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Euglycemic diabetic ketoacidosis:A missed diagnosis

World Journal of Diabetes 2021年第5期12卷 514-523页

作者： Prashant Nasa sandeep chaudhary Pavan Kumar Shrivastava Aanchal Singh Department of Critical Care Medicine NMC Specialty HospitalDubai 7832United Arab Emirates Department of Endocrinology NMC Specialty HospitalDubai 7832United Arab Emirates Department of Internal Medicine NMC Specialty HospitalDubai 7832United Arab Emirates

Euglycemic diabetic ketoacidosis(DKA)is an acute life-threatening metabolic emergency characterized by ketoacidosis and relatively lower blood glucose(less than 11 mmol/L).The absence of hyperglycemia is a conundrum for physicians in the emergency department and intensive care units;it may delay diagnosis and treatment causing worse *** DKA is an uncommon diagnosis but can occur in patients with type 1 or type 2 diabetes *** the addition of sodium/glucose cotransporter-2 inhibitors in diabetes mellitus management,euglycemic DKA incidence has *** other causes of euglycemic DKA include pregnancy,fasting,bariatric surgery,gastroparesis,insulin pump failure,cocaine intoxication,chronic liver disease and glycogen storage *** pathophysiology of euglycemic DKA involves a relative or absolute carbohydrate deficit,milder degree of insulin deficiency or resistance and increased glucagon/insulin *** DKA is a diagnosis of exclusion and should be considered in the differential diagnosis of a sick patient with a history of diabetes mellitus despite lower blood glucose or absent urine *** diagnostic workup includes arterial blood gas for metabolic acidosis,serum ketones and exclusion of other causes of high anion gap metabolic *** DKA treatment is on the same principles as for DKA with correction of dehydration,electrolytes deficit and insulin *** dextrosecontaining fluids should accompany intravenous insulin to correct metabolic acidosis,ketonemia and to avoid hypoglycemia.

关键词： Diabetic Ketoacidosis Sodium/glucose co-transporter-2 inhibitors Pregnancy with diabetic ketoacidosis Diabetes complications Pregnancy in diabetes Ketosis Metabolic acidosis

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Comparative study of outcomes following laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in morbidly obese patients: A case control study

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World Journal of Gastrointestinal Endoscopy 2017年第4期9卷 162-170页

作者： Harshit Garg Pratyusha Priyadarshini sandeep Aggarwal Samagra Agarwal Rachna chaudhary Department of Surgical Disciplines All India Institute of Medical Sciences Department of Medicine All India Institute of Medical Sciences

To compare the impact of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) on weight loss and obesity related comorbidities over two year follow-up via case control study design. METHODSForty patients undergoing LRYGB, who completed their two year follow-up were matched with 40 patients undergoing LSG for age, gender, body mass index and presence of type 2 diabetes mellitus (T2DM). Data of these patients was retrospectively reviewed to compare the outcome in terms of weight loss and improvement in comorbidities, i.e., T2DM, hypertension (HTN), obstructive sleep apnea syndrome (OSAS), hypothyroidism and gastroesophageal reflux disease (GERD). RESULTSPercentage excess weight loss (EWL%) was similar in LRYGB and LSG groups at one year follow-up (70.5% vs 66.5%, P = 0.36) while it was significantly greater for LRYGB group after two years as compared to LSG group (76.5% vs 67.9%, P = 0.04). The complication rate after LRYGB and LSG was similar (10% vs 7.5%, P = 0.99). The median duration of T2DM and mean number of oral hypoglycemic agents were higher in LRYGB group than LSG group (7 years vs 5 years and 2.2 vs 1.8 respectively, P < 0.05). Both LRYGB and LSG had significant but similar improvement in T2DM, HTN, OSAS and hypothyroidism. However, GERD resolved in all patients undergoing LRYGB while it resolved in only 50% cases with LSG. Eight point three percent patients developed new-onset GERD after LSG. CONCLUSIONLRYGB has better outcomes in terms of weight loss two years after surgery as compared to LSG. The impact of LRYGB and LSG on T2DM, HTN, OSAS and hypothyroidism is similar. However, LRYGB has significant resolution of GERD as compared to LSG.

关键词： Bariatric surgery Laparoscopic sleeve gastrectomy Laparoscopic Roux-en-Y gastric bypass Weight loss Comorbidities

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Rice straw recycling: A sustainable approach for ensuring environmental quality and economic security

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Pedosphere 2023年第1期33卷 34-48页

作者： Anjani KUMAR Amaresh Kumar NAYAK sandeep SHARMA Ansuman SENAPATI Debasis MITRA Bipasa MOHANTY Seenichamy Rathinam PRABHUKARTHIKEYAN Kuttalingam Gopalasubramanian SABARINATHAN Indra MANI Rajendra Singh GARHWAL Sugitha THANKAPPAN Mahapatra Smruthi SAGARIKA Sergio DE LOS SANTOS-VILLALOBOS Periyasamy PANNEERSELVAM Crop Production Division Indian Council of Agricultural Research(ICAR)-National Rice Research InstituteCuttackOdisha 753006India Department of Soil Science Punjab Agricultural UniversityPunjab 141027India Department of Plant Pathology Agricultural College and Research InstituteTamil Nadu Agricultural UniversityKillikulamTuticorin 628252India Division of Agricultural Engineering ICAR-Indian Agricultural Research InstitutePusaNew Delhi 110012India Collage of Agriculture Chaudhary Charan Singh Haryana Agriculture UniversityHisarHaryana 125004India School of Agriculture and Biosciences Karunya Institute of Technology and SciencesCoimbatoreTamil Nadu 641141India Laboratorio de Biotecnología del Recurso Microbiano Instituto Tecnológico De SonoraSonora 85000México

One of the major challenges in Asian countries is the effective management of rice *** ensure food security for their ever-growing population,Asian countries grow more rice,leading to increasing rice straw *** of rice straw,a common practice,is detrimental to both environmental and human ***,if managed effectively,rice straw has the potential to safeguard the sustainability of agricultural ecosystems and to uplift the economic security of the population depending on rice *** management of rice straw involving minimum soil disturbance along with retention of residues alters the soil carbon cycle through reduced carbon emissions and increased levels of total soil organic *** alternative uses of rice straw,such as production of livestock feed,bioethanol,biochar,biogas,electricity,mushroom,and paper,can add prosperity to rice farmers’life by fetching extra *** is evident that efficient management of rice straw is of enormous economic ***,it is essential to create awareness among the different rice stakeholders of these alternative economic avenues associated with rice *** review is an attempt to provide effective options for sustainable rice straw management and rice straw value chains for harnessing its economic *** further identifies gaps in our understanding of the effects of rice straw on ecological sustainability,particularly concerning the multifaceted connections between the diverse mechanisms of rice agro-ecosystems,which may greatly influence food security in the 21st century.

关键词： microorganism residue management rice straw burning rotation tillage value addition

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