Background: Chronic Kidney Disease (CKD) is characterized by the presence of kidney damage or an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m² and persisting these conditions for 3 months or more. In case of CKD progressive loss of kidney function occurs. The kidneys play a vital role in the regulation of electrolyte and acid-base balance. With progressive loss of kidney function, derangements in electrolytes and acid-base occur which contribute to poor patient outcomes. The objective of this study was exploring the characteristics of electrolyte imbalance in patients with chronic kidney disease stage 4-5. Materials and methods: A cross-sectional study was conducted at East West Medical College, from July to December 2023. A total of 100 respondents were included in this study where data were collected through structured interviews and medical record reviews. Results: The prevalence of CKD by the gender group where 46% were male and 54% were female. According to aged group 42% were from 51-60 years of age and 23%, 14% and 10%, 11% were from 41-50 years, 31-40 years, 21-30 years and >60 years accordingly. At the level of educational status 33% completed secondary level, 21% completed primary, 20% completed higher secondary level and 15%, 12%, and 4% completed Graduation, able to read and write and illiterate accordingly. Among all respondents 52% were employed and 48% were unemployed. According to economic status 44% belongs to low economic status, 40% from middle income and 16% from high income status. Majority 63% were overweight, 26% and 11% were from Normal weight and underweight accordingly. Family history of CKD 62% had positive family history and 38% had negative history. According to personal habit of excess salt intake 65% had this habit and 35% did not take excess salt. Among all respondents most of the patients had DM which was 51%, HTN were 42%, hypothyroidism and hyperthyroidism were 24% and 06% accordingly. The prevalence of electrolyte imbalance in patients with CKD where mild hyponatraemia were 32%, moderate and severe hyponatraemmia were 16% and 4% were accordingly. Hypernatraemia and hypokalaemia were 18% and 21%. The stages of hyperkalaemia were mild, moderate and severe and prevalence were 19%, 09% and 3% accordingly. Majority 65% were metabolic acidosis and 11% were metabolic alkalosis. Among all respondent’s hyperphosphatemia, hyperparathyroidism, hypoparathyroidism, hypocalcemia, hypercalcaemia, hypomagnesemia and hypermagnesemia deficiency were 71%, 79%, 21% 61%, 17%, 21% and 8% accordingly. Conclusion: If we maintain the screening process at early of life for case detection of CKD and established early treatment of all cases, electrolytes related complication can reduce which improve health outcome of these patients. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 26-30

PurposeCyclophosphamide is a commonly used chemotherapeutic agent in hematopoietic stem cell transplantation (HSCT), but its use can lead to adverse effects such as hemorrhagic cystitis (HC) and electrolyte disturbances, including hyponatremia. While standard hydration protocols are used to mitigate these risks, the optimal regimen remains unclear. This study explores the impact of a restrictive hydration regimen on HC incidence and electrolyte imbalances in patients undergoing high-dose cyclophosphamide treatment as part of HSCT conditioning.MethodsA retrospective cohort study was conducted at Amsterdam UMC, including patients who received high-dose cyclophosphamide as part of HSCT between 2016 and 2024. Patients were grouped based on hydration protocols: an original regimen (5 L of NaCl 0.45%/dextrose 2.5% per day) and a new restrictive regimen (1.5 L/m2/day of 0.65% NaCl). The primary endpoint was the incidence of HC, while secondary endpoints included sodium and potassium changes, fluid overload (measured by furosemide use), and clinical outcomes.ResultsHC occurred in 10/386 (2.6%) patients in the original protocol and 1/69 (1.4%) in the restrictive protocol (odds ratio [95% confidence interval]: 0.55 [0.03–2.96], p = 0.57). Clinically relevant hyponatremia was less common with the restrictive regimen (1.4%) than with the original protocol (4.4%), though the difference was not significant (p = 0.27). On the other hand, patients receiving the restrictive regimen showed more clinically relevant hypokalemia (8.7% vs 5.9%, p = 0.28). Fluid overload, as indicated by furosemide use, was lower in the restrictive group albeit not statistically significant.ConclusionIn this retrospective single-center cohort, we did not observe a higher incidence of HC or electrolyte imbalances with a restrictive hydration regimen compared to the original regimen.

