Provenance des prescriptions de médicaments reçues dans les officines de pharmacie du Département de Dakar / Origin of drug prescriptions received in pharmacies in the Department of Dakar

Introduction. L'accessibilité à des médicaments de qualité constitue un véritable problème de santé publique en Afrique. Cela est dû à des besoins énormes en soins de santé associés à des ressources limitées. La prescription de médicaments qui est un acte médical pour traiter les malades après avoir posé le diagnostic, est réservée aux professionnels de santé. L'objectif de ce travail est d'étudier la provenance des prescriptions de médicaments reçues dans les officines de Dakar. Matériels et méthodes. Il s'agit d'une étude descriptive et transversale. Elle porte sur l'exploitation de prescriptions médicales reçues dans des officines du département de Dakar. Résultats. Les résultats révèlent que plus de la moitié des prescriptions soit 61%, provient du secteur privé et 30.52% sont faites par des médecins généralistes. De plus, la classe de la parasitologie et infectiologie est la plus prescrite (18.26%). Conclusion. L'analyse de ces paramètres nous aide à mieux évaluer la situation sanitaire pour estimer les besoins en médicaments et ainsi faire des recommandations pour une meilleure accessibilité.

Introduction. Accessibility to quality drugs is a real public health problem in Africa. This is due to huge health care needs associated with limited resources. The prescription of drugs, which is a medical procedure for treating patients after having made the diagnosis is reserved for health professionals. The objective of this work is to study the origin of prescription of drugs received in the pharmacies of Dakar. Materials and methods. This is a descriptive and cross-sectional study. It is based on the use of medical prescriptions received in pharmacies in the department of Dakar. Results. The result reveal that more than half of the prescriptions are 61%, come from the private sector and 30,52% are made by general practitioners. In addition, the class of parasitology and infectiology is the most prescribed (18,26%). Conclusion. The analysis of these parameters helps us to better assess the health situation in order to estimate the drug needs and thus make recommendations for a better accessibility.

Is There a Difference between the Preoperative and Postoperative Serum Levels of Interleukin-6 and Tumor Necrosis Factor-α in Children Submitted to Adenotonsillectomy?

Abstract Introduction Palatine and pharyngeal tonsils are the first line of defense against pathogens. Clinically, two alterations may require surgical removal of the tonsils: hypertrophy and recurrent tonsillitis. The two conditions probably result from a dysfunction of the immune system. Objective To evaluate possible differences in the plasma levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) in patients submitted to adenotonsillectomy. Methods Prospective, longitudinal study with 25 children undergoing adenotonsillectomy separated into 3 different groups: recurrent tonsillitis (RT), composed of 7 patients; recurrent hypertrophy tonsillitis (RTTH), with 8 patients; and the tonsillar hypertrophy (TH) group, with 10 patients. Ten healthy control children (SD) were also included in the study. Peripheral blood was collected, and plasma was separated to measure the levels of TNF-α, IL-6, and IL-10. The Mann-Whitney test was used for statistical analysis. Results The plasma level of IL-6 was higher in the RT (p= 0.0394) and TH (p= 0.0009) groups, compared with the control group. The TH group also had higher levels of IL-6 than the RT group (p= 0.039). The IL-6/IL-10 ratio was higher in the RT (p= 0.029) and TH (p= 0.0005) groups compared with the control group. Between the RT and RTTH groups, the IL-6/IL-10 ratio was higher in the RT group, with a statistically significant difference (p= 0.0091). Conclusion Patients with a history of chronic tonsillitis had higher levels of IL-6, compared with the control group.

Development and validation of two spectrophotometric methods for simultaneous determination of diosmine and hesperidin in mixture and their applications

Two spectrophotometric methods were used to determine two substances simultaneously in a binary mix whichare diosmin (DSM) and hesperidin (HSP). First, we used the derivative spectrophotometry by the zero-crossingmeasurements based on the elaboration of the linear calibration graphs of first derivative values, which are plottedat 269 nm for HSP and 262.5 nm for DSM. Then, for the second method, we opted for the calculation of the peakabsorbance ratio λmax of both drug substances (DSM-HSP) in a binary mixture, and the percentage of drugs wasdetermined. Two different ratios were selected.The two methods presented are simple, selective, and reliable, providing satisfactory accuracy. The recoveriesobtained in both cases are good and agreed well with the reported values. The results confirmed that the methodscan be considered as a good alternative to other costly techniques, in particular, chromatographic techniques. Thesemethods can be used easily and effectively for simultaneous dosing of two active ingredients mixed in pharmaceuticalforms with precision. Furthermore, we can use them for monitoring the synthesis of DSM from HSP. Considering thetime saved by these methods presented in the brief period of the analysis, we can use them for daily quality assurance.

