scholarly journals Clinico-etiological profile and outcome of hyponatremia in hospitalised adult patients

2015 ◽  
Vol 1 (7) ◽  
pp. 293 ◽  
Author(s):  
Parijat P. Baji ◽  
Suresh S. Borkar
Keyword(s):  
Diabetes Mellitus ◽  
Serum Sodium ◽  
Environmental Changes ◽  
The Elderly ◽  
Sodium Concentration ◽  
Electrolyte Balance ◽  
Electrolyte Abnormality ◽  
Chi Square ◽  
Exact Test ◽  
Hospitalised Patients

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong><span lang="EN-US"> Hyponatremia is a common electrolyte abnormality in hospitalised patients. Incidence varies from 1% to 40%. It is common in the elderly, mainly owing to impaired water and electrolyte balance in response to diet, drugs and environmental changes. This study is to evaluate clinical features, aetiologies and outcome in patients with hyponatremia (Sr. Na &lt;120 mmol/L at the time of admission).</span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>An observational study was conducted in 76 patients admitted in Kamalnayan Bajaj Hospital, Aurangabad from August 2013 to August 2014. All patients having their serum sodium concentration less than 120 mmol/L were included in the study. History, examination and relevant details were taken. Outcome was noted. Student’s t-test, chi square test and Fisher’s exact test were applied for statistical analysis.</p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> In the present study, mean age of the patients was 59.4% years. 43% patients were euvolemic, 38% hypervolemic and 19% hypovolemic. Nausea (54%) was most common gastrointestinal while drowsiness (42%) was the most common neurological symptom. Etiology of hyponatremia was multifactorial in 76% cases. Use of diuretics (53%) was the most common etiological factor. SIADH was suspected in nine patients. Mortality was 21%. Most common comorbid conditions were hypertension (51%) and diabetes mellitus (42%).</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Hyponatremia is a common electrolyte abnormality in hospitalised patients. There is an increasing tendency for it to occur with increasing age, hypertension, diabetes mellitus and use of drugs (diuretics). Nausea, vomiting and drowsiness are the commonest symptoms. Mortality is high, though not directly related to serum sodium levels. Hyponatremia acts as a poor prognostic marker of primary disease.</p>

Atrial natriuretic peptide suppresses osmostimulated vasopressin release in young and elderly humans

1991 ◽  
Vol 261 (2) ◽  
pp. E252-E256 ◽  
Author(s):  
B. A. Clark ◽  
D. Elahi ◽  
L. Fish ◽  
M. McAloon-Dyke ◽  
K. Davis ◽  
...  
Keyword(s):  
Atrial Natriuretic Peptide ◽  
Hypertonic Saline ◽  
Natriuretic Peptide ◽  
Serum Sodium ◽  
The Elderly ◽  
Sodium Concentration ◽  
Elderly Subjects ◽  
Vasopressin Release ◽  
Young And Elderly Subjects ◽  
Atrial Natriuretic

Atrial natriuretic peptide (ANP) may suppress vasopressin release, but the dynamics of this interaction as well as the influence of age have not been defined. We studied six or seven young (19-40 yr old) and seven elderly volunteers (65-83 yr old) under two circumstances: 1) after infusion of 5% saline (0.04 ml.kg-1.min-1) for 2 h and 2) after the same infusion given with simultaneous synthetic human ANP (0.05 micrograms.kg-1.min-1). Hypertonic saline alone produced a progressive rise in plasma vasopressin with increasing serum sodium. During hypertonic saline alone, vasopressin levels began to rise at an increment in serum sodium of 1.67 +/- 0.35 mM in the young and 1.43 +/- 0.32 mM in the elderly and rose linearly with increasing serum sodium. When ANP was infused with hypertonic saline (with peak ANP levels of approximately 1,000 pM), vasopressin levels began to rise at an increment in serum sodium of 4.43 +/- 0.67 mM in the young and 4.57 +/- 0.43 mM in the elderly (P less than 0.01 vs. saline alone). Furthermore, the vasopressin response for any given serum sodium was significantly reduced in both young and elderly subjects, resulting in a rightward displacement of the curve relating vasopressin response to sodium concentration (P less than 0.001). In conclusion, ANP not only suppresses vasopressin but raises the threshold for release of vasopressin in response to osmotic stimulation in both young and elderly individuals. High circulating ANP levels may be responsible in part for the suppression of vasopressin levels and water diuresis seen during states of volume expansion.

