A 5 Years Audit Report on Diabetic Ketoacidosis Patients from a Tertiary Care Hospital in Saudi Arabia

2021 ◽  
Vol 15 (11) ◽  
pp. 3148-3152
Author(s):  
Asim Hassan ◽  
Mohammad Bilal Jaja ◽  
Mohammed Motasim Ali Haj Elamin
Keyword(s):  
Diabetes Mellitus ◽  
Saudi Arabia ◽  
Diabetic Ketoacidosis ◽  
Tertiary Care Hospital ◽  
Compliance Rate ◽  
Tertiary Care ◽  
Care Hospital ◽  
Presenting Symptoms ◽  
The Mean ◽  
Tract Infections

Objective: To evaluate the causes of high admission rate of diabetic ketoacidosis (DKA) in adults with diabetes mellitus presenting to a tertiary care hospital in Saudi Arabia with specific emphasis on the clinical and biochemical phenotype and identify components of intervention and improve clinical outcomes in these patients. Study Design: Observational study. Place and Duration of the Study: Department of Diabetes & Endocrinology, Armed Forces Hospital Al-Hada, Taif, Kingdom of Saudi Arabia from 1st August 2015 to 31st January 2020. Methodology: One hundred and fifteen patients with diabetes mellitus presenting with diabetic ketoacidosis during the last 5 years were enrolled. Approximately 50 different variables pertaining to the patients at the time of presentation were thoroughly scrutinized. Results: There were 31 (28%) males and 81 (72 %) were females with type 1 DM 92%, type 2 DM 7% and 1% unclassified DM with a mean age of 20.90±7.4 years. 18% were diagnosed to have DM for the first time and others had a mean duration of DM of 8.0±3.6 years with an average daily insulin requirement being 64.0±20.2 units. Moreover 84% of patients were on basal bolus regimen and only 5% were on mixed insulin. 73% of the DKA episodes occurred in 15-25 years of age group. The commonest precipitating factors were non-compliance with insulin (44%) and respiratory tract infections (17%). Most common presenting symptoms were vomiting and abdominal pain present in 81% and 53% of patients. The mean blood sugar on presentation was 463±157.3 mg/dl whereas the mean HbA1c was 14±2.9. The mean pH and bicarbonate levels on presentation were 7.16±0.128 and 7±4.83 meq/L respectively. 80% of the patients were admitted to the general wards however 19% required ICU care. 69% of patients had a history of readmission with DKA and 29% were transferred from another periphery hospital. The mean duration of stay in the hospital was 2±3.8 days and the mortality was 0.9%. Conclusion: A very low mortality rate is witness to excellent acute management of these very sick patients. However a very high non-compliance rate of 44%, combined with a readmission rate of 69% and a mean HbA1c of 14% are very alarming as far as long term prognosis is concerned. Keywords: Diabetes mellitus, Ketoacidosis, Characteristics, DKA, Tertiary level care

Evaluation of Frequency of Diabetic Ketoacidosis and Presenting Symptoms in Patients of Diabetes Mellitus Presenting

2021 ◽  
Vol 15 (12) ◽  
pp. 3390-3392
Author(s):  
Shahnaz Noor ◽  
Irum Noor ◽  
Sadia Bashir
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Tertiary Care ◽  
Type Ii Diabetes Mellitus ◽  
Cross Sectional Study ◽  
Serum Glucose ◽  
Care Hospital ◽  
Cross Sectional ◽  
Family History Of Diabetes ◽  
Presenting Symptoms

Objective: To evaluate the frequency of diabetic ketoacidosis and presenting symptoms in patients of diabetes mellitus presenting at tertiary care hospital. Material and methods: In this cross sectional study total 145 patients of diabetes were selected from Department of Medicine from April 2020 to November 2020. Inclusion criteria was: un-controlled type II Diabetes Mellitus with HBA1c levels > 8, age between 30-70 years, male or female. Diabetic ketoacidosis was studied in selected patients. Results: Mean age of the patients 49.80 ± 9.38 years. Out of 145 patients, ketoacidosis was found in 30 (21%) patients. Vomiting was the most common (88/60.69%) presenting symptom followed nausea in 59 (40.68%) patients, polyuria 50 (34.48%), polydipsia 41 (28.27%), abdominal pain 32 (22.07%), weight loss 16 (11.03%) and Polyphagia in 8 (5.52%) patients. Ketoacidosis was found in 15 (23.44%) male diabetics and 15 (18.52%) female diabetics. Association of ketoacidosis with gender was not significant (P = 0.468). Conclusion: Findings of this study showed a higher rate of diabetic ketoacidosis. Vomiting was the most common presenting symptom. Most of the patients were between 30-50 years. No gender difference was found in development of diabetic ketoacidosis. Most of the patients of diabetic ketoacidosis had family history of diabetes. Keywords: Ketone, Ketoacidosis, fasting serum glucose, diabetes mellitus, random serum glucose