Background: Chronic liver disease (CLD) is a significant global health problem marked by progressive hepatic injury and impaired liver function. One of the frequently overlooked yet clinically important complications of CLD is electrolyte imbalance. Electrolyte disturbances-particularly hyponatremia, hypokalemia, and hypocalcemia-are common in advanced liver disease. Objective: This study evaluate the patterns and prevalence of electrolyte disturbances in CLD patients, aiming to establish their association with disease severity. Methods: This observational cross-sectional study was conducted at Department of Hepatology, Comilla Medical College, Cumilla, Bangladesh, from January 2023 to December 2023. A total of 100 patients diagnosed with chronic liver disease (CLD) were included. Statistical analysis was performed using SPSS version 26.0. Result: In this study of 100 chronic liver disease patients, electrolyte imbalances were found to be highly prevalent, with hyponatremia in 58%, hypokalemia in 36%, and hypocalcemia in 41% of cases. These disturbances were more common in patients with advanced liver dysfunction (Child-Pugh Class B and C) and were significantly associated with complications such as ascites and hepatic encephalopathy. Conclusion: This study highlights the high prevalence of electrolyte imbalances-particularly hyponatremia, hypokalemia, and hypocalcemia-among patients with chronic liver disease. These abnormalities were significantly associated with the severity of liver dysfunction, as graded by the Child-Pugh classification, and were more frequent in patients with complications like ascites and hepatic encephalopathy. J Com Med Col Teachers’ Asso July 2025; 29(2):139-143

Objective: Nausea and vomiting of pregnancy (NVP) are frequently encountered in pregnancy and can lead to serious maternal and fetal complications if neglected. This study aims to determine the frequency of NVP and related factors in Rize. Material and Methods: In this prospective study, the severity and frequency of NVP were determined by scoring pregnant women between 5-20 weeks of gestation, using the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scoring system. Pregnant women with a PUQUE score below 7 were defined as the mild NVP group, and a score of 7 and above was defined as the moderate and severe NVP group. Demographic data and blood electrolyte levels were compared between the two groups. Results: A total of 221 pregnant women were included. The frequency of moderate-severe NVP was found to be 10% (n = 22). The frequency of hyperemesis gravidarum was 2% (n=4). The average body mass index of pregnant women with moderate-severe NVP symptoms was found to be higher than that of pregnant women with mild symptoms (p<0.001). The average blood sodium and potassium levels of pregnant women with moderate-severe NVP were found to be lower (p=0.003 and <0.001). Conclusion: The frequency of NVP in Rize province is similar to the literature. Increased body mass index may be associated with the frequency of NVP. Electrolyte imbalances may occur in the blood of these pregnant women. For this reason, all pregnant women should be carefully evaluated in terms of NVP, and treatments should be planned to eliminate electrolyte imbalances in patients.

Background: Seizures, caused by abnormal brain electrical activity, are a major neurological issue in children. In Pakistan, pediatric seizure prevalence is significantly higher than in many other countries. Electrolyte imbalance is a known but under-researched cause of seizures, especially in children. The present study aimed to determine the frequency of electrolyte imbalance in patients presenting with seizures. Methods: This prospective cross-sectional study was conducted at the Emergency Department of a Tertiary Care Hospital in Rawalpindi from January 1st to June 30th,2023. Forty patients under 18 years presenting with seizures were included using non-probability consecutive sampling. Statistical Package for Social Sciences SPSS version 21.0 was used for data analysis. Mean±SD was used for descriptive statistics. An independent samples T-test was applied, with p ≤ 0.05 considered statistically significant. Results: Of 40 patients, those with known epilepsy (n=14) had significantly lower serum calcium and magnesium levels (p=0.016 and 0.001) than those with first-time seizures (n=26). Patients on anti-epileptic drugs (n = 7) also showed lower calcium and magnesium levels (p = 0.001 for each) and higher sodium levels (p = 0.029) compared to those not on AEDs (n = 33). Potassium levels remained within normal limits across all groups. Conclusion: Patients with prior epilepsy and those on AEDs are more likely to have electrolyte imbalances, particularly involving calcium, magnesium, and sodium. These findings highlight the importance of monitoring electrolytes in pediatric seizure patients, especially those with known epilepsy or on medication.

