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What Is The Significance Of Vomiting In A Child Who Has Dka

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Red Flag Symptoms: Vomiting In Children, Assessment And Possible Causes

Red flag symptoms Bilious vomiting Haematemesis Recurrent vomiting Projectile vomiting in the first few weeks of life Early morning headache Lethargy Bulging fontanelle Peritonism Poor growth/abnormal development Weight loss Abdominal tenderness and/or abdominal mass Vomiting is a common symptom in children, often associated with a self-limiting viral GI infection. Vomiting may be preceded by the sensation of nausea, this may be associated with autonomic symptoms such as sweating and pallor. Nausea does not always precede vomiting, for example, in rumination syndrome where there is oral regurgitation of food. Moreover, vomiting does not necessarily follow nausea, for example, in functional dyspepsia where there is early satiety. Careful history-taking and examination are needed to assess hydration status and whether urgent management is needed. Vomiting may be defined as an autonomic response causing forceful expulsion of gastric or intestinal contents from the mouth. This forceful expulsion is accompanied by an increase in intra-abdominal pressure. This should be differentiated from regurgitation - effortless return of contents. Posseting describes the small amount of milk that of Continue reading >>

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  1. j

    Keto diet while nursing

    My SIL is doing the Ketogenic Diet (low carb/high fat) and is having great results. I was overweight before getting pregnant, and now have even more to lose. I'm thinking of trying the diet but am wondering how it will affect breastfeeding. I've heard it might not be good for baby if your body is in ketosis, but I'm having a hard time finding solid info either way. Anyone have any experience with this?

  2. Mareeena

    I'm doing something similar but a breastfeeding friendly variation... Basically Atkins 20 is not safe for breastfeeding but Atkins 40 is. I think it's important while nursing to eat balanced so I still eat the recommended servings of fruit a day and some whole grains. I try for lower sugar fruits like berries. For grains I do oats and then a small bowl of kashi go lean cereal (the cinnamon crunch kind is amazing)
    So basically I try and eat balanced for the sake of my milk and just reduce my net carbs while trying to eat as much protein and fiber as possible.
    As for your question is keto specifically safe? I don't personally think so.
    I'm not counting carbs and I'm eating a good amount of fat (meats, eggs, cheese)

    I've lost 7lbs the past 9 days and haven't exercised much during that time (baby is teething I'm tired)

  3. Mareeena

    Sorry when I said I'm not counting carbs I meant I'm not counting calories!!'

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Clinical Characteristics Of Diabetic Ketoacidosis In Children With Newly Diagnosed Type 1 Diabetes In Addis Ababa, Ethiopia: A Cross-sectional Study

Abstract Diabetic ketoacidosis (DKA) is one of the most serious acute complications of type 1 diabetes (T1D) and the leading cause of morbidity and mortality in children with T1D. This study was aimed at assessing the prevalence and associated factors of DKA in children with newly diagnosed T1D in Addis Ababa. Methods A hospital based cross-sectional study was conducted in selected hospitals in Addis Ababa. Children below the age of 12 years with DKA who were admitted to the pediatric ward in the selected hospitals between January 2009 and December 2014 and the residence of Addis Ababa were included. DKA was defined as children below the age of 12 years who have blood glucose level ≥250mg/dl, ketonuria, and ketonemia and diagnosed being T1D patient for the first time. Descriptive statistics was performed using frequency distribution, mean, median, tables, and graphs. Logistic regression analysis was used to identify independent factors associated with the prevalence of DKA in children with newly diagnosed T1D. Of 395 DKA patients who were hospitalized during the five-year period, 142(35.8%) presented with DKA at first diagnosis of diabetes. On the other hand 253 (64.2%) children Continue reading >>

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  1. bbearsmama

    Ketones found in urine-is our diet bad for our kidneys?

    Hi there-
    I went to see my PCP for a urinary tract infection today and she said there was a lot of stuff in my urine-ketones, blood (which is always there-which is why I also see a nephrologist), and some protein. She thinks the ketones are because of my high protein diet and she told me to try to eat a more balanced diet (more carbs, fruits, veggies). How is this possible with such a tiny pouch? Has this happened to anyone else and if so-what did you do? Is it dangerous to have ketones in your urine? I do worry about my kidney function. My nephrologist likes to do labwork (blood/urine) every 6 months to keep an eye on things. He doesn't think my labs have warranted doing a kidney biopsy at this point. The last time I saw the nephrologist was before my RNY. I just don't want my diet to be damaging to my kidneys.
    Has this happened to anyone--kidney damage as a result of the post-op diet? I know that it will be easier to eat a more balanced diet as a I get further out, right?
    Thank you all for your advice and help!
    Sincerely,
    Pam

  2. RainbowRN

    I know that when the atkins diet was really popular, more people started talking about ketones in the urine. The big deal about it is that protein molecules are actually really big and more difficult for the kidneys to filter. Therefore the kidneys can be damaged overtime. Now, I'm not sure about how long it takes or how much protein it would take to do that. All I know is that, last year before I even considered WLS, my NUT put me on a protein sparing modified fast. It was a diet that was primarily protein only. It was very high amounts of protein. Greater than 140mg a day. I was told that I would do the diet for 3 months and then I had to go off of it for 3 months and then back on for three months simply because of the risk of damage to my kidneys. I don't consume that much protein since surgery. I try to make sure I get in 60mg a day. I would be curious to find out if kidney damage is a possibilty for us. In all my research I have not heard of that being a side effect.

