scholarly journals Study of electrolyte disturbances and renal parameters in acute gastroenteritis under 5 years of age in a tertiary care hospital of Bengaluru, India

2020 ◽  
Vol 7 (9) ◽  
pp. 1910
Author(s):  
Poornima Shankar ◽  
Shajna Mahamud ◽  
Anjum Aara C. A.
Keyword(s):  
Serum Sodium ◽  
Acute Gastroenteritis ◽  
Fluid Replacement ◽  
Electrolyte Imbalance ◽  
Care Hospital ◽  
Severe Dehydration ◽  
Serum Electrolytes ◽  
Female Ratio ◽  
Electrolyte Disturbances ◽  
Sodium And Potassium

Background: Diarrhoea still continues to be a major cause of hospitalization and death in under fives. Electrolyte disturbances play an important role in the associated morbidity and mortality.  Acute renal failure is one of the important complications of acute gastroenteritis (AGE) in children. Early intervention and proper fluid replacement may lessen this risk. This study was designed to find out the incidence of acute gastroenteritis and the status of associated electrolyte derangements and renal involvement.Methods: This was a cross sectional study conducted at KIMS, Bengaluru in which 117 children from the age of 1 month to 5 years with acute diarrhea were included based on a predefined inclusion and exclusion criteria. Demographic profile of the patients, details of diarrhea, clinical examination and accompanying degree of dehydration (defined as per WHO criteria) were recorded. Serum electrolytes along with renal parameters were investigated.Results: Total 117 children with acute gastroenteritis were enrolled in the study as per the inclusion criteria which constituted 5% of total paediatric admissions. Children aged 1-12 months had the highest incidence of diarrhea (50%). Male to female ratio is 1.3:1. 65% had some dehydration, 19% no dehydration and 16% had severe dehydration. Isonatremia was seen in 58% followed by hyponatremia in 35% and hypernatremia in only 7%. 83% had isokalemia, hypokalemia in 12%, hyperkalemia in 5%. Levels of serum sodium and potassium decreased with the severity of dehydration. Serum urea and creatinine were significantly high in severe dehydration (p value 0.001). Out of 28 children who were given diluted ORS before admission, majority had hyponatremia (39%) and all of them who received concentrated ORS had hypernatremia.Conclusions: Hyponatremic dehydration is the second most common type of dehydration next to isonatremic dehydration, but it is more common in children who took diluted ORS. Increased awareness regarding ORS preparation may help in preventing electrolyte imbalance in AGE. The levels of serum sodium and potassium decreased and urea and creatinine increased with severity of dehydration. Measurements of serum electrolytes and renal parameters early can help to predict the complications due to AGE and may help in the prevention of diarrhea related complications in children.

scholarly journals FREQUENCY OF HYPONATREMIA

2012 ◽  
Vol 19 (05) ◽  
pp. 679-682
Author(s):  
AMEER AHMAD ◽  
SADIQ HUSSAIN ◽  
AYESHA FAYYAZ
Keyword(s):  
Serum Sodium ◽  
Acute Diarrhea ◽  
Sodium Level ◽  
Case Series ◽  
Acute Diarrhoea ◽  
Fluid Replacement ◽  
Female Ratio ◽  
Oral Rehydration ◽  
Watery Stool ◽  
Recommended Treatment

