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Electrolyte disorders in a young female following short-term omeprazole therapy

A 29 years old female presented to us in the metabolic clinic of the University of Port Harcourt Teaching Hospital (UPTH) on account of a week history of easy fatigability, weakness, and lower extremity muscle cramps associated with numbness and tingling sensation in the peri-oral area, fingers and toes. Two weeks prior to the onset of her presenting symptoms, she had visited a local pharmaceutical shop on account of a distressing epigastric discomfort and was subsequently placed on daily oral omeprazole 20mg daily for a month by a pharmacist. She had been on the omeprazole medication for two weeks before her present symptoms manifested. Her past medical history was not suggestive of hypoparathyroidism nor pancreatitis. She was married with three children and has an uneventful family, social and obstetric histories. On examination, she was a healthy well-oriented young female with positive Trousseau’s, Chvostek’s and epigastric tenderness signs. Further Laboratory evaluation revealed she had low plasma magnesium, low plasma albumin-corrected calcium, and low serum parathyroid hormone levels, while other laboratory parameters were essentially normal. A diagnosis of omeprazole-induced electrolyte disorders (hypomagnesaemia and hypocalcaemia) associated with hypoparathyroidism was made following the review of her clinical examination and laboratory findings. She was subsequently managed with oral magnesium supplements following the withdrawal of the omeprazole medication (replaced with oral ranitidine), monitored weekly, and full recovery was achieved after three weeks.




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What to stream this weekend: 'SNL' season finale, 'Dead to Me' S2

The "Saturday Night Live" Season 45 finale, the Season 2 premiere of Netflix's "Dead to Me" and a second installment of "Disney Family Singalong" are just some of the entertainment options available this weekend.




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[ Cell Phones & Plans ] Open Question : What is the closest android equivalent to the 1st generation iPhone SE?

I am torn, I know it is time to upgrade my phone, but I don't know whether to upgrade to just accept the larger phone size and go with the 2nd gen SE or go with an android. I'd be interested to know what the closest equivalent android device there is to the 1st gen SE. I am open to a bigger screen size, but not a bigger phone. So, if there was an andriod that was all screen on the front, but was similar size to the original SE, I would be open to that.




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[ Royalty ] Open Question : Why do males often name their male kids the same name, and a number, but females do not do the same for their daughters?

(I am in the USA). There was 8 Henry s https://en.wikipedia.org/wiki/Henry_VIII_of_England




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Tapping the Talents of Highly Skilled Immigrants in the United States: Takeaways from Experts Summit

Economists project a shortage of 5 million U.S. workers with postsecondary education and training by 2020. Yet 2 million immigrant college graduates in the United States are either unemployed or work in jobs that require no more than a high school degree. How can this skill underutilization, known as "brain waste," be remedied? MPI asked the experts, and this report summarizes their discussion and recommendations.




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Lost in the Smoke-Filled Room: Unexpected Talent

If this were Britain, Russia or India, Rudy Giuliani '08 caps would not be on the clearance racks. In those countries, where bigwigs and insiders get to nominate party leaders, the former Republican front-runner and establishment favorite would have long ago been anointed the winner.




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Clinton, Obama and the Narcissist's Tale

Put yourself in the shoes of Sen. Barack Obama or Sen. Hillary Rodham Clinton. You are widely seen by Democratic voters as a transformational presidential candidate. Democrats are nearly evenly divided between you and your competitor, and you think you are the best candidate for your party -- and...




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Open Door for Venezuelan and Nicaraguan Migrants in Latin America & Caribbean Closes a Bit amid Scale of Flows, Strains on Public Services

WASHINGTON – Even as governments in Latin America and the Caribbean have taken generous and innovative steps to address forced displacement from Venezuela and more recently Nicaragua, the warm welcome has cooled in places amid the vast scale of the inflows, strains on public services and growing public concern.




