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Background: The aim of this study was to determine the disturbances in Calcium and other mineral levels in patients on hemodialysis at Tabba Kidney Institute, Karachi, Sindh, Pakistan.Methods: A cross sectional observational study through convenient sampling technique was conducted from January 2017 to August 2017 at Tabba Kidney Institute, Karachi after obtaining ethical approval. 255 patients, all above 18 years of age and on hemodialysis were included in the study. Multi-organ failure patients on dialysis, other systemic diseased patients on hemodialysis were excluded. Demographic variables, mineral levels, symptoms and supplementations were recorded. SPSS version 20.0 was used for data analysis.Results: A total of 255 patients on hemodialysis were selected and divided into groups depending upon median years of hemodialysis below and above 5 years of hemodialysis. Median and IQR of calcium were 8.8 and 8.2-9.1 mg/dl for below 5 years, 8.6 and 8.1-9.1 mg/dl for above 5 years (P value=0.44). Median and IQR of phosphate were 4.9 and 3.9-5.7 mg/dl for below 5 years and 4.6 and 3.7-5.5 mg/dl for above 5 years (P value=0.21). Median and IQR of parathyroid hormone were 393 and 212-699 pg/ml for below 5 years and 329 and 128-657 pg/ml for above 5 years. (P value=0.13) Median and IQR of albumin were 4.0 and 3.6-4.2 mg/dl for below 5 years and 4.0 and 3.8-4.3 for above 5 years (P value=0.30). Total of 18 (10.9%) had para thyroidectomy.Conclusions: Present study showed that significant difference in mineral levels did not exist in patients on hemodialysis as regards to the duration of dialysis. However clinical features had a tendency to decrease as duration of dialysis increased to above 5 years. Para thyroidectomy and itching were two main significant findings in this study.
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Background: DKA is the most common serious and life-threatening acute complication of diabetes. The mortality rate is currently estimated at 2% to 10% for patients hospitalized with DKA. Mortality is predominantly due to underlying morbidities, such as sepsis or acute myocardial infarction, but deaths also occur as a result of hypokalemia induced arrhythmias and cerebral edema. Aim of the study: To compare arterial and venous blood gas values in the initial evaluation of patients with Diabetic Ketoacidosis (DKA). Materials and methods: The study was conducted in the division of emergency medicine at Rajah Muthiah Medical College and Hospital, Chidambaram in the year 2017 August to February 2018. Totally 61 patients were included in the study. Both sex in the age group of 14 to 70 years whose Capillary Blood Glucose equal to or greater than 250 mg/dl, Urine ketonuria (+) were included in the study. Results: 37% of patients had >12 urine ketone levels of the patients of patients were 2+ (15 mg/dl) which was 41.0%. 39.3% of patients were 1+ (5 mg/dl) and 19.7% of patients were 3+ (40 mg/dl). All G. Balaji, R. Devi. Comparative study on arterial and venous blood gas values in the initial evaluation of patients with diabetic ketoacidosis who are visiting the Emergency Department of Rajamutaiah Medical College and Hospital. IAIM, 2019; 6(5): 160-165. Page 161 patients were ketone positive. ABG pH valune in which 60.7% of patients were between the level of 7.01 – 7.4, 39.3% of them were from 6.7 – 7.0. ABG PCO2 value in which 44.3% of patients had values from 16-25, 21.3% of patients had values between 5-15 as well as 26-35 and 13.1% of patients had values from 36-45. In which about 65.7% of patients had HCO3 levels between 12.01-17, 15.2% of patients had HCO3 levels between 7.01-12 14.1 % of patients had levels between 17.01 – 18 and 5% of them between 2-7. VBG pH in DKA, in which, 57.4% were in between 7.01 – 7.41. 41% of patients had a pH from 6.7 – 7.0 and 1.6% were between 6.03 - 6.6. VBG HCO3 in which, 62.3% of patients had HCO3 levels from 12.01-17, 24.6% had from 7.01 – 12, 11.5% were in between 2-7 and 1.6% were showing levels in between 17.01-18. Conclusion: Venous blood gas measurements accurately and fairly demonstrate the degree of acidosis in the initial evaluation of patients with Diabetic Ketoacidosis in the Emergency Department in comparison with Arterial blood gas values.
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Hawthorn, also known as dried Crataegus pinnatifida, is a kind of woody plants widely distributed in China. Hawthorn resources including berries, leaves, flowers, and barks, which enrich the bioactive substances, such as flavonoids, triterpenes, sterols, organic acid, sugar, and so on. A lot of studies have found the role of hawthorn for preventing and treating type 2 diabetes and its complications. Till now, hawthorn resources have been used as medicine in clinic. In order to take better advantage of hawthorn resources and explore new diabetic drugs, we review here the recent advances in study on the pharmacological effects of hawthorn resources, i.e. reducing blood glucose, lipid, insulin resistance, oxidant stress, inflammations, and relative vascular complications.
