ABSTRACT
Prader-Willi syndrome [PWS] typically presents during the neonatal period as hypotonia with poor feeding and is confused with neonatal sepsis; however, these patients eventually develop special facial characteristics and gain weight dramatically. Some of these patients can have autistic behaviors that manifest as loss of social interest, poor communication as well as repetitive movements. We present a case of a five-year-old female who developed hypotonia and poor reflexes soon after birth and was noticed to have Intrauterine Growth Restriction [IUGR]. Two months later, she was noticed to have dysmorphic features with delayed developmental milestones. At 30 months, she was diagnosed with obesity and obstructive sleep apnea. At three years, she was diagnosed which raised the suspicion of autism.with PWS and at five years of age, she developed autistic behaviors
ABSTRACT
Diuretics are the recommended antihypertensive by several international guidelines. This study was designed to determine the association of hyponatremia in hypertensive patients on diuretic therapy. This was a case control study conducted at the Aga Khan University Hospital, Karachi in adult inpatients [> 18 years] who were known hypertensive. Cases were defined as hypertensives with hyponatremia and controls were defined as hypertensives without hyponatremia. Outcome was hyponatremia. Exposed were those using diuretics. Out of 1800 hypertensive patients sampled by the ICD-9-Coding; 1191 [66%] fulfilled the inclusion criteria. Cases n [%] were 553 [46.4] and controls were 638 [53.5]. Among 553 cases [%] 180 [32.5] were exposed [on diuretics] and in controls 189 [29.6] were exposed [on diuretics] p=0.15. The association of hyponatremia with diuretic use was not significant with OR=1.11 [95% CI=0.86 - 1.45, p=0.40], after adjusting for chronic kidney disease, ischemic heart disease and chronic liver disease, in the final model. Diuretics were not associated with hyponatremia in hypertensive adult patients in this study