ABSTRACT
Background: Hyponatremia, most common electrolyte disorder has symptomatology ranging from asymptomatic to being comatose and etiologically from simple G.I. loss to chronic illnesses like CCF, CKD. Very sparse study has been done in this region on clinic-epidemiological profile of hyponatremia. The aims and objective of this study was to find out most common etiology, type, clinical features and outcome in hospitalised hyponatremic patients and to Correlate clinical profile and outcome with etiology, severity and treatment.Methods: The present observational study was conducted in department of medicine, Maharajah’s Institute of medical sciences, for two months. All patients aged ≥15 years having true hyponatremia were included. Detailed history, examination, relevant investigations including serum and urinary Na were done. Patients were classified to euvolemic, hypervolemic and hypovolemic depending on volume status and proper etiologies were determined in each group.Results: Of 50 patients included, mean age was 50.12±8.8 years. Hyponatremia was more common in older age group>40 years (P<0.05%). CNS manifestations were more prevalent in patients with Na<125 Meq. (80%) P< 0.05%. Hypervolemic was most common type (50%) followed by hypovolemic (34%) and euvolemic (16%). CKD was the most common cause overall (24%) and also among hypervolemic type (40%).Conclusions: Hyponatremia was more predominant in elderly age group (P<0.05%). It is more in 40-60 years age group. Hypervolemic type (50%) of hyponatremia is most common type of the hyponatremia and CKD (24%), to be most common cause of the hyponatremia attributed to Uddanam nephropathy in this region.
ABSTRACT
Malaria is re-emerging as the major infectious killer and it is the top priority tropical disease of the World Health Organization. Indian sub-continent harbours a global threat in the form of epicenter of multidrug resistant plasmodium falciparum. High prevalence of Complicated Falciparum Malaria in Costal Andhra Pradesh requiring ICU admission with high morbidity and mortality prompted this study. 60 cases of falciparum malaria in 3 sub groups, i.e, uncomplicated falciparum, severe falciparum with ARF, severe falciparum without ARF are taken. In Group-II, i.e, severe falciparum with ARF pts., mean serum potassium is 5.06 -hyperkalemia, mean PaO2 and PaCO2 are 80.33 and 32.75 respectively and mean bicarbonate value is 19.83, mean PH is 7.10, which reflects underlying metabolic acidosis and compensatory respiratory alkalosis, also mortality is 6 in Group-II out of total 9 deaths. Hence electrolytes and acid-base disturbance, especially hyperkalemia and acidosis are important cause of mortality in severe falciparum malaria. In acute renal failure setting, which is associated with both hyperkalemia and acidosis, prognosis is worsened. “Humanity has but three great enemies : fever, famine and war; of these by far the greatest, by far the most terrible, is fever(William Osler).