ABSTRACT
Objective:To find the strength of agreement between point-of-care and serum β-hydroxybutyrate. Methods: 236 paired samples (capillary β-hydroxybutyrate by a point ofcare device and serum β-hydroxybutyrate by colorimetric enzymatic estimation) sampleswere collected from 26 children aged <13 years admitted with diabetic ketoacidosis. Inbornerrors of metabolism and septic shock were excluded. Results: Capillary β-hydroxybutyrateshowed excellent agreement with serum â-hydroxybutyrate with mean (SD) bias of 0.027(0.78); 95% limit of agreement -1.51, 1.56 and intraclass correlation 96.1% (95%CI 95%–97%, P<0.001). An increase in the bias noted for value above 5 mmol/L (P<0.001) (serummeasurements were higher than capillary point-of-care measure-ments). Capillary â-hydroxybutyrate correlated significantly with blood pH, anion gap,bicarbonate and carbondioxide levels on blood gas analysis (P<0.05). Conclusions: Capillary β-hydroxybutyrateestimation is a valid method for monitoring of ketonemia in pediatric diabetic ketoacidosis
ABSTRACT
Objective: To study the effect of the second dose of scorpion antivenom in children with nonresolving or worsening scorpion sting envenomation. Methods: 72 children aged ?12 yearswith scorpion sting envenomation grade 2 and above were enrolled. 61 received the first doseof three vials of antivenom at admission (group A). Children with persistent/worseningenvenomation within 6 hours received the second dose (group B). The time required forresolution of autonomic symptoms, myocardial dysfunction, predictors of the second doseand side effects were studied. Results: The mean time taken for resolution of autonomicsymptoms were comparable in Group A and B (4.1 vs. 5.3 h, P=0.4), and of myocardialdysfunction was shorter in Group A (10.8 vs. 37.6 h, P=0.02). On regression analysis,abnormal echocardiography at admission was found to be a significant predictor of thesecond dose (OR=27.6, 95% CI, 4.7–162.5; P=<0.001). Conclusion: Children with severescorpion sting envenomation with abnormal echocardiography may require a higher dose ofscorpion antivenom. Trial registration: CTRI/2015/03/005652.