Serum Electrolyte Levels Research Articles

Reducing refeeding syndrome incidence among patients with head and neck cancer: A quality improvement initiative.

459 Background: Refeeding syndrome (RFS) constitutes a wide spectrum of electrolyte abnormalities and clinical symptoms following re-introduction of nutrition, specifically carbohydrate, in malnourished patients (pts). Refeeding phenomena (RFP) is the isolated decline in electrolyte levels (phosphate, potassium, or magnesium) following refeeding. Average incidence of RFS in head and neck cancer (HNC) pts is 20%. Early identification of high-risk pts and increasing awareness about RFP is crucial to avoid rapid nutritional replenishment and therefore reduce health care costs, morbidity, and mortality from RFS. We conducted a quality improvement (QI) project at a single academic university hospital with objective of reducing RFS incidence, length of hospital stay (LOS) and 30 day all-cause readmission and ED visit rates in HNC pts started on enteral nutrition (EN). Methods: We conducted a prospective observational study between Aug 2021 and Nov 2022 among pts with HNC admitted for feeding tube insertion. Pts determined to be high-risk for RFS according to ASPEN criteria were included. Serum electrolyte levels were obtained and monitored twice daily for 3 days following initiating continuous feeds with a standard, fiber free, 1.5 kcal/mL formula @ 20mL/h (’Safe start’). If low, electrolytes were promptly supplemented. Enteral thiamine supplements (100 mg daily for 5-7 days) were started. A registered dietitian conducted a nutrition assessment within 24 h of EN initiation to provide EN regimen and formula advancement recommendations, as well as EN needs for home. Case management was consulted within 24 h of EN initiation to facilitate timely discharge and delivery of home supplies. Data including LOS and 30-day all-cause readmission and ED visits were collected. ASPEN criteria were used to define mild, moderate, severe RFP. For comparison, similar data was retrospectively collected by reviewing medical records of 57 HNC pts (control group) admitted for feeding tube insertion between Dec 2017 and April 2021. Results: Of the 56 pts in the study group, 8 (14.3%) experienced RFS, 12 (21.4%) mild RFP, 7 (12.5%) moderate RFP, and 12 (21.4%) severe RFP. The average LOS in study group was 10 days compared to 13 in control group. 30-day all-cause readmission and ED visit rates were 21.4% and 12.5% in study group compared to 45.6% and 19.3% respectively in control group (Table 1). Conclusions: RFP/RFS is often underdiagnosed and undertreated in HNC pts. Through QI measures we were able to decrease RFS incidence rate to less than the reported average. Close collaboration between physicians, nurses, dietitians, and case managers facilitates timely intervention to prevent RFS, reduce LOS and readmissions.[Table: see text]

Correlation of Serum Electrolytes and Ovarian Hormones Levels in Premenstrual Syndrome

Background: Premenstrual syndrome (PMS) is a recurrent psychological and physical symptom that may occur during the late luteal phase of menstrual cycle and resolve with menstruation in the women. Alteration of serum electrolyte levels in accordance with ovarian hormonal fluctuations has some association with PMS which affect their regular activities and reproductive life. Methods: A cross-sectional study was conducted to assess the correlation of serum electrolytes and ovarian hormones levels in premenstrual syndrome among the 30 young unmarried women with PMS from July 2016 to June 2017 in the Department of Physiology, Sir Salimullah Medical College, Bangladesh. Results: In the non-PMS and PMS group, the mean of serum sodium level was 139.97±1.30 and 140.93±1.68 mmol/L, and serum potassium level was 4.20±0.32 and 4.17±0.31 mmol/ L. The mean of serum estrogen level was 177.10±6.90 and 283.53±5.73 pg/ml and serum progesterone was 19.35±2.55 and 14.67±2.20 ng/ml in the group A and B. Premenstrual scores of irritability, abdominal bloating, backache, depression, fatigue, breast tenderness, headache, anxiety were significantly higher in comparison to those of postmenstrual scores in PMS group (p<0.05). Serum estrogen level (r= +0.558) and serum progesterone level (r= -0.408) were correlated with PMS symptoms scores in PMS group (p<0.05). Conclusion: The results of the current study showed that the PMS group has some physical and psychological symptoms as a result of fluctuations in ovarian hormone levels and biochemical markers during the late luteal phase of the menstrual cycle. Sir Salimullah Med Coll J 2023; 31: 21-25

