Electrolyte Imbalance Research Articles

COMPARATIVE ANALYSIS OF RENAL PROFILE AND SERUM ELECTROLYTES AMONG DIABETIC AND NON DIABETIC GROUPS IN DISTRICT PESHAWAR KP

Diabetes mellitus is a prevalent non-communicable disease worldwide, contributing significantly to morbidity and mortality. Renal complications are a significant concern in diabetes, with hyperglycemia exacerbating renal dysfunction. Objective: This study aimed to assess renal function and electrolyte balance in diabetic and non-diabetic individuals, focusing on serum urea, creatinine levels, and electrolyte imbalances. Methods: This study was conducted at Al-Khidmat Hospital and processed at the MLT Skill Lab at Abasyn University, Peshawar. A total of 100 participants were enrolled, including diabetic and non-diabetic subjects. Blood samples were collected using a questionnaire design. Renal function tests (RFTs) were analysed using a biochemistry analyser, and serum electrolytes were assessed using an Electrolytes Analyzer. Data collection duration, methodology, and statistical analysis methods were employed. Results: Among the participants, individuals aged 40 to 70 in both genders exhibited a higher prevalence of elevated urea and creatinine levels, particularly in diabetic patients. Diabetic individuals showed a significant association with azotemia. Electrolyte imbalances, notably hypokalemia, were observed, indicating potential complications in diabetic patients. Conclusion: The study highlights the importance of proactive management strategies to mitigate renal complications in diabetic individuals. Comprehensive monitoring of renal function and electrolyte balance is essential in clinical practice.

Unusual presentation of Sjogren’s syndrome during pregnancy: a case report

BackgroundPregnancy imposes significant physiological changes, including alterations in electrolyte balance and renal function. This is especially important because certain disorders might worsen and make people more susceptible to electrolyte abnormalities. One such condition is Sjogren's syndrome (SS), an autoimmune disease that can cause distal renal tubular acidosis (dRTA). This case report offers a unique perspective on the intricate physiological interplay during pregnancy, emphasizing the critical importance of recognizing and managing electrolyte abnormalities, particularly in the context of autoimmune disorders such as Sjogren’s syndrome.Case presentationWe report a case of a 31-year-old pregnant Indian woman at 24 weeks gestation presenting with fever, gastrointestinal symptoms, and progressive quadriparesis followed by altered sensorium. Severe hypokalaemia and respiratory acidosis necessitated immediate intubation and ventilatory support. Investigations revealed hypokalaemia, normal anion gap metabolic acidosis, and positive autoimmune markers for SS. Concurrently, she tested positive for IgM Leptospira. Management involved aggressive correction of electrolyte imbalances and addressing the underlying SS and leptospirosis.ConclusionThis case underscores that prompt recognition and management are paramount to prevent life-threatening complications in pregnant patients with autoimmune disease. This report sheds light on the unique challenge of managing hypokalaemic quadriparesis in the context of Sjogren’s syndrome during pregnancy.

Congenital chloride diarrhoea in a Chinese infant with a compound heterozygous SLC26A3 mutation

IntroductionCongenital chloride diarrhoea (CCD) is an autosomal recessive condition that causes secretory diarrhoea and potentially deadly electrolyte imbalances in infants because of solute carrier family 26 member 3 (SLC26A3) gene mutations.Case presentationA 7-month-old Chinese infant with a history of maternal polyhydramnios presented with frequent watery diarrhoea, severe dehydration, hypokalaemia, hyponatraemia, failure to thrive, metabolic alkalosis, hyperreninaemia, and hyperaldosteronaemia. Genetic testing revealed a compound heterozygous SLC26A3 gene mutation in this patient (c.269_270dup and c.2006 C > A). Therapy was administered in the form of oral sodium and potassium chloride supplements, which decreased stool frequency.ConclusionsCCD should be considered when an infant presents with prolonged diarrhoea during infancy, particularly in the context of maternal polyhydramnios and dilated foetal bowel loops.