Introduction: Acute diarrhea is defined as passage of three or more stools in a day, of consistency softer than usual for thechild, or one watery stool. Acute diarrhea is the major cause of morbidity and mortality in developing countries. It accounts for approximately25% of total admissions in children ward and causes mortality of 5-10% in community. As dehydration is the main complication of diarrhea,treatment focuses upon rehydration through fluid replacement. Oral Rehydration solution (ORS) is the recommended treatment in children withacute diarrhea and some dehydration. Now WHO has recommended Low Osmolarity ORS which contains less sodium and glucose thanstandard ORS. One of the side effect of use of ORS solution with reduced sodium level is the development of hyponatremia ( i.e. serum sodiumlevel less than 130 meq/L) in some of children with acute diarrhea and results in adverse clinical events. Objective: To determine thefrequency of hyponatremia in children taking low osmolarity ORS for management of acute diarrhea with some dehydration. Study design:Descriptive case series. Place and Duration of Study: Study was conducted in Department of Pediatrics, Children ward-2 Bahawal VictoriaHospital Bahawal Pur and Department of Pathology Quaid-e-Azam medical college Bahawal Pur from 7th August 2010 to 22nd September2010. Subjects and methods: Total 32 children with age between 3 months to 60 months with acute diarrhoea and some dehydration withnormal initial serum sodium were included. An informed consent was taken from the parents to include their children in the study. Proforma wasfilled at the time of admission and after 4 hours. Blood sample was taken to measure serum sodium level. Criteria of hyponatreima was serumsodium level below 130 meq/l after giving low osmolarity ORS at a dose of 75 ml/kg to drink. Results: A total of 32 children with acute diarrheawere included in study with age ranging from 3 months to 60 months. Male to female ratio was 1.1:1. Hyponatremia was seen in 2 (6.3%) ofpatients. Conclusions: The risk of hyponatremia in patients treated with the low osmolarity ORS was minimal.

scholarly journals The role of perfusion index and plethysmography variability index for predicting dehydration severity in patients with acute gastroenteritis

2019 ◽  
pp. 102490791988948
Author(s):  
Emine Emektar ◽  
Seda Dagar ◽  
Hüseyin Uzunosmanoğlu ◽  
Gülşah Çıkrıkçı Işık ◽  
Şeref Kerem Çorbacıoğlu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Gastroenteritis ◽  
Clinical Syndrome ◽  
Perfusion Index ◽  
Fluid Replacement ◽  
Severe Dehydration ◽  
Cross Sectional ◽  
Variability Index ◽  
Index Value

Background: Acute gastroenteritis is a clinical syndrome that may cause severe dehydration in affected individuals and a reason of mortality and morbidity in all age groups. Measurement of perfusion index and plethysmography variability index may provide emergency physicians valuable information about hemodynamics of the patient. Objectives: Our study aimed to investigate the role of perfusion index and plethysmography variability index measurement at admission for estimating dehydration severity and determiningthe possible change in those parameters after fluid replacement among patients presenting to emergency department with acute gastroenteritis. Methods: This was a prospective cross-sectional study. Patients diagnosed with acute gastroenteritis at the emergency department were consecutively enrolled. The two groups were defined according to the severity of dehydration: mild and moderate/severe dehydration groups. The values of perfusion index and plethysmography variability index of all patients were measured. Results: A total of 180 patients were included in the study. As compared with the mild dehydration group, moderate/severe dehydration group had a significantly lower perfusion index value and significantly higher plethysmography variability index value on admission (p < 0.001 for both comparisons). Among moderate/severe dehydration patients, perfusion index value significantly increased and plethysmography variability index significantly decreased after treatment (p < 0.001). There was a significant positive correlation between osmolarity and plethysmography variability index (r = 0.298; p = 0.007) and a significant negative correlation between osmolality and perfusion index (r = −0.259; p = 0.019) in the patients with moderate/severe dehydration. Conclusion: The study show that perfusion index and plethysmography variability index may be useful for determining the severity of dehydration in acute gastroenteritis and may be use for assessing the response to fluid replacement especially in patients with severe dehydration at emergency department.

scholarly journals Comparative Assessment of Severity of Dyselectrolytaemia (Sodium and Potassium) in Cerebral Infarction and Cerebral Hemorrhage

2016 ◽  
Vol 3 (1) ◽  
pp. 25
Author(s):  
Surekha Tushar Nemade ◽  
Mrunal Suresh Patil ◽  
Rajendra Annasaheb Chaudhari ◽  
Ashok J. Vankudre
Keyword(s):  
Cerebral Infarction ◽  
Cerebral Hemorrhage ◽  
Electrolyte Imbalance ◽  
Intracranial Hemorrhages ◽  
Serum Electrolyte ◽  
Serum Electrolytes ◽  
Cerebrovascular Accidents ◽  
Significant Difference ◽  
Sodium And Potassium ◽  
Cerebral Insult