Examining preference of elderly for adding indication to the prescription label (Rx Label)

2014 ◽  
Vol 2 (4) ◽  
pp. 523
Author(s):  
Prashant Sakharkar ◽  
Amir Zargarzadeh ◽  
Anandi Law
Keyword(s):  
High School ◽  
Prescription Medication ◽  
The Elderly ◽  
Demographic Characteristics ◽  
School Education ◽  
High School Education ◽  
Chi Square ◽  
Convenience Sample ◽  
Exact Test ◽  
Daycare Centers

Rationale and aim To examine preference of the elderly for adding indication (medication use/purpose) to prescription label, reasons for their preference and its association with demographic characteristics. Methods A convenience sample of 143 patients of age 65 or older, who took at least one prescription medication every day were interviewed using a structured questionnaire. The data were analyzed for descriptive statistics, correlation for demographic characteristics with participant’s preference for adding indication to prescription label using the Chi-square and Fisher’s exact test. Regression analysis was conducted to predict participant’s preference.    Results Participants were ethnically diverse, majority being female (60.8%), with average age of 76.9 yrs. Twenty nine percent participants had more than high school education. About 91% participants preferred adding indications to their prescription label for the reasons: “managing medication by category” (29%), “distinguishing medications” (69%), and “reducing confusion” (29%). Adult daycare centers and community pharmacy participants with lower than high school education showed higher preference for adding indication for reducing confusion and distinguishing medication, respectively. Whereas, Hispanic/Latino participants of adult daycare centers preferred for the reason, distinguishing medications (p<0.05). Age, race/ethnicity and education were found to be good predictors of their preference. Conclusion The elderly showed higher preference for adding indication to the prescription label for improving their ability to distinguish medications and reduce confusion. Our results suggest a need for adopting recently released USP patient-centered prescription label standards, which also include adding indication to the Rx labels. 

scholarly journals Penggunaan Antibiotik untuk Penanganan Ulkus dan Gangren Diabetikum Pasien Rawat Inap di Rumah Sakit

2020 ◽  
Vol 7 (2) ◽  
pp. 99
Author(s):  
Riyan Stiyanto ◽  
Iin Suhesti
Keyword(s):  
Diabetes Mellitus ◽  
Antibiotic Use ◽  
Diabetes Mellitus Patient ◽  
Therapeutic Outcome ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Exact Test ◽  
Chi Square Test ◽  
Empirical Antibiotics ◽  
Diabetes Melitus

Penyakit Diabetes melitus yang tidak dikelola dengan baik dapat menyebabkan komplikasi dan membahayakan kehidupan pengidapnya. Salah satu komplikasi diabetik yang sering terjadi adalah neuropati (kerusakan syaraf) di kaki yang menyebabkan ulkus kaki, infeksi, dan bahkan keharusan untuk amputasi kaki. Penelitian ini bertujuan untuk mengidentifikasi persentase penggunaan antibiotika empiris yang rasional serta pengaruhnya terhadap outcome terapi pada pasien Diabetes melitus dengan ulkus dan gangren di RSUD Dr Moewardi Surakarta dan RSUD Bagas Waras Klaten. Penelitian ini merupakan penelitian observasional dengan pengambilan data pada penelitian dilakukan secara retrospektif dan prospektif selama periode Januari sampai Agustus 2018. Ketidakrasionalan penggunaan antibiotika empiris dievaluasi dengan metode Gyssens. Sebanyak 36 pasien yang memenuhi kriteria inklusi 75% pasien mendapatkan terapi antibiotika empiris yang rasional dan 25% pasien mendapatkan terapi antibiotika empiris yang tidak rasional. Uji Chi Square dengan taraf kepercayaan 5% (p < 0,05) digunakan untuk membandingkan rasionalitas pengunaan antibiotika terhadap outcome terapi. Hasil Fisher’s Exact Test (Two Tailed) menunjukkan bahwa ada hubungan/pengaruh antara rasionalitas penggunaan antibiotika empiris dengan outcome terapi tetapi pemberian antibiotika empiris tidak berpengaruh pada angka leukosit bagi pasien, baik di RSUD Bagas Waras Klaten maupun RSUD dr. Moewardi Surakarta.Diabetes mellitus that is not managed properly can cause complications to endanger life. One of the diabetic complications that often occurs is foot neuropathy (nerve damage) inducing foot ulcers, infections, and even the necessity for a leg amputation. This study aims to determine the percentage of rational use of empirical antibiotics and their effects on outcomes therapy of diabetes mellitus patient with ulcers and gangrene in RSUD dr. Moewardi Hospital Surakarta and Bagas Waras Hospital Klaten. This study is an observational study with data collection in the study carried out retrospectively and prospectively from January to August 2018. The irrationality of using empirical antibiotics evaluated by the Gyssens method. Thirty six patients were enrolled and 75% of them treated with rational and empirical antibiotic therapy,. Chi-Square Test with a confidence level of 5% (p <0.05) used to compare the rationality of antibiotic use to the therapeutic outcome, the results of the Fisher Exact Test (Two-Tailed) indicated that there were relationship/influence between the rationality of using empirical antibiotics and outcomes therapy, but there was no influence between the rationality of using empirical antibiotics and leucocyte both in RSUD Bagas Waras Klaten and RSUD dr. Moewardi Surakarta.Keywords: Diabetes mellitus, therapeutic outcome, empirical antibiotic rationality