Evaluation of serum electrolyte abnormalities in type II diabetic patients presenting in Gulab Devi hospital, Lahore

Background: The hallmark of diabetes mellitus (DM) is hyperglycemia brought on by an absolute or relative insulin shortage. Globally, the prevalence of DM is a major cause for worry. The International Diabetes Federation estimates that 26.7% of Pakistan's adult population would have diabetes in 2022, totalling over 33,000,000 cases 1. Patients with diabetes are more likely to experience electrolyte imbalances, which may be caused by an imbalance in the distribution of electrolytes. Electrolytes play a vital role in the maintenance of blood acid-base balance, composition of body fluids, blood clotting, muscle and nerve conduction. Impaired electrolytes balance in diabetics may lead to micro and macrovascular complications. Aims and objectives: The objective of this study is to investigate disturbances in serum electrolytes including Sodium (Na+), Potassium (K+) and Chloride (Cl) in Type II diabetics. Methodology: This has been a descriptive cross-sectional study where random sampling technique was used. 3cc clotted blood samples of 100 Type II diabetic patients were collected from diabetic OPD and medicine wards of Gulab Devi Chest Hospital Lahore and processed in the Pathology lab of Gulab Devi Educational Complex. Results: Out of 100 samples of type II diabetic patients, there were 65 patients in which serum sodium levels were decreased. Serum potassium and serum chloride were slightly increased in some patients. Conclusion: In this study, serum sodium levels were significantly decreased in type II diabetic patients, while no significant alteration was observed in serum potassium and chloride levels. Serum electrolytes should be routinely measured in diabetics to prevent complications.

Association of serum Sodium with mortality in patients of Congestive heart failure

Objectives: To determine the association of serum Sodium with mortality in patients of Congestive heart failure. Study Design: Prospective observational study Settings and Duration of study: Department of Medicine, Sir Ganga Ram Hospital, Lahore. ( 22-12-2021 to 22-6-2022 ). Methods: Sample size of 100 patients; 50 in each group in calculated with 90% power of study, 5% significance level and taking percentage of mortality i.e. 24.75% patients with low serum sodium level and in 4.21% patients with normal serum sodium level. Sample Selection: Inclusion Criteria: Patients aged between 30-70 years, both genders, Patients with congestive heart failure ,Group I: with serum sodium level <135 mEq/L, Group II: with serum sodium level ≥135 mEq/L. Exclusion Criteria: Liver disorders (AST>25IU, ALT>30IU, hepatitis B or C), renal disorders (eGFR ˂ 30 mL/min/1.73 m2 or creatinine >2.0mg/dl or on hemodialysis), any malignancy, anemia (Hb<9 g/dl), due to inherited hemoglobinopathy such as; sickle cell disease, and thalassemia, Patients with recurrent congestive heart failure or already taking treatment for deranged sodium level , valvular heart disease. Results: Patients in exposed group had 52% mortality rate as compared to unexposed group in which mortality rate was only 18% respective. Value of relative risk showed that patients in exposed group had 2.88 times higher chances of mortality as compared to those patients in unexposed group. Similarly, elderly patients (Relative Risk=3.23), Male patients (Relative Risk= 3.37), Overweight patients (Relative Risk=3.54), non-diabetic patients (Relative Risk=3.50), hypertensive patients (Relative Risk=2.95), ischemic heart disease patients (Relative Risk=4.12), Smoker (Relative risk=4.41) and duration of congestive HF as 0.5-3.5 (Relative Risk= 3.03) had higher risk for mortality. Conclusion: Results obtained from this study showed that low serum sodium level had significant impact on patients of congestive HF in terms of mortality. Keeping its prognostic importance, congestive HF patients should be strictly monitored for electrolyte imbalance. Key Words: Serum sodium, Prognostic, Indicator, Mortality,Congestive Heart Failure.