Effect of P-glycoprotein inhibitor (Carvedilol) on pharmacological and hematological effects of its substrate (methotrexate) on pregnant and lactating rat mothers

Sixty albino rats (40 female rats and 20 males) were allocated into four dosing groups administered orally carvedilol (T1) 0.72mg/kg, methotrexate (T2) 0.36mg/kg, combined doses (T3) carvedilol + methotrexate and control group (Distilled water) for 2 months in male and 2 weeks in female rats before mating and after copulation and approval of pregnancy, dosing continued in female groups during pregnancy and lactation periods. Half of the animal groups were euthanized one day before parturation to determine P-gp concentration in the placenta and liver of pregnant mothers. In contrast, the other half was left for parturition and lactation to study the effects of carvedilol (P-gp inhibitor) on methotrexate (P-gp substrate) when given alone and in combination with some pharmacological, hematological, and biochemical parameters in lactating mothers and pups at the end of lactation. The pharmacological results showed the highest significant antinociceptive responses both in the early and late phase in the T3 (CV+MTX) followed by the T2 (MTX) group. In contrast, the T1 (Cv) animal group showed nearly resembling results as that of the control group in the early and late phases of the formalin test. The written test also recorded the same result as the Formlin test, indicating a significantly higher analgesic effect in T3 followed by T2 in comparison to T1 and control groups. The TNF alpha results supported the anti-inflammatory effect, recording a significant decline mainly in the T3 and T2 groups. The hematological results recorded significantly more reduction in WBC levels in mother and their pups in comparison with T1 and control groups. The serum electrolyte levels (Na+, K+, Ca+2) recorded in all treated groups and pups showed a significant increase in potassium levels in the T1 and T2 mother rat groups. The P-glycoprotein (P-gp) concentration measured in liver and placenta of euthanized pregnant mother before delivery recorded potent inhibition of P-gp in T1 & T3 groups which might altered pharmacokinetic and pharmacodynamic effects of substrate by carvedilol that considered a potent P-gp inhibitor drugs, this might explain our results of increase in pharmacological effect of methotrexate and their side effect on electrolyte concentration and hematology in combined group of CV+ MTX. Keywords: Carvedilol, Methotrexate, p-gp inhibitor, Anti-inflammatory, Hematology, Electrolyte.

A Case Report on Recurrent Episodes of Dyselectrolytemia Diagnosed as Gitleman Syndrome

Background: Gitleman syndrome (GS) is also known as familial hypokalaemia-hypomagnesemia, which is a rare genetic disorder. It is an autosomal recessive disease that is characterized by hypokalaemia, hypomagnesemia, metabolic alkalosis, hypocalciuric hypercalcemia and hyperaldosteronism.
 Case Report: 70-year-old female patient who was diagnosed with Gitelman syndrome with the symptoms of loss of appetite, muscle weakness, and abdominal pain. Electrolyte levels were low. After inconclusive evidence from laboratory investigation, genetic testing was performed. The detection of the SLC12A3 gene mutation encoding thiazide diuretic sensitive sodium chloride cotransporter located in DCT of kidney, confirmed the diagnosis of GS with c.1331delA variant. No pathological variant of CLCNKB for Bartter syndrome has been found. The patient was treated with parenteral normal saline, potassium chloride, Arachitol, spironolactone, metoclopramide, and MgD3 (magnesium glycinate and vitamin D3), the symptoms was significantly relieved. After discharge the intravenous medicines were shifted to oral and followed up with serum electrolyte levels in our institute.

