scholarly journals The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seunghee Na ◽  
Taewon Kim ◽  
In-Uk Song ◽  
Sung-Woo Chung ◽  
Seong-Hoon Kim ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Bacterial Meningitis ◽  
Tuberculous Meningitis ◽  
Serum Sodium ◽  
Sodium Level ◽  
Total Population ◽  
Serum Sodium Level ◽  
Viral Meningitis ◽  
Cross Sectional ◽  
Additional Information

AbstractWe evaluated the association between hyponatremia and tuberculous meningitis (TBM) with the aim of providing additional information for differential diagnosis from other types of infectious meningitis, especially viral meningitis (VM). Cross-sectional and longitudinal data involving 5026 participants older than 18 years were analyzed in the total population and a propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, bacterial meningitis (BM), and VM patients were compared. Participants in the TBM group were enrolled when they were diagnosed as possible, probable, or definite TBM according to the Marais’ criteria. The initial serum sodium level was significantly lower in TBM patients than in BM and VM patients (136.9 ± 5.9 vs. 138.3 ± 4.7 mmol/L, p < 0.001 for TBM vs. BM, and 139.0 ± 3.1, p < 0.001 for TBM vs. VM), and it decreased significantly more steeply to lower levels in both the TBM and BM patients compared with VM patients. The lowest serum sodium level was in the order of TBM < BM < VM patients, and the change was statistically significant in all subgroups (131.8 ± 6.4, 133.1 ± 5.1, 137.4 ± 3.7, respectively, p < 0.001). Participants with lower serum sodium level were more likely to have a diagnosis of TBM rather than VM, and this association was more pronounced for the lowest sodium level than the initial sodium level [OR 4.6 (95% CI 2.4–8.8, p < 0.001)]. These findings indicate that baseline and longitudinal evaluation of serum sodium level can provide information for differential diagnosis of TBM from BM or VM.

The association between serum sodium levels and tuberculous meningitis compared to viral and bacterial meningitis: Multicenter retrospective cohort study

2021 ◽  
Author(s):  
Seunghee Na ◽  
Taewon Kim ◽  
In-Uk Song ◽  
Sung-Woo Chung ◽  
Seong-Hoon Kim ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Bacterial Meningitis ◽  
Tuberculous Meningitis ◽  
Serum Sodium ◽  
Retrospective Cohort ◽  
Total Population ◽  
Viral Meningitis ◽  
Lower Serum ◽  
Cross Sectional ◽  
Additional Information

Abstract We evaluated the association between hyponatremia and tuberculous meningitis (TBM) in hopes of providing additional information for the differential diagnosis of TBM from other types of infectious meningitis, especially from viral meningitis (VM). Cross-sectional and longitudinal data involving 5,026 participants more than 18 years of age were analyzed in the total population and the propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, VM, and bacterial meningitis (BM) patients were compared. The initial serum sodium levels were significantly lower in the TBM patients than in the VM and BM patients (136.9 ± 5.9 vs. 139.0 ± 3.1, p < 0.001 for TBM vs. VM, and 138.3 ± 4.7 mmol/L and p < 0.001 for TBM vs. BM) and it dropped significantly more steeply to lower levels in both the TBM and BM patients compared to the VM patients. Consequently, the lowest serum sodium levels were in the order of the TBM < BM < VM patients, which were also statistically significant in all subgroups. (131.8 ± 6.4, 133.1 ± 5.1, 137.4 ± 3.7, respectively, p < 0.001). The participants with lower serum sodium levels were more likely to have a diagnosis of TBM rather than VM, and this association was more pronounced for the lowest sodium levels than the initial sodium levels (OR 8.4 (95% CI: 4.5–15.8, p < 0.001)). The baseline and longitudinal evaluation of serum sodium levels can provide supportive information for the differential diagnosis of TBM from VM or BM.

scholarly journals Hyponatraemia in Community Acquired Bacterial and Tubercular Meningitis in Hospital Admitted Adult Patients