Relapse of rare diseases during COVID-19 pandemic: bicytopenia in an adult patient with thiamine-responsive megaloblastic anaemia (TRMA)

Thiamine-responsive megaloblastic anaemia (TRMA) is a syndrome associated with megaloblastic anaemia, diabetes mellitus and sensorineural deafness, due to mutations in the SLC19A2 gene, which codes for a thiamine carrier protein. Oral thiamine supplementation is the main treatment. We report the case of a 19-year-old man known for TRMA, who presented in the emergency department with bicytopenia (haemoglobin 5,4 g/dL, thrombocytes 38×109/L) revealed by dyspnea and chest pain. Investigations excluded bleeding, hemolysis, coagulopathy and iron deficiencies. A recent infection and an acute coronary syndrome have also been eliminated. We later found out that thiamine treatment had been discontinued three months before, due to general confinement in Tunisia during the COVID-19 pandemic. Parenteral administration of 100 mg of thiamine daily resulted in the recovery of haematopoiesis within three weeks

Bioequivalence regulation in emerging countries: Example of Moroccan regulations on immediate release formulations and comparison with international guidelines

The purpose of this study was to analyze Moroccan regulations on bioequivalence studies and compare them with someinternational guidelines. It emerged that, as most common guidelines, Moroccan regulations treated essential questionsrelating to the conduct of bioequivalence studies while remaining general. An effort to harmonize the Moroccanregulations as closely as possible with international guidelines such as European Medicines Agency and World HealthOrganization was made. The decree 2-12-198 on bioequivalence studies includes worldwide gold standards such asinclusion and exclusion criteria, study design, choice and number of subjects, conduct of the study, pharmacokineticparameters, BE acceptance criteria, and biowaiver requirements. It specifically addresses issues such as pro-drug,metabolites, urinary samples, and endogenous substances. Specific precisions such as the case of the modified releaseforms, the replacement of subjects on the withdrawal, or drop-out of a volunteer are not covered by this general decreeand should be part of new directives, in the future. For an emerging country, the integration of BiopharmaceuticsClassification System biowaivers within the decree confirms the efforts being made by the Moroccan regulations tojoin the most advanced guidelines on the investigation of bioequivalence and to prepare the International Council onHarmonisation M9 adoption

Impacts of agricultural practices on pyrethroid resistance in Culex pipiens pipiens, an important vector of human diseases, from Tunisia

@#Agricultural pesticides may play a profound role in selection of resistance in field populations of mosquito vectors. The aim of the present study was to examine the relationship between agricultural pesticide use and development of resistance to insecticides in Culex pipiens pipiens from Tunisia. Entomological surveys were conducted in three various districts from Tunisia differ in insect control in agriculture and in public health. A reference locality without any chemical activities was used to do different comparisons. Our results revealed that the level of permethrin resistance ranged from 40.9 to 7438. Practically no susceptible populations were found and resistance to permethrin was important, but significantly higher in site submitted to both agricultural and public health applications. However, resistance ratio has been decreased 7000 folds in site not submitted to agricultural pests. These observations expressed an important influence of agricultural applications on permethrin resistance and need an urgent coordination between the integrated vector control program and the Ministry of Agriculture to reduce the development of resistance in populations. The recorded resistance was slightly associated with DDT suggest the involvement of their common mechanism (target site). Synergist’s tests indicated that different enzymes played an important role in the detoxification of this insecticide.

Microbiology of Tracheal Secretions: What to Expect with Children and Adolescents with Tracheostomies

