ABSTRACT
INTRODUCTION: Giant insulinomas are extremely rare pancreatic neuroendocrine tumor. PRESENTATION OF CASE: A 15-year-old man presenting with acute onset of lightheadedness was found to have serum glucose of 1.5mmol/L. The blood collected from the hypoglycemic episode showed an inappropriately high insulin and C-peptide level. Abdominal computerized tomography showed a 12.5cm well-defined, lobulated hypervascular mass at pancreatic tail, without any evidence of metastasis. En bloc resection with distal pancreatectomy, and splenectomy was successfully performed. The pathological examination confirmed insulinoma, with benign characteristics. Follow-up after the procedure revealed neither hypoglycemic, nor hyperglycemia. CONCLUSION: We report the youngest case of a giant insulinoma. Despite the size of the tumor, the pathological report confirmed the benign characteristics. However, long-term follow-up is still essential to detect recurrence in the future.
ABSTRACT
INTRODUCTION: Nutritional status among adolescents is an important health indicator. The up-to-date information about nutritional status and food consumption pattern in the remote rural area is required for the effective public health intervention in the rural area of the country. The present study aimed to demonstrate the prevalence of malnutrition, eating behavior and nutritional knowledge among secondary school students in a remote rural area in Thailand. MATERIAL AND METHOD: Body weight and height data were collected from 298 secondary school students for nutritional status calculation using the Institute of Nutrition Research, Mahidol University, INMU-Thaigrowth program. Eating behavior and nutritional knowledge were observed by self-administrated questionnaires. RESULTS: The prevalence low height-for-age (<-2SD) 6.1% and it was 0.7% for low weight-for-height (<-2SD). Fruits (69%) and vegetables (79.4%) consumptions were in the high level. The authors found that the students always consumed commercial snacks especially salted chips more often than regular Thai dessert (74.0% VS 52.3%). The inappropriate behavior found in the present study included always drinking caffeine beverage (43.5%), always drinking alcoholic beverage (6.5%) and always consuming instant noodles (64.4%). CONCLUSION: The prevalence of malnutrition was low among this population. The studied population had a fair knowledge about nutrition. The authoes found that regular consumption of highly commercialized snack products especially salted chips and instant noodles were at a high level in this remote rural area of Thailand. The pattern of nutritional problems in Thailand may have changed in which a public health program for children in rural areas of the country should recognize this transition.