2014 ◽  
Vol 15 (2) ◽  
pp. 114-117
Author(s):  
Poly Sengupta ◽  
Md. Roushan Ali ◽  
Fazle Rabbi Mohammed ◽  
Rama Biswas ◽  
Mamunur Rashid ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Clinical Importance ◽  
Tubercular Meningitis ◽  
Cross Sectional ◽  
Medical College ◽  
True Prevalence ◽  
Level Of Consciousness

Background: Bacterial and Tubercular Meningitis is a life-threatening disease. Hyponatraemia in bacterial and tubercular meningitis is a known complication with unknown true prevalence and clinical importance. This study was conducted to find out how commonly hyponatraemia occurs in community acquired bacterial and tubercular meningitis, to evaluate its severity, to see the pattern of presentation and to observe the level of consciousness. Materials and Methods: It was a descriptive cross sectional study performed in 30 admitted patients with clinically diagnosed bacterial and tubercular meningitis in medicine wards of Medical College for Women & Hospital (MCWH) and Dhaka Medical College & Hospital (DMCH) since August 2009 to March 2010. Serum electrolyte and level of consciousness on admission was recorded in all patients. Results: Twenty Nine patients (96.7%) with meningitis had hyponatraemia, serum sodium level ranged from 115-138 mmol/l; mean sodium level is 128.57 ± 5.56 SD mmol/L. Serum sodium level was mild (>125-135 mmol/L) in 20 (66.7%) patients with meningitis and moderate (110-125 mmol/L) in 9 (30%) and severe (<110 mmol/L) in 1 (3.3%) patient. GCS ranged from 8 to 14, mean 11.56±1.40 SD in day 1. In tubercular meningitis (n=8) and bacterial meningitis (n=22) serum sodium level was 128.63±7.44 and 128.55±4.93 while mean GCS was 11.38±2.13 and 11.95±1.40 respectively on the day of admission. Conclusion: Although the true prevalence, severity and clinical importance of hyponatraemia in bacterial meningitis are unknown, its presence may influence the outcome in such patients depending on severity. So knowledge about its prevalence and severity will guide physicians to take decisions about its management.DOI: http://dx.doi.org/10.3329/jom.v15i2.20682 J MEDICINE 2014; 15 : 114-117

scholarly journals Serum Sodium Level on the Recurrence of Febrile Seizure within the Same Febrile Illness-Experience in a District Level Hospital

2019 ◽  
Vol 32 (1) ◽  
pp. 39-45
Author(s):  
M Luthfor Rahman ◽  
Belal Hossain ◽  
Belal Uddin ◽  
Sanaul Haq Mia
Keyword(s):  
Serum Sodium ◽  
Febrile Seizure ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Central Nervous System Infection ◽  
Febrile Illness ◽  
Febrile Seizures ◽  
Febrile Episode ◽  
Cross Sectional ◽  
Recurrent Seizure

Introduction: Febrile convulsion is the most common seizure disorder in the pediatric age group. It occurs in 2-5% of children. A febrile seizure is a seizure accompanied by fever (temperature 100.4°F or 38°C by any method), without central nervous system infection, that occurs in infants and children 6 through 60 months of age. Aim: The study was conducted to see the effect of serum sodium level on the recurrence of febrile seizure during the same febrile illness. Materials and Method: A cross-sectional descriptive study which enrolled 65 children admitted with febrile seizures at 100 bed district hospital, Naogaon. They were divided in to two groups, those with a single seizure and the rest were children with more than one seizures. Serum sodium levels were estimated after stabilization of patients. The probability of recurrent febrile seizures and serum sodium level was analyzed. Results: Hyponatremia (serum sodium <135 mmol/l) was seen in 12(18.5%) of 65 children and the remaining 81.5% children had normal serum sodium level (serum sodium 135-145 mmol/l). Among the hyponatremia group all children developed more than one seizure during the same febrile episode. The mean serum sodium level in patients with single and recurrent seizure was 138.48±2.17mmol/l and 135.27±3.11mmol/(P<0.001). The relationship between the probability of a recurrent seizure and serum sodium level is statistically highly significant. Conclusion: Estimation of the seum sodium in children with febrile seizures help in deciding for admission in hospital as well as to predict seizure recurrence within the same febrile episode. TAJ 2019; 32(1): 39-45

