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Background: Diabetic ketoacidosis (DKA) is a life-threatening condition of biochemical derangements comprising hyperglycemia, acidosis, and ketonemia. The study aimed to explore the prognostic impact of phosphate (Po4) and magnesium (Mg) levels on DKA-associated morbidity and mortality. Methods: Sixty-eight patients with DKA were admitted to the intensive care unit (ICU) in the Internal medicine Department in Zagazig University Hospital over the period of 6 months were evaluated serially for Po4 and Mg levels among other routine investigation. The patients were followed for the inhospital clinical outcome. Results: hyponatremia, HbA1c, random blood sugar (RBS), creatinine, urea, ICU stay, low pH, and hypophosphatemia showed a strong correlation with a mortality rate (P<0.001), while hypomagnesemia was insignificant. A positive correlation was noticed between Po4 and sodium (Na) level (P=0.004), whereas a negative correlation with RBS (P=0.001), HbA1c (P=0.001), creatinine (P=0.001), urea (P=0.001), and ICU stay duration (P=0.008). Hypophosphatemia had a 13-fold higher relative risk for mortality in DKA. Conclusion:We concluded that hypophosphatemia was an independent predictor of the DKA-associated mortality rate, and serial Po4 measurement should be considered in DKA treatment protocols .

Objectives: vehicle exhaust consists of many toxic components and professional drivers are occupationally exposed to vehicle exhaust during their routine daily work. Hence, the aim of the present study is to evaluate genotoxic and nephrotoxic risk of vehicle exhaust in professional drivers in Zagazig city, Al-Sharkia Governorate, Egypt. Subjects and Methods: A comparative cross sectional study was carried out on 33 professional drivers and 34 control office workers as non-exposed control group. A structured questionnaire was offered for all subjects through personal interview. Peripheral blood samples were collected from all participants for detection of chromosomal aberrations and measurement of blood lead level. Urine samples also were obtained from all participants for laboratory analysis to detect levels of B 2microglobulin, microalbumin and trans,trans-muconic acid. Results: A significant increase was observed in the percentage of chromosomal aberrations in non smoker and smoker professional drivers when compared to their respective control groups. Also a significant increase in the mean values of B2 microglobulin and microalbumin was observed in studied professional drivers when compared to their control. The results showed that professional drivers have significant higher blood lead level and urinary trans,trans-muconic acid level as compared to control group, with positive correlation to the duration of exposure. Conclusion: Thus the present study suggests that the induction of cytogenetic changes and renal damage might be due to the cumulative effect of smoking, lead toxicity,