<strong>Aim:</strong> 1) To compare serum electrolyte levels (sodium and potassium levels) in cerebral Infarction and cerebral hemorrhage. 2) To compare serum electrolytes in thalamic and other intracranial hemorrhages. <strong>Material and Methods:</strong> In this retrospective type of study, we compared serum electrolyte levels of 70 patients, 45 diagnosed as cerebral infarction with the 25 patients, diagnosed as cerebral hemorrhage. The sample for electrolyte analysis was collected within first 24 hrs of onset of the event. <strong>Result:</strong> Statistical analysis was done by Z test and independent t test using SPSS 16 which showed statistically no significant difference in serum electrolyte levels in both groups there was also no statistical difference in serum electrolyte levels in thalamic hemorrhages compared to other intracranial hemorrhages. <strong>Conclusion:</strong> Electrolyte imbalance is common in cerebrovascular accidents and needs to be intervene as early as possible irrespective of the type of cerebral insult. Correction of electrolytes imbalance can help in better prognosis of the patient and may avoid complications.

scholarly journals Relationship of blood pressure status, dietary factors and serum electrolytes of in-school adolescents in Ilishan-Remo, Ogun State, Nigeria

2021 ◽  
Vol 21 (4) ◽  
pp. 1754-63
Author(s):  
Olutayo S Shokunbi ◽  
Ngozi A Ukangwa
Keyword(s):  
Blood Pressure ◽  
Serum Sodium ◽  
Dietary Factors ◽  
Elevated Blood ◽  
Table Salt ◽  
Serum Electrolytes ◽  
Ogun State ◽  
The Mean ◽  
Relationship Of ◽  
Sodium And Potassium

Background: Globally, rising blood pressure is of public health concern as it is a major cause of cardiovascular diseases (CVDs), and preventable death. This study accessed the relationship of blood pressure status, dietary factors and serum electrolytes among in-school adolescents in Ilishan-Remo, Ogun State, Nigeria. Methods: A cross-sectional survey of 488 secondary school students (aged 10–19 years). Blood pressures were assessed using auscultatory method and questionnaires were used to obtain food frequency and 24-hour dietary recall data. Blood samples from volunteers were used for serum sodium and potassium assays. Results: The mean systolic blood pressure (SBP) increased with age, irrespective of gender. The prevalence of elevated blood pressure and hypertension among participants were 19.3% and 10.5%, respectively, with males and females having similar pattern. Dietary factors like addition of table salt to already prepared foods, higher intake of eggs, and lower intake of vegetables were associated with the development of elevated blood pressure among the adolescents. The estimated mean dietary intakes (mg/person/day) of sodium and potassium were 2289±938.7 and 1321±603.8, respectively, with majorityconsuming far higher (for sodium – 80%) or far below (for potassium – 95%) recommendations. The mean serum sodium (138.0±18.3 mmolL-1) and potassium (3.06±1.1 mmolL-1) were similar across genders. A significant (p<0.05) negative relationship exists between serum potassium and SBP. Conclusions: The blood pressure status of the adolescents studied are of great concern and are somewhat negatively influenced by poor dietary and lifestyle practices. They require prompt intervention to slow down the development of CVDs in the future. Keywords: Adolescents; dietary patterns; hypertension; table salt.

scholarly journals Evaluation of Serum Potassium Level in Pediatric Gastroenteritis at Children – Welfare Teaching Hospital

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Mohanad Adnan Bakr ◽  
Ghazi Farhan Haji ◽  
Fadil Agla Al-Rubaye ◽  
Asaad Abullah Abbas
Keyword(s):  
Teaching Hospital ◽  
Serum Potassium ◽  
Acute Gastroenteritis ◽  
Paralytic Ileus ◽  
Urban Areas ◽  
Deficiency Anemia ◽  
Prospective Clinical Study ◽  
Severe Dehydration ◽  
Female Ratio ◽  
Children Welfare

