‘’TO EVALUATE ACID-BASE DISTURBANCES IN ACUTE DIARRHEAL ILLNESS’
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Abstract
Introduction- Diarrhea can cause a variety of fluid volume, acid-base and electrolyte abnormality which can cause disruption of various organs functioning and also complicate the disease itself to contribute it to morbidity and mortality.
Maintenance of Acid- base balance requires the cooperation of three major organs: liver, kidneys and lungs. So, it can be said that the disease of these organs can contribute to an important proportion of acid- base disturbances.
Aims and objectives- Main aim of study is ‘’To evaluate acid-base disturbances in acute diarrheal illness’’.
An observational study was conducted on 96 patients admitted in general ward at Department of Medicine, G.R. Medical College and JAH Group of hospitals, Gwalior. These patients were assessed at the time of admission by a detailed history taking and duration of illness also giving due importance to comorbidities like diabetes, chronic renal disease, COPD, any drug history, etc. A thorough clinical examination was done for patients which included general examination, vitals, and other systemic examinations.
Results- Among the studied 96 patients, maximum cases belong to the two age groups 20-29 years and 40-49 years with mean age 40.08. Out of studied 96 patients, 50 were males and 46 were females. Among diarrheal illness patients, 88 were having duration of illness <7 days and 8 patients were having duration ≥ 7days. Out of 96 patients, 56.3% of study participants were severely dehydrated, 28.1% were moderately dehydrated and only 15.6% were mildly dehydrated. Among diarrheal illness patients, it was observed that Sinus tachycardia, sinus tachycardia with U wave and with flat T wave was found statistically associated. Majority of ECG changes were found in severely dehydrated patients. Out of 96 patients, it was found that 31.3% participants were having metabolic acidosis and only 6.3% were having high anion gap in ABG analysis.
Conclusion- The most common acid-base abnormality apart from normal ABG study, observed in patients with acute diarrheal disease is NORMAL ANION GAP METABOLIC ACIDOSIS. Increased anion gap metabolic acidosis is the acid-base abnormality observed in post diarrheal ARF. In acute diarrheal illness and post diarrheal acute renal failure, metabolic acidosis is a prognostic factor and its outcome can be improved with early recognition and correction.
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Dr. Divya
Senior Resident, Department Of General Medicine, Ssmc Rewa