Abstract PO1-20-10: Wernicke Encephalopathy Syndrome in Metastatic Breast Cancer – A Diagnostic Dilemma or An Underdiagnosed Entity

Abstract Wernicke encephalopathy (WE) is an acute medical syndrome that manifests as a clinical triad of encephalopathy, gait ataxia, and oculomotor dysfunction, requiring urgent treatment. Early recognition and treatment can prevent severe neurological morbidity and the chronic neurological consequence of WE, known as Korsakoff syndrome. Thiamine (vitamin B1) deficiency is the root cause of WE, which can occur due to several underlying conditions, including chronic alcoholism, hyperemesis of pregnancy, malnutrition, prolonged fasting, and malignancy. In cases of malignancy, WE is often undiagnosed or misdiagnosed because the presenting symptoms can be confused with several other complications of malignancy. We present the case of a 47-year-old woman with no significant medical history who was diagnosed with triple negative metastatic breast cancer and admitted to the hospital with confusion, memory loss, and progressive lower extremity weakness. During her breast cancer treatments, she experienced significant nausea and vomiting, leading to a prolonged state of nutritional imbalance. Patient underwent extensive infectious and neurological workup for encephalopathy including lumbar puncture which was negative for leptomeningeal disease or infection. MRI brain did not show any new metastatic lesions however revealed enhancement of mammillary bodies bilaterally. Mammillary body enhancement can be seen in WE but not always present on imaging. She was treated for WE with high dose of thiamine infusion for five days, resulting in an improvement of her neurological symptoms. Diagnosing WE in cancer patients is challenging, as there are various factors to consider, such as cerebral metastasis, infection, chemotherapy treatment, and electrolyte imbalances, that can cause neurological symptoms. Cancer patients are at high risk for development of WE due to chemotherapy or whole brain radiation induced nausea and vomiting that can lead to chronic malnutrition. The typical triad of symptoms is not present in many cases and presenting symptoms can be nonspecific which makes the diagnosis challenging. As a result, WE is often underdiagnosed in such patients, making it essential to educate the physician community about this acute neurological manifestation that can be easily treated. A high index of suspicion is necessary for early recognition, and prompt treatment can prevent Korsakoff syndrome, thereby enhancing the overall quality of life of patients with malignancy. Citation Format: Archit Patel, Arya Mariam Roy, Ronald Alberico, Shipra Gandhi. Wernicke Encephalopathy Syndrome in Metastatic Breast Cancer – A Diagnostic Dilemma or An Underdiagnosed Entity [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-20-10.

EVALUATION OF THE EFFICACY AND TOLERABILITY OF A FIXED DOSE COMBINATION OF AMLODIPINE AND INDAPAMIDE IN PATIENTS OLDER THAN 55 YEARS

Objective: There is very limited real-life data on hypertension management in Bangladeshi population. Considering this fact, this study evaluated the effectiveness of treatment with an indapamide/amlodipine single-pill combination (SPC) in Bangladeshi patients over the age of 55 years, in an OPD setting with uncontrolled systolic hypertension in real-life clinical practice. Methods: This was a 3-month, multicenter, observational, open-label study conducted in 3 divisional cities of Bangladesh among patients with grade I or II hypertension who were either uncontrolled on previous antihypertensive treatment or treatment-naïve. The effectiveness of indapamide/amlodipine SPC was assessed by the change in office systolic blood pressure (SBP) and the rate of target SBP (< 140 mmHg) achievement at 2 weeks, 1 month and 3 months, in four age groups: 55-59 years, 60-69 years, 70-79 years, and 80 years or older. Design and method: The COMBINE study recruited 213 patients, of whom 185 took indapamide/amlodipine 1.5/5 mg SPC fora full three-month course of therapy. Mean age was 62.4±7.4 years, 76 men [41.1%] and 109 women [58.9%]. The absolute decrease of SBP during 3 months of taking indapamide/amlodipine single-pill combination (SPC) was 29.3 mm Hg, DBP - 12.9 mm Hg. After 3 months of treatment significant SBP decreases from baseline were observed in each age group: ? 31.8 mmHg (from 156.7 to 124.9), ? 26.4 mmHg (from 152.7 to 126.3), ? 29.5 mmHg (from 152.8 to 123.3), and ? 25.8 mmHg (from 151.7 to 125.9) in the 55-59, 60-69, 70-79, and 80 years and older age groups, respectively. Leg edema was observed in 3 patients (1.62%), electrolyte imbalance was observed in 4 patients (2.16%) and 1 patients observed sudden fall of blood pressure. Conclusion: This COMBINE study results showed that indapamide/amlodipine SPC was associated with significant and rapid reductions in BP even in a different age range of Bangladeshi patients in routine clinical practice. This study result is consistent with already achieved data of this SPC globally.

