Abstract
Background: Electrolyte abnormalities are common in children with diarrhoea. It may remain unrecognized and result in mortality and morbidity. Timely recognition, a high index of suspicion and thorough understanding of common electrolyte abnormalities is necessary to ensure their correction. The present work was undertaken to determine the incidence and clinical importance of Hypokalemia, hypernatraemia, Hyponatremia and Hypernatremia in children with acute diarrheal diseases with dehydration. Method: The present prospective study was conducted at Department of Paediatrics, GSL Medical College & General Hospital, Rajahmundry from 2015 to 2017.Consecutive Patients attending OPD and inpatients in view of acute diarrhea between 1month and 5years of age were included in the study. A detailed history from the patients with acute gastroenteritis of age 1 month to 5 years was taken. Result: The incidence of Acute diarrhoea was greater in males (54.6%%) compared to females (45.4%). Severe Dehydration was present in 39.1% cases and some dehydration was present in 60.8% cases. Hyponatremic dehydration was present in 33% cases, Isonatremic dehydration in 59.8% and hypernatremic dehydration in 7.2% cases. Mean sodium levels being 134.97 mmol/l. Hypokalemia was present in 44.3% cases, normal levels in 51.6% and Hyperkalemia in 4.2% cases. Mean potassium levels being 3.62 mmol/l. Conclusion: Like any other electrolyte abnormalities, which occurs in conditions other than diarhoea, are basically asymptomatic & does not require aggressive correction of electrolytes. They do very well with ORS & fluid correction as recommended by W.H.O.
Highlights
Almost 1.731 billion episodes of diarrhoea occurred in 2010 in children younger than 5 yr. of age in developing countries, with more than 80% of the episodes occurring in Africa and South Asia (50.5% and 32.5%, respectively) and 36 million of the total episodes progress to severe episodes [1]
Manuscript received: 28th June 2019 Reviewed: 7th July 2019 Author Corrected: 15th July 2019 Accepted for Publication: 20th July 2019 In India, acute diarrhoeal disease accounts for about 8% of deaths in under-5 years age group
The high incidence of diarrhoeal diseases in developing countries is related to undernutrition, increased vulnerability to infections, poor education, socio-economic status and the unfortunate trend of early breast milk substitutes
Summary
Almost 1.731 billion episodes of diarrhoea occurred in 2010 in children younger than 5 yr. of age in developing countries, with more than 80% of the episodes occurring in Africa and South Asia (50.5% and 32.5%, respectively) and 36 million of the total episodes progress to severe episodes [1].Global mortality may be declining rapidly, but the overall incidence of diarrhoea has only declined from 3.4 to approximately 2.9 episodes per child-year in the past 2 decades, and it is estimated to account for 23 million childhood disability-adjusted life year [1]. In India, acute diarrhoeal disease accounts for about 8% of deaths in under-5 years age group. The main cause of death in acute diarrhoea is dehydration, which results from the loss of fluid and electrolytes in diarrheal stools. Electrolyte abnormalities are common in children with diarrhoea It may remain unrecognized and result in mortality and morbidity. The present work was undertaken to determine the incidence and clinical importance of Hypokalemia, hypernatraemia, Hyponatremia and Hypernatremia in children with acute diarrheal diseases with dehydration. Conclusion: Like any other electrolyte abnormalities, which occurs in conditions other than diarhoea, are basically asymptomatic & does not require aggressive correction of electrolytes. They do very well with ORS & fluid correction as recommended by W.H.O
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