scholarly journals HUBUNGAN POLA MAKAN TERHADAP KEJADIAN DIABETES MELITUS DI WILAYAH KERJA PUSKESMAS KASSI-KASSI KOTA MAKASSAR

2019 ◽  
Vol 14 (3) ◽  
pp. 247-252
Author(s):  
Juripah Juripah ◽  
Muzakkir Muzakkir ◽  
Sri Darmawan
Keyword(s):  
Diabetes Mellitus ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Fisher's Exact Test ◽  
Fisher’S Exact Test ◽  
Chi Square Test ◽  
Diabetes Melitus

Orang dengan diabetes mellitus memiliki peningkatan mengembangkan sejumlah masalah kesehatan yang mengancam jiwa. Kadar glukosa darah yang tinggi dapat menyebabkan kerusakan pembuluh darah umum yang dapat mempengaruhi jantung, mata, ginjal, saraf, dan dapat mengakibatkan berbagai komplikasi. Sedangkan pola makan merupakan asupan makanan yang memberikan berbagai macam jumlah, jadwal dan jenis makanan yang didapatkan seseorang. Pengaturan pola makan yang tidak tepat dapat meningkatkan kadar glukosa dalam darah sehingga seseorang rentang terkena penyakit diabetes melitus. Penelitian ini bertujuan untuk mengetahui hubungan antara pola makan terhadap kejadian diabetes mellitus. Jenis penelitian yang digunakan adalah non experiment dengan metode survey analitik. Dengan menggunakan pendekatan cross sectional. Populasi dalam penelitian ini yaitu 47 responden. Sampel diambil menggunakan tehnik total sampling. Berdasarkan hasil penelitian menunjukkan bahwa dari total 47 responden terdapat 21 responden yang memiliki pola makan baik (44.7 %). Dimana Pola makan baik yang tidak menderita sebanyak 13 responden (27.7%), sedangkan pola makan baik yang  menderita sebanyak 8 responden (17.0%). Kemudian 26 responden yang memiliki pola makan kurang baik (55.3%). Dimana pola makan kurang baik yang tidak menderita sebanyak 8 responden (17.0%), sedangkan pola makan kurang baik yang  menderita sebanyak 18  responden (38.3%). Setelah dilakukan uji statistic dengan menggunakan uji chi-square test maka berdasarkan hasil fisher’s exact test didapatkan nilai p = 0,033 yang menunjukkan p<0,05, maka dengan demikian dapat disimpulkan bahwa Ha diterima dan H0 ditolak atau ada hubungan yang signifikan antara pola makan dengan kejadian diabetes mellitus di wilayah kerja puskesmas kassi-kassi kota Makassar.

scholarly journals Frequency of Undiagnosed Diabetes Mellitus among Patients with Stroke

2019 ◽  
Vol 5 (2) ◽  
pp. 81-88
Author(s):  
Yaser Moaddabi ◽  
◽  
Alia Saberi ◽  
Hamidreza Hatamian ◽  
Babak Bakhshayesh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Undiagnosed Diabetes ◽  
Chi Square ◽  
Cross Sectional ◽  
Family History Of Diabetes ◽  
Exact Test ◽  
The North ◽  
Undiagnosed Diabetes Mellitus

