RESUMEN
Background: Renal stone is a major health problem with adverse medico-economic consequences. It cost the healthcare services a great deal of money without reaching any desired destiny
Objective: To describe the current prevalence, risk factors, manifestations, methods of diagnosis and treatment of renal stones in Arar city, Northern Saudi Arabia
Method: Cross-sectional community based on survey applied to the adult of the general population of Arar city during the period from June to October 2017. The statistical significance level is made at less than 0.05
Results: Among 470 participants, 57.7% male and 42.3% females, 23% had renal gravel, 13% had renal stones. Only 15% complained from recurrent renal colic and 28% had family history of renal stones or gravels. Among the found cases of renal stones, 39.7% had family history of renal stones [P<0.05], 30% had other chronic diseases, 67% have renal gravels [P<0.05] and more than half [55.2%] of them had recurrent renal colic [P<0.05] and 39.9% were obese [P<0.05]. The most common symptom is renal colic as it appear in 55% of cases and 82% of affected people are diagnosed by complete urine analysis and ultrasound examination. The most common type is oxalate stone 55.2%, uric acid stones 27.6% and mixed stones 17.2%. More than half [55.2%] of renal stones are small in size and 46% found in the kidney. Most [84%] of the cases get herbal treatment, 89% medical treatment and only 8.6% got surgical treatment but 46% had recurrent stones
Conclusion: The prevalence of renal calculi and associated renal colic in Arar city, Northern is considerable. Suggestions for health education about risk factors in addition to future researches are mandatory
RESUMEN
BackgroundiDiabetic Ketoacidosis [DKA] is a hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. It is a medical emergency with a significant morbidity and mortality. It is however a potentially reversible condition in case an emergency and immediate medical attention, prompt recognition, diagnosis and treatment were provided
Aim of the Study: was to leverage the current research data in order to construct a treatment guideline for diabetic ketoacidosis in the emergency department
Methods:A literature search was carried out on MEDLINE [including MEDLINE in-process], CINAHL,Embase and the Cochrane Library. Databases using [diabetic ketoacidosis] as a MeSH heading and as textword. High yield journals were also hand searched
Findings: The initial treatment phase aims to restore circulating volume, reduce blood glucose levels, to correct any electrolyte imbalances and to reduce ketone levels which in turn corrects the acidosis. Evidence also showed that there is no need for insulin bolus prior to starting an insulin drip in the treatment of diabetic ketoacidosis. Also, using beta-hydroxybutyrate at presentation can expedite diagnosis and therefore treatment. Implementing treatment guidelines into the emergency department may help expedite diagnosis and treatment
Conclusion: Prompt first line management of DKA is the most critical stage to profoundly reduce morbidity and mortality rates of this potentially fatal crisis. It's therefore crucial to follow the evidence-based guidelines and DKA protocol in the emergency department to expedite diagnosis, guide treatment, and improve continuity of care between the emergency department and the ICU as well as improving the clinical outcomes of patients with DKA. Initially, this will improve outcomes by decreasing the delay until treatment is initiated andprovide a continuum of treatment between the emergency department and the intensive care unit
Furthermore, the healthcare providersmust ensure that they have the ability to provide support and education to people at risk of developing DKA and those that have had an episode of DKA by spreading awareness and education to help reduce both the initial occurrence and recurrence of this often preventable life-threatening condition