Hyponatremia As A Predictor Of Adverse Outcome In Children With Severe Lower Respiratory Tract Infection In Tribhuvan University Teaching Hospital (Tuth), Nepal

Hyponatremia As A Predictor Of Adverse Outcome In Children With Severe Lower Respiratory Tract Infection In Tribhuvan University Teaching Hospital (Tuth), Nepal | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Hyponatremia As A Predictor Of Adverse Outcome In Children With Severe Lower Respiratory Tract Infection In Tribhuvan University Teaching Hospital (Tuth), Nepal Machhindra Lamichhane, Laxman Shrestha, Luna Bajracharya, Archana Bagale This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.2.20441/v2 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 03 Apr, 2022 Read the published version in Saudi Journal of Medicine → Version 2 posted You are reading this latest preprint version Show more versions Abstract Background Lower respiratory tract infection (LRTI) is one of the major causes of mortality in children with estimated 1 million deaths every year. Hyponatremia is the most common electrolyte abnormality seen in LRTI. Objective To find association of hyponatremia (serum sodium<135meq/l) with severe LRTI. Design Prospective cross sectional study Settings Pediatric Emergency, Ward and Pediatric Intensive Care Unit of Tribhuvan University Teaching Hospital(TUTH) Subjects Children between 2 months to 16 years presenting with cough for less than 3 weeks, fast breathing and chest indrawing. Methods Children between 2 month to 16 years of age having cough, fast breathing and chest indrawing admitted in emergency, ward or PICU of TUTH were screened and among them, children having pediatric respiratory severity score of 4-5 were enrolled in the study. Serum sodium was sent during admission and collected within 2 hours. Daily follow up was done to find need of respiratory support, duration to resolve hypoxia, total duration in hospital and final outcome of patient. Statistical test applied were Chi-square test and Fisher exact test. Results 47.5% of study population had hyponatremia, of whom 65.79% had mild hyponatremia 26.31% had moderate and 7.89%had severe hyponatremia. Association of hyponatremia with need of non rebreathing face mask (p=0.001), ventilatio r (p=0.009), duration of hospital stay (p=0.047) were significant. The study also found the association of severity of hyponatremia with need of non rebreathing facemask (p=0.001),ventilator (p=0.01), outcome (p=0.001), duration of stay (0.002). Mean time to resolve hypoxia in children with hyponatremia (4.5 days) was longer compared to normal sodium (2.58 days). Four patients died during the study period and all of them had hyponatremia. Pediatrics Pulmonology Hyponatremia Severe LRTI TUTH Figures Figure 1 Figure 2 Figure 3 Background Lower respiratory tract infection (LRTI) is infection below the level of the larynx and it includes bronchiolitis, pneumonia and empyema. It is inflammation of the airways/pulmonary tissue, commonly due to viral, bacterial or fungal infection( 1 ). ARIs are the major cause of mortality among children aged less than 5 years especially in developing countries. Worldwide, 1 million (16%) mortality among children aged less than 5 years is attributed to respiratory tract infections predominantly pneumonia associated. Southeast Asia stands first in number for ARI incidence accounting for more than 80% of all incidences together with sub-Saharan African countries( 2 , 3 ). Children with ARI account for 30% to 50% of the children attending outpatient clinics and 20% to 40% of admissions into hospitals( 4 ). According to Nepal demographic health survey 2016, prevalence of symptoms of ARI among children under age 5 in Nepal fell from 5% in 2011 to 2% in 2016. Prevalence of symptoms of ARI was the highest among children age 6-11 months and age 12-24 months (4% each), followed by children age 24-35 months (2%)( 5 ). LRTI comprises bronchiolitis, pneumonia and empyema. Bronchiolitis is one of the common childhood illness and Respiratory syncytial virus is the most common etiologic agent. Hospitalization due to bronchiolitis is required in approximately 1% of affected children, primarily