Acute Necrotizing Encephalopathy of Childhood from Eastern AfricaHilary Chipongo1, Shaffin Rajan1, Abizer Sarkar 2 Ronald Mclarty 3, Esmail Sangey1

Liberal use of oxygen plays a significant role in exacerbating the long-term lung injuries associated in COVID-19. Hypoxemia and hypoxia are two different entities. Correcting hypoxemia without hypoxia tends to have disastrous effect and delays lung healing.

IntroductionOxygen is one of the most common and inexpensive treatment components in today’s world of modern medicine. It is the most essential medicinal gas available in majority of the hospitals and highly beneficial when used in appropriate amounts. However, it must be acknowledged that too much of anything tends to do more harm than good, and even oxygen therapy is no exception.When one talks about oxygen, hypoxia and hypoxemia are two such terminologies often encountered and used interchangeably. It is of paramount importance to note that these two terminologies, though they may overlap are not synonymous. Hypoxia is a state of insufficient amount of oxygen in the tissues whereas hypoxemia is a decreased amount of oxygen content in the blood. Hypoxemia may often go unnoticed, and when homeostatic mechanisms no longer compensate, can lead to hypoxia.(1)With the ongoing COVID-19 pandemic, oxygen utilization has been on the rise worldwide, with some countries often experiencing scarcity in such crucial times.(2) The goal of oxygen therapy in COVID-19, as with any other form of respiratory illness, is to treat hypoxia. The WHO has classified severe COVID-19 to have saturations less than 90% and thus warranting supplemental oxygen therapy.(3) In an effort to treat the hypoxia, prolonged oxygen therapy may lead to pathophysiological processes associated with increased levels of hyperoxia-induced reactive oxygen species (ROS) which may readily react with surrounding biological tissues causing protein denaturation and breaking down of nucleic acids into strands.(4) Here, we describe a case of a patient with COVID-19 treated at our hospital.

Nephrogenic diabetes insipidus (NDI) is rarely considered against more common differentials such as diabetes mellitus in patients presenting with polydipsia and polyuria. Hypokalaemia and hypercalcemia are known to induce NDI but not much is known about hypomagnesemia. Hypokalaemia refractory to therapy should prompt consideration of hypomagnesemia.