Paediatric Neurosurgical emergency operations:Clinical spectrum, Presentation-Intervention Interval and Early operative outcome in Regional Neurosurgical center, Nigeria

BACKGROUND: Pediatric neurosurgical emergencies are prevalent worldwide, often triggered by acute, life-threatening conditions that necessitate immediate surgery to prevent disability and death. Managing these conditions perioperatively poses significant challenges for neurosurgeons and anesthetists due to potential complications like anemia, seizures, electrolyte imbalances, intracranial hypertension, and vision threats, alongside the primary neurosurgical issues. Proper correction and optimization of these physiological derangements before surgery are crucial for favorable postoperative outcomes. PATIENTS AND METHODS: This retrospective study analyzes emergency neurosurgical operations performed on children aged sixteen and under at a neurosurgical center in Sokoto, Nigeria, from January 2018 to December 2021. The center caters to a population of approximately twenty million people from three north-western and one north-central Nigerian states, as well as neighboring Niger and Benin republics. The area features a mostly arid climate with limited seasonal rainfall and experiences the Sahara’s harmattan winds. RESULTS A total of 131 children underwent emergency neurosurgical procedures during the study period. The majority were males (71%), with an average age of 5.6 years. Hydrocephalus was the most frequent emergency condition, leading to 44.3% of surgeries, primarily through ventriculoperitoneal shunt procedures, which accounted for 42.7% of interventions. Anemia was the most common comorbid condition. The mean time from presentation to intervention was 10 days. Postoperatively, 17.9% of patients suffered from surgical site infections, yet 67.9% had favorable outcomes with a mortality rate of 7.1%. CONCLUSION: This study underscores the importance of timely surgical interventions and highlights the predominance of ventriculoperitoneal shunts in treating pediatric hydrocephalus in the region, with generally positive outcomes despite delays

Investigating the Urinary Salt Losing Phenotype in R607H and L919X Mutant Mice with Distal Renal Tubular Acidosis

Introduction: The renal collecting duct consists of two cell types: principal and intercalated cells (ICs, alpha- and beta-type). These cells play a crucial role in regulating fluid, electrolyte, and acid-base homeostasis. Specifically, alpha-ICs promote secretion of protons into the urine through an apical proton ATPase while enabling the reabsorption of bicarbonate into the blood via the basolateral protein, kidney anion exchanger 1 (kAE1). Genetic mutations that impact IC cell function can lead to a condition called distal renal tubular acidosis (dRTA). Patients with dRTA typically exhibit alkaline urine, metabolic acidosis, electrolyte imbalances, and urinary ion loss. Study Objective and Hypothesis: Some dRTA patients continue to exhibit impaired conservation of sodium, despite sustained correction of their acidosis. The mechanisms that lead to this impairment need further investigation. Our lab has two dRTA kAE1 knock in (KI) mouse models, L919X (LX) and R607H (RH), that recapitulate classical metabolic acidosis seen in human patients. We hypothesize that these mice serve as an effective model for studying the cause behind the persistent urinary ion loss. The objectives of our work are to 1) determine whether our mouse models accurately reflect the urinary ion loss seen in dRTA patients, 2) comprehensively characterise the previously unpublished mouse line, kAE1 KI L919X, and 3) elucidate the mechanism behind this urinary salt loss. Methods: To test our hypothesis, we fed wild-type (WT) and dRTA mutant mice a low NaCl, acid, or combination (NaCl + acid) diet, to mirror conditions previously studied in human patients. We collected urine and plasma from the mice to measure ion concentrations and pH. We harvested and processed their kidney and gut tissues for analysis through qRT-PCR, immunoblot, and immunofluorescence to investigate acid-base and salt transports in the collecting duct and thick ascending limb. We aimed to identify potential alterations in these transporters between WT and KI mice. Results: On the low NaCl diet, there were little differences between WT and KI mice, either in comparison to each other or relative to their baseline conditions. However, the combination diet revealed a urinary salt losing phenotype in the RH and LX KI mice. These KI mice also displayed hypernatremia, hyperchloremia, and a failure to secrete potassium and to properly concentrate their urine. qRT-PCR analysis of whole kidney tissues revealed a surprising increase in the paracellular transport pathways, including claudin-4 and claudin-10b in the KI compared to WT. Initial immunoblots indicate a concordant upregulation and downregulation of protein expression that aligns with transcriptional changes seen at the mRNA level. Conclusion: Our current findings suggest a defective collecting duct function in the KI mice, thus validating our hypothesis. Additionally, there appears to be a compensatory mechanism at play in earlier nephron segments to rescue ion homeostasis. The results from this research may contribute to improved treatment options for patients that suffer with this severe disease. It will also deepen the understanding of the interconnected and complex functions of the nephron, aiding in treatment of other major conditions like hypertension or end-stage renal disease. Canadian Institutes of Health Research (CIHR), Canada Graduate Scholarship - Master's CIHR, and Kidney Foundation of Canada. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Modified Zhenwu Tang delays chronic renal failure progression by modulating oxidative stress and hypoxic responses in renal proximal tubular epithelial cells