Serum Sodium Level and Its Correlation with Curb-65 Score in Community Acquired Pneumonia – A Study from Bangalore, India

2021 ◽  
Vol 8 (30) ◽  
pp. 2702-2707
Author(s):  
Avinash Hanbe Rajanna ◽  
Swetha Rajoli ◽  
Nitish Ashok Gurav
Keyword(s):  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Hormone Secretion ◽  
Community Acquired Pneumonia ◽  
Initial Assessment ◽  
Cross Sectional ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
High Sodium ◽  
Severity Scores

BACKGROUND Community acquired pneumonia (CAP) refers to pneumonia contracted by a person with little or no contact with health care system. Severity scores like CURB 65 severity score are useful in estimating the outcome. Hyponatremia is defined as serum sodium level < 135 mEq/L. The incidence of hyponatremia at hospital admission among CAP patients is found to be 28 %and the mechanism behind it has been found to be due to syndrome of inappropriate antidiuretic hormone secretion (SIADH). Hence this study is an effort to explore how hyponatremia is associated with severity and outcomes, in hospitalized patients with pneumonia. The purpose of this study was to assess the proportion of hyponatremia in patients with community acquired pneumonia and compare hyponatremia with CURB-65 as an initial screening tool for assessment of severity of CAP. METHODS This is a hospital-based cross-sectional study. 75 community acquired pneumonia patients admitted as inpatients are included in this study. Information is collected and detailed history is taken using pre-formed proforma at the time of admission. Serum sodium levels were measured, after initial assessment of patients. The lab values of serum sodium levels were analysed with the clinical profile and outcome in these study groups. RESULTS In our study, it was observed that as the sodium levels are decreasing, the CURB 65 score increases. Study subjects who had sodium levels < 125 mg/dl, presented with CURB 65 score as 4 (30 %). Inversely, the study subjects with high sodium levels (> 135 mg/dl) had CURB 65 scores as 1 (75 %). The association between sodium levels and CURB 65 score was significant in patients who got discharged but not in patients who expired. CONCLUSIONS Present study of serum sodium levels as biomarkers in CAP showed that hyponatremia carried poor prognosis which correlated with high CURB 65 score. KEYWORDS Sodium, Community Acquired Pneumonia, SIADH, CURB 65, Hyponatremia, COPD

scholarly journals Asymptomatic hypernatremia in exclusively breastfed neonates

2019 ◽  
Vol 6 (4) ◽  
pp. 1642
Author(s):  
Babalala Kadegaon ◽  
Jyoti B. Sarvi
Keyword(s):  
Serum Sodium ◽  
Odds Ratio ◽  
Sodium Level ◽  
Adjusted Odds Ratio ◽  
Significant Positive Correlation ◽  
Serum Sodium Level ◽  
Mode Of Delivery ◽  
Summer Season ◽  
Cross Sectional ◽  
Positive Correlation

Background: The aim of study was to identify the asymptomatic hyparnatremia in exclusively breastfed neonates and to study the factors associated with it.Methods: A cross-sectional study was conducted from November 2010 to October 2012 in Jawaharlal Nehru Medical College and Hospital, A. M. U., Aligarh. Consecutive term appropriate-for-gestational age and asymptomatic neonates who were exclusively breastfed since birth were enrolled.Results: A total of 1360 term neonates were screened, out of which 145 neonates in each early and late neonatal group were enrolled. Prevalence of hypernatremia in 290 patients was 4.48% (n=13) with mean serum sodium level of 156.6±5.5 mmol/L, ranging from 151 to 167 mmol/L. It was 16 times more common in early compare to late neonates (adjusted odds ratio=16.074, P=0.001), 6 times more common in primi mothers (adjusted odds ratio=6.037, P=0.010) and 7 times more common during summer season (May-August) (adjusted odds ratio=6.566, P=0.017). Other variables like sex, mode of delivery and blood urea levels do not show significant association with hypernatremia. There was a significant positive correlation of serum sodium level with blood urea (r=0.123, P=0.037) and serum creatinine levels (r=0.157, P=0.007), and a negative correlation with blood sugar levels, but it was not significant (r=-0.072, P=0.224).Conclusions: The prevalence of hypernatremia in exclusively breastfed term asymptomatic neonates is 4.8%, and is more common in early neonatal period, in summer season and in babies born to primi mothers. There was a significant positive correlation of serum sodium with blood urea and creatinine levels.

