Diabetic ketoacidosis; the precipitating entities in patients with type 2 diabetes mellitus

To determine the frequency of various precipitating factors for Diabetic Ketoacidosis [DKA] in patients with type 2 diabetes mellitus. Study Design, This was a prospective study carried out at Department of Medicine, Muhammad Medical College and Hospital Mirpurkhas, from February 2007 to February 2009. 100 patients with type 2 diabetes mellitus admitted with diabetic ketoacidosis [DKA] were analyzed to determine the precipitating factors. Out of 100 patients 47 were males and their average age was 47 years [range=17-65] while 53 were females with an average age of 43 [range=14-58], among them 54 had various systemic infections, 18 were non-compliant to the treatments, 24 had other co-morbidities like chronic liver disease [n=8], stroke [n=7], chronic renal failure [n=5], sub-endocardial infarct [n=2] and acute pancreatitis [n=2] as precipitating factors while 4 had their first presentation of diabetes mellitus as diabetic ketoacidosis. A mortality of 14% was recorded in the study. Systemic infections, non-compliance to treatments and co-morbid conditions were the major precipitating factors for diabetic ketoacidosis

Arrangements and use of blood in elective surgical procedures

To evaluate Blood Ordering and Transfusion ratios for elective surgical procedures. This was a prospective study carried out at Muhammad Medical College Hospital Mirpurkhas from January 2007 to December 2007. A total of 1032 patients were included, both male and female. All patients who underwent elective surgical procedures in Surgical Unit, Muhammad Medical College hospital, Mirpurkhas from January 2007 to December 2007 were included in this study. Blood units cross matched and units transfused intra-operatively and post-operatively were recorded apart from patient demography and hepatitis profile. A total of 1032 patients underwent elective surgical procedures during the study period. Total 1500 blood units arranged, among these only 74 units of blood were transfused. This means only 4.9% of blood was utilized while 95.1% of blood was not utilized. Cross-match to transfusion ratio [C/T] = 20.27, Transfusion probability [Tp] = 7.1 and Transfusion index [Ti] = 0.07. For elective surgical procedures, there is no need for routine cross matching of blood. However, one must confirm the availability of blood for Hepatitis B and Hepatitis C reactive patients, and for cases, where the bleeding is inevitable like transvesical / transurethral removal of prostate