DSME in this rural agricultural town improved glycemic control and promoted foot examination.

Objective. 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/m 2 , 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/m 2 , 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.

We report a case of a 29-year-old woman who suffered from severe bilateral inguinal pain and left mandibular mass. CT scan showed innumerable expansile osteolytic bone masses on the iliac wings, femur, ribs and vertebral bodies, diffuse skeletal osteopaenia, calyceal lithiasis on the right kidney and a left thyroid mass. Ionised calcium and intact parathyroid hormone (PTH) were elevated. Parathyroid sestamibi scan showed a hyperfunctioning left inferior parathyroid gland. Biopsy of the left mandibular mass was consistent with brown tumour. The patient underwent parathyroidectomy of the enlarged parathyroid gland. Final histopathology, however, revealed parathyroid carcinoma, 4.7 cm in widest dimension, with capsular and vascular space invasion. The patient underwent repeat surgery, specifically, left thyroid lobectomy, isthmectomy and central node dissection. Intact PTH decreased from 681.3 to 74 pg/mL (normal range: 10-65) 24 hours postoperatively. Follow-up at 6 months showed normal serum calcium levels, size reduction of bone lesions and improvement of quality of life.

SummaryA 51-year-old Filipino woman presenting with hypertension was unexpectedly found to have a large right adrenal mass by ultrasound. As she did not have symptoms of adrenal disease, this was labelled an adrenal incidentaloma. Ultrasound and CT imaging demonstrated a large adrenal mass on the right measuring 15 cm at its greatest diameter, with both benign and malignant features. Tests for endocrine hyperfunction (excess of cortisol, catecholamines and aldosterone) concluded that the mass was hormonally non-functioning. The patient eventually underwent open adrenalectomy. Histopathological examination revealed myelolipoma. BACKGROUND