, only a higher waist circumference associated with BE behaviour (Adjusted R2 = 0.028, p < 0.05). The finding suggests that understanding sex-specific factors are necessary to prevent BE. These are the potential targets for tailored eating behaviour intervention among university students.
Rosdina Zamrud Ahmad Akbar, Sharifah Faradila Wan Muhammad Hatta, Rosnida Mohd Noh, Fatimah Zaherah Mohd Shah, Thuhairah Abdul Rahman, Rohana Abdul Ghani, et al.
Introduction: Hormonal abnormality is one of many clinical manifestations of HIV infections
that is not well understood. However, the consequences could affect quality of life and are
potentially treatable. Thus, this study aimed to determine the prevalence and associated
factors of thyroid, adrenal and gonadal dysfunctions among HIV-infected patients. Methods:
This is a single centre cross-sectional study involving 150 HIV-infected patients attending the
HIV clinic. Each subject was required to answer specific symptoms questionnaire and their
medical records were reviewed for relevant clinical and biochemical data. Blood for was
collected and thyroid hormones, cortisol, ACTH, FSH, LH, testosterone and estradiol were
analysed using electrochemiluminescent immunoassay. Thyroid, adrenal and gonadal axes
abnormalities were identified. Results: Hypogonadism had the highest prevalence amongst
the endocrine abnormalities, which was detected in 23 patients (15.3%), followed by thyroid
dysfunction in 18 patients (12%) and hypocortisolism in 2 patients (1.3%). There was
significant correlation between CD4 count, BMI and age with the hormone levels. Conclusion:
Prevalence of endocrine abnormalities was low in these well-treated HIV-positive patients,
with hypogonadism being the most common. However, significant correlations between CD4
count, age and BMI with the hormonal levels were detected. Clinical symptoms in relation to
endocrinopathy are not specific as a screening tool thus underscoring the need for
biochemical tests to identify these treatable conditions.
The Binge Eating Scale (BES) questionnaire is a self-administered instrument developed to identify binge eaters. The aim of this study was to assess the validity of the Malay language version of BES as a screening instrument for binge eating. A cut-off point of 17 is taken as comparable to the Structured Clinical Interview for the DSM-IV patient version (SCID-I/P), the gold standard for the diagnosis of Binge Eating Disorder.
We examined the effects of liraglutide, a glucagon-like peptide-1 analogue on appetite and plasma ghrelin in non-diabetic obese participants with subclinical binge eating (BE). Forty-four obese BE participants (mean age: 34±9 years, BMI: 35.9±4.2kg/m(2)) were randomly assigned to intervention or control groups for 12 weeks. All participants received standard advice for diet and exercise. Binge eating score, ghrelin levels and other anthropometric variables were evaluated at baseline and at the end of the study. Participants who received liraglutide showed significant improvement in binge eating, accompanied by reduction in body weight, BMI, waist circumference, systolic blood pressure, fasting glucose and total cholesterol. Ghrelin levels were significantly increased which may potentially diminish the weight loss effects of liraglutide beyond the intervention.