BACKGROUND: Atrial fibrillation (AF) is a prevalent arrhythmic condition resulting in increased stroke risk and is associated with high mortality. Electrolyte imbalance can increase the risk of AF, where the relationship between AF and serum electrolytes remains unclear.
METHODS: A total of 15,792 individuals were included in the observational study, with incident AF ascertainment in the Atherosclerosis Risk in Communities (ARIC) study. The Cox regression models were applied to calculate the hazard ratio (HR) and 95% confidence interval (CI) for AF based on different serum electrolyte levels. Mendelian randomization (MR) analyses were performed to examine the causal association.
RESULTS: In observational study, after a median 19.7 years of follow-up, a total of 2551 developed AF. After full adjustment, participants with serum potassium below the 5th percentile had a higher risk of AF relative to participants in the middle quintile. Serum magnesium was also inversely associated with the risk of AF. An increased incidence of AF was identified in individuals with higher serum phosphate percentiles. Serum calcium levels were not related to AF risk. Moreover, MR analysis indicated that genetically predicted serum electrolyte levels were not causally associated with AF risk. The odds ratio for AF were 0.999 for potassium, 1.044 for magnesium, 0.728 for phosphate, and 0.979 for calcium, respectively.
CONCLUSIONS: Serum electrolyte disorders such as hypokalemia, hypomagnesemia and hyperphosphatemia were associated with an increased risk of AF and may also serve to be prognostic factors. However, the present study did not support serum electrolytes as causal mediators for AF development.

UNASSIGNED: Ascorbic acid (AA) is a water-soluble vitamin that is well known for its antioxidant and immune-boosting properties. Owing to the wide-range application of AA in the treatment of numerous ailments and its sweet taste, it is usually abused i.e. overused. However, the effect of the abuse has rarely received attention. Therefore, this study was designed to assess the effect of oral administration of high-dose ascorbic acid on biochemical and haematological parameters as well as the effects on the kidney, liver and lungs.
UNASSIGNED: adult guinea pigs were divided into four (4) groups where group 1 served as the untreated control group and groups 2-4 were dosed with 29 mg, 662 mg and 1258 mg of ascorbic acid per day, respectively for 28 days.
UNASSIGNED: the result revealed that administration of high dose ascorbic acid significantly (P<0.05) increased serum creatinine from 50.0 ± 7.09 (NC) to AA29- 73.8 ± 4.5, AA-662-89.7 ± 3.3 and AA1258- 79.9 ± 5.7mmol/L and urea levels in the treatment group AA-1258 -18.3 ± 0.5 µmol/L compared to the normal group (NC-2.15 ± 0.6 µmol/L). Disturbance in electrolyte balance was observed with a significant (P<0.05) increase in Na+ from NC- 131.3 ± 3.5 mmol/L to 135.7 ± 3.6 mmol/L in the AA-1258 treatment group, Cl- ( NC- 67.1 ± 1.6 mmol/L increased to AA29- 92.1 ± 0.83, AA662- 95.3 ± 1.3 and AA-1258- 95.6 ± 0.4 mmol/L), and Ca2+ (NC- 2.66 ± 0.03 to AA1258- 3.36 ± 0.03 mmol/L) and a significant (P<0.05) decrease in serum K+ in the AA29-5.0 ± 0.2, AA662-5.2 ± 0.3 and AA1258-5.6 ± 0.3 mmol/L treatment groups compared to the normal group 6.6 ± 0.3 mmol/L. There was also a significant (P<0.05) increase in the differential blood count in the animals with a significant (P<0.05) increase in red blood count ( NC-5.11 ± 0.13 ×106/µL to AA1258- 5.75 ± 0.11×106/µL ), haematocrit count (NC 39.90 ± 0.52% to AA-29-42.08 ± 0.24 and AA1258-46.13 ± 0.86%), white blood count (NC 10.15 ± 1.01 ×103/µL to AA1258- 15.18 ± 1.65×103/µL ), total lymphocytes (NC 3.5 ± 0.51×103/µL to AA29-5.28 ±0.43×103/µL), monocytes (NC 0.45 ± 0.07×103/µL to AA1258 0.80 ± 0.07×103/µL), eosinophils (NC 0.23 ± 0.03×103/µL to AA12580.40 ± 0.03×103/µL), basophils (NC0.68 ± 0.10×103/µL to AA12581.20 ± 0.10×103/µL) and neutrophil count (NC 4.73 ± 0.68×103/µL to AA1258 8.36 ± 0.71×103/µL). The histopathological indices indicate cellular necrosis in the AA662 and AA1258 treatment groups of the kidney and liver respectively compared to the normal control which has normal cells.
UNASSIGNED: high dose of ascorbic acid can therefore be suggested to cause damage to the cells by causing cellular necrosis as observed in the histopathology results and has effect on the blood cells as observed in the increase compared to the normal control, and the consequences are possibly triggered through inflammatory responses.

