الفهرس 
Introduction and aim of workOnly 14 pages are availabe for public view
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Abstract
Hyponatremia is serum Na of less than 135 mmol/L. It?s the most common electrolyte abnormality in clinical practice. In most cases, hyponatremia is mild and asymptomatic but sometimes it is severe, with Na+ concentration less than 120 mmol/L. Severe hyponatremia is a serious medical condition associated with neurological complication and mortality. The present study conducted on a total number of (30) patients with hyponatremia selected randomly from Mansoura University and Emergency Hospitals, they comprised 21 male (70%) and 9 females (30%) their age ranged from 20 to 70 years with a mean age (53.6 (R+ (B13.47) and this group was classified into two subgroups according to the degree of hyponatremia: Mild hyponatremic patients: this group comprised 10 patients with a mean age (53.0 (R+ (B13.0) years. Severe hyponatremic patients: this group comprised 20 patients with a mean age (47.0 (R+ (B5.5) years. In addition, 10 apparently healthy subjects of matched age and sex were included (7 males and 3 females), with a mean age (48.0 (R+ (B9.2) years. All participants in the study were subjected to the following: (1) Clinical assessment: Complete history talking and clinical examination. (2) Laboratory investigations: Osmolality (serum and urine), Na+ (serum and urine), acidbase status, other electrolytes (K+ and HCO3), urea, uric acid, glucose, triglycerides, total proteins, cortisol and TSH: There were non significant difference in age, gender, weight and BMI in hyponatremic patients versus controls while, SBP, DBP and MBP were significantly higher in hyponatremic patients compared to controls. No mixed etiology were found between all studied cases. There were 16.7% CRF, 23.3% of intra cerebral, heamorhage 16.7 CHF, 16.7 diabetic ketoacidosis and 26.7% of respiratory failure. Mild hyponatremia was detected in patients (33.3%) while severe hyponatremia was detected in 20 patients (66.7%). There was significant elevation of fasting blood glucose and serum urea in total, mild, severe hyponatremic patients compared to controls, while serum triglycerides and serum creatinine showed significant elevation in total and severe hyponatremic patients compared to controls. Total proteins was significantly reduced in total, mild and severe hyponatremic patients compared to controls. The present study showed non significance difference in blood gases parameters (PH, PCO2, HCO3) and K+ levels in hyponatremic patients compared to controls and non significant correlation between serum Na+ level and the same parameters. The present study showed non significant difference in serum TSH level in all studied groups of hyponatremic patients compared to controls. Also, there was non significant correlation between serum Na+ and TSH level. The present study demonstrated significant elevation of the serum cortisol in (total and mild) hyponatremic patients compared to controls. While, non significant correlation between serum Na+ and serum cortisol level. Urinary Na+ level were significantly decreased in all studied groups (total, mild and severe hyponatremic patients) compared to controls. While non significant changes were found in urine osmolality, measured serum osmolality in all studied group compared to controls. In contrast calculated serum osmolality demonstrate significant decrease in severe cases and non significant changes in mild and total cases. Patients with higher serum osmolality had significant elevation in serum glucose, serum urea, uric acid, serum Na+ compared to patients with lower osmolality while non significant differences were found as regard serum total protein, triglycerides, urine osmolality, urine, cortisol and TSH. There were significant positive correlations between serum total proteins, calculated serum osmolality, urinary Na+ and serum Na+ in all studied groups. While there were significant negative correlation between serum glucose level, serum urea, serum creatinine, serum triglycerides and serum Na+ in all studied groups.