Online ISSN: 2515-8260

Keywords : Diabetic Ketoacidosis


To Study efficacy and safety of low dose insulin against standard dose insulin infusion inchildren with diabetic ketoacidosis: An open label randomized controlled trail.

U Ashok Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1778-1786

Background: The primary objective was to compare time taken until resolution of
acidosis in standard dose insulin infusion group and low dose insulin infusion group.
The secondary objectives were to compare the time taken until decline in blood glucose
till 250 mg/dl in both the groups, to compare the proportion of children developing
Hypoglycemia in both the groups, to compare the proportion of children developing
Hypokalemia in both the groups, to compare the episodes of treatment failures in both
the groups.
Materials and Methods: This study was conducted from March 2017 to August 2018,
atMamatha Medical College,Khammam with aim to compare efficacy and safety of low
dose insulin infusion against standard dose insulin infusion in children with diabetic
ketoacidosis. All consecutive children 12 years of age or younger, admitted with
diagnosis of Diabetic Ketoacidosis were enrolled for the study. Children who present
with symptomatic cerebral edema were excluded from the study. Cases were enrolled
after valid consent obtained from the parents. Among 34 eligible cases, 30 were
randomized equally into two groups and 4 cases were excluded due to symptomatic
cerebral edema. Total 30 cases 15 in each group completed the study and were available
for data analysis.
Results: In our study mean age in standard dose insulin infusion group was 8.30+/- 2.57
years and in low dose insulin infusion group was 6.83+/- 2.67 years. After fast breathing
(93.3%), vomiting (90%), and pain abdomen (76.6%), polyurea (76.6%), polydypsia
(73.7%), fever (56.7%), altered sensorium (53.3%), were the predominant presenting
complaints of DKA. Signs of dehydration (100%) were the most common presenting
signs of DKA followed by acidotic breathing (93%) and tachycardia (86%). In our
study, most common precipitating causes of DKA, infection (46.7%), followed by
unknown cause (26.7%), and dose omitted (23.3%), and insufficient dose (3.3%).
Family history was present in 16.7% patients. Malnutrition was present in 40% cases of
DKA.
Conclusion: To conclude, the time taken to resolution of acidosis is similar in standard
dose insulin infusion group and low dose insulin infusion group and time taken to
decline blood glucose till 250 mg/dl or less is similar in both the groups. Incidence of
hypoglycemia and hypokalemia comparatively less in low dose insulin infusion group.
Treatment failure was not found in both the groups.

Role of Serum Albumin as a Prognostic marker of mortality and duration of hospital stay among Diabetic Ketoacidosis Patients.

Vinay Verma; Shilpa Gaidhane; Anuj Varma

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2580-2584

Abstract: Background: Diabetic Ketoacidosis (DKA) is an critical and menacing problem
of Type 1 as well as type 2 diabetes mellitus (T2DM). DKA is associated with high amount
of risk of mortality and morbidity (hospital stay). The prognostic factors of DKA are
important factors affecting the outcome of the patients (as treated or death). S. Albumin is
one of the prognostic factor less studied up till now.
Objectives: To determine Clinical profile of DKA patients: aetiologies, precipitating
factors, biochemical parameters and other complications of T2DM patients and to corelate
serum albumin level with mortality, duration of stay among DKA patients.
Methodology: This cross sectional study will be conducted among 100 diabetic patients
with and without ketoacidosis from May 2019 to May 2021. Biochemical parameters:
glycated Haemoglobin, urine ketones and serum albumin will be gathered to determine the
prognosis. Controls will be adult diabetic patients without ketoacidosis. Data from Cases
and controls will be statistically analysed and then compared accordingly.
Expected Results: It is expected that decreased Sr. albumin will be associated with poor
prognosis in DKA patients. Sr. Albumin might be an indirect prognostic marker of diabetes
control due anabolic effect of Insulin, which affects both ketosis possibility and glucose
levels.

MUCORMYCOSIS - A REVIEW

Dr. G. NISHANTH; Dr. N. Anitha; Dr. N.Aravindha Babu; Dr. L. Malathi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1786-1791

Mucormycosis is a rare angio invasive infection mainly recognized in immunocompromised patients which occurs due to the fungi mucorales. This rare fungal infection can be classified into rhino-orbitocerebral, cutaneous, disseminated, gastrointestinal, and pulmonary types. Inspiote of aggressive treatment once detected or diagnosed overall increased mortality rate is reported. This review aims in providing with brief details regarding the Etiopathogenesis of Mucormycosis, fatality of rhinocerebral Mucormycosis along with recent advances in diagnostic and treatment methods