Serum lipid profile, liver function indices and electrolyte levels in diabetics and subjects with hepatic impairment in the University of Port Harcourt Teaching Hospital

This study investigated serum lipid profile, liver function indices and electrolyte levels in diabetics and hepatitics in the University of Port Harcourt Teaching Hospital. 210 subjects comprising 70 subjects each for diabetics, hepatitics, and control matched for age and sex were sampled for the purpose of the study based upon specified criteria. 45 each were males while 25 each were females. Mean alanine and aspartate aminotransferases (ALT and AST), alkaline phosphatase (ALP) and gamma glutamyltransferase (GGT) activities, respectively, were significantly elevated (p<0.05) in the diabetics (22 U/L, 30 U/L, 91 U/L, and 12 U/L respectively) and hepatitics (86 U/L, 161 U/L, 113 U/L, and 50 U/L respectively); mean triglycerides (TG), total cholesterol (TC) and low density lipoprotein-cholesterol (LDL-C) levels respectively, were significantly elevated (p<0.05) in the diabetics (1.8 mmol/L, 4.6 mmol/L, and 2.6 mmol/L respectively) and hepatitics (1.4 mmol/L, 3.6 mmol/L, and 1.8 mmol/L respectively) except the hepatitics mean LDL-C level, whereas mean high density lipoprotein-cholesterol (HDL-C) level was significantly reduced (p≥0.05) in the diabetics (1.2 mmol/L) and hepatitics (1.0 mmol/L). Mean sodium and potassium levels were significantly reduced (p≥0.05) in the diabetics (135 mmol/L and 3.5 mmol/L respectively). Mean sodium level was reduced in the hepatitics while mean potassium level was elevated in the hepatitics. Mean bicarbonate level was significantly elevated (p<0.05) in the diabetics (28 mmol/L) but slightly elevated in the hepatitics. Conclusively, differences in lipids, electrolyte levels and liver function indices found in diabetics and hepatitics have a great potential as a diagnostic means in clinical practice

Pattern of serum electrolytes and cortisol levels in Nigerians with uncomplicated type 2 diabetes mellitus

Diabetes mellitus (DM) is a metabolic disorder, the commonest endocrine disease with increasing prevalence worldwide. Studies on electrolytes derangement in complicated diabetes abound but there are few in uncomplicated diabetes. To determine, compare and correlate serum electrolytes and Cortisol levels in a cohort of uncomplicated type 2 diabetics. A cross sectional study of sixty (60) type 2 diabetes patients of 5-10 years duration without complications and 50 healthy non-diabetic controls that were recruited from the diabetes and general out-patient clinics of a tertiary care facility over 3 months. Using a study questionnaire, information on age, anthropometry, fasting blood Glucose, serum electrolytes and Cortisol were obtained and analyzed following standard procedures. The mean 2 age (years) of diabetics was 49.58 ( ± 11.2) and controls 47.00 ( ± 12.1) and their BMI (Kg/m )[26.47 ( ± 3.97) vs 25.77 ( ± 4.85) respectively were not significantly different (p=0.524; p=0.407). The Waist-hipratio (WHR) was significantly higher in diabetics [0.933 ± 0.004 vs 0.905 ± 0.83) p=0.024]. The mean values of studied parameters among the diabetics and controls respectively are as follows: fasting blood glucose (FBG) [138.4 ± 78.7 vs 82.5 ± 73.7 mg/dl]; serum electrolytes: Sodium 139.0 ± 8.4 vs 142 ± 4.2mg/dl], Potassium [5.2 ± 1.4 vs 4.1 ± 0.53mg/dl] and Chloride [99.3 ± 6.8 vs 104.5 ± 5.0 mg/dl] with significant differences in each (p=0.000, 0.011, 0.000, 0.000 respectively). The mean serum Cortisol was not statistically different [125.5 ± 43.2 vs 121.5 ± 61.3 ng/mL (p=0.693)]. There was no correlation between the various serum electrolytes and Cortisol levels. Electrolytes imbalance in uncomplicated diabetes are present, with higher potassium and lower sodium than in controls with no accompanying change in Hypothalamus-Pituitary-Adrenal activity as measured by serum Cortisol level. This derangement in electrolyte level may be attributed to hyperglycaemia, osmotic diuresis and dietary habit

