I am totally confused now , after certan new recommendations about managementof hypernatremc dehydration . we all knew that during corection of the dehdration in hypernatremic setting one has to go slow to avoid cerebral oedema as , neuronal cells make their own osmolar substances and even before the intervention in form of infusion of the fluids is done , osmlality is restored to some extent , by fluid moving in to cells .there are some recommendations that relatively hypertonic fluid ( eg half strength saline in a 2 weeks old child ) should begiven to pevent cerebral oedma during correction of dehydration . whils this will further increase serum sodium level to my best understanding . Can you please explianmanagemt of Hypernatremic dehydration to me     Check out the answer

Normally looking children with excessive sweating of palms thyroid function normal how to manage     Check out the answer

A 2 mon. old child was investigated for repeated convulsions which were tonic,clonic in nature,responding to IV Calcium gluconate dramatically.Sr.Calcium 5.6mg%,Sr.Magnesium 1.4mg%,Alkaline Phosphatase760iu,Hb. 7.8Gm%,Sr.Phospherous 7.1mg%,CBC Not specific,Repeated Sr.Calcium levels were below 6 mg%.CT scan and Sr.Parathormone levels not done.Treated with Iv calcium gluconate IM Magsulf.What should be the probable diagnosis?PL suggest any additional investigations.     Check out the answer

Dear sir I meet frequently alot of cases of dirrhea some of them are hypertonic dehydration we have no investigation facility most of the cases will have repeated fits then died dispite the following regime 1- i.v fluid 1\5 glucose saline 80ml\kg weight slow infusion in two days after combating shock to avoid rapid correction of Na level 2- Ca in drip to avoid fit 3- antibiotic cover 4- antiepelitic mesures 5- no invetigation in all iraq because of the war what will you do if you are in my place     Check out the answer

How to differentiate from clinical sign hypo,hyper or normonatremia dehydrated in diarrhea's patient without check for their electrolyte status, and how to correct it? what kind of infuse should we use?     Check out the answer

What is the normal spot urine sodium potassium levels in children     Check out the answer

At what age can we give ors     Check out the answer

A 2yr male child has episodes of hypercarbia range of pco2 120 to 130 -is ventilated - lungs not that bad does not breathe adequately and cns good if co2 falls if it rises drowsy. Lungs seem grossly ok . How do we make him breathe better of his own ? does cchs behave like this ? if so what do we do to help him - chronic ventilation is something they cannot afford     Check out the answer

Please tell me how does one manage some and severe dehydrations in neonates? Are there different protocols and fluids for managing them, given their electrolyte values and renal immaturity?     Check out the answer

What is meant by central pontine myelinosis? q.2 What happens to Na in DKA. plz tell also regarding corrected sodium.     Check out the answer

3 months male child wt-3.3 kg, repeatedly admitted after every 7days from the age of 2 months of life with complaints of vomitting, fits or respiratory distress. he is on exclusive mother feed. he has been found to have persistent hyponateramia, hyperkalemia and metabolic acidosis AND was HYPOTENSIVE. his serum ACTH, 17 OH-progesterone and plasma renin was sent after 12 hours of commencement of normal saline. results are following Serum --ACTH -----135 mg\dl (normal-46 mg/dl) -plasma renin------0.29 mg/dl -17 OH- Progesterone ---12 mg/dl ( age adjusted < 2mg/dl) ---SERUN ANION GAP ------25 TREATMENT GIVEN: 1-I/V FLUID NORMAL SALINE FOR INITIAL two DAYS 2-TREATMENT FOR HYPERKALEMIA 3-HYROCORTISONE on stress dose(40mg/m2/day in three divided doses continued for 7days ,then shift to 20 mg/m2/day in divided doses) 4- FLORINEF 0.2 MG/DAY IN TWO DIVIDED DOSES serum CORTISOL, ALDOSTERONE TESTOSTERONE couldnot be sent initially due to financial constrained. Later when patient remain hyponateremic ( plasma Na ranges between 129----131mmol/l) on 0.2mg Florinef , diagnosis was reevaluated and following investigation was sent , note patient is continously taking medication when investigation was sent ---TESTOSTERONE LEVEL---- LOW NORMAL -SERUM CORTISOL ------- LOW NORMAL -ALDOSTERONE ---REPORT AWAITED MY QUESTIONS ARE: 1- WHAT ARE THE DIFFERENTIAL DIAGNOSIS 2- WHAT FURTHER MANAGEMENT REQUIRED     Check out the answer