Proton-pump inhibitor use amongst patients with severe hypomagnesemia.

Long-term proton pump inhibitor (PPI) use has been associated with hypomagnesemia. It is unknown how frequently PPI use is implicated in patients with severe hypomagnesemia, and its clinical course or risk factors. All patients with severe hypomagnesemia from 2013 to 2016 in a tertiary center were assessed for likelihood of PPI-related hypomagnesemia using Naranjo algorithm, and we described the clinical course.

Recalcitrant hypercalcemia in a dialysis patient: Case report, literature review, and proposed management algorithm.

A 62-year-old male on maintenance hemodialysis, who was bedbound after a cerebrovascular accident, developed progressive hypercalcemia during a prolonged hospital stay. The etiology of hypercalcemia was attributed to immobility after extensive workup including imaging for malignancy or granulomatous disease, parathyroid hormone levels, parathyroid hormone related peptide, and vitamin D levels were unyielding. Low calcium dialysate would transiently reduce serum calcium levels, but levels would rebound in the interdialytic period.

Regional citrate anti-coagulation dose titration: impact on dose of continuous renal replacement therapy.

Background: Regional citrate anti-coagulation (RCA) is the recommended anti-coagulation for continuous renal replacement therapy (CRRT). Citrated replacement fluids provide convenience but may compromise effluent delivery when adjusted to maintain circuit ionised calcium levels (circuit-iCa). This study aims to evaluate the effect of RCA titration on the delivered CRRT effluent dose.

Effect of multidisciplinary intensive targeted care in improving diabetes mellitus outcomes: a randomized controlled pilot study - the Integrated Diabetes Education, Awareness and Lifestyle modification in Singapore (IDEALS) Program.

Background: There is a global pandemic of type 2 diabetes mellitus (T2DM), especially in Asia. Singapore has a prevalence of T2DM at 10.5%, which is higher than the world average of 8.