Turnaround time for electrolytes, urea, and creatinine in a clinical laboratory

Background: Timeliness is expressed as the turnaround time and is often used by the clinician as a benchmark for laboratory performance.Clinicians depend on fast turnaround time to achieve early diagnosis and treatment of their patients and early patient discharge from departments or hospital in-patient services. Determination of the turnaround time would enable a critical self- appraisal of our laboratory services and improve our turnaround time. Objective: This study assessed the turnaround time for electrolytes, urea and creatinine tests from the emergency departments of the hospital. Materials and Methods: An observational study was conducted between September and October 2016 amongst patients from the Intensive Care Unit, Accident and Emergency Department and Children Emergency Room, whose blood specimens were received at the Chemical Pathology Department foremergencyelectrolytes, urea and creatinine tests. A total of 122 specimens were randomly selected and the average time taken to complete each phase was measuredand the overall turnaround time calculated. Data was analysed using statistics software SPSS (version 13.5). Results: Audited cases consisted of 20 (16.4%) specimens from the Intensive Care Unit, 40 (32.8%) from the Children Emergency Room and 62 (50.8%) from the Accident and Emergency Department. The average turnaround time for the Accident and Emergency Department, Intensive Care Unit, and Children Emergency room were 6.5hours, 4.2hours and 5.2hours respectively. Conclusion: This study revealed that the turnaround time for electrolytes, urea and creatinine for patients in the emergency units is quite long and requires some improvement which could be done with the use of Laboratory Information System to track specimens from the various emergency units of the hospital

Enteropathogens Associated with the Seasonal Fluctuations in Plasma Sodium and Potassium Levels in Childhood Diarrhoea

This paper aims to assess the clinical; nutritional; microbiological; environmental and socio-economic determinants that have a seasonal distribution; or are potential confounders of a seasonal association of previously described seasonal fluctuations in plasma sodium and potassium concentrations in children with dehydrating diarrhoea. A cross-sectional analytical study was conducted from 15 April 2002 to 14 April 2003 of 350 children aged six weeks to two years admitted to the diarrhoea rehydration unit of a children's hospital in Cape Town. Multiple linear regression analysis showed the plasma sodium levels to be statistically significantly associated with age [-0.3 mmol/l per month of age; 95 confidence interval (CI): -0.2; -0.4]; enterotoxigenic Escherichia coli infection [-2.1 mmol/l; 95 CI: -4; -0.2]; enteropathogenic E. coli infection [-5.1 mmol/l; 95 CI: -7.1; -3.1]; being breastfed [1.9 mmol/l; 95 CI: 0.4; 3.4] and living in a brick house [2.7 mmol/l; 95 CI: 0.8; 4.5]. Plasma potassium levels were associated with duration of diarrhoea before admission [-0.02 mmol/l per day of diarrhoea; 95 CI: -0.01; -0.04]; cryptosporidium infection [-0.3 mmol/l; 95 CI: -0.1; -0.6] and parental education [0.04 mmol/l per year of education; 95 CI: 0.1; 0.01]. Of these; enterotoxigenic and enteropathogenic E. coli and cryptosporidium infections followed seasonal distributions that were similar to those of the electrolyte concentrations. Seasonal fluctuations in plasma sodium and potassium levels are at least partly explained by both enterotoxigenic E. coli and cryptosporidium infections working together. Enterotoxigenic E. coli infection has a larger effect on plasma sodium levels and cryptosporidium infection has a larger effect on plasma potassium levels

Plasma electrolytes in healthy individuals and elective surgical patients in Khartoum

Objectives: This study aimed to investigate if the frequently observed low preoperative values of the plasma electrolytes Na+; K+; and Ca+2 in our surgical patients; in Khartoum; is a reflection of their levels in the population at large or it is a genuine finding in patients.Methods: 90 male and female subjects were included in this study. 60 healthy; young and elderly individuals were selected randomly from amongst medical students and employees of the University of Khartoum. 30 elective orthopedic and general surgical patients were randomly selected from Khartoum teaching hospital. Plasma Na+ and K+ were measured using a digital flammometer; and plasma Ca+2 was measured using a spectrophotometer. Results were compared to international data using the Z test. Comparison between the groups in the study was done using the student t-test. Results: Plasma Na+; K+; and Ca+2of the healthy subjects and the surgical patients were found to be low compared to the international reference values. Plasma K+ is higher and Ca+2is lower in the older subjects when compared to young ones. Conclusion: a larger study is needed to set the normal values for plasma electrolytes in the Sudan. The high environmental temperature and nature of our diets could be the reason for the observed differences between our subjects and international reference values

Electrolyte changes and renal functions in children with severe malaria

Background: Electrolyte disturbances and renal impairment have been reported in patients with severe malaria (SM). However, the contributing mechanisms are not well identified.Objectives: The study aims to identify disturbances in electrolytes and renal functions in children with SM and their possible pathophysiology. Methods: The study included fifty six children with SM identified according to WHO criteria of SM. Investigations included parasitemia; glucose; urea; creatinine; sodium; and potassium estimation. Plasma osmolality was calculated.Results: Children with SM had higher frequency of hyponatremia and hypokalemia than children with uncomplicated malaria (UM). Hyperkalemia complicated 10.7% of cases of SM. Children with SM had lower creatinine and plasma osmolality than those with UM. Children presenting with more than one of the complications, showed higher plasma osmolality, urea levels and creatinine levels than those with UM. Conclusions: Hyponatremia may reflect the syndrome of inappropriate ADH secretion. Hypokalemia is a frequent complication while hyperkalemia complicates some cases. Dehydration may play a role in renal impairment; thus fluid therapy is indicated in cases with evidence of dehydration