Background: Stroke is one of the common causes of disability and death in the world. Furthermore, diabetes mellitus is among the main risk factors for cerebrovascular events. However, a high percentage of individuals with diabetes mellitus are unaware of their disease. Objectives: To determine the frequency of Undiagnosed Diabetes mellitus (UD) in patients with stroke. Materials & Methods: In a descriptive cross-sectional study, all patients with stroke hospitalized in neurology ward of an academic hospital in the north of Iran were included in the study in 2016. A questionnaire was used to collect data including all demographic, laboratory and clinical factors such as high blood pressure, hypercholesterolemia and stroke type. Finally, the data were analyzed using Chi square, Fisher’s exact test and multinomial binary logistic regression in SPSS V. 21. Results: Most samples were male (53.8%) with a mean age of 69.2±10.1 years. The percentage of the UD was 21.7% based on level of HbA1c. The highest percentage of UD was observed in Subarachnoid Hemorrhage(SAH) (66.7%). The frequency of UD in patients with family history of diabetes mellitus (16.7%) was lower than that in patients without that history (27.7%). There was a significant relationship between UD and cholesterol and triglyceride levels and, in general, dyslipidemia (P<0.05). Conclusion: In this study, a large percentage of patients with stroke suffered UD. Therefore, it is recommended that extensive screening be conducted for diabetes mellitus in the community in order to prevent stroke.

scholarly journals Approach to Hyponatremia

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kaylie Schachter
Keyword(s):  
Serum Sodium ◽  
Laboratory Finding ◽  
Sodium Concentration ◽  
Serum Sodium Concentration ◽  
Medical Conditions ◽  
Electrolyte Abnormality ◽  
Disease States ◽  
Extracellular Compartment ◽  
Common Causes ◽  
Common Laboratory

Hyponatremia is a common laboratory finding in numerous patients. It is defined as a serum sodium concentration <135 mmol/L and represents an excess of water in the extracellular compartment. The severity of this electrolyte abnormality ranges from asymptomatic to seizures, coma and death as a consequence of cerebral swelling. There are multiple medical conditions, medications and disease states that can cause hyponatremia. This article summarizes the important pathophysiological pathways involved in the development of hyponatremia, describes an approach to common causes and reviews the initial steps in management.

Entrepreneurship of Dietetic Program Graduates

2004 ◽  
Vol 65 (4) ◽  
pp. 166-173 ◽  
Author(s):  
Linda L. Mann ◽  
Ilya Blum
Keyword(s):  
Self Efficacy ◽  
Environmental Changes ◽  
Early Career ◽  
Chi Square ◽  
Exact Test ◽  
Business Skills ◽  
Dietetic Education ◽  
Entrepreneurial Intent ◽  
Entrepreneurial Action ◽  
Dietetic Internship

Successful dietetic program graduates must have an entrepreneurial mindset and skills to respond to environmental changes and consumer trends. The purpose of this study was to determine current or intended entrepreneurship by graduates of a Dietitians of Canada accredited university program, as influenced by self-efficacy stemming from entrepreneurial experiences in education or early career, as well as by internal and external factors. This study employed an exploratory descriptive methodology with a questionnaire mailed to a discrete sample. Ninety graduates completed and returned the questionnaire for a response rate of 55%. Data analysis included descriptive statistics, two-way table analysis, the chi-square test for independence, and Fisher's exact test. Significant relationships were found between self-efficacy scores and entrepreneurial action, specific entrepreneurial experiences and entrepreneurial intent and action, dietetic internship and intent, and belief in the importance of business skills and intent. Those with entrepreneurial intent and/or action identified creativity, dietetic education/internship, persistence, business skills, and family/friend support as helping factors. These results suggest that undergraduate, internship, and continuing education programs for dietitians should incorporate activities that develop entrepreneurial skills and contribute toward an entrepreneurial mindset.

Hyponatremia in Children

1980 ◽  
Vol 2 (6) ◽  
pp. 187-190
Author(s):  
Robert C. Kelsch ◽  
William J. Oliver
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Serum Sodium ◽  
Sodium Concentration ◽  
The Body ◽  
Serum Osmolality ◽  
Serum Sodium Concentration ◽  
A Minor ◽  
Effector Mechanisms

