Risk factors of hypoglycemia in diabetics

To find the frequency of risk factors of hypoglycemia in diabetics in our setup. Prospective observational study. This study was conducted at Emergency and Medical Wards Nishtar Hospital Multan from January 2010 to December 2013. One hundred and eighteen patients presented with hypoglycemia to Nishtar Hospital Multan. One hundred and eighteen diabetic patients above the age of 16 years admitted with hypoglycemia were included in the study. Written informed consent was taken from the patients or the attendants in case of patients with altered state of consciousness. Approval was taken from hospital ethical committee. Mean age of patients was 60.46 +/- 14.20. Forty two patients [35.6%] were males and 76 [64.4%] were females. Mean duration of diabetes was 6.4 +/- 6.04years. Mean blood glucose level at the time of presentation was 36.25 +/- 12.49mg/dl. Thirty four [28.8%] patients had only neuroglycopenic symptoms without autonomic symptoms while 4[3.4%] hadautonomic symptoms alone. Eighty [67.8%] presented with both adrenergic and neuroglycopenic symptoms. Regarding risk factors, 77[65.25%] had renal failure, 66[55.93%] had missed meal, 37[31.35%] had vomiting, 23[19.49%] had recent increased dose of hypoglycemic agents, 19[16.10%] had delayed meal, 16[13.55%] had diarrhea, 14 [11.86%] had liver dysfunctionand 2[1.69%] had excessive physical activity. Hypoglycemia is common in old patients with long history of diabetes. Patients usually present late when they develop neuroglycopenic symptoms. Renal failure and missed meal are most common risk factors followed by vomiting and increased dosage of hypoglycemic agents. Patients need education about early symptoms of hypoglycemia, common risk factors and remedial steps to avoid this serious complication

Causes of acute renal failure in Nishtar hospital Multan

To identify the common causes of Acute Renal Failure [ARF] in Nishtar Hospital Multan. Prospective observational study. This study was conducted at Medical Wards, Nishtar Hospital Multan from September 2012 to March 2013. One hundred and thirty six [136] patients presented with Acute Renal Failure to Nishtar Hospital of ages 15 and above. Fifty three patients [39%] were males and 83[61%] were females. Mean age of patients was 40.43 +/- 18.56 years. Our study showed that common causes of ARF were diarrhea with or without vomiting [22%], septicemia [22%], obstetric causes like septic abortion and APH/PPH [19.11%],obstructive uropathy [11%], hair dye ingestion [9.6%], glomerulonephritis [7.35%], nephrotoxins [5.9%], hemolysis [4.4%] and cardiac failure [3.7%]. Diarrhea with/without vomiting,sepsis, post-partum and ante-partum hemorrhage, septic abortion, obstructive uropathy, hair dye, glomerulonephritis, nephrotoxic drugs, hemolysis and cardiac failureare the common causes of acute renalfailure in our setup. ARFis associated with high morbidity and mortality. So all these causes should be managed aggressively to avoid this life threatening complication