Hyponatremia in Patients Admitted to Intensive Care Unit of a Tertiary Center: A Descriptive Cross-sectional Study

Parajuli, Suraj; Tiwari, Sanjeeb; Gupta, Sanjay; Shakya, Yogendra Man; Shakya, Yagya Laxmi

doi:10.31729/jnma.7123

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Parajuli (2013) undertakes a more thorough analysis by examining the financing of the entire TVET sector in Nepal until 2011/12. That scientific article is based on a study commissioned by the SDC entitled Resource needs Assessment for TVET Sub-Sector in Nepal, Dec. 2012 (Parajuli & Shakya, 2012). Most of the data is based on the Red Book, which also provides information about donor funding in government programmes.…”

Section: Lamsal (2011) Examines Internationalmentioning

confidence: 99%

Constitutional Reform and its Impact on TVET Governance in Nepal

Renold

Caves

Bolli

2021

J. Tech. & Voc. Educ. & Train.

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This paper analyses the challenges of the constitutional reform in Nepal and its impact on the governance of technical and vocational education and training (TVET). Thereby, the paper suggests five crucial recommendations. First, establish an Inter-Governmental TVET Council/Coordination committee, a high-level body with representatives of all three government levels. Second, describe the key TVET processes in a Master Plan that allocates tasks and processes to the appropriate level and supports a consistent federalisation process. Third, the high-level committee must address the remaining unclear normative issues in a TVET Policy for 2030 with goals and a vision for the sector. This should include allocating responsibilities to formal and non-formal education, defining what Nepal means by "good governance", defining the TVET programme approach, allocating detailed tasks to all three government levels and defining specific objectives for the TVET sector. Fourth, develop a TVET Act as quickly as possible. This is particularly important because the seven provinces depend on a national TVET legal framework to develop their own laws. Fifth, conduct a comprehensive TVET financial flows analysis to reconcile TVET funding sources and expenditures.

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Section: Lamsal (2011) Examines Internationalmentioning

confidence: 99%

Constitutional Reform and its Impact on TVET Governance in Nepal

Renold

Caves

Bolli

2021

J. Tech. & Voc. Educ. & Train.

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Implications of Dysnatremia and Endocrine Disturbances in COVID-19 Patients

Zlosa,

Grubišić,

Švitek

et al. 2024

IJMS

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Sodium imbalance is a common electrolyte disturbance in COVID-19, often linked to disruptions in hormonal regulation. This review explores the relationship between sodium dysregulation and endocrine disturbances, particularly focusing on primary and secondary hypothyroidism, hypocortisolism, and the renin–angiotensin–aldosterone system (RAAS). Hypocortisolism in COVID-19, due to adrenal insufficiency or secondary to pituitary dysfunction, can lead to hyponatremia through inadequate cortisol levels, which impair renal free water excretion and enhance antidiuretic hormone (ADH) secretion. Similarly, hypothyroidism is associated with decreased renal blood flow and the glomerular filtration rate (GFR), which also increases ADH activity, leading to water retention and dilutional hyponatremia. Furthermore, COVID-19 can disrupt RAAS (primarily through its interaction with the angiotensin-converting enzyme 2 (ACE2) receptor), diminishing aldosterone secretion and further contributing to sodium loss and hyponatremia. These hormonal disruptions suggest that sodium imbalance in COVID-19 is multifactorial and warrants further investigation into the complex interplay between COVID-19, endocrine function, and sodium homeostasis. Future research should focus on understanding these mechanisms to develop management algorithms that address both sodium imbalance and underlying hormonal disturbances in order to improve prognosis and outcomes in COVID-19 patients.

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Approach to Hyponatremia in the ICU: A review article

Alitelat,

Hammad,

Abuhayyeh

et al. 2024

JAPAJ

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Hyponatremia is a common condition in clinical practice and a major cause of morbidity and mortality. Differentiating between its acute and chronic forms is challenging because of their variable symptoms. A thorough approach is necessary to diagnose hyponatremia. Proper interpretation of the numerous laboratory tests aids in the differentiation of hyponatremia types. In the ICU, management varies for acute and chronic cases to prevent neurological issues. While fluid restriction and hypertonic saline administration are two common forms of management, however, individualized strategies are essential for illnesses like cirrhosis or Syndrome of Inappropriate Anti Diuretic Hormone. To successfully treat hyponatremia, use vaptans and other protocols while monitoring the patient's condition closely. Monitoring acute and chronic cases must adhere to specific monitoring frequency and indices, and should cease only when Na+ levels are deemed safe. Balancing the diagnosis and therapy provides patient safety and avoids side effects.

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Hyponatremia in Patients Admitted to Intensive Care Unit of a Tertiary Center: A Descriptive Cross-sectional Study

Cited by 3 publications

References 10 publications

Constitutional Reform and its Impact on TVET Governance in Nepal

Constitutional Reform and its Impact on TVET Governance in Nepal

Implications of Dysnatremia and Endocrine Disturbances in COVID-19 Patients

Approach to Hyponatremia in the ICU: A review article

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