profound hyponatremia

31yrs/M newly diagnosed with HIV presented to casusalty in with tonic clonic activity,The patient reported several syncopal events only a months prior to admission. *Chief Complaints* Headache, vomitting *Vitals* GCS -12/15,Bp -160/90,PR -92,RR -22,Spo2-98°F,Temp -100°F *Lab Report* CD4 counts -402,TLC -12000,CRP -22,B.urea -48,S.creatinine -1.8,Elevated liver enzymes,Na -132,K -2.2.

60yrs O/C/O laparotomy for sigmoid volvulus. 3rd day .drowsy. tachypnoeic. BP 100/60. PR 120. Na 126.K 3.6.PH 7.4. oedema+. .ECG findings?please opine .

57 yrs old female come to casualty with drowsy condition BP 92/60 mmhg urine output about 250 ml in 24 hrs Na 76 k 2.3 CT head normal. Trop T negative

A 80 years female KCO HTN (on TELMA-CT 6.25mg BD & Metazok 50 OD) , b/b realetive with c/o Alfred behavior with Drowyness since 2 days.. BP 140/90 mmhg HR 83 bpm E3V3M5 ABG , ECG, CXR, ECHO GIVEN. ?MANAGEMANT

54-year-old man known case of diabetes since eight years on insulinPresented with the loss of appetite since one month, vomiting since 15 days nonprojectile, I history of decrease urine output since one month History of seizure of two episodes which lasted for 5 to 10 minutes Last night. Pass history:Patient went to a nearby government hospital for diabetic work up where his sr creatinine and found to be elevated patient was referred to Apollo Hospital for further management. Patient was admitted in Apollo Hospital six months back where he was diagnosed and diabetic kidney disease and dyselectrolemiaAnd patient electrolytes where are corrected and patient vitals were haemodynamically stable and discharge from the hospital. Patient is a known case of diabetes on insulin since eight years On examination:Patient drowsy GCS:14/15 ABG :respiratory alkalosis Pupil:2 mm NRTL DRY SKIN Treatment given 3% NAcl @20 ml / hr