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@#As one of the first-line antipsychotic drugs, olanzapine(OLA)inducing insulin resistance and metabolic disorder has become a serious clinical concern. This study aimed at investigating the effect of OLA on white adipose tissue(WAT)beiging as a potential mechanism behind its metabolism-disturbing effects. C57BL6/J mice were orally administered with low and high-dose OLA(4, 8 mg/kg, once daily)for 28 consecutive days; body weight and food intake were recorded every other day. Mice were subjected to glucose-tolerance test(GTT)and a cohort from each group was challenged with cold stress for 36 h before sacrifice. The perirenal, epididymal and inguinal WAT were carefully dissected, weighed and processed separately for hematoxylin-eosin staining, UCP-1 immunohistochemical and Western blot analysis. The results showed that OLA induced significant impairment in basal heat generation and glucose regulation. There were fewer beige adipocytes in the inguinal WAT after OLA treatment. The beiging of inguinal WAT in response to cold stress was significantly inhibited in OLA-treated mice. Mechanistically, OLA induced the activation of mTOR-Notch pathway, as evidenced by a significant increase in phosphorylated mammalian target of rapamycin(p-mTOR)and intracellular domain of Notch1(N1ICD)expression. Together, our study reveals that the inhibitory effects on WAT beiging may explain the propensity of OLA to induce metabolic disturbance, and mTOR-Notch pathway activation could play key roles in this effect. Future validation and elucidation of these novel findings are expected to provide novel insights into the metabolic risks of OLA and related second generation antipsychotics, which may lead to innovative intervention strategies in the clinic.
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INTRODUCCIÓN: las litiasis urinarias constituyen un problema de salud. La recurrencia de ellas hace necesario implementar estrategias preventivas, para lo cual es indispensable conocer la frecuencia de los diferentes trastornos metabólicos renales. OBJETIVOS: identificar los disturbios metabólicos más frecuentes en la enfermedad litiásica urinaria y la posible relación de estos con características de los pacientes. MÉTODOS: estudio observacional analítico, transversal. Se estudiaron 3 655 pacientes adultos con litiasis urinaria, que se realizaron estudio metabólico renal en el Instituto de Nefrología entre los años 2003 y 2009. Las determinaciones analíticas fueron realizadas por técnica espectrofotométrica, según las normas del servicio. Toda la información se procesó mediante el paquete estadístico SPSS versión 15.0. Se utilizó la técnica de análisis de distribución de frecuencias. Las relaciones entre las variables se identificaron mediante el test de independencia. RESULTADOS: los principales trastornos metabólicos encontrados fueron: hiperuricemia (48,2 %), hipercalciuria (45,1 %) e infección del tracto urinario (16,2 %). La hipercalciuria y la hiperuricosuria fueron menos frecuentes en los sujetos mayores de 42 años (p= 0,01). La hipercalciuria, la hiperoxaluria y la hiperuricosuria resultaron más frecuentes en los hombres (p= 0,00), mientras la hipocitraturia tuvo mayor frecuencia en las mujeres (p= 0,04). La hiperuricosuria se encontró con mayor frecuencia en pacientes sobrepesos y obesos (p= 0,00), y la hiperoxaluria fue más frecuente entre los sobrepesos (p= 0,01). CONCLUSIONES: en los pacientes con litiasis renal los trastornos metabólicos más frecuentes son hiperuricemia, hipercalciuria e infección del tracto urinario. Los menores de 43 años tienen más hipercalciuria e hiperuricosuria. Los hombres tienen mayor frecuencia de hipercalciuria, hiperoxaluria e hiperuricosuria y las mujeres, de hipocitraturia. La frecuencia de presentación de hiperoxaluria, hiperuricosuria e hipocitraturia se encuentra relacionada con el estado nutricional de los sujetos.
INTRODUCTION: the recurrence of urinary lithiasis is a health problem needing the implementation of preventive strategies, thus knowing the frequency of the different renal metabolic disorders is essential. OBJECTIVES: To identify the most common metabolic disorders in urinary lithiasic disease and their relationship with patient characteristics. METHODS: an analytical, cross-sectional study was conducted in 3655 adult patients with urolithiasis. A renal metabolic study was conducted at the Institute of Nephrology from 2003 to 2009. The analytical determinations were performed by spectrophotometric technique according to the standards of service. All information is processed using SPSS version 15.0. The technique of frequency distribution analysis was used. Relationships between variables were identified by the test of independence. RESULTS: The main metabolic disorders found were: hyperuricemia (48.2%), hypercalciuria (45.1%), and urinary tract infection (16.2 %). Hypercalciuria and hyperuricosuria were less frequent in subjects older than 42 years (p= 0.01). Hypercalciuria, hyperoxaluria and hyperuricosuria were more frequent in men (p= 0.00), while hypocitraturia was more frequent in women (p= 0.04). Hyperuricosuria was found more frequently in overweight and obese patients (p= 0.00), and hyperoxaluria was more frequent among overweight subjects (p= 0.01). CONCLUSIONS: In patients with renal lithiasis the most common metabolic disorders are hyperuricemia, hypercalciuria, and urinary tract infection. All subjects younger than 43 years suffered hypercalciuria and hyperuricosuria. Men have higher frequency of hypercalciuria, hyperuricosuria and hyperoxaluria. Women have higher frequency of hypocitraturia. The frequency of submission of hyperoxaluria, hyperuricosuria and hypocitraturia is related to the nutritional status of these subjects.
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Humans , Spectrophotometry/methods , Urolithiasis/metabolism , Cross-Sectional Studies , Cuba/epidemiology , Observational Studies as TopicABSTRACT
Electrolyte disturbance was prominent in patients with severe acute mountain sickness. In these patients hypoxia caused water and salt retension together with vasoactive substances and excessive free radicals might play important roles in the development of multiple organ dysfunction syndrome (MODS). More attention should be given to electrolyte monitoring in dealing with these severe mountain sickness in field.
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Some immunosuppressants influence the synthesis and metabolism of lipids,which is a major factor for hyperlipidemia in organ transplant patients.The recent studies on the relationship between immunosuppressants and hyperlipidemia are reviewed.
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Metabolic disturbances such as hypertension and insulin resistence,as well as cardiovascular events are more frequent in primary aldosteronism patients than in essential hypertension patients.When the diagnosis of primary aldosteronism is made,more attention should be paid to the associated metabolic disturbances and cardiovascular events,which may benefit the prognosis of patients.