Abstract
Introduction: Cerebral edema is an uncommon but devastating consequence of diabetic ketoacidosis occurring more in children than adults. Younger children and those with newly diagnosed diabetes are at highest risk. The objective of this study is to determine the frequency of cerebral edema in pediatric diabetic ketoacidosis at Children’s Hospital, Lahore in children with type 1 diabetes mellitus.
 Methods: This descriptive study was carried out in the pediatric intensive care units and medical wards of the Children’s Hospital and the institute of Child Health, Lahore from 2nd Feb 2016 to 2nd Aug 2016. A total of 150 patients fulfilling the inclusion criteria were enrolled. After taking consent from parents, demographic information including name, age, sex, address, and date of admission were recorded. Fundoscopic findings were recorded before initiating diabetic ketoacidosis treatment and neurological examination was conducted at presentation. Cerebral edema was labeled as per operational definition and sampling was done as per hospital DKA management protocol.
 Results: In our study, out of 150 cases, 58.67%(n=88) were between 1-7 years of age while 41.33%(n=62) were between 8-14 years of age, mean + sd was calculated as 6.92+3.12 years, 51.33%(n=77) were male and 48.67%(n=73) were females. Frequency of cerebral edema in pediatric diabetic ketoacidosis at children’s hospital Lahore in the child with type 1 diabetes mellitus was calculated in 18.67%(n=28) while 81.33%(n=122) had no findings of cerebral edema.
 Conclusions: Frequency of cerebral edema is high in pediatric diabetic ketoacidosis at Children’s Hospital Lahore in the child with type 1 diabetes mellitus.
Highlights
Second trimester abortion comprise 10-15% of total cases worldwide because of maternal disease, fetal anomalies and delay in obtaining first trimester services during unintended pregnancies
The availabilty of legal safe abortion services with skilled hands are limited in rural hilly areas of Nepal.Unsafe and delays in seeking abortion services in resources poor countries like Nepal are contributing to maternal mortality and morbidity
This study aims to describe the demographic profile of patients, indications, and methods of second-trimester abortion with possible complications and family planning acceptance in the rural hilly areas of Nepal
Summary
Second trimester abortion comprise 10-15% of total cases worldwide because of maternal disease, fetal anomalies and delay in obtaining first trimester services during unintended pregnancies. This study aims to describe the demographic profile of patients, indications, and methods of second-trimester abortion with possible complications and family planning acceptance in the rural hilly areas of Nepal. Second Trimester Abortion practices in Eastern Hilly District of Nepal: A Cross-Sectional Study. Conference on Population and Development in 1994 ,the quality of sexual and reproductive health services remains inadequately addressed in many parts of the world.[1] The situation of SRHR in developing nations like Nepal is at an unacceptable state where unsafe abortion is still being practiced widely. ,the United Nations sustainable devlopmental goals (SDG 3) have mentioned universal access to sexual and reproductive health care services and to reduce maternal mortality.[2]
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