Acid-Base Status & Electrolyte Imbalance in Critically ill Ventilated Infants

Introduction: Children who are critically ill typically suffer from a disease process that impacts many organ systems. To improve the outcome, these children are treated in a pediatric intensive care unit. The primary focus of intensive care medicine is the care of patients who are facing immediate life-threatening conditions. The aim of this study was to determine the acid- base status & electrolyte imbalance in critically ill ventilated infants. Methods: This was a prospective observational study and was conducted in the Department of Intensive Care Unit (ICU) of Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh during the period from January 2020 to December 2020. In our study, we included 50 critically ill ventilated young infants in ICU of Bangladesh Shishu Hospital & Institute. Results: In our study, we found that almost three fourth (74.0%) patients died and 13(26.0%) patients survived. Majority of our patients were ≤ 15 days and male. We found 22(59.5%) patients had PH level <7.25 in death group and 6(46.2%) in survival group and PH level ≥7.15 was (81.1%) in death group and 10(76.9%) in survival group. Before extubation & death metabolic acidosis was 19(51.4%) in dead group and 2(15.4%) in survival group. Significant relation was found between serum sodium level <135 and outcome of ventilated patients [p=0.039, OR=0.19(0.04-0.89)]. Imbalance of single & more than one electrolyte was found 43.24% & 56.76% in death group and 61.5% & 38.5% in survival group respectively. Conclusion: We found that arterial blood gas analysis & serum electrolytes level provide valuable information for correction of acid–base imbalance associated with a pathological condition. Electrolyte imbalance, regardless of the basic disease etiology, is a significant prognostic indicator that must be rapidly treated in critically ill children to get a good outcome.

Electrolyte Disturbances in Post-Acute Myocardial Infarction Arrhythmias

Introduction: Electrolyte disturbances are an important predictor for the prediction of arrhythmias after acute myocardial infarction (AMI). This study investigated the prevalence and relationship of various electrolyte disorders with common types of arrhythmias after AMI. Material and Methods: This cross-sectional study was performed on 153 patients with arrhythmias after AMI. Patient's demographic variables were collected from patient files and required laboratory findings including serum potassium (K), calcium (Ca), and magnesium (Mg) were measured in the first 12 hours after AMI. Any type of serum electrolyte disturbance was defined as a value above or below the reference values. The incidence of any arrhythmias during hospitalization was determined for each group of electrolyte disturbances using chi-square test and fisher exact test. Logistic regression was used in order to evaluate the risk of any arrhythmias in association with serum electrolyte levels. Results: In this study, the most common arrhythmias after AMI were inappropriate sinus tachycardia (IST) (43.1%), sinus bradycardia (33.3%), and premature ventricular contractions (30.7%), respectively. Majority of subjects had normal levels of serum K and Ca levels (P=0.001). Also, most of the patients with ventricular tachycardia and SB were in the range of normokalemia (P=0.015) and normocalcemia (P=0.035), respectively. The risk of IST increases by 1.911 times for every 0.648 units increase in K (P=0.033). However, no significant relationship was seen between other electrolyte disturbances and any other post-AMI arrhythmias. Conclusion: Occurrence of IST increases with higher levels of K. lack of association between other serum electrolytes levels and arrhythmias indicate the importance of further studies in this regard with consideration of other affecting factors.

The impact of maternal electrolyte and albumin levels on the efficacy of single-dose methotrexate treatment for ectopic pregnancies.

This study aims to investigate the impact of maternal albumin and serum electrolyte levels on the efficacy of single-dose methotrexate (SDMtx) therapy for ectopic pregnancies. Building on previous research, recommendations are provided to enhance the success of SD-Mtx therapy in the management of ectopic pregnancy. Conducted at a tertiary center gynecology clinic, the study included 353 patients diagnosed with ectopic pregnancy and treated with SD-Mtx from 2012 to 2023. Patients who responded positively to SD-Mtx treatment comprised Group 1 (n=313), while those requiring surgical intervention due to failed SD-Mtx therapy constituted Group 2 (n=40). Through the hospital's digital database, patient data including complete blood count, biochemistry, and hormone test results were retrospectively examined. The mean β-hCG value was 1996 IU/mL for Group 1 in contrast to 2058 IU/mL for Group 2. There was no statistically significant difference in β-hCG levels between the two groups. Notably, Group 1 patients exhibited lower serum magnesium levels but higher potassium levels compared to Group 2 patients, with statistically significant differences. Furthermore, Group 1 patients had higher albumin levels than those in Group 2, with a statistically significant difference. Successful SD-Mtx treatment was associated with lower maternal serum magnesium levels and higher potassium and albumin levels. Considering electrolyte levels before administering SD-Mtx and addressing any imbalances could potentially enhance treatment success. Additionally, restoring low albumin levels might improve the efficacy of SD-Mtx treatment for ectopic pregnancies. While this study suggests these trends, further extensive studies with a larger sample size are necessary to establish more definitive evidence.

