scholarly journals A medical audit on management protocol of Diabetic Ketoacidosis in EMW

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Umair Javaid Chaudhary ◽  
Sajid Abaidullah ◽  
Jawad Zaheer ◽  
Anjum Razzaq ◽  
Zafar Niaz ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Blood Sugar ◽  
Blood Sugar Level ◽  
Blood Gases ◽  
Medical Audit ◽  
Serum Electrolytes ◽  
Arterial Blood ◽  
Audit Data ◽  
Management Protocol ◽  
Initial Blood

A retrospective medical audit was conducted on patients admitted in East Medical Ward from January 2004 to July 2005 with a diagnosis of diabetic ketoacidosis. There were 44 patients included in this audit. Patients who had initial blood sugar level more than 250mg/dl and later found to have negative urinary ketones were excluded from the audit. Data was collected on a predesigned proforma and was analysed by the programme SPSS version 10. Results: We found that mean age of the patients was 35.39 18.26 years including 21 (47.7%) males and 23 (52.3%) females. Fourteen (31.8%) patients had their first presentation as diabetic ketoacidosis where as rest of the patients were known diabetics including 56.8% diabetic for less than 10 years and 11.4% diabetic for more than 10 years. Blood sugar level of all the patients was checked at presentation and none of them had blood sugar level less than 250mg/dl and record was missing for 3 patients. Urinary ketones of 44 patients were found to be positive with a max.no. 20 (45.5%) having 4+ ketones where as 3 had their record missing. We found that out of 44 patients arterial blood gases record of 36 (81.8%) patients was available ( mean pH = 7.0786,mean pCO2 = 22.231, mean HCO3 = 12.867) and 8 (18.2%) had their record missing. Serum electrolytes investigation record showed that 11 (25%) patients had their record missing for serum Na+ and K+. Rest of the patients had their record available in which serum Na+ ranged from 131 to 151 mEq/L where as serum K+ values showed that only 1(2.3%) patient had hyperkalemia (serum K+ >5.5) and 4(9.1%) had hypokalemia (serum K+ <3.5).

scholarly journals Electrolyte Disturbances in Acute Exacerbation of COPD

2019 ◽  
Vol 9 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Md Haroon Ur Rashid
Keyword(s):  
Acute Exacerbation ◽  
Stable State ◽  
Blood Gases ◽  
Chronic Obstructive ◽  
Electrolyte Disorders ◽  
Serum Electrolytes ◽  
Acute Exacerbation Of Copd ◽  
Electrolyte Disturbances ◽  
Arterial Blood ◽  
Exacerbation Of Copd

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. Acute exacerbation is an acute and sustained worsening of a patient’s condition from a stable state and it is associated with significant electrolyte disturbances. Objectives: The main objective of this study was to determine the prevalence of electrolyte disturbances in patients with acute exacerbation of COPD and to determine possible effects of these electrolyte disorders. Materials and Methods: This observational prospective study was carried out in the Department of Pulmonology, Enam Medical College & Hospital from 1st January to 31st December 2017. Sixty patients with acute exacerbation of COPD were included. Serum electrolytes and arterial blood gases were measured. Results: Low level of serum sodium (131 ± 5.66 mEq/L) and potassium (3.20 ± 0.44 mEq/L) were found in subjects with acute exacerbation of COPD. In patients with respiratory failure Na+ and K+ levels were even lower. Conclusion: Serum electrolytes in acute exacerbation of COPD patients should be monitored routinely and should be corrected early to avoid poor outcomes. J Enam Med Col 2019; 9(1): 25-29

scholarly journals Can Venous Blood Gases Replace Arterial Blood Gases in Diabetic Ketoacidosis/Renal Failure Induced Metabolic Acidosis?