Altered acceptance and rejection of NaCl in rats with diabetes insipidus

1960 ◽  
Vol 199 (1) ◽  
pp. 22-24 ◽  
Author(s):  
Libby F. Titlebaum ◽  
John L. Falk ◽  
Jean Mayer
Keyword(s):  
Diabetes Insipidus ◽  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Extracellular Fluid ◽  
Solution Concentration ◽  
Lower Solution ◽  
Extracellular Fluid Volume ◽  
Internal Environment ◽  
Nacl Solution

Groups of normal rats and animals with diabetes insipidus were tested on their relative acceptance and rejection of various concentrations of NaCl solution. Rats with diabetes inspidus drank more than normal rats in the hypotonic range. Their acceptance was maximal at a lower solution concentration than in the case of normal animals and relative rejection began at concentrations where normals ingested maximally. The results are discussed in relation to such factors in the internal environment as serum sodium level and extracellular fluid volume.

Continuous veno-venous hemofiltration in the treatment of severely burned patients with acute hypernatremia: A retrospective study of 13 cases

2019 ◽  
Vol 43 (6) ◽  
pp. 416-421
Author(s):  
Chen Huang ◽  
Yirong Liu ◽  
Li Li ◽  
Hongbao Liu ◽  
Peng Zhang
Keyword(s):  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Reduction Rate ◽  
Serum Levels ◽  
Clinical Effects ◽  
Sodium Reduction ◽  
Replacement Fluid ◽  
Hemodynamic Variables ◽  
Sodium Replacement

Objectives: This study aimed to evaluate the clinical effects of continuous veno-venous hemofiltration in the treatment of severely burned patients with acute hypernatremia. Methods: A total of 13 severely burned patients with acute hypernatremia admitted to Xijing Hospital were included in this study. All patients received continuous veno-venous hemofiltration treatment in addition to conventional treatment. The original sodium level in the replacement fluid was set to be lower than the serum sodium level by 8 mmol/L and subsequently undergoes a reduction rate of 2.16 ± 0.18 mmol/L every 4 h. Patients’ clinical features, serum laboratory tests, hemodynamic variables, changes in sodium levels in serum, and replacement fluid during continuous veno-venous hemofiltration treatment were monitored. Results: Patients had an average total burn surface area of 66.69% ± 20.28%. Two patients died of systematic Pseudomonas aeruginosa infections, and 11 patients survived. After continuous veno-venous hemofiltration treatment, patients showed a significant reduction in the serum sodium level (168.91 ± 4.88 mmol/L vs 144.62 ± 2.98 mmol/L, p < 0.01). Likewise, the serum levels of urea and creatinine decreased from 24.8 ± 6.5 mmol/L to 14.9 ± 8.3 mmol/L and from 278.6 ± 155.3 μmol/L to 152.6 ± 29.7 μmol/L, respectively (p < 0.05). The patients also displayed improvements in the Acute Physiology and Chronic Health Evaluation II and Glasgow scores (p < 0.05) and showed a significant reduction in hemoglobin and serum albumin levels (p < 0.05), but no obvious change in levels of platelets, alanine aminotransferase, and aspartate aminotransferase (p > 0.05). Conclusion: Our results indicate that continuous veno-venous hemofiltration with gradient sodium replacement fluid is effective in treating hypernatremia in severely burned patients with the controllable sodium reduction rate and satisfactory clinical outcomes.

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