Changes of Serum Electrolytes and Serum Vitamin C Levels in a Sample of Iraqi patients Infected with Helicobacter pylori (H. pylori)

Helicobacter pylori (H. pylori) is widespread and involved in the pathogenesis of the majority of stomach and duodenal diseases. Reduced stomach acidity facilitates the initial infection. Electrolytes (sodium, potassium, and chloride) are essential for the production of stomach acid. This study aimed to observe any changes in the levels of serum electrolytes (Na, K, and Cl) and serum vitamin C levels in a sample of Iraqi patients infected with H. Pylori. We studied 30 infected patients with H. Pylori and 30 matched healthy controls. The results revealed that the serum sodium, potassium, and chloride levels were significantly decreased (p = 0.002, 0.003 and 0.0001, respectively) in the patients infected with the H. Pylori group in comparison with those of the healthy controls. Also, vitamin C levels were significantly lower in patients infected with H. Pylori than in the control group (p = 0.001). The present results suggest that these changes may be attributed to or contribute to the infection itself through changes in gastric acidity, and this needs further study.

Exploiting Machine Learning Technologies to Study the Compound Effects of Serum Creatinine and Electrolytes on the Risk of Acute Kidney Injury in Intensive Care Units.

Assessing the risk of acute kidney injury (AKI) has been a challenging issue for clinicians in intensive care units (ICUs). In recent years, a number of studies have been conducted to investigate the associations between several serum electrolytes and AKI. Nevertheless, the compound effects of serum creatinine, blood urea nitrogen (BUN), and clinically relevant serum electrolytes have yet to be comprehensively investigated. Accordingly, we initiated this study aiming to develop machine learning models that illustrate how these factors interact with each other. In particular, we focused on ICU patients without a prior history of AKI or AKI-related comorbidities. With this practice, we were able to examine the associations between the levels of serum electrolytes and renal function in a more controlled manner. Our analyses revealed that the levels of serum creatinine, chloride, and magnesium were the three major factors to be monitored for this group of patients. In summary, our results can provide valuable insights for developing early intervention and effective management strategies as well as crucial clues for future investigations of the pathophysiological mechanisms that are involved. In future studies, subgroup analyses based on different causes of AKI should be conducted to further enhance our understanding of AKI.

Assessment of serum electrolytes levels of obese individuals in Enugu southeastern, Nigeria

Assessment of serum electrolytes levels of obese individuals in Enugu southeastern, Nigeria

Evaluation of Tribulus terrestris effect on kidney and liver function in healthy mice

This research aims to evaluate the pharmacological efficacy of aqueous spine extracts of Tribulus terrestris (TT) on liver and kidney function through physiological, biochemical, haematological, and histological assessments. Tribulus terrestris is renowned for its therapeutic benefits in traditional medicine practices in China, India, Pakistan, and Sudan for treating various chronic ailments. The study employed 5 weight per volume percentage (% w/v) of TT aqueous spines extract. BALB/c mice, both male and female, aged 4-6 weeks, were maintained in controlled ecological conditions (temperature: 22-24°C, humidity: 50-70%, light/dark cycle: 12-h). The mice were divided into two groups: the control group received normal tap water throughout the experimental period, while the other group was administered 5% (w/v) TT spines solution for 15 days. The outcomes of BALB/c mice treated with 5% Tribulus terrestris were compared with the control group after 15 days, revealing no significant difference in the drug's efficacy. The physiological results indicated reduced body weight, food intake, and adverse effects in the biochemical profile, including urinary and serum electrolyte levels, liver function tests, increased random blood glucosem, aspartate aminotransferase (AST), alkaline phosphatase (ALP), alanine aminotransferase (ALT), bilirubin (BIL), cholesterol (CHO), high-density lipoprotein (HDL), and triglycerides (TRI). Similarly, kidney function tests showed increased Urinary Nitrogen and creatinine plasma levels, with low blood urea nitrogen (BUN), urinary creatinine, and glomerular filtration rate (GFR). However, no significant difference was observed in haematological profile readings. In conclusion, the findings suggest that the aqueous spine extract of Tribulus terrestris does not demonstrate beneficial effects on liver and kidney function, indicating that this study supports the notion that the plant cannot be utilized as a medicinal remedy.