Hyponatremia is usually recognized following an electrolyte screen since it is not symptomatic, except in its severest degrees. The pathophysiologic implications of hyponatremia and its therapy are quite varied. The purpose of this review is to present a diagnostic plan which in most instances will resolve the therapeutic dilemma. This approach is a minor modification of that developed by Schrier and Berl1 for evaluating hyposmolar states. GENERAL PRINCIPLES The occurrence of hyponatremia indicates a failure of those receptor and effector mechanisms designed to assure that the quantity of water in the body will closely relate to the amount of solute in the major bodywater spaces. The principal sensors are designed to recognize osmolar changes, not changes in sodium concentration. Nevertheless, measurement of serum sodium concentration is the most readily available tool for estimation of disturbances in osmolality. Fanestil2 has recorded 14 formulae designed to estimate osmolality from serum sodium concentration or sodium, glucose, and urea concentrations. The simplest of these formulae, osmolality = 2 x Na+ + 10, is satisfactory in the vast majority of clinical circumstances occurring in pediatrics. Diabetes mellitus is the only relatively common state that requires the use of alternate formulations to correct for hyperglycemia. The contribution to serum osmolality by glucose can be approximated by adding to the above formula 1 mOsm for each 18 mg/100 ml of blood glucose above the level of 100 mg/100 ml.

identification risk for falls diagnosis in the elderly serviced by the elderly care program

2011 ◽  
Vol 5 (10) ◽  
pp. 2507 ◽  
Author(s):  
Erika Cássia Lopes Chaves ◽  
Laís De Andrade Martins Cordeiro ◽  
Sueli Leiko Takamastu Goyatá ◽  
Mônica Lá-Salette da costa Godinho ◽  
Valéria Cruz Meirelles ◽  
...  
Keyword(s):  
Elderly Care ◽  
Statistical Significance ◽  
Care Program ◽  
The Elderly ◽  
Diagnostic Study ◽  
Chi Square ◽  
Significance Level ◽  
Exact Test ◽  
The North ◽  
Nursing Diagnosis

ABSTRACT Objective: identifying the frequency of nursing diagnosis Risk for falls in the elderly and assess their risk factors. Method: retrospective study based on data recorded in the medical records of elderly patients in the Elderly Care Program. Data collection was done between May-June 2009, by means of a questionnaire with information on the epidemiological and diagnostic study, classified according to the North American Nursing Diagnosis Association (NANDA-I), after approval by the Ethics Committee of the Federal University of Alfenas (protocol 23087.001613/2009-01). For tabulation and analysis of data the statistical program Statistical Package for Social Sciences (SPSS) was used.  Descriptive statistics allowed us to describe and summarize the data obtained which were compared using the chi-square (X2) and Fisher's exact test. The statistical significance level adopted was 5% (p

scholarly journals Prevalence and factors related to infection and mortality due to COVID-19 among patients of Shohada Ghaen Hospital, Ghaen, Iran, 2020

2021 ◽  
pp. 375-384
Keyword(s):  
Risk Factors ◽  
Clinical Symptoms ◽  
Age Groups ◽  
The Elderly ◽  
Shortness Of Breath ◽  
Hospital Data ◽  
Chi Square ◽  
Exact Test ◽  
Risk Of Death ◽  
First Case

Background and Aims: Coronavirus disease 2019 (COVID-19) is an emerging disease, whose first case was reported in December 2019, and rapidly affected the world. Therefore, the present study was conducted to investigate the frequency and factors associated with morbidity and mortality due to COVID -19 in Ghaen, Iran. Materials and Methods: This retrospective descriptive-analytical study used the information sources of the portal of Shohada Ghaen Hospital, Gaen, Iran, from March 2020 to December 2021, which was collected from 1,124 patients with suspected respiratory infection referring to the hospital. Data using Chi-square and Fisher's exact test for univariate relationships. Moreover, two-way logistic regression was used to investigate the causal relationships, and P<0.05 was considered statistically significant. Results: In this study, the mean age of participants (n=1,124) was obtained at 51.6±24.5 years, and 546 (48.6%) subjects had a positive COVID-19 test by reverse transcription polymerase chain reaction, among whom 65 (11.9%) cases passed away. Clinical symptoms of body aches, coughs, diarrhea, and shortness of breath were associated with a positive COVID-19 test. It was also revealed that habitat, diabetes, cardiovascular and lung diseases, age, and job were risk factors of COVID-19 infection, and hospitalization in the ICU and age were identified as risk factors for COVID-19-caused death (P<0.05). Conclusion: In the present study, cough and shortness of breath were found to be the most frequent symptoms among patients and deceased individuals. Since these symptoms may be associated with a worse prognosis, they require the special attention of medical staff. The findings of this study also showed that the elderly were more at risk of death from this disease than other age groups, which increased the need for more education and attention to this group of society.

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