BackgroundTubulointerstitial fibrosis (TIF) is a critical pathological feature of chronic renal failure (CRF), with oxidative stress (OS) and hypoxic responses in renal proximal tubular epithelial cells playing pivotal roles in disease progression. This study explores the effects of Modified Zhenwu Tang (MZWT) on these processes, aiming to uncover its potential mechanisms in slowing CRF progression. MethodsWe used adenine (Ade) to induce CRF in rats, which were then treated with benazepril hydrochloride (Lotensin) and MZWT for 8 weeks. Assessments included liver and renal function, electrolytes, blood lipids, renal tissue pathology, OS levels, the hypoxia-inducible factor (HIF) pathway, inflammatory markers, and other relevant indicators. In vitro, human renal cortical proximal tubular epithelial cells were subjected to hypoxia and lipopolysaccharide for 72 h, with concurrent treatment using MZWT, FM19G11, and N-acetyl-l-cysteine. Measurements taken included reactive oxygen species (ROS), HIF pathway activity, inflammatory markers, and other relevant indicators. ResultsAde treatment induced significant disruptions in renal function, blood lipids, electrolytes, and tubulointerstitial architecture, alongside heightened OS, HIF pathway activation, and inflammatory responses in rats. In vivo, MZWT effectively ameliorated proteinuria, renal dysfunction, lipid and electrolyte imbalances, and renal tissue damage; it also suppressed OS, HIF pathway activation, epithelial-mesenchymal transition (EMT) in proximal tubular epithelial cells, and reduced the production of inflammatory cytokines and collagen fibers. In vitro findings demonstrated that MZWT decreased apoptosis, reduced ROS production, curbed OS, HIF pathway activation, and EMT in proximal tubular epithelial cells, and diminished the output of inflammatory cytokines and collagen. ConclusionOS and hypoxic responses significantly contribute to TIF development. MZWT mitigates these responses in renal proximal tubular epithelial cells, thereby delaying the progression of CRF.

Role for clock protein PER1 in cardiac adaption to salt-sensitive hypertension in male rats

