RESUMO
OBJECTIVE: To create awareness among health care professionals and nurses regarding interference with point-of-care (POC) blood glucose (BG) meter by high-dose intravenous vitamin C and other potential substances. We report a case that probably resulted in the death of a patient from an erroneous interpretation of POC-BG readings due to interference from high-dose vitamin C. METHODS: Retrospective case review. RESULTS: Our patient was admitted following a syncopal episode associated with an acute non-ST elevation myocardial infarction. She was found to have significant hyperglycemia with blood glucose >600 mg/dL on POC testing, associated with moderate ketoacidosis. She was treated with intravenous insulin as a case of diabetic ketoacidosis (DKA). She developed severe hypoglycemia, which was confirmed on a venous BG, and her condition was complicated by an apparent stroke-like state. The patient deteriorated and subsequently died. We found no report of vitamin C causing apparent DKA, as seen in our case. CONCLUSION: POC-BG monitoring is very commonly used in intensive care unit settings to monitor BG as they are minimally invasive, convenient, and quick. However, physicians and nurses need to be aware that certain substances can interfere with and alter POC-BG levels, leading to incorrect diagnosis of pseudohyperglycemia or pseudohypoglycemia. This may potentially lead to catastrophic consequences and result in increased morbidity and mortality in intensive care unit settings. The Food and Drug Administration advises against the use of POC-BG meters in critical settings, and they should never be used to diagnose DKA.
RESUMO
One of the most important aspects of postsurgical care is finding an efficient way for the management of pain. Third molar extractions/surgical impaction is one of the most frequent surgical procedures in dental hospitals, and it is most often associated with postoperative complications like severe pain, oedema and reduced mouth opening. This study was aimed to evaluate the efficacy of 2 g intravenous (IV) vitamin C compared to 100 mg aceclofenac on postsurgical pain, swelling and trismus after the surgical removal of third molars. A total of 101 patients were recruited for the study, and theywere divided into two treatment groups; group A (n = 51) received 2 g IV vitamin C and group B (n = 50) received 100 mg aceclofenac. Pain intensity, facial swelling and mouth opening were assessed till day 3 post-surgically. Statistical analysis of pain intensity revealed that IV vitamin C performed slightly better but not significantly different (p>0.05) from aceclofenac group at the end of day 3. No significant difference for facial swelling and mouth opening between the two treatment protocols was seen (p>0.05). Our results concluded that both treatment groups were overall similar in analgesic efficacy, postoperative oedema and reduction in mouth opening. It was also determined that the method devised administering 2 g IV vitamin C intravenously was well suited to the treatment of postoperative pain, swelling and trismus following the surgical extraction of impacted third molars.