Background Disturbances in electrolyte levels are frequently observed in patients experiencing acute stroke and may substantially influence clinical outcomes. A thorough understanding of these abnormalities and their relationship to stroke classification and prognosis is essential for improving patient care. Objective To assess the occurrence of electrolyte imbalances in individuals with acute stroke and to examine their distribution across various age groups and stroke categories. Methods This institution-based, forward-looking observational research was performed in the Intensive Care Unit of Sir Sunderlal Hospital, BHU. Fifty patients between the ages of 20 and 85, who presented within 72 hours of their initial acute stroke (validated through CT or MRI), were enrolled. Patients with potential confounding conditions, such as kidney dysfunction, hormonal disorders, or those on medications like diuretics or corticosteroids, were excluded. Clinical and laboratory data, including serum concentrations of sodium, potassium, calcium, chloride, bicarbonate, arterial blood gases, and blood glucose, were collected. Stroke classification and clinical outcomes were evaluated. Results Of the 50 subjects, 66% were male and 34% were female. The majority fell within the 51–70-year age range. Ischemic strokes accounted for 52%, whereas hemorrhagic strokes represented 48%. The mean serum values were: sodium 141.09 mmol/L, potassium 3.97 mmol/L, chloride 107.53 mmol/L, calcium 0.979 mmol/L, and bicarbonate 24.37 mmol/L. Mortality rates were notably higher among individuals older than 60. Prominent electrolyte anomalies, particularly low sodium (hyponatremia) and low calcium (hypocalcaemia), were associated with less favorable outcomes. Conclusion Electrolyte irregularities are prevalent in acute stroke and can significantly affect patient prognosis. Regular assessment and timely correction of electrolyte levels are vital components of comprehensive stroke care. Age and stroke type should also be considered when predicting clinical outcomes.

Abstract Background and Aim: The morbidity and mortality associated with stroke in older persons are high, and electrolyte imbalances may play an important role. Early detection and correction of these factors can improve patient outcomes. This study aimed to assess electrolyte imbalance in patients presenting to a tertiary care center with acute stroke. Materials and Methods: This was a retrospective observational study conducted in the department of geriatrics of a tertiary care hospital in South India. We included 43 inpatients aged ≥60 years who were admitted with an acute stroke between November 2019 and November 2021. Laboratory values of sodium, potassium, calcium, and phosphorus checked during the inpatient stay were recorded. Data were obtained from the discharge summaries, electronic medical records, and online prescriptions. Results: Forty-three patients were included in the study, of which 33 (77%) had ischemic stroke (IS) and 10 (23%) had hemorrhagic stroke. Electrolyte imbalance was observed in 27 (62.8%) patients. Eighty percent of hemorrhagic stroke patients and 57.7% of IS patients had an electrolyte imbalance. The most common electrolyte imbalance was hyponatremia (25.5%), followed by hypokalemia (20.9%). Fourteen percent had hypophosphatemia, 9.3% had hyperphosphatemia, 4% had hyperkalemia, 4.7% had hypernatremia, and 2.3% had hypocalcemia. Conclusion: Electrolyte imbalance is common in patients presenting with acute stroke. Hyponatremia is the most common electrolyte abnormality, followed by hypokalemia. Patients with an acute stroke should be regularly assessed for electrolyte abnormalities.

Hyperkalemia is a common and potentially life-threatening electrolyte imbalance in patients with Chronic Kidney Disease (CKD) and Chronic Liver Disease (CLD), often exacerbated by comorbid conditions such as hypertension and diabetes. Objective: To assess the frequency and risk factors associated with hyperkalemia in patients with Chronic Kidney Disease (CKD) and Chronic Liver Disease (CLD) at a tertiary care hospital in Karachi, Pakistan. Methods: This cross-sectional study was carried out from March 2024 to May 2024, including 120 adult patients diagnosed with CKD (stage 3 or above) or CLD. Data on demographics, disease duration, comorbidities, previous hyperkalemia episodes, and medication compliance were collected. Serum potassium levels were measured, with hyperkalemia severity classified as mild (K+ 5.0–5.5 mEq/L), moderate (K+ 5.5–6.0 mEq/L), or severe (K+ >6.0 mEq/L). Statistical analysis was performed using SPSS version 24.0, with Spearman correlation and Chi-square tests applied. Results: The average age of the patients was 53.33 years, with 55% being male. The mean serum potassium level was 5.42±0.92 mEq/L. Medication compliance was high in 74.2% of patients. Hyperkalemia was present in 70.8% of patients, with 22.5% exhibiting severe hyperkalemia. Significant association was found between severity of hyperkalemia and age (p<0.01). Hypertension (p=0.001) and diabetes mellitus (p=0.001) were significantly associated with severity of potassium levels. Conclusion: The study highlighted a high prevalence of hyperkalemia in CKD and CLD patients, significantly associated with age, hypertension, and diabetes mellitus.

