No abstract

Background: DKA is the leading cause of mortality among pediatric age and young adults with T1D, responsible for almost 50% of all fatalities in diabetic patients younger than 24 years of age. Goals of DKA management include optimization of volume status, hyperglycemia and ketoacidosis, electrolyte abnormalities, and potential precipitating factors. Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1987, through February 2017. The following search terms were used: ketoacidosis, management of diabetic ketoacidosis, type I diabetic patients’ emergency complication, fluid replacement in DKA, insulin therapy approach. Aim: in this review, we aim at evaluating the various ways of approaching patients who suffer from type-one diabetes during ketoacidosis and keto-acidotic coma. We will try to understand the triggers and pathophysiology behind this condition, and explore ways to prevent them. Conclusion: prompt diagnoses, aggressive treatment, and education of patient and their care providers about prevention strategies must be implemented. Also, more studies are required in the area of preventing health complications due to these types of diseases to effectively manage DKA in the future.

Bile duct stones (BDSs) may happen in up to 4%-15% of all patients for whom cholecystectomy is performed. Patients giving CBDS have manifestations including: biliary colic, jaundice, cholangitis, pancreatitis or might be asymptomatic. It is critical to recognize essential and auxiliary stones, in light of the fact that the treatment approach shifts. Stones found some time recently, amid, and after cholecystectomy had likewise contrasting medicines. Distinctive strategies have been utilized for the treatment of CBDS yet the appropriate treatment relies on upon conditions, for example, quiet' fulfilment, number and size of stones, and the specialists involvement in laparoscopy. Endoscopic retrograde cholangiopancreatography with or without endoscopic biliary sphincterotomy, laparoscopic CBD investigation (transcystic or transcholedochal), or laparotomy with CBD investigation (by T-tube, C-tube inclusion, or essential conclusion) are the most regularly utilized strategies overseeing CBDS (Common bile duct stones). We will survey the pathophysiology of bile duct stones, finding, and distinctive procedures of treatment with particular concentrate on the different surgical modalities.

In spite of the fact that anemia is the most widely recognized systemic sign of inflammatory bowel disease (IBD), among the expansive range of extraintestinal malady complexities experienced in IBD, including joint inflammation and osteopathy, it has for the most part gotten little thought. In any case, as far as recurrence, as well as to its potential impact on hospitalization rates and on the personal satisfaction and work, sickliness is, in fact, a huge and expensive intricacy of IBD. Frailty is multifactorial in nature, the most predominant etiological structures being iron deficiency anemia (IDA) and anemia of a chronic disease. In a condition related to irritation, for example, IBD, the assurance of iron status utilizing normal biochemical parameters alone is insufficient. A more exact evaluation might be achieved utilizing new iron lists including reticulocyte hemoglobin content, the rate of hypochromic red cells or zinc protoporphyrin. While oral iron supplementation has generally been a backbone of IDA treatment, it has likewise been connected to a broad gastrointestinal reactions and conceivable infection compounding. Be that as it may, numerous doctors are as yet hesitant to administer iron intravenously, in spite of the wide accessibility of an assortment of new IV arrangements with enhanced safety profiles, and in spite of the proposals of worldwide master rules. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD.

Background: DKA is the leading cause of mortality among pediatric age and young adults with T1D, responsible for almost 50% of all fatalities in diabetic patients younger than 24 years of age. Goals of DKA management include optimization of volume status, hyperglycemia and ketoacidosis, electrolyte abnormalities, and potential precipitating factors. Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1987, through February 2017. The following search terms were used: ketoacidosis, management of diabetic ketoacidosis, type I diabetic patients’ emergency complication, fluid replacement in DKA, insulin therapy approach. Aim: in this review, we aim at evaluating the various ways of approaching patients who suffer from type-one diabetes during ketoacidosis and keto-acidotic coma. We will try to understand the triggers and pathophysiology behind this condition, and explore ways to prevent them. Conclusion: prompt diagnoses, aggressive treatment, and education of patient and their care providers about prevention strategies must be implemented. Also, more studies are required in the area of preventing health complications due to these types of diseases to effectively manage DKA in the future.