Spectrum of clinical and biochemical profile and its importance in diabetic ketoacidosis: a tertiary care hospital experience in Gujarat

Background: Diabetes mellitus (DM) is a disorder of multiple etiologies, and diabetic ketoacidosis (DKA) is one of the life-threatening complications of DM. This study was aimed to study the clinical and biochemical profile of DKA patients. Methods: We conducted this retrospective study at a tertiary care hospital in Gujarat. We included total 100 patients above the age of 18 years having DM, presented with DKA. A detailed history, clinical examination and biochemical tests were carried out: random blood sugar, urinalysis, arterial blood gas analysis, serum ketone, HbA1c, serum creatinine, serum electrolytes- potassium and sodium and serum osmolality. The results were analysed using Microsoft excel. Results: Out of total 100 patients, 76 (76%) patients had type 1 DM and 24 (24%) had type 2 DM, 42 (42%) were in the age group of 18-30 years. The mean age was 39.75±12.14 years. There were 56 (56%) males and 44 (44%) females with male: female ratio of 1.3:1. Most common clinical features of DKA were nausea/vomiting (88%), breathlessness (43%) and fever (35%). The main biochemical parameters altered were blood sugar (>400 mg/dl in 41%) and serum ketones (≥5 in 84%) as well as majority of patients (64%) had their HbA1c level between 11-15% with the mean HbA1c value of 12.25±2.43%. Conclusions: DKA is a frequently observed emergency with high mortality rate. Education regarding symptoms of ketoacidosis, not missing insulin doses especially during illness, strict adherence to treatment and lifestyle modifications can greatly reduce DKA occurrence

A study of prevalence and morphology of various types of leukemia’s at a tertiary care centre (Dhiraj Hospital) Piparia Vadodara

Introduction: Haematological malignanacy comprises a major health problem due to its high mortality and morbidity. A progenitor cells either becomes a myeloid or lymphoid progenitor cell. The various types of hematological malignancies can be grouped according to which pathway they travel. It is important to identify haematological maliganancies for prognosis and management lacunae for better risk assessment and treatment. Method: All cases with abnormal hematological findings (200 sample size) from different departments were sent to the central laboratroy. According to clinical information, hematological findings and morphologic appearance of the malignant cells, types of leukemia was diagnosed. Result: Out of the 200 patients, 120 had acute leukemia, which was the most common type. The present study shows that the majority of patients having leukemia have hemoglobin in the range of 6.1-9.0 gm/dl, WBC count in the range of 51,000-1,00,000 and platelet count <50,000. Conclusion: The observation made from the study has shown maximum number of cases in the age group of 41-60 years and with male predominance. Among all leukemias, CML is the most common malignancy in the study