Abstract Introduction People with tracheostomies exhibit a higher risk of colonization of the lower respiratory tract, acute tracheitis and pneumonia. Despite this, the culture of tracheal secretions is not a routine inmost hospitals, and sometimes empiric therapy is based on personal experience, which is not an ideal situation. Objective To recognize the pathogens present in the tracheal secretions collected from people up to 18 years old with tracheostomies. Methods Prospective evaluation of patients under the age of 18 of a tertiary care hospital. A standardized questionnaire was completed, and tracheal secretion aspirates were sent for microbiological cultures and antibiograms. Results Twenty patients under 18 years of age were evaluated, 65% of whom were male. The microbiological culture was positive in 90% of the patients, and the most common microorganisms found were Pseudomonas aeruginosa (55.5%) and Staphylococcus aureus (27.7%). Discussion Tracheostomized children and adolescents have respiratory tracts colonized by pathogens, the most common of which is Pseudomonas aeruginosa. These patients must undergo tracheal secretion cultures, whether they present symptoms or not, to determine if there is a correlation between the colonization and the infections. This finding could guide the adequate treatment, avoiding the inappropriate use of antibiotics and indicating the better therapy in cases of laryngeal reconstruction. Conclusion In this sample, the culture of tracheal secretions was mainly positive, and the most common agent was P. aeruginosa. We suggest the routine access to Brazilian children and adolescents tracheal secretion cultures, which could help tomake a profile of these children and guide the use of antibiotics.

Antioxidant and antiglycation properties of two mango (Mangifera indica L.) cultivars from Senegal

Objective:To evaluate the total phenolic contents,antioxidant and antigiycation activities of leaves,barks,roots and kernels from two cultiivars of Mangifera indica (Anacardiiaceae).Method:Total phenolic contents were determined by using Folin-Ciocalteu's method.The antioxidant activities were assessed by three different protocols including DPPH,oxygen radical absorbance capacity and iron (Ⅱ) chelation assays.In addition,in vitro bovine serum albumin/D-ribose assay was chosen to evaluate the antiglycation properties of the extracts.Results:All the investigated extracts were found to contain high level of total phenols as well as potent antioxidant activities.Kernel extracts showed the highest total phenol contents and DPPH radical scavenging activities whereas higher oxygen radical absorbance capacity values were observed for leave,root and bark extracts.Besides,extracts from leaves,roots and barks from both cultivars exhibited potent inhibitory effects against the formation of advanced glycation end products,with IC50 values lower than the standard positive control aminoguanidine.Conclusions:The potent antigiycation and antioxidative activities of these two Mangifera indica cultivars suggest a possible role in targeting aging,diabetic complications and oxidative stress related diseases.

Multiple resistance mechanisms associated with low pirimifos-methyl resistance in Culex pipiens pipiens in three populations of Tunisia

@#The aim of this study was to evaluate the resistance status of Culex pipiens pipiens to pirimiphos-methyl insecticide. Three field populations of mosquitoes were collected from Tunisia and analyzed in laboratory. The samples studied showed low level of resistance not exceeding 5-folds. The low resistance recorded is particularly interesting, because it leaves a range of tools useable by vector control services. Both metabolic and target-site resistance mechanisms were identified. Different esterases of high activity including A2-B2, A4-B4 (and/or A5-B5) and B12 were observed in studied field samples using starch electrophoresis although opposite results were found using synergists tests on samples # 1 and 3. The polymorphism of AChE1 (Acetylcholinesterase) was analyzed and three phenotypes were detected: susceptible (ACHE1S, phenotype [SS]), resistant (ACHE1R, phenotype [RR]), and heterozygous (phenotype [RS]) of ACHE1. The resistance of Culex pipiens pipiens to pirimiphos-methyl remains low although the occurrences of multiple resistance mechanisms are able to confer high resistance levels to organophosphate insecticides. Therefore, continuous monitoring of resistance is fundamental for rational use of insecticides and mosquito control programs.

Characterization of resistance to pirimiphos-methyl (an organophosphate insecticide) in Culex pipiens pipiens (Diptera: Culicidae) from Northern and Southern Tunisia

@#Despite the public health importance of Culex pipiens pipiens, their resistance to pirimiphos-methyl insecticides has not been explored enough. Late third and early fourth larvae of Culex pipiens pipiens were collected from three localities between 2003 and 2005 in Northern and Southern Tunisia. All bioassays were carried out using pirimiphosmethyl and propoxur insecticides. Populations of Culex pipiens pipiens were susceptible, moderate and resistant to pirimiphos-methyl insecticide. Resistance to this compound ranged from 2.62 in sample # 2 to 19.9 in sample # 1. The moderate resistance (5.25) was recorded in sample # 3. Synergist’s tests showed that the resistance to pirimiphos-methyl was not affected by detoxification enzymes. However, biochemical assays showed the involvement of both metabolic (esterases) and target site (insensitive acetylcholinesterase) resistance mechanisms. The highest frequencies of the resistant phenotypes ([RS] and [RR]) (>0.74) were detected in the most resistant samples (#1). Four esterases enzymes including C1 encoded by the Est-1 locus and three esterases encoded by the Ester super locus: A2-B2, A4-B4 (or A5-B5, which has the same electrophoretic mobility) and B12 were detected. The highest (0.61) and the lowest (0.22) frequencies of these esterases were recorded in samples # 1 (Sidi Hcine) and # 2 (El Fahs) which recorded the highest and the lowest level of resistance, respectively. Monitoring of insecticide resistance should be evaluated regularly for management of vector control.

