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Previous studies have yielded inconsistent results on whether glycated hemoglobin (HbA1c) and random blood glucose (RBG) are associated with mortality of coronavirus disease 2019 (COVID-19) patients with type 2 diabetes mellitus (T2DM). This study aimed to assess the association of HbA1c and RBG with mortality among COVID-19 patients with T2DM. A retrospective study was conducted on 237 patients with COVID-19 and T2DM (survival (n = 169) and non-survival groups (n = 68)). Data on socio-demography, comorbidities, clinical symptoms, laboratory examination, and mortality were collected. Patients in the non-survival group had an older age range as compared with those in the survival group (60 (52.3-65.0) vs. 56.0 (48.5-61.5) years, p = 0.009). There was no statistical gender difference between the two groups. After matching was done, chronic kidney disease, NLR, d-dimer, procalcitonin, and random blood glucose were higher in the non-survival group compared to the survival group (p < 0.05). HbA1c levels were similar in survivors and non-survivors (8.7% vs. 8.9%, p=0.549). The level of RBG was independently associated with mortality of COVID-19 patients with T2DM (p = 0.003, adjusted OR per 1-SD increment 2.55, 95% CI: 1.36-4.76). In conclusion, RBG was associated with the mortality of COVID-19 patients with T2DM, but HbA1c was not.

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BACKGROUND Atypical manifestations of Graves' disease (GD) such as anemia have been noticed in the last decades. Anemia is present in up to 34% of patients with GD, yielding various anemia types such as GD anemia, pernicious anemia, iron deficiency anemia, and autoimmune hemolytic anemia (AIHA). So far, AIHA is the rarest manifestation of anemia in GD. CASE REPORT We report a case of 29-year-old woman with initial presentation of typical anemia. Further findings revealed GD signs and symptoms such as orbitopathy, increased appetite along with loss of weight, and hand tremors. Laboratory findings showed very low hemoglobin (3.9 g/dL), reticulocytosis, elevated indirect bilirubin, and positive direct Coomb's test. Later, thyroid function testing showed decreased TSH, elevated fT4, and positive TrAb. The diagnosis of GD was made, with AIHA as initial presenting manifestation. The patient was treated using corticosteroids followed by anti-thyroid without any blood transfusion and responded well. CONCLUSIONS In this case, typical AIHA was the initial presenting manifestation of GD and should not be overlooked since delayed diagnosis increases morbidity and mortality. Thyroid function assessment may be needed to search for etiologies of AIHA. Regardless of the exact underlying pathophysiology, AIHA under GD generally responds well to anti-thyroid and steroid treatment.

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BACKGROUND: sarcopenia and frailty cause immobility, disability, neuromuscular disorders, and homeostatic balance failure syndrome, characterized by gait and balance abnormalities in the elderly, and an increasing prevalence worldwide. This further contributes to the elevated incidence of falls and fractures, hospitalization, immobilization, and even mortality, hence, a national-level study was conducted on the prevalence rates of sarcopenia and frailty in the elderly. METHODS: this descriptive study used primary data of elderly people (n = 308) in Surabaya, Indonesia. Furthermore, the biopsychosocial data, weight loss, fatigue, and physical activity measurements were obtained through interviews, while handgrip strength, muscle mass, and physical performance (walking speed) were evaluated using instruments. RESULTS: the median age of the subjects was 63 years (60-100 years), and 230 (74.7%) were women. In addition the prevalence rate of sarcopenia was 41.8% (in 86 [27.9%] women), while the prevalence rate of frailty was 36.7% (in 16 [5.2%] men and 97 [31.5%] women). CONCLUSION: the prevalence of sarcopenia and frailty in the elderly is significantly high, thus, it is expected that this study results are used as a basis for subsequent research, especially to determine the sarcopenia cut-off, in accordance with Indonesian sociodemography.

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