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BORLOTTI BEAN AND TUSCAN BLACK KALE (CAVOLO NERO) SOUP

Fortunately Tuscan black kale (cavolo nero) with its sweet, earthy flavour is readily available now, however as it's gratifyingly hardy and easy to grow, if you have a small patch or pot to put some in I can't encourage you enough to do so; it will pay you back in spades. The crinkly blue/green leaves are quite tough, but with long, slow cooking they become tender and gently sweet, and that's the quality they give to this stick-to-your-ribs soup. I usually make it on the weekend when I have a bit more time to potter around in the kitchen, and love that it makes rather a lot (I've never been one to cook by halves! Although by all means make half the recipe if you'd rather not have leftovers) as having a tub tucked away in the fridge is like gold in the bank in a busy week. There's a fair bit of chopping required to start with, however once that's done the recipe is really straightforward.




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Jerusalem artichokes cooked overnight with hazelnut praline

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, shared by Dan Hunter, chef and owner of Otways' restaurant Brae.




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The Prevalence and Determinants of Cognitive Deficits and Traditional Diabetic Complications in the Severely Obese

OBJECTIVE

To determine the prevalence of cognitive deficits and traditional diabetic complications and the association between metabolic factors and these outcomes.

RESEARCH DESIGN AND METHODS

We performed a cross-sectional study in severely obese individuals before bariatric surgery. Lean control subjects were recruited from a research website. Cognitive deficits were defined by the National Institutes of Health (NIH) Toolbox (<5th percentile for lean control subjects). Cardiovascular autonomic neuropathy (CAN) was defined by an expiration-to-inspiration (E-to-I) ratio of <5th percentile for lean control subjects. Retinopathy was based on retinal photographs and nephropathy on the estimated glomerular filtration rate (<60 mg/dL) and/or the albumin-to-creatinine ratio (ACR) (≥30 mg/g). NIH Toolbox, E-to-I ratio, mean deviation on frequency doubling technology testing, and ACR were used as sensitive measures of these outcomes. We used multivariable linear regression to explore associations between metabolic factors and these outcomes.

RESULTS

We recruited 138 severely obese individuals and 46 lean control subjects. The prevalence of cognitive deficits, CAN, retinopathy, and nephropathy were 6.5%, 4.4%, 0%, and 6.5% in lean control subjects; 22.2%, 18.2%, 0%, and 6.1% in obese participants with normoglycemia; 17.7%, 21.4%, 1.9%, and 17.9% in obese participants with prediabetes; and 25.6%, 31.9%, 6.1%, and 16.3% in obese participants with diabetes. Waist circumference was significantly associated with cognitive function (–1.48; 95% CI –2.38, –0.57) and E-to-I ratio (–0.007; 95% CI –0.012, –0.002). Prediabetes was significantly associated with retinal function (–1.78; 95% CI –3.56, –0.002).

CONCLUSIONS

Obesity alone is likely sufficient to cause cognitive deficits but not retinopathy or nephropathy. Central obesity is the key metabolic risk factor.




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Get Free Local COVID-19 Alerts with Inoreader

Everyone is concerned as the novel Coronavirus spreads at rapid rates across all countries of the world. We believe every…




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How we made our Free COVID-19 Alerting System and how you can build your own for any topic

Ever since we launched our Free COVID-19 Alerting System, we’ve been continuously asked how we made it. In this blog…




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PROactive: A Sad Tale of Inappropriate Analysis and Unjustified Interpretation

Jay S. Skyler
Apr 1, 2006; 24:63-65
Commentary




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Was this yard sale successful?

The problem with this sign is that the best yard sale goodies were probably available “yesterday.” You’re down to the dregs today. Better to post a sign that is fuzzy with time and refers only to “today.” Hat tip to photographer Mary Ann Henningsen.




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“Mandate-Schmandate,” Rick Perry and the HPV vaccine – by Richard Thaler

Nudge blog note: Last night’s Republican debate prompted Richard Thaler to weigh in on Rick Perry’s handling of an HPV vaccine executive order, but not the policy itself. Also, Thaler recently started tweeting. Follow him. By Richard Thaler In the Republican Presidential debate last night at the Reagan library a question emerged about Rick Perry’s [...]