Antioxidant and antiglycation properties of two mango (Mangifera indica L.) cultivars from Senegal

Objective: To evaluate the total phenolic contents, antioxidant and antiglycation activities of leaves, barks, roots and kernels from two cultivars of Mangifera indica (Anacardiaceae). Methods: Total phenolic contents were determined by using Folin-Ciocalteu's method. The antioxidant activities were assessed by three different protocols including DPPH, oxygen radical absorbance capacity and iron (II) chelation assays. In addition, in vitro bovine serum albumin/D-ribose assay was chosen to evaluate the antiglycation properties of the extracts. Results: All the investigated extracts were found to contain high level of total phenols as well as potent antioxidant activities. Kernel extracts showed the highest total phenol contents and DPPH radical scavenging activities whereas higher oxygen radical absorbance capacity values were observed for leave, root and bark extracts. Besides, extracts from leaves, roots and barks from both cultivars exhibited potent inhibitory effects against the formation of advanced glycation end products, with IC

Relation entre santé parodontale chez la femme enceinte et faible poids du nouveau-né à la naissance à Dakar/Sénégal: étude cas-témoin

INTRODUCTION: Plusieurs facteurs de risques ont été incriminés dans la survenue du faible poids. Cependant Barnett et al trouvent que 25% des naissances de faible poids ou prématurés se produisent sans facteurs de risque connus. La relation entre la maladie parodontale et la grossesse et particulièrement le faible poids à la naissance a été évoquée par Offenbacher en 1996. L'objectif de ce travail est d'étudier la relation état parodontal chez la femme enceinte et la survenue du faible poids à la naissance du nouveau-né. MÉTHODE: L'étude était de type cas-témoin portant sur 397 patients dont 129 femmes enceintes donnant un bébé de faible poids (cas) versus 258 femmes enceintes donnant un bébé de poids normal (témoins). Les données collectées concernaient les caractéristiques sociodémographiques, les habitudes de vie, les données concernant le faible poids et celles parodontales : indice de plaque, indice de saignement papillaire perte d'attache clinique, profondeur de poche et le CPITN. Les données en analyse univariée étaient exprimées en proportions et moyennes puis des rapports de cotes avec leurs intervalles de confiance en analyse multivariée. RÉSULTATS: Les caractéristiques parodontales sont plus élevées chez les cas que chez les témoins. Il apparait que la parodontite était significativement associée au faible poids (P= 0,00013) ajustée sur l'âge de la mère, l'IMC et les autres paramètres parodontaux. L'âge de la mère et l'indice de plaque étaient marginalement associés au faible poids (P= 0,05 et 0,053) tandis que l'IMC, l'indice gingival et de saignement papillaire étaient aussi associés à la survenue du faible poids

The role of health insurance in the coverage of oral health care in Senegal

Oral diseases costs are among the most expensive health care benefits. In Senegal, households contribute up to 37.6% of the national health spending through direct payments. The aim of this work was to study the role of health insurance in the coverage of oral health care in Senegal. The study was based on health insurance agents and policyholders. The study reveals that oral health care coverage through health insurance still does not meet requirements for treatment of oral infections. In financial terms, oral health care costs health insurance too much. As a result, carriers cover them partially. On top of that, the majority of the population's lack of knowledge about mutual, because they have a little background on oral health care, the latter weighs heavily on health insurance leading to the use of self-medication, traditional medicine and handicraft prosthetists. The analysis reveals an unequal access to oral health care through the health insurance system. To bring under control the expenditure for oral health care, carriers and dental surgeons must work together to raise the populations' awareness on community solidarity