The clock protein PERIOD1 (PER1) is known to regulate the transcription of many genes, impacting subsequent physiological responses and working with other proteins to establish rhythmicity in processes such as blood pressure regulation. Global PER1 knock-out (KO) in male rats is associated with increased severity of the salt-sensitive (SS) hypertensive phenotype in Dahl SS rats. Male PER1 KO SS rats demonstrated reduced amplitude of heart rate as well as altered renal electrolyte and fluid balance with accompanying changes in the expression of relevant genes in the kidney. However, little is known regarding changes in gene expression in cardiac tissue which may contribute to this phenotype. The goal of this study was to test the hypothesis that knockout of PER1 in SS rats results in altered gene expression in the heart. We selected the following genes due to their role in the clock protein complex and circadian control over blood pressure: Basic Helix-Loop-Helix ARNT Like 1 ( Bmal1), Cryptochrome 1 and 2 ( Cry1, Cry2), and Period 2 ( Per2). Given its role in compensatory natriuretic responses to pressure overload, we also assessed the gene Nppa which encodes atrial natriuretic peptide (ANP). In order to test this hypothesis, hearts were collected at 2 am (during the rat active period) from male Dahl SS control and PER1 KO rats following 3 weeks of high salt (4% NaCl) diet (n=5-6). Changes in expression of candidate genes were measured using quantitative real time RT-PCR. Genotype effects were assessed using unpaired student’s t test. PER1 KO SS male rats on high salt diet exhibited significantly decreased cardiac expression of in the clock genes Bmal1 (p<0.0001), Cry1 (p=0.0007), and Cry2 (p=0.0094). Changes in Per2 expression were not apparent (p=0.1152). In contrast, PER1 KO rats exhibited significantly increased expression of Nppa (p=0.0017). Global PER1 knock-out in male SS rats results in hypertension associated with disrupted rhythms in heart rate. These changes are associated with reduction in expression of the genes encoding regulatory clock proteins Bmal1, Cry1, and Cry2, but not Per2. The decreased circadian gene expression in PER1 KO Dahl SS rats may contribute to the disrupted rhythms in heart rate. Increased ANP gene expression in the hearts of PER1 KO SS rats could serve as a compensatory mechanism to induce natriuresis. Thus, the data support the hypothesis that knockout of PER1 in SS rats alters gene expression in the heart. Together, these data illuminate a possible circadian-regulated pathway through which the heart and kidney communicate to respond to fluid and electrolyte imbalance in salt-sensitive hypertension. This work was supported by the National Institutes of Health grants R35 HL135789 (to AS), R01 DK109570 (to MLG and AS), R56DK128271 (to MLG), and Department of Veteran Affairs grants I01 BX004024 (to AS). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Prospective study of post-operative hyponatremia in patients undergoing lower-limb orthopedic surgery

Prospective study of post-operative hyponatremia in patients undergoing lower-limb orthopedic surgery

IMPROVING THE TREATMENT OF CALF DYSPEPSIA

Dyspepsia is a polyetiological disease, accompanied by digestive disorders, diarrhea, weakness, dehydration and intoxication. Treatment of calf dyspepsia should be based on the etiopathogenetic principle and should be aimed at normalizing the digestive process, eliminating dysbacteriosis, dehydration and intoxication. The research was conducted at the cattle farm "Akbar shox Shavkat" in the Pastdarom district of the Samarkand region. 3 groups of 3 calves with dyspepsia were formed [1,5,15]. Calves in the first experimental group were fasted for 8 hours and during this time 10 ml/kg (300) ml Regidron solution was administered every hourAfter the fasting period, 1/3 of the cow's milk (333 ml) + an equal amount of warm physiological solution was added, and it was rinsed 3 times a day. 40 ml of artificial gastric juice (1 g of pepsin, 1.5 NSl, 100 ml of distilled water) was injected 15 minutes before giving colostrum. Vetom 1.2 (Bacillus subtilis VKPM I-10641) probiotic 50mg/kg (2 times a day) was injected every 8 hours from the second day of treatment until the clinical symptoms disappeared. Calves in the second experimental group were fed differently from the first experimental group 1.2. probiotic 50mg/kg (4 times a day) was administered every 6 hours, and citrated blood from additional cows was injected intramuscularly at a dose of 0.2 ml/kg (3 times in total). Calves in the third control group were treated in traditional ways: during 8 hours of fasting, they were fed 1 liter of warm physiological solution 4 times. Macrolan antibiotic was injected at a dose of 1 ml/10 kg once daily for 5 days. The best result was shown in the calves of the second experimental group. Treatment of dyspepsia in such a complex way reduces metabolic acidosis, intoxication, dehydration by correcting electrolyte imbalance in the body, improves digestion by normalizing intestinal biocenosis, and treats dysbacteriosis.