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The intangible effects of walls | Alexandra Auer

More barriers exist now than at the end of World War II, says designer Alexandra Auer. And when you erect one wall, you unwittingly create a second -- an "us" versus "them" partition in the mind that compromises our collective safety. With intriguing results from her social design project focused on two elementary schools separated by a fence, Auer encourages us to dismantle our biases and regain perspective on all the things we have in common.




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After Okla. Historic Pay Raise, Morale Is Up—But Teacher Shortage Persists

Despite a $6,100 teacher pay raise this spring, school districts report that they're starting the new academic year with nearly 500 teaching vacancies.




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Budget Cuts Lead Wyoming to Scale Back Relationship With Accrediting Agency

AdvancED, the national accreditation company, has for the last two years operated Wyoming's entire accreditation process but the state will now do the work on its own.




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How Principals and District Leaders Are Trying to Boost Lagging Teacher Morale During COVID-19

Knowing the shift to remote learning would be tough for teachers, school and district administrators have scrambled to assemble as many kinds of supports as they can.




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Minnesota bans large-scale high school graduation ceremonies




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Maryland among three finalists for top 2021 QB recruit Caleb Williams

Mike Locksley and the Terrapins are making a push for local five-star Caleb Williams.




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“There but for the grace of God” : review of recent lawyer misconduct cases / presented by: Anna Jackson, Magistrates Court of South Australia, Alex Ward, Edmund Barton Chambers.




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Witness statements / presented by Alex Lazarevich, Anthony Mason Chambers.




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Bless Family memories : in the Vales / by Gramother Christine.

A young artist inherits her Grammy's home in The Vales and begins to remember the stories her Grammy once shared with her. Where they real or has Grammy already lost her marbles a wee bit? When some friends come to visit she regales them with the stories and gives them a tub of her Grammy's favourite chees - the Bless Family Vegan Parmesan Cheese that she had procured from the famous Blessed Cheese cafe run by the Bless family.




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24 1/2 Almond Tree Grove i:n the Vales / by Grandmother Christine.

"24 1⁄2 Almond Tree Grove is the second story in the series In the Vales. A fun, light fantasy story about a young girl who inherits her Grammy's Cottage in the Vales, then starts to remember some of Grammy's favourite stories of her wee friends. The Almond Tree fairies are so helpful to us all, just read my wee story and see. "These stories allow you to enter into a parallel world set within our local community. They will take you on a journey to allow your imagination to tell the tales of the adventurous characters in a variety of unique situ's. The dialogue twists between now and then to provide a rich connection to the character's shenanigans, which motivates the reader to visualise beyond the text to create deeper meaning and connection to self, family and the community we live in."




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Secret wee caves : in the Vales / by Grandmother Christine.

Secret wee Caves the third story in the series "In the Vales" A fun, light fantasy story about a young girl who inherits her Grammy's Cottage in the Vales, then starts to remember some of Grammy's favourite stories of her wee friends. I hear Max the Purple Dragon is such a gentleman, find out more by reading my wee story. "These stories allow you to enter into a parallel world set within our local community. They will take you on a journey to allow your imagination to tell the tales of the adventurous characters in a variety of unique situ's. The dialogue twists between now and then to provide a rich connection to the character's shenanigans, which motivates the reader to visualise beyond the text to create deeper meaning and connection to self, family and the community we live in."




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Ghost train walk : in the Vales / by Grandmother Christine.

With two quick bursts of the Ghost train's whistle it indicates that the time is 12 midnight, but as quick as we rush out of the front door we have never been able to catch a glimpse of that train, till now! Grammy's tales are being shared through her granddaughter, but are they tales or real events and people, hmm? Read on to find out for yourself. He He. A fictional story set In the Vales as a Children's Bedtime Story. History and characters of this rolling countryside between sea and hills has been packaged up to be fun, informative and thought provoking.




