Title: Acid - Base Imbalance and Dyselectrolytemia in Malaria
Authors: T.N. Dubey, Nikhil Gupta
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.95
Abstract
Introduction: Electrolyte imbalance and acid base imbalance is a common complication in severe infectious disease including malaria. The aim of this study was to evaluate the acid base and electrolyte imbalance in malaria.
Material and Methods: This descriptive observational study was carried out from March 2015 to Aug 2016 in department of medicine Gandhi medical college Bhopal. All malaria positive cases admitted in medical ward and who were willing to participate were enrolled the study and those patient who received i/v fluid before admission and associated with co morbid condition like copd acute exacerbation, diabetic ketoacidosis, chronic renal failure etc. Were excluded from the study. Serum electrolyte were analyzed using flame emission spectro photometric method and ABG analysis by ESCHWELER COMBISYS II.
Results: Out of 100 malaria positive cases[P. Vivax(39), P. Falciparum(46), Mixed infection(15)] hyponatremia, hypokalemia, hyperkalemia was observed 27%, 9%, 14% respectively. And metabolic acidosis and respiratory acidosis were observed as 17%, 3%, respectively and P. Falciparum had most common dyselectrolytemia [hyponatremia(16/46), hypokalemia(3/46), hyperkalemia(11/46)] and acid base imbalance[M.acidosis(12/46), M.alkalosis(3/46), R.acidosis(1/46)].
Conclusion: This study was aimed to electrolyte and acid base imbalance, hyponatremia was most commonly associated with pl.falciparum wherein most patients had moderate hyponatremia.The most common complicatin of severe malaria was acute renal failure.And this was associated with hyperkalemia.Among the acid base imbalances ,the most commonly observed was metabolic acidosis which had a very high correlation with falciparum malaria, other acid base imbalances common in decreasing order were metabolic alkalosis and respiratoryacidosis.
Keywords: Malaria, electrolyte imbalance, acid-base imbalance, hyponatremia, hyperkalemia, hypokalemia, metabolic acidosis, metabolic alkalosis, respiratory acidosis.
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