Electrocardiographic Changes in Type-1 Diabetes Mellitus Children with Diabetic Ketoacidosis Presenting to Tertiary care Hospital, Karachi

2021 ◽  
Vol 15 (11) ◽  
pp. 3340-3342
Author(s):  
Irum Rafique ◽  
Roshia Parveen ◽  
Zubair Khoso ◽  
Shazia Mahar ◽  
Versha Rani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Ecg Changes ◽  
Electrocardiographic Changes

Introduction: Cardiac arrhythmias and arrest have been described in children with diabetic ketoacidosis and generally have been presumed to be caused by electrolyte abnormalities. The rationale of this study was to assess the role and importance of ECG monitoring, as a simple, quick, non-invasive and readily available tool in the diagnosis and confirmation of hypokalemia and hyperkalemia in patients with DKA in the Emergency Department Objective: To Assess the Frequency of electrocardiographic changes in Type-1 diabetes mellitus children with diabetic ketoacidosis presenting to tertiary care hospital, Karachi. Materials and Methods: This retrospective cross sectional study was carried out at the department of pediatric medicine, NICH Karachi. At the time of presentation, the standard 12-lead ECG was recorded by a single pediatric cardiologist having more than 2 years of experience, QT and RR intervals were measured. Three separate measurements were obtained from each ECG, and the mean of these measurements was used as the value for QTC. QTC of at least 0.45s (450ms) was considered as prolonged QTC. QTD was also assessed at the same time and QTD>50 ms was considered as prolonged QTD. Results: One hundred cases of T1DM with DKA were included in this study. Average age of children was 7.9 ±3.5 years (Min – Max = 0.5 – 14 years), male to female ratio was 1: 0.96. Prolong QTc and QTd interval was observed in (56%) and (38%) children respectively, Mean (±SD) QTc and QTd interval was 449.4 ±36.6 mc and 39.3 ±16.1 mc respectively. While ECG changes were found in (58%) cases. Association between ECG changes and the cases with higher RBS (>350 mg/dl) was statistically significant 81 (81%) cases with ECG changes had higher RBS (p<0.0001) while ECG changes were statistically similar in both age groups and gender (p-values > 0.05). Conclusion: The frequency of ECG changes was higher in T1DM children with diabetic ketoacidosis. ECG changes was significantly associated with higher RBS (>350 mg/dl). Key words: T1DM, Diabetic Ketoacidosis, ECG, QTc, QTd

scholarly journals Spectrum of uropathogens and their antibiotic sensitivity pattern in diabetes mellitus patients at a tertiary care hospital in Odisha, India

2018 ◽  
Vol 6 (5) ◽  
pp. 1549
Author(s):  
Malati Murmu ◽  
Karun Mahesh K. P. ◽  
Rajesh Kumar Meher ◽  
Butungeshwar Pradhan ◽  
Ayaskanta Kar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Number Of Patients ◽  
Sensitivity Pattern ◽  
Tract Infections ◽  
Culture Positive

Background: Diabetes Mellitus is the most common endocrine disorder involving almost all systems of body. Untreated or poorly treated Diabetics are susceptible to develop a series of complications responsible for raised morbidity and mortality. Diabetes Mellitus has a number of long term effects on the Genitourinary system. Urinary tract infections have long been recognised as a significant problem in patients with Diabetes Mellitus.Methods: Prospective observational study. Diabetic patients with culture positive UTI were included. Gestational diabetes, Immunocompromised patients and patients with congenital renal anatomical abnormalities were excluded.Results: Authors included 211 numbers of culture positive UTI among diabetic patients. Out of which, 65 were male and 146 were female. Maximum number of patients belong to 56-65 years age group. Escherichia coli was the predominant organism isolated. Gram positive organisms showed 100% sensitivity to Vancomycin and Linezolid. Gram negative organisms showed 100% sensitivity to Polymyxin B.Conclusions: Genitourinary tract infection is not an infrequent complication seen in diabetes patients. Most common causative organism and their antibiotic sensitivity pattern should be done in tertiary care hospital for a better antibiotic policy.

Confidence toward vaccination as reported by parents of children admitted to a tertiary care hospital in Riyadh, Saudi Arabia: A cross sectional study

Vacunas ◽  
2020 ◽  
Vol 21 (2) ◽  
pp. 95-104 ◽  
Author(s):  
Y.M. AlGoraini ◽  
N.N. AlDujayn ◽  
M.A. AlRasheed ◽  
Y.E. Bashawri ◽  
S.S. Alsubaie ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

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