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A climate guide for agriculture : Murray, New South Wales.




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Forum 2019 : 7B Privilege : recent developments as to privilege self: incrimination and stay of civil proceedings, privilege over investigative reports and privilege over instructions to experts / paper presented by Alex Lazarevich, Anthony Mason Chambers




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Revisiting the forum non-convenience and inappropriate forum / paper presented by Dr Ricky J. Lee, Globalex Tax & Legal.




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CTP update : meeting the threshold for a CTP claim / paper presented by Alex Ward, Edmund Barton Chambers.




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A kaleidoscope of paintings / Arlie Jane Kirkham.




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Secrets of the maze : in the Vales / created by Grandmother Christine.




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The China Defence Universities Tracker : exploring the military and security links of China's universities / Alex Joske.

The Chinese Communist Party (CCP) is building links between China’s civilian universities, military and security agencies. Those efforts, carried out under a policy of leveraging the civilian sector to maximise military power (known as ‘military–civil fusion’), have accelerated in the past decade. Research for the China Defence Universities Tracker has determined that greater numbers of Chinese universities are engaged in defence research, training defence scientists, collaborating with the military and cooperating with defence industry conglomerates and are involved in classified research.1 At least 15 civilian universities have been implicated in cyberattacks, illegal exports or espionage. China’s defence industry conglomerates are supervising agencies of nine universities and have sent thousands of their employees to train abroad.




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Neidra's lore / Kaleen Kar.

The timeless, yet tragic, theme of reaching for the stars with Icarus-like wings-but forgetting who we are in the process. Destruction reigns down on a peaceful planet and now after everything else they need a new place to live. The search is on. Myana is a "multi-telepath" about to embark on a quest! See what adventures await Myana and Purza. How difficult it is for her to leave the safety of her home, a cave far beneath the surface where she can block out all the noise, to seek out inhabitable lands, not knowing how long the journey will be or how far away it will take her. What lies ahead for our reluctant explorer.




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McLaren Vale and District RSL Sub Branch : the first 100 years : 1919 - 2019 / Dr Cécile Cutler and Robert Richards.




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The tale of many tails : [in the Vales] / created by Grandmother Christine.

A fun light story by Grammy of camping in the Vales with nighttime noises and shadows scaring all. She knew who was scurrying around the campsite. Would you like to know too? -- Publisher.




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Distracted driving : prevalence and motivations / SA Edwards, LN Wundersitz.




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Exploring the prevalence of in-vehicle driver distraction in moving traffic : a pilot study / G Ponte, LN Wundersitz.




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Lingua cosmica : science fiction from around the world / edited by Dale Knickerbocker.

Science fiction -- History and criticism.




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The gendered brain : the new neuroscience that shatters the myth of the female brain / Gina Rippon.

Neuropsychology.




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Warndu mai good food : introducing native Australian ingredients to your kitchen / Damien Coulthard & Rebecca Sullivan ; forewords by Bruce Pascoe & Dale Tilbrook.

Wild plants, Edible.




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Honourable healers : pioneering women doctors : Elizabeth Blackwell, Elizabeth Garrett Anderson and Constance Stone / Merrilyn Murnane.

Stone, E. Constance (Emma Constance), 1856-1902.




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Volcanoes & earthquakes / Chiara Maria Petrone, Roberto Scandone & Alex Whittaker.

Volcanoes.




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Advertising, gender and society : a psychological perspective / Magdalena Zawisza-Riley.

Advertising -- Psychological aspects.




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Single and free : female migration to Australia, 1833 - 1837 / Elizabeth Rushen.

Women immigrants -- Australia -- History.




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Secondhand : travels in the new global garage sale / Adam Minter.

Minter, Adam, 1970- -- Travel.




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Contractions of the foramen ovale of the new born lamb.

United Kingdom, c.193?




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Contractions of the foramen ovale of the new born lamb.

United Kingdom, c.193?