Certain anti-diabetic medications may exacerbate electrolyte imbalances, potentially complicating glycemic control in diabetic patients. The present study aimed to correlate the serum electrolyte imbalances such as Na+, K+, Ca+2, Cl-, and Mg+2 with the duration of disease, glycemic control, and medication regimens. In this cross-sectional study, 31 patients with type 2 diabetes mellitus (T2DM) and 30 healthy controls, with mean ages of 52.06 and 48.5 years, respectively, were recruited based on eligibility criteria. Data on demographic information, medication history, and duration of diabetes were collected. Fasting blood sugar (FBS), postprandial blood sugar (PPBS), glycated hemoglobin (HbA1C), and serum electrolytes were measured. The data were statistically analyzed. The mean differences in serum electrolytes between T2DM patients and non-diabetic participants were compared using the Mann-Whitney U test, and correlation analysis was performed. A p-value of <0.05 was considered statistically significant. Around 9.6% of participants had diabetes duration of less than one year, while the majority (45%) fell within the 1-5-year duration range. Most diabetic patients (61.2%) exhibited poor glycemic control. Statistically significant differences were observed between the mean FBS, PPBS, and HbA1C levels of T2DM (150, 249, and 8.82, respectively) and control group (95, 114, and 5.52, respectively). Analysis of serum electrolytes showedstatistically significant differences with regard toNa+, K+, andCl-between the diabetic and control groups. Mean sodium and chloride levels were lower and potassium levels were higher in diabetic patients compared to the control group. Negative correlations were observed between sodium and chloride levels and duration of diabetes and HbA1C levels. The study reveals significant electrolyte imbalances in patients with T2DM, characterized by reduced sodium and chloride levels and elevated potassium levels compared to healthy controls. These alterations are closely associated with poor glycemic control and longer disease duration, emphasizing the importance of regular electrolyte monitoring in T2DM management to mitigate potential complications.

Introduction: Hyponatremia is one of the most common electrolyte abnormalities [35-71%] associated with tuberculous meningitis [TBM]. It is an independent predictor of patient outcome. Cerebral salt wasting syndrome [CSWS] and syndrome of inappropriate secretion of antidiuretic hormones [SIADH] are two common causes of hyponatremia in patients with TBM. This study targets patients with tuberculous meningitis to provide a detailed analysis of hyponatremia in TBM patients and it’s predictive value in terms of outcome and also describes the distinguishing features of CSWS and SIADH. Materials and methods: This was a clinical, prospective study of 31 patients with TBM in which various parameters were analysed . Serial sodium levels were recorded on the day of admission, day 2, 7 and 28. Patients with hyponatremia were divided into CSWS and SIADH. Results: In this study, 24[77.42%] patients had hyponatremia. In 14 [58%], hyponatremia was due to CSWS and in 10[42%] of the patients with hyponatremia it was SIADH. Hyponatremia was related to disease severity, GCS score, hospital stay, ventilator stay and patient outcome. CSWS was more strongly associated with disease severity than SIADH. Conclusion: Hyponatremia is a common electrolyte imbalance in patients with TBM and a direct and valid predictor of disease outcome. CSWS should be differentiated from SIADH due to the different treatment strategies.

Background: Hemodialysis is a therapy to control uremia, fluid overload, and electrolyte imbalance in patients with chronic renal failure. However, the long time undergoing hemodialysis can risk causing cognitive function instability. The purpose of this study was to determine the presence of cognitive impairment chronic renal failure patients undergoing hemodialialysis. Methods: Type of quantitative research using cross-sectional correlational analysis research design, conducted on 121 samples with purposive sampling technique. Data collection was done using the Montreal Cognitive Assessment questionnaire using the Pearson Product Moment test. Results: The results showed that the majority of respondents were 46–65 years old, male; their last level of education was college; and the majority did not work. The long time undergoing hemodialysis is 120 months, with an average of 46 months. Most respondents experienced mild cognitive function impairment with memory domain, followed by visuospatial and attentional cognitive domains that cause the risk of dementia. Conclusion: There is a significant relationship between the long time undergoing hemodialysis and the cognitive function of chronic renal failure patients at RSUP Dr Kariadi Semarang (p = 0.000), with a strong relationship in the opposite direction (r = -0.610). The need to improve cognitive memory domain, such as conducting periodic cognitive screening with high-sensitivity instruments on hemodialysis patients who have a risk of severe dementia.