Epidemiology, clinical features and treatment of lip cancers in Senegal

Introduction. Lip cancers are uncommon among black people but not unusual. The objectives of this study were to describe the epidemiological, clinical and therapeutic aspects of lip cancers at ENT Department of National University Hospital of Fann in Dakar, Senegal. Patients and methods. We performed a retrospective and descriptive study at ENT Department of Fann teaching Hospital in Dakar, Senegal, over a period of seven years, among patients with lip cancers confirmed by the pathology. The following data were studied: age, gender, past medical history, alcohol and tobacco intake, oral hygiene, the location of the lesions and their extensions, pathological findings, TNM classification, postoperative complications and mortality. Results. 19 cases were collected. The mean age of patients was 51 years, with a sex ratio of 1.4. Bad oral hygiene was the main risk factor followed by prolonged sunlight exposure. The lower lip was the main location of the lesion (73.7%). The budding ulcerative appearance was predominant (73.68%). Squamous cell carcinoma was found in all our patients. 68.42% of our patients were classified T3-T4. 63.15% of our patients underwent surgical resection of the tumor. The most common technique of reconstruction was Estlander flap (25%). Morbidity and mortality were respectively 50% and 31.6%. The global survival rate at one and three years was 85.7%. Conclusion. Lips cancers are relatively uncommon tumors in the black people. In our context, patients consult at advanced stages, making their treatment more difficult

Value of water enema computed tomography in elderly symptomatic patients

Background and study aims: colonoscopy remains the gold standard for the examination of the colon. However, its use in the elderly is not well tolerated, and there is often a need for general anaesthesia, thus increasing the risk, especially if there are co-morbidities. Water enema computed tomography has been suggested to be a satisfactory alternative as a non-invasive, fast and effective means for the diagnosis of colorectal supra-centimetric lesions

Background and study aims: the aim of our study was to assess the performance of water enema computed tomography as first-line examination by calculating its negative predictive value [NPV] for the diagnosis of supra-centimetric lesions in symptomatic elderly referred to colonoscopy

Patients and methods: this was a prospective study including 57 symptomatic patients older than 65 years. All patients were explored by water enema computed tomography at first, followed by colonoscopy, and responded to a questionnaire on the tolerance to the preparation and both procedures

Results: the mean age of patients was 73 years. The M:F sex ratio was 1.59. The most frequent indication for colonoscopy was bowel disorders associated with abdominal pain [30%]. Water enema computed tomography allowed the diagnosis of tumours [n = 2], polyps [n = 6], diverticulosis [n = 7], inflammatory wall thickening [n = 1] and extra-colic lesions [n = 28]. NPV of water enema computed tomography for supra-centimetric lesions was 96.5%. Sensitivity and specificity were 87.3% and 98%, respectively. However, for sub-centimetric lesions, water enema computed tomography had a low sensitivity estimated at 6%, specificity at 89.9%, positive predictive value at 91.9% and NPV at 27.7%

Conclusion: water enema computed tomography has proven to be a valuable and non-invasive method indicated as a first-line examination in case of colonic symptoms in the elderly to diagnose supracentimetric lesions

Trends in hematopoietic stem cell transplant activity in Lebanon

Hematopoietic stem cell transplantation [HSCT] has been accessible to the population residing in Lebanon and surrounding countries since 1997. HSCT programs were developed in two major hospitals in Beirut: American University of Beirut Medical Center [AUBMC] and Makassed General Hospital. Mount Lebanon Hospital initiated an autologous HSCT activity later. Between 2012 and 2016, the HSCT activity in Lebanon reached a total of 897 transplants, among which 303 [33.8%] were allogeneic HSCT and 594 [66.2%] were autologous HSCT. Overall, autologous HSCT activity has remained stable over the past 5 years, whereas allogeneic HSCT activity has seen a steep increase between 2012 and 2013 followed by a modest increase later. Haploidentical transplantation has mushroomed and represented almost half of allogeneic HSCT activity in 2016. AUBMC and Makassed General Hospital are members of the European Blood and Marrow Transplantation [EBMT] and East Mediterranean Blood and Marrow Transplantation groups, and AUBMC has been accredited by JACIE [Joint Accreditation Committee - ISCT and EBMT] since 2016. The past 5 years have seen an increase in HSCT-related research and publications, mainly from AUBMC. These research activities were predominantly focused on personalized conditioning for allogeneic HSCT and post-transplant maintenance therapy

[Prognosis of refractory ascites in cirrhosis]

Background: Ascitic decompensation is a common major complication of cirrhosis and is associated with a poor outcome. In 5-10% of patients, ascites become resistant to treatment [either do not respond to a high dose of diuretics or because these drugs induce complications], which is called refractory ascites [RA]. RA is associated with poor survival: 20-50% at 1 year. The aim of this study was to investigate the outcome of RA

Methods: Retrospective study including consecutive cirrhotic patients admitted for controlling ascites between January 2010 and April 2013. Patients and cirrhosis characteristics were studied. Development of RA during follow-up was investigated. The impact of RA on the outcome [cirrhosis complications and survival] was evaluated