Influence of Thyroid Dysfunction on Electrolyte Levels of Outdoor Patients of Tertiary Care Hospitals

The study aimed to evaluate the impact of thyroid dysfunction on serum electrolyte levels in individuals visiting outpatient departments of tertiary care institutes. The study included 88 participants who were divided into five groups: NTF, Hypo-TF, Hyper-TF, NTFT, and HC. The thyroid hormones T3, T4, and TSH and electrolyte levels, were analyzed in the sera obtained from the control and study groups. The results showed a statistically significant variation in thyroid hormone levels among the different study groups of both genders. The Hyper-TF group had higher levels of T3 and T4, while the TSH level was higher in the Hypo-TF group of both genders. The age of the patients and duration of treatment did not significantly affect the thyroid hormones and electrolyte levels of the study groups. The Na+ level was positively correlated with T3 and T4 levels of the control and Hypo-TF groups and TSH of the Hyper-TF group. The K+ level was negatively correlated with the thyroid hormone levels of each group except TSH of the Hyper-TF group. The study found that thyroid dysfunction significantly affected the thyroid hormone levels in male and female patients, which were positively correlated with Na+ level and negatively correlated with K+ level.

Cryptococcal Meningitis in An Immunocompetent Patient

A fungal illness called cryptococcal meningitis is most often thought of as an opportunistic infection that affects immunocompromised people, typically those who have HIV infection. Numerous problems are linked to it, including widespread illness and neurologic ones such as intracranial hypertension, cerebral infarcts, vision loss, and other abnormalities. Here is a case 18-year-old male patient, who presented with persistent headache and fever. A lumbar puncture revealed a cryptococcal infection in him. His workup indicated no known underlying illness that may have compromised his immune system. CSF was then tested for cryptococcal species using an Indian ink preparation, and the results were positive. He was admitted to the hospital for initiation of antifungal therapy with amphotericin B along with serial serum creatinine and electrolytes levels and after the 5th day of getting amphotericin B, he had shown remarkable improvement in total symptomatology.

Effect of standardized Eucalyptus globulus leaf extract on brain oxidative stress and aberrant neurochemistry of fructose-streptozotocin-induced diabetic rats.

The neuro-pharmacological effect of Eucalyptus globulus ethanol leaf extract in fructose-streptozotocin-induced diabetic rats was evaluated in this study. The phytochemical analysis of the extract was carried out using HPLC-DAD. Diabetes was induced in rats with 10% fructose in drinking water and a single intraperitoneal injection of 40 mg/kg streptozotocin (STZ). Diabetic animals were orally treated with 100-400 mg/kg of the extract for 21 days with glibenclamide as the reference drug. Blood and brain tissue were processed for the determination of serum electrolyte levels, hematological indices, and biochemical estimations. Ergosterol, pinitol, catechin, quercetin, robinetinidol, and other polyphenols were identified in the extract. Diabetic animals showed decreased serum potassium and sodium ion levels and decreased hematocrit, hemoglobin, red blood cells, white blood cells and lymphocytes but increased neutrophils. The brains of animals in the untreated diabetic group with increased blood glucose level showed oxidative stress (increased level of MDA and myeloperoxidase but decreased level of reduced glutathione and superoxide dismutase) and disturbed neurochemistry (increased level of acetylcholinesterase and monoamine oxidase but decreased level of Na+K+ATPase, tyrosine hydroxylase and dopamine). Administration of the Eucalyptus globulus leaf extract remarkably ameliorated the observed hyperglycemia, electrolyte, and hematological imbalances in animals. In addition, the administration of the extract attenuated the brain redox imbalance, and neurochemical disturbances in the rats. These results show that Eucalyptus globulus leaves contain antioxidant and neurotransmitter modulating phytochemicals with the potential to be developed as therapeutic agents for the management of diabetic cerebrovascular problems and related complications.

