18100006006 THESIS

TITLE:

“ETIOLOGY,MANAGEMENT AND OUTCOME IN PATIENTS WITH HYPONATREMIA IN ICU KIMS,NARKETPALLY”


INTRODUCTION:

Hyponatremia is the most common electrolyte disorder among hospitalized patients and has been associated with increased mortality. Hyponatremia is defined as a serum sodium concentration (Na+) less than 135 mEq/L

Serum sodium levels and serum osmolality are normally maintained under precise control by homeostatic mechanisms involving thirst, anti-diuretic hormone and the renal handling of filtered sodium. Hyponatremia occurs in a broad spectrum of patients who are asymptomatic or critically ill.

Patients in whom the serum sodium concentration is greater than 130 mEq/L are usually asymptomatic, whereas those in whom these values are lower may have symptoms. Clinical symptoms vary from individual to individual. Majority of patients with hyponatremia are asymptomatic. Most patients with hyponatremia have non-specific symptoms or symptoms due to an underlying disease or disorder. The clinical manifestations of hyponatremia are produced  by brain swelling and are primarily a function of the rate of fall of serum sodium concentration and not the absolute level. Symptoms occurring early in hyponatremia is usually anorexia, nausea, vomiting. Some patients may have headache and irritability. As serum sodium levels falls further patients develop neuropsychiatry symptoms.

These symptoms range from restlessness, altered consciousness, lethargy, seizures to coma. As the symptomatology vary markedly, the diagnosis of hyponatremia is difficult to establish. Prompt recognition and optimal management of hyponatremia in hospitalized patients may reduce in-hospital mortality and symptom severity, allow for less intensive hospital care, decrease the duration of hospitalization and associated costs and improve the treatment of underlying co morbid conditions and patients’ quality of life. So the treating clinician should have a high index of suspicion to diagnose hyponatremia.

There are serious neurological sequelae associated with hyponatremia and its management. The possible causes of hyponatremia should always be sought in every case. The presence of symptoms and duration of hyponatremia guide the treatment strategy. Thorough evaluation for hyponatremia  mandates accurate history taking and clinical examination along with various investigations.

 

AIM:

To study etiology, management and outcome in patients with

hyponatremia in ICU KIMS, Narketpally.

 

OBJECTIVES:

      To determine the etiology of clinically significant hyponatremia in ICU patients
To study the management given to these patients
To observe the outcome in  these patients
To study the various diseases associated with hyponatremia
 


PATIENTS AND METHODS

 

Place of study         - Intensive Care Unit in Kamineni Institute Of   

                                 Medical Sciences     

 

Period  of study       - oct 2018 – sept2020

 

Type of study           - prospective study

 

Study population      - 60 patients



THE LABORATORY

The Biochemistry lab is a standardized laboratory. The methods used for estimation are:

                                         1.    Serum Sodium – HILITE/Transaminase

 

2.    Serum Potassium – I.S.ELECTRODE (Ion selective

Electrophoresis)

 

3.    UREA – Glutaraldehyde LDH

 

4.    Creatinine – Jaffe Kinetic

 

5.    SUGAR – (GOD/POD/Glucose oxidase peroxidase)

 

6.    LFT – Enzymes – kinetic

 

7.    TFT – Automated ELISA reader

 

8.    Urine Na – I.S.ELECTRODE

 

9.    Urine K – I.S.ELECTRODE

 

10.    Lipids – ENZYMATIC METHOD

 

                                    

INCLUSION CRITERIA:

All patients greater than 13 years of age

All patients with sodium values less than 130mmol/l

                               

EXCLUSION CRITERIA:

Patients with age less than 13 years

Patients who are treated with mannitol and osmotic diuretics



LINK TO COMPLETE THESIS WITH MASTER CHART:

https://www.scribd.com/document/519437512/Manasa-thesis 

Comments

Post a Comment

Popular posts from this blog

PG FINAL YEAR (2K18-21 BATCH) UNIVERSITY PRACTICAL EXAMS - DEPARTMENT OF GENERAL MEDICINE

PG FINAL YEAR (2K18-21 BATCH) UNIVERSITY PRACTICAL EXAMS DEPARTMENT OF GENERAL MEDICINE     S. NO HALLTICKET NO BLOG LINKS  CASE PRESENTATION   VIDEO LINKS  1 18100006001 CASES https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006001-case-presentations.html THESIS https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006001-thesis.html ACADEMIC PRESENTATIONS https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006001-academic-presentations.html https://youtu.be/mU4Lmxe5Vm4   2 18100006002 CASES https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006002-case-presentations.html THESIS https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006002-thesis.html https://youtu.be/vNGnqECBv40 3 18100006003 CASES htt
Read more

18100006003 CASE PRESENTATIONS

Image
LONG CASE: A 44 year old man presented with a 3-day history of bilaterally symmetrical rapidly progressive generalized edema. Present Illness An agile stonemason, the patient reported that this symptom first started suddenly 3 days ago, at night, when he noticed he started feeling facial puffiness with pedal edema. The next morning, while brushing his teeth, the patient noticed he had facial puffiness, in the mirror. At the same time, he also noticed that he developed bilaterally symmetric, pitting type pedal edema, extending upto the middle of his legs. He immediately presented to the hospital with these complaints.  On interviewing the patient further, he denied having breathlessness, palpitations or chest pain. He reported frothing of urine but no haematuria. He also reported gradually decreasing urine output over the past 3 days. He did not have pain during micturition, no pus or any other abnormal discharge (casts) in urine. He did not have any history of vomiting or diarrhea, no
Read more

18100006002 CASE PRESENTATIONS

Image
  LONG CASE: A 70 years old female patient residing in Nalgonda, is a homemaker, presented to OPD with  complaints of-  loss of appetite since one week,  - generalised weakness since one week  - fever since 5 days  -burning micturation since 5days  History of present illness- patient was apparently asymptomatic one week back then she gradually developed loss of appetite since one week which was not associated with nausea, vomiting, associated with generalised weakness fever since 5 days which was high grade associated with chills and rigors, no diurnal variation, relived on taking medication, not associated with headache, cold , cough she also started experiencing burning micturation since 5 days associated with low backache , no history of dark coloured urine or blood in urine no h/o cold, cough, chest pain, palpitations, shortness of breath, pedal edema , reduction in urine output, diarrhoea, constipation, vomiting, nausea, pain abdomen Past history: she has been having similar episo
Read more