sir, But the standard protocol in acute or symptomatic case is giving 100ml 3%NS bolus 3 times or more till Sod. level improves by 4-6 mEq/L whenever patient has symptoms irrespective of Calculating then continue 3% NS by Calculating deficit till it reaches 125. Then only we diagnose and treat cause.
also, you told that if baseline is 110 in first four hours, you'll raise serum sodium to 114, then you told to increase by 8 that sums to total 122, ie increase by total 12 in first 24 hrs ...but maximum we can increase in a day is upto 10.... so, shouldn't our aim be to raise serum sodium till 120? Also, American Guidelines tell to stop infusion once sodium is 125, and if signs of improvement, if worsens then can give 50ml 3%ns bolus once or twice.... you didn't mention these or we don't follow in our settings?
Sir in 1st case of hypovolemic hyponatremia, (patient is severely dehydrated), only 2.2L fluid is sufficient to correct dehydration??? Or how we correct dehydration in this case???
Sir meri mummy ko insect bite suspected h ,unko fever and chills aa rhe the to pcm and dexa lga h ,abhi us area se swelling extend ho ri h please guide sir , please
I have seen physicians treating in opd basis for long standing hyponatremia in old age with sodamint tablets or nodosis tablets. I didn't seen use of oral sodabicarbonate for hyponatremia in medicine textbooks and your video also. Is this rationale correct?
Sir,suppose if i have a patient with hypotension and no idea about serum sodium status.if i give bolus normal saline will it cause pontine myelinolysis, if yes what precaution to be taken to prevent,if working in a small setup??
In last case which you discussed patient Na was 120 and was already taking spironolactone which itself causes hyponatremia… If fluid restriction is not enough do you think it’s wise to add another diuretic furosemide which also tends to cause sodium loss?? What if this patient has symptoms of hyponatremia?? Kindly share your views.
If in last case which you discussed patient had symptoms of hyponatremia and Na would have been suppose 110 and patient was on spironolactone with oedema what should you do? Stop spironolactone and substitute with furosemide or something else?? Kindly share you views
A doctor should have basic knowledge of English.......if it is in hindi it will b useful for only people who are in north india...if it's in English it will b beneficial for a lot of people irrespective of which region ur belongs to
Complicated topic explained in simplified manner. That is the beauity of a great teacher. Kudos to you sir.
Thanks a ton
Important topics explain in short time.. great explanation sir🙏🏻💐
Thanks and welcome
Sir, please don't stop posting these types of videos.
It's been very helpful for the residents who are posted in emergency wards like me.
Friend u will be more knowledgeable than ur seniors.
Every ,pg , consultant can learn .Short and to the point
It's our boon to us to get this informative videos
Glad it’s helpful for you
Such a great explanation, thank you sir
You are most welcome
Arvind sir ❤❤😊is gods given gift for medicos
So nice of you
Thank you sir .. u being the best
So nice of you
Sir ,very nice lecture thank you so much
Waiting such valuable vedios
Keep watching
You are really the best teacher what so ever. Many many thanks.
Welcome
Very good explanation seen ever ❤
Glad you liked it
Thank you, Respected Sir...
Most welcome
Very informative thanks you sir 🙏
Keep watching
This topic is so complicated but sir , you explained in a very simple way thank you so much
You are most welcome
Thank you so much sir 👍👍👍 very nice explaination.👌👌👌
Most welcome
Excellent lecture
Thank you sir
Most welcome
Sir please do arrhythmias… like practical approach… in real life scenario what drugs do we use in different arrythmias dose and how its given etc
Excellent lecture
Keep watching
nicely explained sir thank you sir ❤❤❤❤❤❤❤
Most welcome
Sir very helpful . Plz make a video on medical disorders of pregnancy. .
Thankyou sir❤
Thnk u sir for teaching us
It's my pleasure
Thank you so much sir
Very good video 👍🏻
Most welcome
Sar very useful explanation thanks to you sir
Keep watching
Thank you so much for the video sir huge respect for you .....
Best wishes always
It's a humble request sir if possible pls make videos on dermatology cases along with diagnosis and treatment ....
Very well explined❤
Thanks a lot 😊
Nice explaination sir👌
Thanks and welcome
Best lectures sir
Keep watching
Thank you sir!
You are welcome!
Thank you so much sir
Most welcome
Thank you very much sir in my mbbs final year onwardsi don't hyponatremia and management thanks for explanation in simple way 🙏
All the best
Thank you Sir
Most welcome
Hi sir very good evening ...
Excellent sir really , superb explanation ... each n everything.. thanks alot ... sir .. ❤
Please sir ... don't stop posting ... complicated topic .. really I have learned so much from ... 😊😊
Keep watching
Thankyou so much sir😊
Most welcome
Great explanation 👏
Glad it was helpful!