Akut Miyokard Infarktüslü Hastalarda Hemogram, Biyokimya, İnflamatuar Belirteçler ve Elektrolit Düzeylerinin Değerlendirilmesi

Aim: Hemogram, biochemistry, serum electrolyte, and inflammatory marker levels are altered in patients with acute myocardial infarction. When diagnosing and monitoring patients with acute myocardial infarction using cardiac-specific biomarkers, the levels of these markers should also be under control. We looked into the diagnostic and therapeutic value of hemogram, biochemistry, inflammatory markers, and electrolyte levels in acute myocardial infarction patients.
 Material Method: It is a descriptive epidemiological study. Within the scope of the study, all patients aged 18 years and over and diagnosed with acute myocardial infarction in the Emergency Department and Cardiology Department of Kahramanmaraş Sütçü İmam University Faculty of Medicine Hospital between 01.01.2020 - 31.07.2022 were included retrospectively. Hemogram, biochemistry, serum electrolyte and inflammatory marker levels were investigated in acute myocardial infarction patients.
 Results: Leukocyte, neutrophil, procalcitonin and C-reactive protein values were significantly higher in patients with acute myocardial infarction. Although platelet/lymphocyte ratios were high, no significance was found. In patients with acute myocardial infarction, glucose values measured at the time of stress were found to be high (hyperglycaemia). When we analysed the serum lactate levels of patients with acute myocardial infarction, it was found to be significantly higher. 
 Conclusion: In patients with acute myocardial infarction, hemogram, biochemistry, serum electrolyte and inflammatory marker levels are altered. The levels of these markers should also be controlled during the diagnosis and follow-up of acute myocardial infarction patients with cardiac specific biomarkers. We believe that hemogram, biochemistry, inflammatory markers and electrolyte levels may contribute to the prediction of early serious complications in patients with acute myocardial infarction.

Assessment of Serum Electrolytes and Glycated Hemoglobin Level in Non-diabetic Iron-Deficient Anaemic Patients.

The WHO has recognised iron deficiency anaemia (IDA) as the most common nutritional deficiency in the world, with 30% of the population being affected by this condition. The patient's glycemic status during the past three months is shown by the glycated haemoglobin A1C (HbA1c) test. According to several studies, iron deficiency can increase HbA1C levels without affecting blood sugar levels. HbA1C levels of≥6.5% have been approved by the American Diabetes Association (ADA) as a diagnostic indicator for diabetes mellitus (DM). An imbalance in serum electrolyte levels and anaemia havebeenlinked by several studies. Aim: To analyze the effect of iron deficiency anaemia on HbA1c levels and serum electrolytes in an adult non-diabetic population. This was a descriptive cross-sectional studyconducted in Shri BM Patil Medical College, Hospital and Research Centre, Vijayapura, Karnataka, India from January 2021 to June 2022. A total of 65 moderate to severe normoglycemic iron deficiency anemia patients between 18 to 75 years were enrolled in the studyafter fulfilling inclusion and exclusion criteria. A detailed history, clinical and biochemical examination was performed including HbA1c levels. The results were pooled and statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY, USA). We found elevated HbA1c levels (5.67±1.1%) in non-diabetic iron-deficient anaemia individuals, and elevation was more in women of reproductive age group (30.8%). There was a statistically significant Spearman negative correlation between hemoglobin and HbA1C levels. Also, 16 patients had hyponatremia with a mean haemoglobin (Hb) of 4.8 g/dL and one patient had hyperkalemia with a mean Hb of 3.2 g/dL which was statistically non-significant. In this study haemoglobin and HbA1c had a statistically significant positive correlation with serum sodium and a negative correlation with serum potassium in moderate to severely iron-deficient anaemic patients, especially females of the reproductive age group.

