ABSTRACT
BACKGROUND: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a well-known adverse effect of vincristine (VCR). Literature suggests that Asians are predisposed to develop SIADH following VCR administration. However, data regarding the occurrence of SIADH in children with malignancy are limited. This study aims to analyze the incidence, clinical picture, risk factors, management, and outcome of SIADH during induction chemotherapy for pediatric acute lymphoblastic leukemia (ALL). MATERIALS AND METHODS: A prospective study was conducted among the 166 newly diagnosed pediatric ALL patients who were treated at a tertiary cancer center in India between January 2015 and December 2015. Patients who developed hyponatremia during induction chemotherapy were further investigated for SIADH. RESULTS: The incidence of SIADH was 10.8% (n = 18) with a mean sodium level of 125 mEq/L (114–129 mEq/L). In the preceding 2 weeks, 72% of episodes were associated with the administration of two (n = 6) or three (n = 7) doses of VCR. One child presented with seizures. All the patients were managed with fluid restriction and only two patients required sodium correction with 3% saline. Girls older than 10 years of age showed a marginally significant correlation to develop SIADH (P-value = 0.059). CONCLUSION: We report a higher incidence of SIADH (10.8%) in Indian children, compared to that described in the literature, during induction chemotherapy for ALL. Regular monitoring of sodium levels during this period of chemotherapy is hence essential for the timely diagnosis and appropriate management of SIADH, which in turn will avert complications, including neurological symptoms secondary to SIADH.
ABSTRACT
The present work was executed to evaluate the anti-diabetic potency of a polyherbal formulation, and its influence on derangement in the metabolism of glucose and cholesterol and changes in sodium levels in serum and urine in normal and alloxan induced diabetic rats. Serum glucose and serum cholesterol levels were found to be increased in diabetic animals. Serum sodium and urinary sodium, hepatic glycogen levels are found to be decreased in diabetic state. Treatment with the polyherbal formulation (1.0 ml/kg body wt) for 30 days in diabetic animals has shown decrease in serum glucose and serum cholesterol levels in comparison to control animals, whereas in normal treated animals, the formulation does not effect the serum glucose and serum cholesterol levels. Serum sodium and urinary sodium levels were increased in both diabetic treated and the control animals. Hepatic glycogen levels were increased in diabetic treated animals, but there was no change in the control treated animals.