2015 ◽  
Vol 3 (3) ◽  
pp. 65-69
Author(s):  
Naveen Mohan ◽  
Gireesh Kumar K. P ◽  
Sreekrishnan T. P ◽  
Ajith Kumar J ◽  
Ajith V. ◽  
...  
Keyword(s):  
Renal Failure ◽  
Metabolic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Venous Blood ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Arterial Blood

scholarly journals The relationship of the blood sugar level to the systemic blood pressure

1935 ◽  
Vol 117 (805) ◽  
pp. 436-454
Keyword(s):  
Blood Pressure ◽  
Blood Sugar ◽  
Blood Sugar Level ◽  
Systemic Blood Pressure ◽  
Marked Rise ◽  
Arterial Blood ◽  
Low Blood Pressure ◽  
Relationship Of ◽  
The Brain ◽  
Fasted Rats

The marked hyperglycæmia which follows section of the brain stem through the pons in fasted rabbits (Donhoffer and Macleod, 1932) and in cats (Peterson, 1933) could not be observed in fasted rats although it occurred in recently fed ones (Bell, Horne, and Magee, 1933). In certain of the experiments with fasted rats, instead of a rise in the blood sugar level, a decided fall occurred, but the main feature of these results was that transection of the brain at any level did not markedly affect the blood sugar. This contrasts with the marked rise which invariably occurs in the rabbit, cat, or fed rat when the pons is involved. On further investigation of this peculiar behaviour of the fasted rat, it was soon found that although the blood sugar level did not rise markedly, as in the cat and rabbit, it sometimes rose slightly and still more frequently fell somewhat following decerebration. As the work progressed, it became apparent that the lesions which caused the blood sugar level to become lowered were also those which might be associated with a marked fall in arterial blood pressure, and accordingly the effects of low blood pressure per se on the blood sugar level were investigated. These effects are usually considered to be such as will raise rather than lower the sugar level, but it must be remembered that the observations from which this impression has been formed have as a rule been made on animals whose livers contained glycogen from which sugar can be formed by glycogenolysis. When the liver is free of preformed glycogen, however, and can produce sugar only by gluconeogenesis, the effects of low blood pressure are entirely different, as the present investigations show.

Abstract #211 Analysis of a Community Hospital’s Diabetic Ketoacidosis Management Protocol

2018 ◽  
Vol 24 ◽  
pp. 33
Author(s):  
Chinelo Okigbo ◽  
Fatima Mohiuddin ◽  
Jesus Vargas ◽  
Edward Hamaty
Keyword(s):  
Diabetic Ketoacidosis ◽  
Management Protocol

PENGARUH SENAM KAKI TERHADAP KADAR GULA DARAH PADA PASIEN DENGAN DIABETES MELITUS

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Niken Sukesi
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Disease ◽  
Blood Sugar ◽  
Research Design ◽  
Blood Circulation ◽  
Blood Sugar Level ◽  
Consecutive Sampling ◽  
Post Test ◽  
The One ◽  
Diabetes Melitus

Penyakit Diabetes Melitus dapat menyebabkan komplikasi yang sangat berat. Komplikasi dari Diabetes Melitus ini meliputi jantung iskemik, serebrovaskuler, gagal ginjal, ulkus pada kaki, gangguan penglihatan. Komplikasi yang paling sering terjadi adanya perubahan patologis pada anggota gerak bawah yang disebut kaki diabetik. Salah satu jenis olahraga yang dianjurkan dengan diabetes mellitus adalah senam kaki. Senam kaki merupakan latihan yang dilakukan bagi penderita DM atau bukan penderita untuk mencegah terjadinya luka dan membantu melancarkan peredaran darah bagian kaki. Penelitian ini bertujuan untuk menganalisis pengaruh senam kaki terhadap kadar gula darah pasien diabetes mellitus. Desain dalam penelitian ini adalah Quasy Eksperiment dengan rancangan Pre and Post Test Without Control. Teknik pengambilan sampel menggunakan Consecutive sampling. Alat pengumpul data yang digunakan instrument observasi senam kaki untuk menilai senam kaki, dan alat menilai kadar gula darah yaitu glucometer, kapas dan jarum. Rata-rata kadar gula darah sebelum dan setelah dilakukan senam kaki mengalami penurunan dan ada pengaruh kadar gula darah sebelum dengan sesudah dilakukan senam kaki pada pasien diabetes melitusKata Kunci: Senam Kaki, Kadar Gula Darah THE EFFECT OF GYMNASTIC FEET TOWARD THE BLOOD SUGAR LEVEL FOR THE DIABETICSDiabetes Mellitus causes the complication case. It concludes the heart iskemik, serebrovaskuler, cronic kidney disease, ulcus on the feet, and the impairment of sight. The complication often causes the changing of pathological in certain place such as feet. The one of recommended sport for diabetics is gymnastic feet. Gymnastic feet is an experience for diabetics or not in order to prevent the wound and launch the blood circulation. The research objective is to analyze the effect of gymnastic feet to blood sugar level for diabetics. The research design is using experiment quasy with pre and post test without control. It is using consecutive sampling as the sample of collecting technique, and using observation of gymnastic feet as the collecting data technique to assess the blood sugar level, those are glucometer, cotton, and needle. The average of blood sugar level is decrease after doing the gymnastic feet. Moreover, there is differences between after and before doing the gymnastic feet for diabetics.Key Words : Gymnastic Feet, Blood sugar level