  3. bbearsmama

    Before I had my surgery, I did talk to my nephrologist about the high protein diet and he thought it would be fine. He said that 60 g. of protein is really not that much. What is considered the "normal" intake of protein (for people who haven't had wls)? I think it's around 50 g. of protein. I'm not sure, though. And the reality is-I struggle to get 60 g. in per day. Most days I don't even get there-it's more like 50 or 55 g.
    That is interesting about the protein molecules being big.
    Thank you so much for your reply!
    Pam :)

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Management Diabetic Ketoacidosis

Management Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) is a metabolic derangement caused by the absolute or relative deficiency of the anabolic hormone insulin. Together with the major complication of cerebral edema, diabetic ketoacidosis is the most important cause of mortality and severe morbidity in children with diabetes, particularly at the time of first diagnosis. Early recognition and careful management are essential if death and disability are to be avoided. Insulin is the pivotal hormone of blood glucose regulation, increasing peripheral glucose uptake, switching off hepatic gluconeogenesis, while stimulating glycogen synthesis and peripheral fat deposition. Insulin deficiency exaggerates the normal response to fasting, which is to increase liver production of glucose by gluconeogenesis from fat and protein together with breakdown of liver glycogen stores by glycogenolysis. Peripheral glucose uptake is impaired and levels of the main counter-regulatory hormones (ie, glucagon, cortisol, catecholamines, growth hormone) increase. Various metabolic consequences follow.2 Glucagon stimulates glycogenolysis and gluconeogenesis, doubling liver glucose production. Hyperglycem Continue reading >>

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  1. doctorketo

    So after some Reddit lurking and reading up from some other sources, I decided to try Keto. I've already lost 10 pounds in 2 weeks, feel great, and last night I visited my doctor for a physical (medical forms). Upon taking the urine test, he seemed to be alarmed by the ketones in my blood, and he said they were acidic/poisonous to my body and my body was in "starvation mode". I definitely wasn't starved - I just enjoyed a steak salad for lunch and all my carb cravings have completely vanished. He said a balanced diet was healthier, and that the "acid" in my blood would make me tired, but I feel better and more energetic than ever before. He said that diabetics fall into comas as a result of excess Ketones, which also cause organ damage and cancer? We were able to agree on one thing though - all the ketones in my pee were a result of some serious fat burning, and that's enough to keep me motivated. I'm just looking for some clarification on how much of what he said was true, or just BS (he is a self-employed general physician, and I don't think he's very experienced in the dieting field). To be so convinced that Keto is the way to go and have a sudden conflicting opinion is pretty tough - I really hope I'm not killing myself with this.
    Edit: So it looks like he is confusing Ketosis with Ketoacidosis, which is when I am in an uncontrollable state of extreme/dangerous Ketosis. Thanks for the support and knowledge my friends, this will give me the confidence and motivation to continue!

  2. zeezle

    Ketosis is very dangerous... if you're on a high-carb diet. Because that means something's going really really wrong and your blood sugar is not being managed correctly; ketosis in that situation is a precursor to full-blown ketoacidosis. If you're eating 300g+ of carbs daily for a while and staying deep in ketosis, that's bad. Really bad. Because in that situation, your body absolutely should be burning glucose, and if it's not, well, that's no bueno, because that means the glucose is floating around in your bloodstream uncontrolled.
    But if you're on a low-carb diet, ketosis is perfectly safe and expected. In this situation, ketosis is a sign that your body is doing what it's supposed to be doing. There's no huge quantities of glucose to be managing, so ketosis is naturally what's going to happen. It's a sign that everything is exactly as it should be.
    He probably learned the bit above about ketosis being dangerous without the dietary carbohydrate qualifier, and has never learned more about it.
    Also, in a normal functioning human (a.k.a. not a diabetic), your blood pH will never go outside a narrow range. Your body will use minerals from your diet to buffer your bloodstream to keep it within a pH of 7.35 to 7.45. If it were to fall outside that range, it would be very dangerous (this is why diabetic ketoacidosis is dangerous); but that only happens with specific health problems and is not something any normal-functioning human needs to worry about. Your body will go to any lengths necessary to maintain that pH. That said, it is important to make sure you're getting enough of the buffering minerals (like calcium, and magnesium so that the calcium is being absorbed properly) in your diet, because your body WILL take it from whatever calcium source is available (like, say, your bones) if there's not enough of it in your diet.

  3. murderofcrows

    It is so vitally important that your blood pH stay in that narrow range, that if your body can't get the correct minerals from your diet, it will use the minerals it stores in your bones to get it. If you are consistently running an acidic pH in your blood, it can lead to osteoporosis later on in life. The body runs best when your blood pH is slightly alkaline.

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