Objective: The study aims to assess electrolyte imbalances in patients diagnosed with acute coronarysyndrome (ACS) and to explore whether these imbalances are associated with poor clinical outcomes in ACS.Study Design: Cross-sectional analytical study.Place and Duration of Study: The study was conducted at the Department of Cardiology, Mardan MedicalComplex Mardan, Pakistan from September 2023 to December 2023.Methods: A cross-sectional study on 360 patients was conducted using the WHO sample size calculator.Patients from both genders were included in this study. Demographic information of patients was obtained.Serum electrolyte levels were done from the hospital's laboratory. Information was collected in predesignedproforma. Sampling was done via non-probability convenient sampling. Informed consent was taken from allpatients, ensuring confidentiality and the fact that there will be no risk to the patients who are taking part in this study.Results: Unstable angina was found in 60 (16.7%), in Non-ST-elevation myocardial infarction (NSTEMI) 154(42.8%) and in ST elevation myocardial infarction (STEMI) 146 (40.6%) patients. Hyponatremia was found to bein 108 (30%) patients, and it was associated in causing heart failure in around 58 (16.11%) patients.Hypokalemia was present in 65 (18%) patients and showed VT in 28 (7.77%) cases. Hypomagnesemia (31.9%)caused heart failure in 30 (8.33%) patients followed by VT in 26 (7.22%), cardiogenic shock in 24 (6.66%). Allelectrolyte disturbances of the current study carried statistical significance in causing complications i.e. P-value&lt;0.001.Conclusion: We concluded that electrolyte disturbances are common in patients with acute coronarysyndrome, and they carry adverse outcomes with respect to ACS related complications and mortality.

BackgroundInflammatory bowel disease involves chronic inflammation and ulceration, primarily Crohn’s disease and ulcerative colitis. The prevalence of inflammatory bowel disease is rising in industrialized countries. We describe the case of a patient with inflammatory bowel disease and multiple electrolyte disturbances that emphasize the link between a vitamin D deficiency and electrolyte imbalances.CaseAn 86‐year‐old Japanese man with severe hypocalcemia, hypophosphatemia, hypokalemia, and hypomagnesemia was referred to the gastroenterology and hepatology department our university hospital for severe diarrhea and abdominal pain. Based on clinical symptoms and biochemical and endoscopic findings, Crohn’s disease, intestinal Behçet’s disease, and intestinal tuberculosis were considered as differential diagnoses, but a final diagnosis was not reached. Prednisolone, azathioprine, and metronidazole were administered, and no apparent electrolyte abnormality was observed at the patient’s admission to our hospital. On the 80th hospital day, marked hypocalcemia, hypophosphatemia, hypokalemia, and hypomagnesemia were noted and prolonged, despite daily supplementation with Ca and inorganic P. At his consultation with our department, we observed decreased fractional excretion of Ca, tubular reabsorption of phosphate, fractional excretion of K, and fractional excretion of Mg, suggesting the depletion of vitamin D and extrarenal wasting of K and Mg. The patient’s serum Ca and inorganic P were quickly elevated in response to treatment with an active form of vitamin D, and his serum levels of K and Mg were restored to the normal range by an intravenous administration of K and Mg. A vitamin D deficiency is not rare in inflammatory bowel disease and is caused primarily by the decreased intestinal absorption of vitamin D. In the management of electrolyte imbalances in patients with inflammatory bowel disease, clinicians must consider the possible development of vitamin D deficiency-related disorders.ConclusionVitamin D deficiency in entero-Behçet’s disease leads to severe hypocalcemia and hypophosphatemia, highlighting the importance of awareness in management.