Results: We included 124 cirrhotic patients: 59 females [47.6%]; mean age was 58 years. Ascites was grade 3 in 38.5% and was the first episode in 45.1% of patients. Etiology of cirrhosis was mainly viral [57.3%]. Child-Pugh score was B in 39.5% and C in 28.2%. Mean MELD score was 16 [6-40]. During follow-up, 27 patients developed RA, meaning a prevalence of 21.8%. RA type was diuretic intractable in all cases. Survival without complications was significantly reduced in patients with RA [4 vs 17 monthsp<10-3]. RA was an independent predictive factor of global complications, spontaneous bacterial peritonitis and hepatic encephalopathy. Global survival was reduced in patients with RA [12 vs 16 months, p=0.069]. One year survival was 45% for patients with RA vs 63% for other cirrhotics. In multivariate analysis, only Child-Pugh score, but not RA was an independent prognostic factor

Conclusion: In this Tunisian sample we confirm that RA reduces survival and increases risk of cirrhosis complications, especially hepatic encephalopathy and spontaneous bacterial peritonitis. Therefore, these patients should be promptly listed for liver transplantation, over and above the MELD score

Does protein energy malnutrition affect the outcome in Tunisian cirrhotic patients?

Background: Malnutrition is commonly seen in cirrhotic patients and has been shown to adversely affect outcome. However, it remains associated with the severity of cirrhosis. Therefore, its role as an independent prognostic factor is still under debate. The aims of our study were to determine the prevalence of malnutrition in cirrhotic patients and determine whether this condition was an independent prognostic factor

Patients and methods: We prospectively analyzed the nutritional status of 104 consecutive patients with cirrhosis Subjective global nutritional assessment [SGA] and anthropometry [dry body mass index [BMI], triceps skinfold [TSF], arm muscle circumference [AMC]] were used for the evaluation of the nutritional status. Complications of cirrhosis during follow-up and patient's survival were recorded. Global survival and survival without complications was studied by Kaplan Meier method and using Log Rank test

Results: Prevalence of malnutrition ranged from 16.3 and 62.5% according to the method of nutritional assessment used. Survival without complications was reduced in malnourished patients. This difference was significant when assessing malnutrition by dry BMI [p=0.001]. In multivariate analysis, malnutrition defined by dry BMI<18.5 kg/m2 was an independent predictor of complications [p<0.001; RR 3.2] especially hepatic encephalopathy [p=0.001; RR 2.66]. In univariate analysis, global survival was worse in malnourished patients [by BMI and SGA; p=0.03 and p=0.0014 respectively], but this trend was lost in multivariate analysis

Conclusion: In our study, malnutrition was an independent predictor of complications in cirrhosis. However, it did not appear as an independent prognostic factor for global survival. These results raise again difficulties to clarify whether malnutrition influence itself the prognosis of cirrhosis or if it is only related to the severity of cirrhosis

[Hyponatremia in cirrhosis: risk factors and prognostic value]

Background: Hyponatremia is the most common electrolyte abnormality encountered in cirrhotic patients. Recent studies have shown that hyponatremia was correlated with severity of cirrhosis and associated with increased risk of complications and mortality. However this relationship is still unclear. The aims of the present study were to search predictive factors for hyponatremia in cirrhosis and to assess its prognostic value

Methods: We performed a retrospective study, including consecutive cirrhotic patients admitted to our department between January 2011 and April 2014. Patients and cirrhosis characteristics were studied. Serum sodium levels were determined at admission. The cutoff level of 130 mmol/l was chosen because it is widely accepted to define hyponatremia in patients with cirrhosis. Predictive factors of hyponatremia development and its impact on the outcome [cirrhosis complications and survival] were evaluated

Results: We included 143 cirrhotic patients: 67 females [46.9%] and 76 males [53.1%] with a mean age of 58 years. Etiology of cirrhosis was mainly viral [56.7%]. Child-Pugh stage was B in 41.2% and C in 25.9%. Mean MELD score was 15 [6-40]. The prevalence of dilutional hyponatremia as defined by a serum sodium concentration 16 [OR=6.76; p=0.001]. Survival without complications was reduced in patients with hyponatremia but was only significant if a serum sodium concentration

Conclusion: Low serum sodium level was correlated with severity of cirrhosis. Hyponatremia was a negative prognostic factor associated with increased short-term morbi-mortality