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Pyrexia Two Weeks after an Attack of Alcohol-Induced Acute Pancreatitis
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Routine bloods were sent on readmission and this confirmed that serum lipase was elevated at > 4× upper limit of normal, now two weeks after initial admission. He also had a blood alcohol level of 280 mg/dL. Hematology revealed a hemoglobin of 132 g/L, total white blood count of 15.2 × 10-9/L, and a platelet count of 224 × 10-9/L. The hematocrit was 0.45. Electrolytes were normal but his renal function was impaired, with a blood urea nitrogen of 11 mmol/L (Normal range = 2.5–7.1). Liver function tests were normal other than a mildly elevated gamma glutamyl transferase. Random blood glucose was 11.2 mmol/L. An arterial blood gas confirmed hypoxemia and respiratory acidosis (pH 7.32, bicarbonate 30 mEq/L, partial pressure of carbon dioxide of 49 mmHg).
Enteral Feeding
Published in Susan Carmody, Sue Forster, Nursing Older People, 2017
In assessing a person’s dietary requirements and the type of enteral feed to be used, blood tests can be ordered to determine urea, electrolytes, albumin, total protein, creatinine, and blood glucose levels. After an initial assessment and stabilisation, biochemistry should be sought at least every six months to check for urea, electrolytes, albumin, and total protein. For diabetics, once the condition is stable, random blood glucose levels should be checked and recorded as needed.
Kidney Dysfunction in Older Adults with Diabetes
Published in Medha N. Munshi, Lewis A. Lipsitz, Geriatric Diabetes, 2007
Mark E. Williams, Robert C. Stanton
We recently reported the largest analysis of the benefit of glycemic control in diabetic ESRD. Half of type 1 and a third of type 2 ESRD patients were above the ADA glycemic HbAlc goal of 7% (60). Glycohemoglobin levels correlated only roughly with mean random blood glucose measurements, but appeared similar to the Diabetes Control and Complications Trial results. The study found no correlation between HbAlc levels and subsequent 12-month mortality risk. Clinical practice recommendations by the ADA acknowledge individual differences in the risks and benefits of glycemic control. Age, comorbidities, life expectancy, and the risk of hypoglycemia may affect diabetic ESRD glycemic targets. Older persons are at higher risk for drug-associated hypoglycemia (61) and have decreased symptom recognition, worse cognitive impairment, and attenuated physiologic counter-regulatory responses (62). The failure of these data to demonstrate the benefit of tight glycemic control may add to controversy regarding an aggressive glycemic control strategy in elderly diabetic ESRD patients. For those with limited levels of care, that is, reduced life expectancy, and functional and cognitive impairment, incapable of implementing a tight control program, with poor social support or dependent on nursing home care, treatment of symptomatic hyperglycemia may be indicated. Other elderly diabetics with ESRD may merit the more aggressive approach used in younger patients, to further prevent the chronic complications of diabetes.
Hyperglycaemia, diabetes mellitus and COVID-19 in a tertiary hospital in KwaZulu-Natal
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2022
We recommend that all patients hospitalised with COVID-19 have a random blood glucose performed on admission, as well as prompt active management of hyperglycaemia. The intended benefit is threefold. First, it may serve as a prognostic marker for severe disease and poorer outcome. Second, in those patients identified with hyperglycaemia, active glycaemic control measures can then be implemented to potentially avert the associated adverse consequences. Lastly, those patients with hyperglycaemia (and no history of DM) can be screened for DM – and more so if other risk factors are present. Further studies of such nature with larger cohorts need to be conducted to assess the strength of this association, as well as the effects of pre-hospital and in-hospital glycaemic control on COVID-19 outcomes in African populations. Additionally, although it has been suggested that COVID-19 may precipitate new-onset DM in the acute setting, there is a paucity of data regarding the long-term effects of this virus on glycaemic status.8 In this regard, further studies investigating the long-term effects will be forthcoming.
Lipid profile, random blood glucose and carotid arteries thickness in human male subjects with different ages and body mass indexes
Published in The Aging Male, 2020
Mohammed Elimam Ahamed Mohammed, Safar Alshahrani, Gaffar Zaman, Magbool Alelyani, Ibrahim Hadadi, Mustafa Musa
Blood glucose level is affected by the diet type and amount, psychological or physical stress due to the effect of stress hormones, dehydration, aging, uric acid to HDL ratio, during menstrual period because of the hormonal changes, hypoinsulinemia in Diabetes, and as side effect of steroids such testosterone and antipsychotic medications [22–24]. Random blood glucose concentration (≥100 mg/dl) is considered as one of the diabetes mellitus screening tests by the International Diabetes Federation and it should be confirmed by glucose tolerance test [25]. It was mentioned that the random blood glucose (≥100 mg/dl) is strongly associated with undiagnosed diabetes and it should be introduced as screening test for diabetes [26]. However, the diabetes mellitus is mostly accompanied by abnormal lipid metabolism like the primary hyper lipoproteinemia and hypertriglyceridemia [27].
Basidiobolomycosis complicated by hydronephrosis and a perinephric abscess presenting as a hypertensive emergency in a 7-year-old boy
Published in Paediatrics and International Child Health, 2018
Sriram Krishnamurthy, Rakesh Singh, Venkatesh Chandrasekaran, Gopinathan Mathiyazhagan, Meenachi Chidambaram, S. Deepak Barathi, Subramanian Mahadevan
In view of the severe hypertension, an intravenous infusion of sodium nitroprusside was commenced, which led to improvement in sensorium and transient restoration of blood pressure to normal limits. Subsequently, he required multiple antihypertensive agents (amlodipine, atenolol, clonidine and prazosin). Magnetic resonance imaging (MRI) of the cranium showed multiple cortical and subcortical areas of T2-weighted hyperintense signal involving the occipital and parietal lobes bilaterally. These features were consistent with the posterior reversible encephalopathy syndrome (PRES). Haemoglobin was 6 g/dl, total leucocyte count 8.8 × 109/L (55% polymorphs, 30% lymphocytes, 15% eosinophils) and platelet count was 550 × 109/L. Peripheral smear showed microcytic hypochromic anaemia with eosinophilia. Blood urea was 4.65 mmol/L (2.49–6.64) and serum creatinine 44.2 μmol/L (44.2–88.4). Random blood glucose was 7.00 mmol/L (<11.0). Chest radiograph was normal. HIV serology was negative. The immunoglobulin profile showed very high IgE levels (3720 IU/ml), but the IgA, IgM and IgG levels were normal. Urinalysis was normal (no haematuria or proteinuria).