Acute watery diarrhoea cases during cholera outbreak in Syria: a cohort study

ObjectivesThe aim of this study is a descriptive presentation of cases of acute watery diarrhoea (AWD) that were presented to Aleppo University Hospital (AUH) during the recent cholera outbreak in...

Colonoscopy preparations: electrolyte imbalances and precautions in the fragile patients

Abstract Bowel preparation intake for colonoscopy can cause electrolyte imbalances. Although it is a rare complication, occurs as a consequence of the loss of electrolytes and water into the intestinal lumen, and because some electrolytes from the preparations can be absorbed. The possible imbalances cover all the alterations range of the internal environment (hypo and hypernatremia, hypo and hyperkalemia, metabolic acidosis, hypocalcaemia, and hyperphosphataemia or hypermagnesaemia). Electrolyte disturbances and their severity depend on electrolyte content of the preparation solution, the fluid replenishment conducted, and patient characteristics. Electrolyte imbalances are generally transient, and these should not cause complications if adequate fluid replenishment with or without electrolytes during bowel preparation is conducted and maintained over time once the colonoscopy is performed. We reviewed the most frequent electrolyte imbalances that occur with the most used bowel cleansing preparations and precautions to be taken into consideration in fragile patients.

Specifically formulated ketogenic, low carbohydrate, and carnivore diets can prevent migraine: a perspective.

This article presents a hypothesis explaining the cause of migraines, suggesting that electrolyte imbalance, specifically a lack of sufficient sodium in the extracellular space of sensory neurons, leads to failed action potentials. The author argues that migraines are triggered when sodium channels fail to initiate action potentials, preventing communication between neurons. The article discusses the evolutionary perspective of the migraine brain, stating that migraineurs have a hypersensitive brain with more sensory neuronal connections, making them more reactive to environmental stimuli and in need of more minerals for the increased sensory neuronal communication. Since glucose is often used to reduce serum hypernatremia, it follows that a high carbohydrate diet reduces sodium availability for use in the brain, causing an electrolyte imbalance. Low carbohydrate diets, such as ketogenic, low carb-high fat (LCHF), and carnivore (all animal products), can be beneficial for migraineurs by reducing/eliminating carbohydrate intake, thereby increasing sodium availability. In support, many research papers and some anecdotal evidences are referred to. The article concludes by proposing lifestyle modifications, such as dietary changes and sodium intake management. These will provide migraineurs with a long-term healthy metabolic foundation helping them to maintain strong nutritional adherence and with that aiding continued proper neuronal functioning and migraine free life.

Toxicological effects of two major types of potash used as food additives in Nigeria: Biochemical, hematological, and histopathological analysis of major organs in Wistar rats

Trona or natron, often called potash, are evaporites, which are natural salts used unregulated in Nigeria as food additives, particularly to soften hard beans or tenderize tough cow meat, and for medical purposes. A 90-day sub-chronic toxicological study was conducted on Wistar rats weighing 120-140g to investigate the effects of consumption of these natural salts on hematological, histological and biochemical parameters. The experimental design involved 30 rats (n=10), considering attrition of two rats per group. The animals were divided into 3 groups. Group 1 was administered potash type A, group 2 administered potash type B while group 3(control) received only food and water. Standard methods were used to analyze all parameters. All results were presented as mean ± SD, with p-values < 0.05 considered significant. Each potash type has LD50s exceeding 5000mg/kg. Potash types significantly increased AST and ALT levels (p<0.05) in liver function measures compared to the control group. In both potash types, creatinine levels were considerably higher (p<0.05) than the control, but Urea levels were not statistically different (p>0.05). Sample A (Trona) reduced RBCs, Hb, and PCV more than sample B (natron) in rats. Both types had WBCs and Platelets that were similar to controls (p>0.05). Effects of potash on four electrolytes :Na+, K+, Cl- and HCO3- shows that potash type B contained elevated (p<0.05) levels of sodium than type A. Our results indicate that chronic consumption of each potash type or even both types, might expose users to hypernatremia, electrolyte imbalance, hematological problems, liver and kidney failures.

