Myocardial Infarction in Diabetics

The hospital mortality of acute myocardial infarction amongst285 known diabetics treated in the last decade was 39.7 percent at one month and had increased to 51 per cent at 12 months.Treatment in a coronary care unit during the acute stage hadlittle effect on the mortality amongst patients on insulin,but was beneficial for patients whose diabetes had been controlledby oral hypoglycaemic drugs. Female patients on oral hypoglycaemicdrugs had the highest mortality. When considering age, durationof diabetes and presence of retinopathy, acute myocardial infarctionin diabetics controlled on oral therapy appeared to have a worseoutcome than in patients on insulin. Independently of whetherpatients were on insulin or on oral hypoglycaemic drugs 12 monthsafter the acute episode, only about half of them were stillalive.     

Studies in Whole Body Potassium and Whole Body Nitrogen in Newly Diagnosed Diabetics

Serial measurements of whole body potassium and whole body nitrogenwere carried out in 18 newly diagnosed diabetics. Initial measurementswere made before treatment of diabetes was commenced, and furthermeasurements were carried out following the start of treatment.Six patients required insulin and the remainder were treatedeither with diet alone (four cases) or with diet and oral hypoglycaemicagents. Significant increases in whole body potassium and wholebody nitrogen were noted following control of diabetes. Thesechanges were most marked in the patients treated with insulin.The techniques used for measurement of body potassium and nitrogenoffer considerable advantages over conventional metabolic balancestudies and the results indicate that the losses of potassiumand nitrogen during periods of poor diabetic control are muchgreater than has been realized.     

Nausea and vomiting after gynaecological laparoscopy: comparison of premedication with oral ondansetron, metoclopramide and placebo

We have compared the incidence of postoperative nausea and vomitingup to 48 h after day-case gynaecological laparoscopy after oralpremedication with ondansetron 4 mg, metoclopramide 10mg ora placebo allocated randomly and assessed blindly. Emetic symptoms(nausea or vomiting) occurred in 26% of patients who receivedondansetron, 42% of those who received metoclopramide and 50%of those given placebo.