ESTIMATION OF ACUTE KIDNEY INJURY AND DYSELECTROLYTEMIA IN ASPHYXIATED NEWBORNS - A SINGLE CENTRE STUDY

Background: In babies with perinatal asphyxia, hypoxia and ischemia can cause damage to almost every tissue and organ of the body and kidneys are one of the most commonly affected organs. Renal insufciency may occur within 24 hours of a hypoxic ischemic episode leading to variable degree of kidney injury. Serum electrolyte levels are also found to be signicantly affected in perinatal asphyxia.Aims & Objective: Estimation of acute kidney injury and its correlation with severity of perinatal asphyxia and assess electrolyte imbalance in term neonates with perinatal asphyxia. Materials and Methods: It is a prospective observational study conducted at a tertiary care centre during the study period. Renal parameters and serum electrolytes of asphyxiated newborns were evaluated and kidney injury was classied on the basis of AKIN criteria. Results: Among 175 newborns with perinatal asphyxia, 29.7% had HIE1, 14.3% of them developed HIE 3 while maximum of them (56%) had HIE stage 2. It was observed that 38.3% of the enrolled babies developed acute kidney injury. 14.9 % of cases had stage 1 AKI, stage 2 acute kidney injury was found in 16.6 % of cases and stage 3 acute kidney injury developed in 6.8 % of cases. Among total babies, 77.1% of the babies had hyponatremia while 9.7% of the babies had hyperkalemia. Out of 160 babies who were followed till outcome, 90% discharged while 10% of them died. Conclusion: Perinatal asphyxia is an important cause of renal dysfunction which plays an important role in mortality and morbidity of the asphyxiated newborn. Early diagnosis and management of AKI in babies with perinatal asphyxia can improve their outcome. Electrolyte disturbance in the form of hyponatremia and hyperkalemia is also an important derangement in babies with birth asphyxia which needs accurate and careful management for better outcome.

Effect of γ-tocopherol supplementation on premenstrual symptoms and natriuresis: a randomized, double-blind, placebo-controlled study

BackgroundThis randomized, double-blind, placebo-controlled study aimed to investigate the effects of γ-tocopherol (Toc) supplementation on premenstrual symptoms and natriuresis.MethodsWe enrolled 51 Japanese women with premenstrual symptoms, particularly those who showed increased symptoms induced by water retention during the luteal phase compared with the follicular phase. Premenstrual symptoms were recorded in the first cycle’s postmenstrual follicular phase; physical measurements and urine collection were conducted during the 48-h run-in period. The test supplement, which contained 180 mg of γ-Toc or placebo, was orally administered twice a day for 7 days during the luteal phase of the first and second cycles in a crossover manner. The same evaluation was conducted during the luteal phase, beginning in the morning of the sixth day of supplement administration.ResultsCompared with placebo intake, γ-Toc intake significantly reduced “fatigue” and “irritability/anger” symptoms. Furthermore, compared with placebo intake, γ-Toc intake significantly reduced the thigh circumference. Regarding the “swelling of the legs” and “heavy legs” symptoms and the thigh circumference, the biphasic trend of increasing and decreasing values in the daytime and morning, respectively, during the follicular phase was not observed at the luteal phase with placebo intake. Contrastingly, γ-Toc intake resulted in significantly lower values in the morning than placebo intake. The mean difference in 24-h urinary sodium excretion between γ-Toc and placebo intake was 10.6 mEq (95% confidence interval (CI): -0.1, 21.4, p = 0.05, power 55%). Plasma γ-Toc and its metabolite γ-carboxyethyl hydroxychroman (CEHC) levels were significantly higher with γ-Toc intake than with placebo intake. There were no significant between-supplement differences in serum electrolyte levels or cumulative urinary potassium excretion.Conclusionγ-Toc intake could effectively alleviate certain premenstrual syndrome symptoms, particularly those related to water retention during the luteal phase. Furthermore, the underlying mechanism may involve the diuretic effect of γ-CEHC, which is a γ-Toc metabolite.Trial registrationUMIN000047989; registration date: 10/06/2022, retrospectively registered.