UNASSIGNED: This study aims to investigate the impact of maternal albumin and serum electrolyte levels on the efficacy of single-dose methotrexate (SDMtx) therapy for ectopic pregnancies. Building on previous research, recommendations are provided to enhance the success of SD-Mtx therapy in the management of ectopic pregnancy.
UNASSIGNED: Conducted at a tertiary center gynecology clinic, the study included 353 patients diagnosed with ectopic pregnancy and treated with SD-Mtx from 2012 to 2023. Patients who responded positively to SD-Mtx treatment comprised Group 1 (n=313), while those requiring surgical intervention due to failed SD-Mtx therapy constituted Group 2 (n=40). Through the hospital\'s digital database, patient data including complete blood count, biochemistry, and hormone test results were retrospectively examined.
UNASSIGNED: The mean β-hCG value was 1996 IU/mL for Group 1 in contrast to 2058 IU/mL for Group 2. There was no statistically significant difference in β-hCG levels between the two groups. Notably, Group 1 patients exhibited lower serum magnesium levels but higher potassium levels compared to Group 2 patients, with statistically significant differences. Furthermore, Group 1 patients had higher albumin levels than those in Group 2, with a statistically significant difference.
UNASSIGNED: Successful SD-Mtx treatment was associated with lower maternal serum magnesium levels and higher potassium and albumin levels. Considering electrolyte levels before administering SD-Mtx and addressing any imbalances could potentially enhance treatment success. Additionally, restoring low albumin levels might improve the efficacy of SD-Mtx treatment for ectopic pregnancies. While this study suggests these trends, further extensive studies with a larger sample size are necessary to establish more definitive evidence.

BACKGROUND: The WHO has recognised iron deficiency anaemia (IDA) as the most common nutritional deficiency in the world, with 30% of the population being affected by this condition. The patient\'s glycemic status during the past three months is shown by the glycated haemoglobin A1C (HbA1c) test. According to several studies, iron deficiency can increase HbA1C levels without affecting blood sugar levels. HbA1C levels of ≥ 6.5% have been approved by the American Diabetes Association (ADA) as a diagnostic indicator for diabetes mellitus (DM). An imbalance in serum electrolyte levels and anaemia have been linked by several studies.  Aim: To analyze the effect of iron deficiency anaemia on HbA1c levels and serum electrolytes in an adult non-diabetic population.
METHODS: This was a descriptive cross-sectional study conducted in Shri BM Patil Medical College, Hospital and Research Centre, Vijayapura, Karnataka, India from January 2021 to June 2022. A total of 65 moderate to severe normoglycemic iron deficiency anemia patients between 18 to 75 years were enrolled in the study after fulfilling inclusion and exclusion criteria. A detailed history, clinical and biochemical examination was performed including HbA1c levels. The results were pooled and statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY, USA).
RESULTS: We found elevated HbA1c levels (5.67±1.1%) in non-diabetic iron-deficient anaemia individuals, and elevation was more in women of reproductive age group (30.8%). There was a statistically significant Spearman negative correlation between hemoglobin and HbA1C levels. Also, 16 patients had hyponatremia with a mean haemoglobin (Hb) of 4.8 g/dL and one patient had hyperkalemia with a mean Hb of 3.2 g/dL which was statistically non-significant.
CONCLUSIONS: In this study haemoglobin and HbA1c had a statistically significant positive correlation with serum sodium and a negative correlation with serum potassium in moderate to severely iron-deficient anaemic patients, especially females of the reproductive age group.

