Background: Diabetic ketoacidosis (DKA) is characterized by a spectrum of clinical manifestations due to deficiency of insulin which results in hyperglycemia, ketonemia with ketonuria, and metabolic acidosis. Administration of insulin inhibits the production of keto acids and facilitates their metabolism, thereby helps in correcting the acidosis. However, in some situations, the acidosis takes longer to get corrected. Objectives: The aim of this study is to evaluate the factors at admission predicting the duration of acidosis in a child presenting with DKA. Methods: Study Type: This was a retrospective case record review. Inclusion Criterion: All children <15 years who were admitted under the pediatric intensive care unit of a tertiary care hospital from April 2012 to January 2016 with DKA were included in this study. Their demographic data, investigations, treatment details, and length of hospital stay were noted in a predesigned pro forma. Prolonged acidosis was defined as acidosis taking longer than 24 h to resolve. Results: Forty-eight cases met the inclusion criteria; of the 48 cases, 27 (56%) had prolonged acidosis. The median duration of correction of acidosis was 31 h (interquartile range 18.75-48 h/range of 6-192 h). On univariate analysis, children with prolonged acidosis had a low pH (7.1 vs. 7.25), a low serum bicarbonate (4.69 vs. 7.49 mEq/L), base excess (?22.7 vs ?17.04), a high total leukocyte count (TLC) (24,275 vs. 13,557 cells/mm3), and platelet count (450,651 vs. 316,140 cells/mm3) at admission (t-test, p<0.05). On stepwise logistic regression analysis, only low pH and a high TLC were associated with prolonged acidosis.The presence of rhabdomyolysis and myocardial impairment and degree of dehydration at admission which could contribute to prolonged acidosis were not measured in this study. Conclusion: Prolonged acidosis (lasting more than 24 h) was associated with a high TLC and a low pH at admission.

Aim: To observe the variation of the body temperature after routine sponge bath in stable very low birth weight preterm babies. Methods: 74 babies admitted to the neonatal intensive care unit (NICU) of a tertiary care teaching hospital were enrolled. The inclusion criteria were babies with corrected gestational age between 28 and 36 weeks, birth weight <1500 g during postnatal age of 14-28 days who were stable, on full feeds. All babies were in incubator at preset temperature. The babies received sponge bath within the incubator as a part of developmental care by a trained nurse. The axillary temperatures before bath and at 15, 30 and 60 min post bath were measured. The mean differences between the temperature before bath and after bath were analyzed using repeated measures analysis of variance. A p<0.05 was considered significant. Results: None of the babies receiving sponge bath developed hypothermia. There was a drop in the axillary temperature at 15 min post bath as compared to the temperature before bath (p=0.00, mean difference=?0.174°F, 95% confidence interval=0.119-0.229). Subsequently, there was a rise in temperature at 30 min and the temperature normalized by 60 min after bath. The differences in temperature before and 15 min post bath were uniformly significant across all weight groups. Conclusion: Routine sponge bath in stable preterm babies causes a transient drop in temperature but does not lead to hypothermia. As it is a relatively simple technique and incorporates developmental care, it can be used as a part of routine care of stable preterm babies.