Objective: To measure the incidence of the hypokalemia in children who are suffered from acute gastroentitis and to estimate their complications. Method: A prospective  clinical study, is enrolled (153) patients from 1st of January 2017 to  1st of December 2017, at the Children-Welfare Teaching Hospital and it is included the children from ( 1-5 years ) who are firstly admitted to the emergency department and then to the pediatric wards who were  suffered from acute gastroentitis and their serum potassium levels were below (3.5 mmol/l )and is excluded the children with a chronic diarrhea or a bloody diarrhea or with any nutritional diseases, like  marasmus disease, kwashiorkor  or  iron deficiency  anemia disease or parenteral  diarrhea, like ( pneumonia, UTI), or   their ages either below ( 1year )  or more than ( 5 years )  and the study depends on history and physical examination and serial serum potassium levels. Result: A total of (153) patients with acute gastroenteritis were included in a study, (91) male patients, (62) female patients with male to female ratio (1.4:1), the majority of the patients were from urban areas. In this study, 61(39%) of patients with acute gastroenteritis were complicated by hypokalemia, 92(61%) were not. Of  those with a severe dehydration, 11(23%) had a mild hypokalemia, 17(36%) a moderate, 19(41%) a severe one, patients with a moderate dehydration, 7(50%) had a mild hypokalemia, 5(38%) a moderate, 2(15%) a severe one .Concerning the main complain, 65(44%), had both diarrhea and vomiting, 61(39%), had only diarrhea, 28(17%), had only vomiting.  According to degree of dehydration, there were 72(47%) with moderate dehydration, 81(53%) with a severe dehydration. UOP is poor in (70) with a severe dehydration, and (21) with a moderate dehydration, and is good in (8) with a moderate dehydration, (53) with a severe dehydration. The percentages of the complications were 51(83%), had generalized weakness, 10(17%), and had both generalized weakness and paralytic ileus. Conclusion: Children with acute gastroenteritis were complicated by a hypokalemia 61(39%) paralytic ileus. Diarrhea and vomiting were the commonest complaint of acute gastroenteritis.

scholarly journals Study of Renal Profile in Babies with Perinatal Asphyxia in a Tertiary Care Hospital: A Prospective Case Control Study

2013 ◽  
Vol 33 (3) ◽  
pp. 206-212
Author(s):  
Banasree Roy ◽  
Gobinda Mondal
Keyword(s):  
Case Control Study ◽  
Tertiary Care Hospital ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Case Control ◽  
Electrolyte Imbalance ◽  
Care Hospital ◽  
Functional Abnormality ◽  
Sodium And Potassium ◽  
Control Study

Introduction: Perinatal asphyxia is one of the important causes of preventable cerebral injury occurring in the neonatal period. Kidney is one of the most commonly affected organs leading to renal functional abnormality and blood electrolyte imbalance. This was a prospective case control study done in the NICU and neonatal unit at a tertiary care hospital. The objective of this study were to detect renal functional abnormality and electrolyte imbalance (sodium and potassium) among babies with perinatal asphyxia and to correlate severity and type of renal involvement with degree of asphyxia. Materials and Methods: Thirty two neonates for perinatal asphyxia and 32 babies selected randomly from non asphyxiated babies for the control group. Blood samples were taken for measurement of serum urea, creatinine, sodium and potassium levels on 1st and 3rd day of life. If any abnormality detected, values were repeated every alternate days till it become normal. Results: There were total 32 cases (asphyxiated). Among 32 cases 14 (43.75 %) had elevated levels of urea and creatinine on day 1 [Mean urea (43.21± 23.08), creatinine (1.14 ± 0.57)], 18 (56.25%) had elevated levels of urea and creatinine on day 3.Mean urea (58.06 ± 28.52) and creatinine (1.24±0.5) were significantly higher on day 3 (p value<0.05) in study group as compared to control. Mean urea and creatinine levels showed increasing trend with degree of severity of hypoxic ischaemic encephalopathy. Eighteen babies with perinatal asphyxia developed renal failure (56.25%). 18 had Hyponatremia on day 1 (56.25%), 3 of them had value < 125 meq /l. Conclusion: Among study cases significantly higher values of urea and creatinine were found than controls. The values were positively correlated to the degree of asphyxia. Though, mean sodium and potassium level was within the normal limit, the value of potassium was higher among cases than controls. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8385   J. Nepal Paediatr. Soc. 2013;33(3):206-212

