Hypoglycemia is a life-threatening condition, especially if recurrent. Most common causes include patients with diabetes due to medications, nephropathy with oral hypoglycemic drugs, faulty dietary habits and other endocrine causes. In a patient presenting with recurrent hypoglycemia with central hypothyroidism, Sheehan syndrome must be suspected as diagnosis can prevent disastrous complications

Introduction: Visceral obesity and dyslipidemia are the two most commonly occurring components of the metabolic syndrome. Epicardial fat is a true visceral adipose tissue deposited around the heart and has characteristics of a high insulin-resistant tissue. Material and methods: The study included 66 subjects (33 cases and 33 controls). Epicardial fat thickness was measured by echocardiography on the free wall of the right ventricle from both parasternal long- and short-axis views and anthropometric and biochemical parameters were recorded. Results: Range of epicardial fat thickness varied between 0.8 to 7.3 mm. The normal cutoff value is considered to be between 1 to 4 mm. The mean epicardial fat thickness was found to be 4.3 ± 1.83 mm (mean ± standard deviation) in females and 3.5 ± 1.18 mm in males amongst the cases, and 2.4 ± 1.33 mm in females and 2.2 ± 1.02 mm in males in the control group. Epicardial fat thickness was higher in the patients with metabolic syndrome as compared to controls. There was a statistical significant correlation between epicardial adipose tissue and body mass index (BMI), fasting plasma glucose, triglycerides and homeostasis model for assessment of insulin resistance (HOMA IR). Conclusion: Our data showed that epicardial adipose tissue measured by echocardiography is related to the main anthropometric and clinical parameters of metabolic syndrome which was the objective of our study. Epicardial adipose tissue measurement could be an important tool to increase the knowledge of metabolic syndrome on epidemiological basis.

Background and Aims: Shorter and longer duration of sleep are known to be risk factors for diseases such as diabetes mellitus, hypertension and obesity. Most studies were done in the developed countries and there are limited populationbased data from Malaysia regarding this topic. The objective of this study is to determine the prevalence of short sleeping duration among residents in the Hulu Langat district and determine its associated factors. Methods: This was a cross-sectional study done in the year 2000. 7731 respondents in the Hulu Langat district were surveyed using a self-administered questionnaire. Short sleep duration was defined as having sleeping duration of less than 6 hours per day and long sleep duration as having sleeping duration of 6 hours or more per day. Results: The prevalence of short sleep duration was 6.2%. The mean age of participants was 43.2 years (±14.31) and 64.1% were females. Multiple logistic regression revealed significant association between short sleeping duration and younger age group (< 40 years old) (aOR=1.41, 95% CI: 1.15-1.73) and between short sleeping duration and smoking (aOR= 2.26, 95% CI: 1.57-3.26). Association between sleeping duration and gender, ethnicity, marital status, hypertension, diabetes and body mass index (BMI) were found to be not significant after multivariate analysis was done. Conclusion: This study shows that shorter sleeping duration is significantly associated with younger age group (<40 years old) and smoking. Health promotion strategies should aim to educate the public regarding getting adequate sleep and stop smoking.