scholarly journals Elimination of nasal obstruction improves pulmonary functions and oxygenation

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Eman Sobh ◽  
Fatma Elhussieny ◽  
Taghreed Ismail
Keyword(s):  
Nasal Obstruction ◽  
Blood Gases ◽  
Medical Problem ◽  
Forced Expiratory Volume ◽  
Nasal Packing ◽  
Nasal Pack ◽  
Arterial Blood ◽  
Study Population ◽  
The Mean ◽  
The Impact

Abstract Background Nasal obstruction is a significant medical problem. This study aimed to examine the effect of nasal obstruction and nasal packing on arterial blood gases and pulmonary function indices, and the impact of the elimination of nasal obstruction on preoperative values. Results The mean age of the study population was 26.6 ± 10.1 years, males represented 50.8%. Spirometric indices showed statistically significant improvement (preoperative forced expiratory volume in 1st second 66.9 ± 13.9 vs 79.6 ± 14.9 postoperative and preoperative forced vital capacity 65.5 ± 12.7 vs 80.4 ± 13.8 postoperative). Oxygen saturation was significantly lower during nasal packing (95.6 ± 1.6 preoperative vs 94.7 ± 2.8 with nasal pack), and significant improvement (97.2 ± 1.4) was observed after removal of the nasal pack. Nasal obstruction scores significantly improved. Conclusion The results of this study indicate that either simple nasal obstruction or nasal packing may cause hypoxemia and abnormalities in lung function tests. Hypoxemia was more evident with nasal packing.

scholarly journals Outcome of the use of 0.9% saline versus 0.45% saline for fluid rehydration in moderate and severe diabetic ketoacidosis in children

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Nora El Said Badawi ◽  
Mona Hafez ◽  
Heba Sharaf Eldin ◽  
Hend Mehawed Abdelatif ◽  
Shimaa Atef ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Normal Saline ◽  
Sodium Concentration ◽  
Saline Group ◽  
Serum Electrolytes ◽  
Serum Chloride ◽  
Significant Difference ◽  
Rehydration Solution ◽  
The Moment

Abstract Background The debate for the optimum sodium concentration in the rehydration solution in diabetic ketoacidosis (DKA) persists till the moment. The aim was to compare the outcome of 0.9% saline versus 0.45% saline in children with moderate and severe (DKA) regarding the effect on serum electrolytes, duration of DKA resolution and the incidence of hyperchloremia. Results A retrospective analysis of 121 children with moderate or severe DKA was done. After the initial 4 h in which both groups received normal saline, patients were divided into two groups continuing on 0.9% (N=72) or switched to 0.45% saline (N=49). Serum chloride and Cl/Na ratios were significantly higher in 0.9% saline group at 4 and 8 h. The 0.9% saline group had significantly higher proportion of hyperchloremia at 4 and 8 h (P value: 0.002, 0.02). The median duration of correction of DKA (14 h among 0.9% saline versus 10 h among 0.45% saline) without significant difference (P value= 0.43). The change in plasma glucose, effective osmolarity, corrected Na levels were comparable between groups. Conclusion There is an unavoidable iatrogenically induced rise in serum chloride with higher incidence of hyperchloremia with the use of normal saline in rehydration of children presenting in DKA and shock. The use of 0.45% saline as post-bolus rehydration fluid is not associated with a decline in the corrected serum sodium concentration and does not affect the rate of correction of acidosis or rate of drop in blood glucose or duration of DKA resolution when compared to normal saline.

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