Dr. Yamuna Naik, Dr. Swati Chavan, Dr. Rupal Padhiyar and Dr. Dhirendra Yadav
Background: Hyponatremia in cirrhosis is currently defined as a serum sodium level of less than 130 meq/L. Recent studies have reported that lower serum sodium levels are associated with increased complications and mortality leading to incorporation of sodium in the MODEL FOR END STAGE LIVER DISEASE.
Aim: To study serum sodium levels in patients admitted with cirrhosis of liver and its outcome.
Materials and Methods: A hospital based survey was conducted on 100 patients of liver cirrhosis for period of 18 months. The status of the patients at the time of inclusion as well as severity of cirrhosis was assessed using Child-Pugh score and Model for End Stage Liver Disease (MELD) Score.
Results: Based on the serum sodium levels, 34% of patients had serum sodium levels less than or equal to 130. Grade 1 hepatic encephalopathy prevalence was 72.7% in sodium<130., grade 2 hepatic encephalopathy prevalence 38.9%,and grade 3 hepatic encephalopathy 57.1%.Similarly,the prevalence of SBP in the hyponatremia group is 63.6% ( p value =0.004). The prevalance of coagulopathy is 44.4% among hyponatremia group (p value =0.003). The mean CHILD PUGH SCORE in the sodium group less than or equal to 130 was high compared to sodium more than 135 High MELD score was seen in patients with sodium less than 130. All these differences are statistically significant (p value <=0.001) Conclusion: Patients with decreased serum sodium levels should be considered a high risk population because of the increased frequency of complications and mortality.
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Emmanuel Ifeanyi Obeagu, Getrude Uzoma Obeagu and Edward Odogbu Odo
Anemia remains a pervasive concern among children in malaria-endemic regions, presenting a significant health challenge compounded by the coexistence of malaria. This review aims to explore practical interventions and effective strategies for managing anemia specifically in children afflicted with malaria, with the overarching goal of improving health outcomes in this vulnerable population. The interplay between anemia and malaria is multifaceted, wherein the parasitic infection leads to hemolysis, compromised hemoglobin synthesis, and consequent anemia in affected children. Accurate diagnosis is pivotal, necessitating the utilization of rapid diagnostic tests for timely identification of both conditions amid overlapping symptoms. The management approach involves a comprehensive strategy encompassing prompt antimalarial therapy alongside targeted interventions addressing anemia. This includes the administration of iron supplements, folic acid, and vitamin B12, coupled with blood transfusions in severe cases to restore depleted stores and enhance erythropoiesis. Moreover, ensuring adequate nutrition, hydration, and community engagement are integral facets of holistic care. Promoting balanced diets rich in essential nutrients, alongside education programs emphasizing preventive measures and early recognition of symptoms, plays a crucial role in mitigating morbidity and mortality rates. In conclusion, the effective management of anemia in children with malaria demands a multifaceted approach, integrating timely diagnosis, tailored treatment, nutritional support, and community-based interventions. Collaborative efforts among healthcare professionals, policymakers, and communities are imperative to address the complexities of these concurrent health challenges, aiming for improved health outcomes and a brighter future for affected children in malaria-endemic regions.
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