There is a paucity of predictive models for uncontrolled diabetes mellitus. The present study applied different machine learning algorithms on multiple patient characteristics to predict uncontrolled diabetes. Patients with diabetes above the age of 18 from the All of Us Research Program were included. Random forest, extreme gradient boost, logistic regression, and weighted ensemble model algorithms were employed. Patients who had a record of uncontrolled diabetes based on the international classification of diseases code were identified as cases. A set of features including basic demographic, biomarkers and hematological indices were included in the model. The random forest model demonstrated high performance in predicting uncontrolled diabetes, yielding an accuracy of 0.80 (95% CI: 0.79-0.81) as compared to the extreme gradient boost 0.74 (95% CI: 0.73-0.75), the logistic regression 0.64 (95% CI: 0.63-0.65) and the weighted ensemble model 0.77 (95% CI: 0.76-0.79). The maximum area under the receiver characteristics curve value was 0.77 (random forest model), while the minimum value was 0.7 (logistic regression model). Potassium levels, body weight, aspartate aminotransferase, height, and heart rate were important predictors of uncontrolled diabetes. The random forest model demonstrated a high performance in predicting uncontrolled diabetes. Serum electrolytes and physical measurements were important features in predicting uncontrolled diabetes. Machine learning techniques may be used to predict uncontrolled diabetes by incorporating these clinical characteristics.

BACKGROUND: CBC (complete blood count) tests, along with RPM (Renal parameters) and LFT (Liver function tests), are clinically important for coronavirus patients; curcumin can serve as a possible treatment for SARS- CoV.
OBJECTIVE: The objective of the study was to determine the relationship of CBC parameters with renal parameters and liver function tests and to develop the hypothesis that curcumin may be the best and non-invasive drug for coronavirus. Materials &Methods: The differences between the results of 91 confirmed cases of covid-19 (symptomatic and asymptomatic) and 100 controls were assessed by an independent t-test and Mann-Witney U Wilcoxon test. Microscopy, hematological tools, and techniques were used to assess the improvements/abnormalities in blood components and parameters.
RESULTS: This is a case control study along with the feasibility of curcumin as covid treatment. The association between parameters was assessed by Pearson & Spearman correlation analysis. The level of significance was p<0.05. Changes were observed in urea (p=0.000), creatinine (p=0.02), total bilirubin (P=0.000), SGPT (ALT) (p=0.000), RBC (p=0.001), HGB (p=0.001), MCV (p=0.002), MCH (p=0.03), MPV, PDW, NE%, LY%, and MO% EO% (p=0.00), in comparison to normal controls. Differences in the correlation of electrolytes, RPM, and LFT tests along with CBC parameters in Pakistani and Chinese individuals provided a new idea for using various diagnostic and therapeutic tools in different ethnic groups. The covid-19 infected blood components and parameters showed rapid improvement/recovery, especially the total count of platelets and WBCs (lymphocytes and basophils), HGB, HCT, MCV, and MCH.
CONCLUSIONS: Curcumin drugs can be used as an immediate remedy/treatment to cure COVID-19 patients.

UNASSIGNED: To analyze the effects of continuous renal replacement therapy (CRRT) on acute physiology and chronic health scoring system II (APACHE-II) score, creatinine, and urea nitrogen levels in patients with acute kidney injury (AKI).
UNASSIGNED: Medical records of 79 patients with AKI treated in Shandong Provincial Third Hospital from January 2019 to January 2021 were retrospectively divided into two groups based on the received treatment. Of them 37 patients received intermittent hemodialysis (IHD) treatment (control group) and 42 patients received CRRT (observation group). Clinical efficacy, survival rate, severity of disease, renal function and serum electrolytels and fluid balance were analyzed.
UNASSIGNED: After the treatment, the total efficacy of the observation group was 95.24%, and the 6-month survival rate was 97.62%, which was higher than 81.08% and 83.78% in the control group, respectively (P<0.05). The Apache-II score of the observation group was (15.76±4.29), which was lower than that of the control group (23.62±5.37). Levels of creatinine, urea nitrogen, and serum levels of potassium (K+), chlorine (Cl-) and sodium (Na+) in the observation group were lower than those in the control group (P<0.05).
UNASSIGNED: CRRT can achieve significant results in the treatment of patients with AKI, help to improve the curative effect, survival rate, alleviate the severity of the disease, recovery of renal functions, the recovery of serum electrolytels and fluid balance.