Incidence of Electrolyte Imbalances Following Traumatic Rhabdomyolysis: A Systematic Review and Meta-Analysis.

Rhabdomyolysis, a medical condition caused by the destruction of striated muscle fibers, can have many etiologies, with the most common one being traumatic etiologies, that is, crushing injuries, heavy exertion, and being trapped under rubbles, and so forth. Rhabdomyolysis causes many complications, including acute kidney injury and different electrolyte imbalances, which later can cause cardiac dysrhythmia and even death as a result. This systematic review and meta-analysis investigate the incidence of imbalances of four important electrolytes among patients diagnosed with traumatic rhabdomyolysis. PubMed, Scopus, Web of Science, and Embase databases were searched for any article related to traumatic rhabdomyolysis using keywords related to the topic of our study, excluding case studies and case series. Relevant data were extracted from the included articles, and finally, a meta-analysis was performed on them to calculate the pooled incidence of each electrolyte imbalance. Collectively, 32 articles were included in our study (through the database and citation checking). The following were the pooled incidence of each electrolyte imbalance: hyperkalemia, 31% (95%CI 22%-41%); hypokalemia, 10% (95%CI 4%-17%); hypernatremia, 3% (95%CI 0%-8%); hyponatremia, 23% (95%CI 7%-44%); hypercalcemia, 0% (95%CI 0%-1%); hypocalcemia, 57% (95%CI: 22%-88%); hyperphosphatemia, 33% (95%CI 11%-59%); hypophosphatemia, 4% (95%CI 0%-16%). According to the meta-analyses, the rate of hyperkalemia, hyponatremia, hypocalcemia, and hyperphosphatemia is higher than their counterpart in patients diagnosed with traumatic rhabdomyolysis.

Diuresis's importance in maintaining health and managing illness

Diuretics are a class of medication used to treat a variety of conditions, including heart failure, high blood pressure, glaucoma, liver and kidney disease, and fluid accumulation in the body. Physicians have been using them for many years; they are available in several forms, including potassium-sparing diuretics, thiazides, loop diuretics, carbonic anhydrase inhibitors, osmotic diuretics, and natural diuretics. On the other hand, frequent use of these diuretics may have some adverse effects. An electrolyte imbalance, blood pressure fluctuations, and treating disorders associated with fluid accumulation in the body are some examples of these side effects. In order to effectively manage a variety of medical disorders, healthcare practitioners must be aware of the proper use of diuretics and the significance of inducing diuresis, or the removal of excess fluid from the body. Healthcare practitioners can select the best courses of action and therapies for their patients by being knowledgeable about diuretics and how they function. Individuals can also make educated choices regarding the amount of fluids they consume, lifestyle modifications, and drugs to aid with diuresis and enhance their general health. This review article succinctly discusses the various applications for diuretics as well as any possible risks associated with encouraging diuresis.

Serum magnesium level in peritoneal dialysis patients

Introduction: Electrolyte imbalances are common among dialysis patients, and disorders related to magnesium, calcium, and phosphorus are particularly concerning. However, comparatively less research is available on disorders related to magnesium ion disorders. Objectives: This paper aims to assess magnesium disorders in patients with renal failure undergoing peritoneal dialysis. Patients and Methods: In this cross-sectional study, we recruited patients who had been undergoing peritoneal dialysis for at least three months. We collected demographic information, body mass index (BMI), drug history, the underlying disease leading to renal failure, duration of dialysis, and serum magnesium level. Additionally, we measured levels of calcium, phosphorus, parathyroid hormone (PTH), albumin, and 25-hydroxyvitamin D. Results: A total of 91 patients were undergoing peritoneal dialysis, including 41.8% women and 58.2% men, with a mean magnesium level of 2.86±0.53 mg/dL. More than 70% of patients had hypermagnesemia and only one patient suffered from hypomagnesemia. Diabetic patients had a lower magnesium level than non-diabetics (P=0.01). Conclusion: Given the frequent occurrence of electrolyte imbalance in peritoneal dialysis, it may be necessary to regularly monitor electrolyte levels and make appropriate adjustments to both the patient’s diet and electrolyte levels.