Journal of Translational Medical Research

Background and aim: ِDiabetic ketoacidosis is one of the major complications of diabetes whose due treatment can reduce its mortality. The aim of this study was to evaluate the clinical manifestation, laboratory data and precipitating factors in admitted patients to Booali hospital in Ghazvin. Materials and Methods: In this descriptive retrospective study, all medical files of DKA patients between 1999 and 2004 in Ghazvin Booali hospital were surveyed. Totally, 60 episodes were evaluated with respect to clinical features, lab. findings and hospital mortality. Finally, the obtained data was statistically analyzed by means of SPSS software. Results: Mean±SD age of patients was 26.63±11.74. Females and males were 60% and 40%, respectively. Mean±SD hospitalization time was 7.2±3.9 days. DKA as the first symptom of diabetes occurred in 18.3% of clients. Feebleness and weakness were the most common complaint in 50% of patients, 75% were alert to their problem when hospitalized. Fever was detected in 50 %.The mean PH was 7.1±0.1. Hyponatremia occurred in 25%, urinary tract infection (UTI) in 54%, and hypoglycemia in 23% of the patients. During management, recurrent DKA was found in 3.3% and mortality rate was 5%. Conclusion: Regarding the results of the study, which confirms lack of knowledge of the clinical staff as to how to confront and manage DKA-as a medical emergency due education in this field can reduce prevalence and mortality of DKA.

Sheehan syndrome, also known as postpartum hypopituitarism, is a very serious complication of postpartum hemorrhage. It usually remains underdiagnosed years after delivery as symptoms may be subtle, especially in developing countries due to poor obstetric care and home deliveries. This case report highlights the importance of recognizing atypical presentations, such as hypoglycemic attacks, to help with early diagnosis and better management.
A female 34-year-old, G4P2Ab2L2, presented with a low level of consciousness, diaphoresis, and severe hypoglycemia after C-section delivery. Adetailed history revealed a history of failure of lactation following her first vaginal delivery, 8 years ago, accompanied by no complication or history of postpartum hemorrhage. She has experienced a few episodes of hypotension, malaise, and hypoglycemia afterward. Laboratory examination displayed adenohypophyseal insufficiency as evident from low blood glucose level in the presence of low levels of cortisol, Adrenocorticotropic hormone (ACTH), and prolactin. Sheehan syndrome was confirmed with Magnetic resonance imaging (MRI) of the pituitary as an empty sella turcica consistent with the provisional diagnosis. This case report emphasizes the significance of early suspicion in cases presented with less known complications of Sheehan's syndrome as recurrent symptomatic episodes of hypoglycemia and management of this easily missed and treatable condition.