OBJECTIVE: To evaluate possible interactions of magnesium sulfate-the drug of choice in the management of pre-eclampsia/eclampsia-in response to a few case reports that revealed maternal electrolyte disturbances, especially symptomatic changes, following magnesium sulfate administration in pre-eclampsia.
METHODS: Prospectively, women with pre-eclampsia were given 4 g of intravenous magnesium sulfate followed by a 2 g/h infusion up to 24 h after delivery. Sequential blood samples were drawn from each patient and used to measure the serum levels of sodium, potassium, calcium, phosphorus, magnesium, and parathyroid hormone.
RESULTS: A total of 30 pregnant women with pre-eclampsia were evaluated. They were aged between 20 and 41 years with median gestational age of 37.6 (interquartile range 35.4-38.9) weeks. Only five patients reached the therapeutic window of magnesium in at least one of our measuring intervals during magnesium sulfate infusion. Plasma magnesium concentrations increased significantly during magnesium sulfate administration and dropped during the next 12 and 24 h after infusion discontinuation (P < 0.05). Fifteen of 30 (50%) patients developed asymptomatic hypocalcemia, mainly at hour 24 of infusion. Negative moderate correlations were detected between the calcium and magnesium concentrations at 12 and 24 hours of infusion (ρ = -0.390, P = 0.044 and ρ = 0.315, P = 0.096, respectively). None of the patients with hypocalcemia reached the therapeutic level of magnesium or experienced parallel hyperphosphatemia. Eleven of 30 (36.6%) patients developed hyperphosphatemia mainly at 2 and 12 h of magnesium sulfate infusion.
CONCLUSIONS: Our study implies that magnesium sulfate could cause hypermagnesemia-induced hypocalcemia in women with pre-eclampsia, independent from parathyroid hormone. The negative correlations between calcium and magnesium concentrations could be indicative of dose-dependent associations between serum magnesium level and degree of hypocalcemia in our study.

BACKGROUND: SUSPPUP, calculated as serum sodium [Na+] to urinary Na+ divided by (serum potassium [K+]) 2 to urinary K+, is a composite electrolyte index that reflects renal Na+ retention and K+ excretion. It remains unclear whether SUSPPUP and its components including serum or urinary Na+ or K+, are associated with glucose metabolism. This study aimed to address their associations.
METHODS: We conducted a cross-sectional study enrolling 5,581 Chinese adults (1,269 with prediabetes, 1,044 with diabetes, and 3,268 with normoglycemia). Fasting serum and morning spot urine were used to measure electrolytes that included Na+ and K+.
RESULTS: SUSPPUP was higher in prediabetes and diabetes than normoglycemia. The odds of prediabetes and diabetes were increased by 21% and 39% for every 1-standard deviation increment of SUSPPUP after multivariable-adjustment. Multiple linear regression analysis showed that SUSPPUP correlated positively with fasting plasma glucose, 2 h plasma glucose after OGTT, and glycated hemoglobin A1c. Higher spot urinary Na+ was associated with lower odds of prediabetes and diabetes, while spot urinary K+ showed the opposite.
CONCLUSIONS: Increases in Na+ retention and K+ excretion in the kidney, as reflected by an elevated SUSPPUP, are associated with increased prevalence of prediabetes and diabetes in Chinese community-dwellers.

Trypanotolerance of the West African dwarf (WAD) breeds may not rule out significant pathophysiological changes that may affect productivity. In this study, the effects of infection of WAD rams with Trypanosoma brucei brucei (Tbb) and Trypanosoma congolense (Tc) on their serum levels of electrolytes [calcium, phosphorus, sodium, potassium]; oxidative stress markers [superoxide dismutase (SOD), malondialdehyde (MDA)]; and sperm parameters [sperm count, motility, vitality, and morphology] were investigated. Fifteen WAD rams, assigned to 3 groups (A, B & C) of 5 rams each, were used for the study. Group A rams were infected with Tbb, while Group B rams were infected with Tc, both intraperitoneally, at the dose of 106 trypanosomes/animal. Group C rams served as the uninfected control. The infections were monitored for 70 days. Serum calcium levels were significantly (p < 0.05) lower in Tbb and Tc infected rams compared to the control throughout the study. Serum sodium was significantly (p < 0.05) higher in the Tb infected rams compared to the Tc infected and control rams on days 14 and 28 PI. Serum SOD activity decreased while MDA levels increased in both infected groups of rams. Tbb infected rams were azoospermic, while Tc infected rams had lower sperm motility, vitality and concentration, and higher number of abnormal sperm cells compared to the control. Necrotic and inflammatory lesions occurred in the testis and epididymis of both infected rams. These results suggest that despite trypanotolerance, trypanosome infections in the WAD rams significantly impact on health and reproduction.