Acidosis Frequency in Children of Pediatric Acute Diarrhea

Objectives: To Found out the frequency of aidosis in patients of paediatric accute diarrhea. Methods: Two hundred and eighty children fulfilling the inclusion/exclusion criteria admitted in Department of Paediatrics, Services Hospital, Lahore was taken. Informed consent of the parents of children was obtained to include their data in the study. Every children with acute diarrhea was followed through 1-2cc arterial sample sent to the hospital laboratory of the hospital. Results: out of the total 280 patients, 83(29.5%) had acid base abnormality and 197(70.5%) had normal acid base imbalance. Out of 83(29.5%) patients who had acid base abnormality 50(17.5%) males and 22(8%) females had acidosis while only 8(3%) males and 3(1%) females had alkalosis. Conclusion: Acidosis is the most common abnormalities. Its incidence increase with increase in duration of diarrhea. Key Words: Acidosis, paediatric acute diarrhea How to Cite: Zain-ul-Abadin M, Zaheer A, Tariq S, Ans M, Mehmood K, Farooq M. Acidosis Frequency in Children of Pediatric Acute Diarrhea. Esculapio.2020;16(04):14-17.

El lado más sensible del esófago en relación con el reflujo gastroesofágico. Enseñanzas de ROMA IV

Rome IV incorporated a new diagnostic category into the functional esophageal disorders group called reflux hypersensitivity. This new name replaced the term hypersensitive esophagus and included patients with normal acid reflux parameters but with symptomatic correlation with reflux events. Functional heartburn, which denoted lack of correlation between symptoms and reflux events in the background of normal pH test, and reflux hypersensitivity, should be excluded in heartburn patients who failed proton pump inhibitor treatment. Reflux hypersensitivity patients demonstrates esophageal hypersensitivity to reflux (any type), and both, reflux hypersensitivity and functional heartburn’s symptoms are driven by central and peripheral sensitization. The correct differentiation between these two esophageal disorders allows a therapeutic approach with greater chance of success. Neuromodulators are considered the mainstay of treatment for these patients even though patients with reflux hypersensitivity demonstrate response to anti-reflux treatment as well.

Acid-Base Status Disturbances in Patients on Chronic Hemodialysis at High Altitudes

Background. Acid-base disorders have been previously described in patients with chronic hemodialysis, with metabolic acidosis being the most important of them; however, little is known about the potential changes in acid-base status of patients on dialysis living at high altitudes. Methods. Cross-sectional study including 93 patients receiving chronic hemodialysis on alternate days and living in Bogotá, Colombia, at an elevation of 2,640 meters (8,661 feet) over sea level (m.o.s.l.). Measurements of pH, PaCO2, HCO3, PO2, and base excess were made on blood samples taken from the arteriovenous fistula (AVF) during the pre- and postdialysis periods in the midweek hemodialysis session. Normal values for the altitude of Bogotá were taken into consideration for the interpretation of the arterial blood gases. Results. 43% (n= 40) of patients showed predialysis normal acid-base status. The most common acid-base disorder in predialysis period was metabolic alkalosis with chronic hydrogen ion deficiency in 19,3% (n=18). Only 9,7% (n=9) had predialysis metabolic acidosis. When comparing pre- and postdialysis blood gas analysis, higher postdialysis levels of pH (7,41 versus 7,50, p<0,01), bicarbonate (21,7mmol/L versus 25,4mmol/L, p<0,01), and base excess (-2,8 versus 2,4, p<0,01) were reported, with lower levels of partial pressure of carbon dioxide (34,9 mmHg versus 32,5 mmHg, p<0,01). Conclusion. At an elevation of 2,640 m.o.s.l., a large percentage of patients are in normal acid-base status prior to the dialysis session (“predialysis period”). Metabolic alkalosis is more common than metabolic acidosis in the predialysis period when compared to previous studies. Paradoxically, despite postdialysis metabolic alkalosis, PaCO2 levels are lower than those found in the predialysis period.

Advances in the Diagnosis of GERD Using the Esophageal pH Monitoring, Gastro-Esophageal Impedance-pH Monitoring, And Pitfalls

PH monitoring is not capable of detecting all types of reflux, especially when the amount of acid is very low or not at all in the refluxate. Multichannel intraluminal impedance-pH monitoring (MII-pH) is used as a new method to assess bolus transport. The types of reflexes including acid, weak acid and weak alkaline MII-pH is capable of distinguishing more reflux episodes based upon use of physical and chemical parameters of the refluxate, leads to a diagnosis of normal acid reflux from abnormal nonacidic reflux. 24-h oesophagal pH monitoring can be effectively used to assess the potential relationship between symptoms and refluxes. MII-pH is capable of distinguishing more reflux episodes based upon use of physical and chemical parameters of the refluxate, leads to a diagnosis of normal acid reflux from abnormal nonacidic reflux. It can be used to confirm gastro-oesophagal reflux episodes, where has a sensitivity and specificity for diagnosing GERD in comparison with endoscopy or pH-metry.

Status Asthmaticus

The therapy of status asthmaticus must be rational. Thus it is important to evaluate: 1. the severity and duration of an asthmatic attack. 2. the degree of dehydration. 3. whether infection plays a role. 4. all medication previously administered. 5. any possible complication.Treatment is as follows :Fluid and electrolyte therapy is important not only for the correction of dehydration and electrolyte disturbances but also for preventing inspissation of mucus in the bronchi. The best route of fluid administration is intravenous.Potassium iodide orally administered may be helpful as an expectorant.After hydration and normal acid-base balance have been established, epinephrine may be of benefit.Aminophylline is effective when administered intravenously. It should be used with extreme caution: the dose should not exceed 3 mg per kg of body weight, it should be given slowly and should not be given more frequently than every 8 hours.Corticosteroids should be administered, especially in cases who have received suppressive doses previously.Humidified oxygen administration is of the utmost importance.Antibiotics are recommended when infection is suspected.Management of complications.

Application of Colour Changing Fulgimide on Wool Fibre

2-Indolylfulgimide was synthesized to examine the practical dyeing feasibilities and behaviors. A one-pot efficient process was discovered with good yield (52%). The color changing properties of fulgimide in solvents and on wool fibers were investigated. With UV irradiation, fulgimide showed color variation from light yellow to light red. The same color changing behavior appeared in the wool fiber which was dyed with 2-indolylfulgimide through a normal acid dye dyeing process.