A 62-year-old female patient with a history of cystic bronchiectasis was brought to the emergency department with complaints of weakness, nausea, and shortness of breath.The patient was hospitalized at the internal medicine service for the accompanying acute renal failure, hypocalcemia, hypokalemia, and hypomagnesemia.The patient was started on oral active vitamin D therapy.Intravenous calcium treatment was given to the patient with a corrected calcium value of 6.4 mg/dl.In addition, intravenous potassium and intravenous magnesium replacement were performed.The patient's fluid intake and output were monitored to prevent fluid overload.The creatinine value of the patient decreased to the normal limits after five days of treatment.The patient, who had no electrolyte imbalance and whose complaints regressed, was discharged on the 8th day of hospitalization with recommendations.Clinicians should be careful about the potential risk of accompanying renal failure and electrolyte imbalance in patients with cystic bronchiectasis.

Background Hyponatremia (Na&lt;136mmol) is the most common electrolyte imbalance in patients with heart failure (HF) and is associated with increased mortality, morbidity and rehospitalizations. The mechanisms of hyponatremia in heart failure are multifold and include an increased sympathetic tone and renin-angiotensin-aldosterone-system, salt and water retention in the proximal and distal tubules, high antidiuretic hormone coupled low glomerular filtration rate and diuretic use. We present a case highlighting the complexity of sodium balance in acute decompensated heart failure. Case Presentation A 65-year-old female with a medical history of heart failure with preserved ejection fraction (EF 60-65%), pulmonary hypertension, atrial fibrillation, and CKD presented to the Emergency Department with volume overload. We began diuresis with bumetanide on hospital day 1 (HD#), however given inadequate urine output chlorthalidone was added on HD #5 and metolazone on HD #7. On admission, her sodium was 134 and down trended to a low of 121 on HD#13. She had worsening BUN/Cr from 62/2.14 at admission to a peak 135/2.66. She developed oral intake intolerance, asterixis and encephalopathy. The management changed to halting diuretics, fluid restriction, and hypertonic saline without improvement. Urine electrolytes were used to tailor treatment, leading to cessation of hypertonic saline stopped and introducing Ramen (875 mg of Na) and salt tablets (394 mg of Na). While maintaining euvolemia, there was resolution of symptoms and improvement in Na=134, BUN 49, Cr 1.16. Discussion Treatment options for hyponatremia in HF, such as water restriction or the use of hypertonic saline with loop diuretics, have limited efficacy. The use of high oral salt intake with close monitoring of jugular vein pressure, weight, symptoms, and urine electrolytes can help a select group of patients with hyponatremia and advance heart failure despite traditional knowledge.

Electrolyte abnormalities are common in acute stroke patients and have a substantial impact on the course and prognosis of the disease. Electrolyte imbalances such as hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, and phosphate abnormalities are frequently seen in this patient population. The incidence, root causes, and medical ramifications of electrolyte abnormalities in acute stroke patients are investigated in this comprehensive study. According to our research, hyponatremia is the most prevalent electrolyte imbalance. The most common reason for hyponatremia in stroke patients is the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Higher mortality rates, longer hospital admissions, and less favorable functional outcomes are all linked to hyponatremia. Acute stroke patients also typically experience hypokalemia, which affects the severity of the stroke and the recovery of functional abilities. The review furthermore emphasizes the incidence and clinical consequences of hypercalcemia, hypomagnesemia, hypophosphatemia, and hypocalcemia in patients with acute stroke. The results highlight the significance of early electrolyte imbalance detection and treatment in acute stroke patients. To better comprehend therapeutic approaches, evaluate their influence on stroke outcomes, and analyze prognostic implications, more research is required.

The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis. A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis. A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p<0.05), while gender, hyponatremia, potassium, magnesium, intracranial infection, pneumonia, allogeneic blood transfusion, hypertension, diabetes, abnormal liver function, and abnormal renal function were not statistically significant (p>0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05). The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.