Metabolic Kinetics: A Predictor for Encephalopathy, Seizure, and Stroke in Patients Hospitalized with SARS-CoV-19? (P4-10.005)

<h3>Objective:</h3> To investigate the effect of maximum serum electrolyte levels and their rate of change as a predictive factor for encephalopathy, seizure and stroke in patients hospitalized with SARS-CoV-2 infection. <h3>Background:</h3> Among patients hospitalized with SARS-CoV-2, serum electrolyte levels and select markers have been shown to predict morbidity and mortality. However, an association between peak electrolyte values and their rate of change with the prevalence of severe neurological complications has not been completely characterized. <h3>Design/Methods:</h3> A retrospective analysis on 907 patients hospitalized with SARS-CoV-2 between April 2020 and March 2021 was conducted. Rate of change and peak values were evaluated for sodium, potassium, phosphorus, blood urea nitrogen, and creatinine in each patient. Correlations between electrolyte values and the presence of encephalopathy, seizure, or stroke were then determined and assessed for significance. <h3>Results:</h3> Serum electrolyte values above the normal range were associated with a significant increase in the prevalence of encephalopathy for all electrolytes evaluated (p&lt;0.0001). The rate of change of potassium was significantly different in patients with encephalopathy compared to those without (p&lt;0.01). Patients with a peak serum phosphorus level greater than 4.5 mg/dL had a significantly higher number of seizures when compared to those with phosphorus levels within the normal reference range (5.4% vs 1.9%, p&lt;0.05). Patients with a peak serum BUN ≥30 mg/dL or peak serum creatinine ≥1.1 mg/dL had a significantly higher prevalence of stroke compared to patients with a BUN or creatinine within the normal reference range (4.2% vs 0.72%, p&lt;0.01, 2.9% vs 0.83%, p&lt;0.05 respectively). <h3>Conclusions:</h3> These results suggest that the kinetics of select serum electrolytes correlate with a significant increase in the prevalence of encephalopathy, seizure and stroke in patients hospitalized with SARS-CoV-2 infection. Further studies that control for confounding variables are needed to validate serum kinetics as a predictive tool for neurological complications in these patients. <b>Disclosure:</b> Mr. Ahmed has nothing to disclose. Mr. Azhar has nothing to disclose. Mr. Ahmed has nothing to disclose. Mr. Ahmed has nothing to disclose. Ms. Azhar has nothing to disclose. Dr. Souayah has received publishing royalties from a publication relating to health care.

Serum Electrolytes in Patients Presenting With Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) and Their Comparison With Stable COPD Patients.

Introduction Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, which may be further aggravated by episodes of acute exacerbationof COPD (AECOPD). Electrolyte imbalances during these episodes may add to the duration of hospitalization and disease outcome. Aims and objectives This study aims to compare the serum electrolyte levels of patients with AECOPD and stable COPD and correlate them with the severity of exacerbation and disease outcome. Materials and methods The study was conducted as a case-control study between January 2021 and December 2022. Patients with AECOPD and stable COPD were included as "cases" and "controls," respectively. The various serum electrolyte levels were defined as per recent guidelines. Statistical analysis was performed using SPSS 20.0 (IBM Corp., Armonk, NY). Results A total of 75 patients wereincludedwith 41 in the study group and 34 in the control group. The majority of people were between the ages of 61 and 70. The most frequent electrolyte abnormality found was hyponatremia.The mean serum sodium and calcium levels were lower in patients with AECOPD while the mean serum potassium levels were higher. A total of five deaths were recorded in patients with two or more electrolyte imbalances. The latter also had a requirement for home oxygen or non-invasive ventilation at the time of discharge. Conclusion Patients of AECOPD with multiple electrolyte imbalances need scrutinized treatment as they are more prone to develop complications, have poorer outcomes, and prolonged hospital stays.