HYPONATREMIA IN CHILDREN OF 2 MONTHS TO 5 YEARS OF AGE WITH PNEUMONIA AND ITS CORRELATION WITH OUTCOME

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Kapil Kumar ◽  
Anita Devi ◽  
Rakes Kumar Sharma
Keyword(s):  
Observational Study ◽  
Serum Sodium ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Pneumonia ◽  
Electrolyte Imbalance ◽  
Care Hospital ◽  
Keywords Children ◽  
Who Criteria

Background: Hyponatremia is a common electrolyte imbalance observed in children with pneumonia. Presence of hyponatremia may increase the morbidity and mortality in pneumonia. The purpose of the study was to find the frequency of hyponatremia in 2 months to 5 years old children hospitalized with pneumonia and to correlate the hyponatremia with the severity of pneumonia. Methods: This prospective observational study involved 100 children of 2 months to 5 years, admitted in tertiary care hospital with pneumonia. Subjects were classified as pneumonia and severe pneumonia according to WHO criteria. Relevant demographic, clinical data and outcome of the patients were noted. Serum sodium was analyzed and was correlated with severity of pneumonia. Results: Out of 100 children included in this study, 64 were boys and 36 were girls. Hyponatremia was found in 43.0% of children with pneumonia. Mild hyponatremia was the commonest and seen in 26 children. Mortality was more in children with hyponatremia compared to normonatremia. Conclusion: Hyponatremia is a common electrolyte imbalance found in pneumonia and more commonly seen in severe pneumonia. Hyponatremia is associated with increased mortality.  Keywords: Children, Hyponatremia, Mortality, Pneumonia.

scholarly journals Acid-base and Electrolyte Disturbances in Children Presenting with Acute Watery Diarrhoea in Emergency Observation and Referral Unit of Dhaka Shishu (Children) Hospital

2021 ◽  
Vol 36 (2) ◽  
pp. 120-124
Author(s):  
Md Abu Tayab ◽  
Md Ariful Hoq
Keyword(s):  
Serum Sodium ◽  
Statistical Significance ◽  
Acute Diarrhoea ◽  
Watery Diarrhoea ◽  
Severe Dehydration ◽  
Bicarbonate Concentration ◽  
Acid Base ◽  
Arterial Blood ◽  
Significant Difference ◽  
Sodium And Potassium

Background: Acute watery diarrhoea (AWD) is a leading cause of illness and death amongst children in developing countries. Electrolyte and acid-base disturbances play an important role in the associated morbidity and mortality. Objectives: To observe the acid-base and electrolyte changes in moderate and severe dehydration in AWD in children. Methods: This cross sectional study was carried out in the Observation and Referral Unit of Dhaka Shishu (Children) Hospital from July 2018 to December 2018. Children below five years of age who came with acute diarrhoea with moderate to severe dehydration were included in the study. After admission 2ml of whole blood was collected with all aseptic measures at the time of insertion of intravenous cannula before giving intravenous fluids to measure serum levels of Na and K while arterial blood was also taken for analysis. The data was analyzed by using SPSS version 20. Results: Total 125 AWD cases were admitted among them 98(78.4%) had moderate dehydration whereas 27(21.6%) had severe dehydration. Hyponatremic dehydration was present in 41(32.8%) cases. Among them 30(30.6%) had moderate dedydration and 11(40.4%) had severe dehydration, hypernatremic dehydration was present in 11.11% cases, hypokalemia was present in 54(43.2%) cases. Among them 42(42.86%) had moderate dedydration and 12(44.44%) had severe dehydration. Metabolic acidosis was present in 38(30.4%) cases [28(28.57%) in moderate dedydration and 10(37.04%) in severe dehydration]. The comparison of mean serum sodium and potassium value of the children with moderate and severe degrees of dehydration did not attain statistical significance, but there was a significant difference in bicarbonate concentration among moderate and severe dehydration cases (p=0.02). Conclusion: Hyponatremia and hypokalamia was the commonest electrolyte abnormality among moderate to severe dehydration with AWD. Mean serum sodium and potassium of the children with moderate and severe degrees of dehydration did not attain statistical significance, but bicarbonate concentration was significantly low among severe dehydration cases. DS (Child) H J 2020; 36(2): 120-124

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