@@dr-arvindkumar 🙏
Sir if possible please publish your own clinical book
We would be highly thankful to you
Make videos on opd COPD management
Asthma management
Hyperthyroidism
Nice presentation sir, plasma osmolality measured or calculated?
Great sir❤
sir, But the standard protocol in acute or symptomatic case is giving 100ml 3%NS bolus 3 times or more till Sod. level improves by 4-6 mEq/L whenever patient has symptoms irrespective of Calculating then continue 3% NS by Calculating deficit till it reaches 125. Then only we diagnose and treat cause.
Thank you so much dr im an aspiring internist in kenya.
Plsase do a video on management of ckd abd cirrhosis
Noted
Sir your presentation is excellent but you did not explain how to treat diuretic induced hyponatremia
Make a you tube
Same as hypovolumic hyponatremia
Sir Hindi main explain kijiyega sir
Sir pls make more video for general practitioner🙏🙏
Sure I will
Great explanation, I see many doctor prescribe sodium bacarbonate is that relevant to hyponatremia managment
No
@@dr-arvindkumar thx, can you tell me the reason why to use sodium bicarbonate tablets
Very nicely explained sir
How do we treat Na level of 130 ?
Treat the cause
also, you told that if baseline is 110 in first four hours, you'll raise serum sodium to 114, then you told to increase by 8 that sums to total 122, ie increase by total 12 in first 24 hrs ...but maximum we can increase in a day is upto 10.... so, shouldn't our aim be to raise serum sodium till 120? Also, American Guidelines tell to stop infusion once sodium is 125, and if signs of improvement, if worsens then can give 50ml 3%ns bolus once or twice.... you didn't mention these or we don't follow in our settings?
Sir Frusemide is a diuretic. Will it not aggravate hyponatremia?
It causes equivalent amount of Na and water loss
Sir in 1st case of hypovolemic hyponatremia, (patient is severely dehydrated), only 2.2L fluid is sufficient to correct dehydration??? Or how we correct dehydration in this case???
Dehydration correction is separate.NS quantity only for Na correction
Sir how do u treat
Patients of hyponatremia
Secondary to thiazide
Induced hyponatremia also has SIADH
Same as hypovolumic hyponatremia
Sir ..does membership includes more such practical video ...as i am a practicnor and not a student for pg exams ...will the membership help me ....??
Membership right now is only for NEET PG/INICET exams.
Na-132 .Can natrise be given?He is 93 years old and symptomatic
Not needed at this level
Sir meri mummy ko insect bite suspected h ,unko fever and chills aa rhe the to pcm and dexa lga h ,abhi us area se swelling extend ho ri h please guide sir , please
NICE sir
Sir, for correction of hyponatremia usually we give maximum around 30ml/ HR in our hospital, what is the Max infusion rate per hour ? sir
That depends on correction rate.For acute and chronic it’s different rate
@@dr-arvindkumar sir ,if as per correction formula infusion can be given at any rate upto70-80/ hr
I have seen physicians treating in opd basis for long standing hyponatremia in old age with sodamint tablets or nodosis tablets. I didn't seen use of oral sodabicarbonate for hyponatremia in medicine textbooks and your video also. Is this rationale correct?
Not correct to give soda bicarbonate
@@dr-arvindkumar thank you sir for this special information
Sir,suppose if i have a patient with hypotension and no idea about serum sodium status.if i give bolus normal saline will it cause pontine myelinolysis, if yes what precaution to be taken to prevent,if working in a small setup??
It will not
@@dr-arvindkumar thanku sir for the wonderful video and clearing my doubt.
Sir kindly include emergency medicine residents also
These topics are also very useful for MD emergency medicine residents
Sure I will
In last case which you discussed patient Na was 120 and was already taking spironolactone which itself causes hyponatremia… If fluid restriction is not enough do you think it’s wise to add another diuretic furosemide which also tends to cause sodium loss?? What if this patient has symptoms of hyponatremia?? Kindly share your views.
You will be surprised to know that Furosemide doesn’t cause hyponatremia
If in last case which you discussed patient had symptoms of hyponatremia and Na would have been suppose 110 and patient was on spironolactone with oedema what should you do? Stop spironolactone and substitute with furosemide or something else?? Kindly share you views
How can I contact you for consultation
Call 7982456723
Sir,a small suggestion..try Hinglish in your videos...it will help many doctors to understand better... Thanks
It won’t help doctors in the south or those who don’t know Hindi! You are a doctor and you should understand English!
A doctor should have basic knowledge of English.......if it is in hindi it will b useful for only people who are in north india...if it's in English it will b beneficial for a lot of people irrespective of which region ur belongs to
Please don't
Onu english can reach many people
Im south
I can gain more knowledge as it is only said through English
Thanks sir..