Risk of pre-existing hyponatremia and mortality in patients with traumatic brain injury across age groups

BackgroundHypokalemia is a frequent electrolyte imbalance in patients with COVID-19. The aim of this study was to estimate the association between hypokalemia and clinical prognosis in patients with moderate COVID-19.MethodsA single-center, retrospective, observational study was conducted on 81 non-ICU admitted patients with moderate COVID-19 according to the criteria issued by the Chinese Health Bureau in the Third People’s Hospital of Yangzhou (Northern Jiangsu People’s Hospital New District Branch) from 4th to 25th August 2021. The demographic, clinical, and laboratory data were reviewed and collected, then the correlation between hypokalemia and prognosis was determined.ResultsThe level of serum potassium of patients ranged from 2.80 mmol/L to 4.70 mmol/L. Hypokalemia was detected in 39 out of the 81 included patients (48.15%) during hospitalization. Patients with hypokalemia had prolonged days of negative nucleic acid conversion and hospital stay. Correlation analysis showed that the level of serum potassium was negatively correlated with days of negative nucleic acid conversion and length of hospital stay. Bivariate logistic regression analysis proved that hypokalemia was a risk factor for prolonged hospital stay in patients with moderate COVID-19.ConclusionHypokalemia was prevalent in patients with moderate COVID-19 in Yangzhou, China. Hypokalemia was associated with the prolonged hospital stay in patients with moderate COVID-19.

Human immunodeficiency virus HIV infected individuals on national AIDS control organization NACO India based highly active antiretroviral therapy (HAART) regimen often continue experiencing neurological complications referred to as HIV associated neurocognitive disorders (HAND).The cognitive impairment is attributed to HIV replication in the brain and liberation of inflammatory neurotoxins leading to neuronal dysfunction.The American academy of neurology task force on the acquired immune deficiency syndrome AIDS defined two level of neurological impairment in HIV patients: 1.HIV associated dementia(HAD)and 2.minor cognitive motor disorder (MCMD).A core difference between the two is the degree of functional impairment present . Patient with HAD have more impairment than those with MCMDTimely detection of Cognitive dysfunction in patients with HIV infection is very crucial as HAND could affect patient’s activities of daily living such as medication adherence, employment; driving and so on this worsens disease indirectly.Methods:A Cross sectional Study on Patients with immune compromised states infected by HIV/AIDS was the main aim. The study includes 75 HIV infected patients attending ART centre in Victoria hospital. Patients taken into study were aged above 18years, of both sexes, then MINI Screening for Psychiatric diagnosis will be applied to rule out Axis I Psychiatric illnessIHDS scale will be applied to know the neurocognitive severity (score less than <=10) patients will be considered.Results:More than half of the HIV patients had scored less in IHDS SCALE, reported.Conclusion:the results show that patients with HIV states have the high prevalence of prevalence of HIV associated neurocognitive impairment.Introduction:Electrolyte abnormalities are common in chronic alcoholics as a result of chronic alcohol consumption, acute alcohol intoxication. They are especially significant during alcohol withdrawal. We should be aware of these clinically important disturbances caused by alcohol abuse for their appropriate management.Material and methods:A cross-sectional observational study was conducted for a period of 18 months and 126 patients of alcohol dependence in withdrawal state were included. Diagnosis of alcohol withdrawal were confirmed using ICD-10 and patients were evaluated using CIWA-Ar. Venous blood was obtained for the determination of serum potassium, sodium and magnesium, calcium, phosphates, bicarbonates concentrations and LFT.Results:The prevalence of electrolyte imbalance was 71%. Hyponatraemia was noted in 28.6% and hypernatremia in 11.9% of individuals with alcohol dependence syndrome. Hypokalemia was noted in 42.1% and hyperkalemia was noted in 1.6% of individuals with alcohol dependence syndrome. 14.3% of the individuals have decreased magnesium levels and 15.1% have increased magnesium levels. 67.5% of individuals have normal calcium levels and hypocalcaemia was noted in 31.7%, while hypercalcaemia was noted in only one patient. Hypophosphatemia was present in 15.1% of individuals while in rest the serum phosphorous levels were normal. Metabolic acidosis was found in 19.8% and metabolic alkalosis in 3.2% patients.Conclusion:The prevalence of electrolyte imbalance in patients of alcohol dependance in alcohol withdrawal state was 71%. The most frequent electrolyte disturbances in these patients were hypokalemia (42.1%) followed by hypocalcemia (31.7%), hyponatremia (28.6%), and hypomagnesemia (14.3%). The metabolic disturbances ware present in 23% patients. The patients consuming 7/weeks were significantly more likely to have electrolyte imbalance and deaarranged liver function tests than in individuals consuming 4/weeks or less.