because of associated dehydration, inadequate oral intake, or respiratory insufficiency. Among those admitted, 10-15% requires intensive care due to impending respiratory failure( 6 ). Pneumonia is a form of acute respiratory infection that affects the lungs Pneumonia is usually preceded by upper respiratory tract infection, which promote invasion of lower respiratory tract by virus, bacteria or other pathogens that trigger an immune response. ( 7 ). Empyema is defined as collection of pus in pleural cavity. Common pathogens are Streptococcus pneumonia , Staphylococcus aureus and Streptococcus pyogenes. Empyema starts as moderate to large exudative parapneumonic effusion, which can progress to being loculated with further development of a fibrinous peel. This can be associated with fever, fast breathing and respiratory distress( 8 ). LRTI can be complicated as lung abscess, pneumatocele, pneumothorax, apnoea, hyperinflation, atelectasis, respiratory failure. Complications beside respiratory include sepsis, meningitis, pericarditis, endocarditis, osteomyelitis, septicarthritis, and electrolyte imbalance( 9 , 10 ). Fluids and electrolytes are the main pillars in the maintenance of body homeostasis. Most important among electrolytes is sodium which is the abundant cation of the extracellular fluid. Hyponatremia is the most common electrolyte abnormality seen in the intensive care unit (ICU), with an incidence as high as 30% in some reports( 11 , 12 ). Hyponatremia is defined as serum sodium (Na) concentration of less than 135mEq/L (9-10).A major consequence of hyponatremia is influx of water into the intracellular space, resulting in cellular swelling that can lead to cerebral edema and encephalopathy. The clinical manifestations of hyponatremia are primarily neurologic and related to cerebral edema caused by hypo- osmolality( 13 ). Hyponatremia associated with pediatric pneumonia is most commonly due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This syndrome is characterized by hyponatremia and hypo-osmolality. It results from the inappropriate and continued secretion and/or action of antidiuretic hormone despite normal or increased plasma volume ( 14 , 15 ). Hyponatremia associated with bronchiolitis is due to hyperinflation of lungs. Hyperinflation reduces blood flow to the right atrium and stimulates the release of vasopressin(AVP)from the posterior pituitary causing accumulation of intravascular fluid leading to dilutional hyponatremia( 16 ,). In a study done by Shingi S et.al to determine the frequency of electrolyte disturbance in pneumonia in 264 hospitalized children in chandigrah, India found hyponatremia in 71(27%) children with pneumonia. It was associated with two fold increase in complications and 3.5 times higher mortality( 17 ). Single-center retrospective cohort study was done in Children’s Hospital Colorado, USA comprising children age 1month to 2 years admitted to the PICU between January 2009 and April 2011. Study was done to characterize the relationship between hyponatremia and clinical outcome in bronchiolitis. One hundred and two children with bronchiolitis were enrolled. Twenty-three patients (22%) were diagnosed with hyponatremia. Mortality (13% vs 0%; P = .011), ventilator time (8.41 ± 2 days vs 4.11 ± 2 days; P = .001), duration of stay in the PICU (10.63 ± 2.5 days vs 5.82 ± 2.09 days; P = .007), and noninvasive ventilator support (65% vs 24%; P = .007) were significantly different between subjects with Hyponatremia than those without ( 18 ). Acute respiratory tract infection is one of the serious health problems leading to hospitalization and mortality. In developing countries, 7 out of 10 deaths happen due to ARI in under 5-year age group( 19 ). Acute respiratory infection is classified by World Health Organization (WHO) as no pneumonia(child presenting as cough and cold), pneumonia(child with cough an fast breathing and or chest indrawing) and severe pneumonia or very severe disease( child with cough, fast breathing, chest indrawing and danger signs like unable to drink, convulsions, stridor)( 20 ). In Nepal, according to the most recent Annual Health Report by Department of Health Services (DOHS), in fiscal year 2073/74, a total of 1,810,722 ARI cases were registered, out of which 10.5% were categorized as pneumonia cases and 0.29% were severe pneumonia cases. The incidence of pneumonia at national level was 66 per 1000 under five children( 21 ). Pneumonia Pneumonia is a form of acute respiratory infection that affects the lungs. ( 7 ). The physiological intrapulmonary shunting of de-oxygenated blood and ventilation perfusion mismatch following these pathological changes results in hypoxemia( 22 ). Causes of pneumonia in children are Bacteria- Escheriichia coli,Group B Streptococcus Listeria monocytogens in birth to 20days, Bacteria-Chlamydia trachomatis,Sterptococcus pneumonia Viruses Adenovirus,Influenza, Parainfluenza virus 1,2,3 from 3 weeks to 3 months, Bacteria-Chlamydia pneumonia,Mycoplasmapneumonia,Streptococcus pneumonia from 4 months to 5 years and from 5 years to adolescence Bacteria-Chlamydia pneumonia,Mycoplama pneumonia,Streptococcus pneumoniae( 23 ) Etiology of Bronchiolitis( 24 ) : Respiratory syncital virus(50%cases), Rhinovirus, Adeno virus, Influenza, Parainfluenza, Human metapneumovirus, Human Bocavirus, Mycoplasma pneumoniae, Chlamydophila pneumonia, Chlamydophila trachomatis. Bronchiolitis is a common cause of illness and is the leading cause of hospitalization in infants and young children. RSV infection is common in children older than two years( 25 ). Hypoxia, co-morbid condition such as diarrhea, age below 1 year, inability to feed, presence of loose stools and severe malnutrition are known factors for adverse outcome in children with lower respiratory tract infection. These factors increases duration of stay at hospital and if not managed properly can lead to death ( 26 , 27 ). Hyponatremia Table 1: Severity of hyponatremia Severity of Hyponatremia Sodium(mEq/L) Mild 131-135 Moderate 126-130 Severe <125 Hyponatremia is defined as serum sodium (Na) concentration of less than 135 mEq/L. The effect of ADH on plasma osmolality depends on intact kidney function, which is required for appropriate retention or excretion of free water. ( 28 ). SIADH syndrome is characterized by hyponatremia and hypoosmolality and results from the inappropriate and continued secretion and/or action of antidiuretic hormone despite normal or increased plasma volume presumably due to inflammatory cytokines, such as interleukin-6 ( 29 ), stress, and hypoxemia( 30 , 31 ). Hyperinflation of the lungs, a hallmark of the bronchiolitis, wheezing, reduces blood flow to the right atrium and stimulates the release of vasopressin(AVP)from the posterior pituitary causing accumulation of intravascular fluid leading to dilutional hyponatremia( 32 ). Pediatric Respiratory Severity Score (PRESS score) This score was devised for a study done in National Hospital Organization Yokohama Medical center, an urban emergency hospital in Japan, in 2010-2011 to establish and examine the utility for assessing severity in children with respiratory symptoms ( 33 ). The World Health Organization has suggested that children suspected of having infective illnesses and presenting not only with drowsiness, feeding difficulties, vomiting, convulsion but respiratory complains as dyspnoea should be hospitalized quickly( 34 ). For calculating the score, objective signs such as respiratory rate, wheezing, retraction (accessory respiratory muscle use), SpO2, and feeding difficulties are assessed with each component given a score of 0 or 1, and total scores classified as mild (0–1), moderate (2–3), or severe (4–5). Using PRESS score, hospitalization rate was higher in moderate to severe cases and duration of oxygen therapy was significantly longer in severe cases compared with mild and moderate cases. Table 2 : Pediatric Respiratory Severity Score ( PRESS ) ( 33 ) Score component Operational definition 0 or 1 Respiratory rate Month RR 60 12- 36 months >40 >36 months > 30 Wheezing/ Crepitations Based on auscultation Accessory muscle use Subcostal retraction, intercostal recession, suprasternal recession Spo2 Less or more than 95 % Feeding difficulties Refusing feedings or not Methodology Research Design: Prospective Cross sectional Study Research Method : Quantitative Type of study: Observational study Study Population/Sampling Frame : Children of age 2 month to 16 years with severe lower respiratory tract infection admitted in TUTH during duration of data collection. Study site : Emergency, ward and PICU of Tribhuvan University Teaching Hospital. Sampling Method: Purposive sampling technique was used to select patient with lower respiratory tract infection admitted in emergency, Pediatric ward and PICU of Tribhuwan University Teaching Hospital. Sample size: 80 Inclusion criteria Children 2 months to 16 years admitted at TUTH with cough(<3 weeks), fast breathing and chest indrawing. PRESS score 4-5 Duration of the Study : 1 year Data Management and Statistical Analysis Data were entered in Microsoft Excel and converted into SPSS 20 version for statistical analysis. The descriptive data were expressed in frequency, percentage, mean, standard deviation, median etc. along with graphical and tabular presentation.Descriptive statistics was used to analyse data like mean, median and mode and standard deviation (SD). Inferential statistics i.e. Chi square test, Fisher exact test were used at 95% confidence interval where p value<0.05 was considered statistically significant to assess association of hyponatremia with selected outcome variables and to assess association of socio-demographic variables. Results The study was conducted over a period of 12 month from September 1 st 2017 to September 1 st 2018. Total 90 cases were screened, 10 cases were excluded. Among the excluded case 5 cases were of congenital heart disease, two patients came after receiving IV fluids , 2 cases had cough for more than 3 weeks and 1 patient had PRESS score of less than 4.Total 80 children were enrolled. Thirty eight patients had hyponatremia at presentation. Patients were admitted in pediatrics ward or pediatric ICU. Serum sodium was sent during IV cannulation after stabilizing the patients, patients were followed till discharge or mortality. Outcome evaluated were need of non invasive and invasive respiratory support, time taken for hypoxia to resolve, discharge of the patient or mortality Fig 1: Flow chart of screened and enrolled cases in the study Sociodemographic variable of study population Fig 2: Age of study population Figure 2 shows age of study population. Out of 80 children, majority of the children were infant accounting for 41.3% followed by toddler and preschool children. Fig 3: Sex of study population Figure 3 shows the sex distribution in study population. Out of 80 children 66.25%were boys and rest were girls. Table 3: Sociodemographic variable of study population n=80 Variables Characteristic* Frequency Percentage (%) Age of study population (mean ±SD)=(2.3± 1.4) years Father’s education Lower secondary Secondary Higher secondary University level 18 23 11 28 22.5 28.8 13.8 35 Mother’s education Lower secondary Secondary Higher secondary University level 18 27 14 21 22.5 33.8 17.5 26.3 Father’s occupation Technical/professional Sales/service agriculture labor abroad 26 26 4 8 16 32.5 32.5 5 10 20 Mother’s occupation Technical/professional Sales/service agriculture labor housewife 10 6 1 1 62 12.5 7.5 1.3 1.3 77.5 *Characteristics of parent’s education and occupation according to NDHS 2016 Above table 3 depicts sociodemographic variable of study population, about one third of father had university level education followed by 28.8% in secondary level. Among mothers about one third that is 33.8% mothers had education upto secondary level followed by 26.3% university level. Occupation of most of the fathers was technical/ profession and sales/service each 32.5% and 77.5% of the mothers were housewife. Table 4: Clinical characteristics of study population n=80 Characteristics Frequency Value Percentage (%) Cough (mean ±SD) 80 5.15 ( ± 2.89)days Fast breathing (mean ±SD) 80 2.687( ± 1.24) days Chest indrawing (mean ±SD) 80 1.74 ( ± 0.97)days Refusal to feed 15 18.7 Fever 54 67.5 Respiratory rate(mean) · Infant · Toddler · Preschool · School going · Adolescent 33 15 14 9 9 (64.69±5.62)/min (58.33±10.96)/min (36.28±3.22)/min (47.22±15.98)/min (44.22±12.46)/min Temperature(mean ±SD) 80 (99.13 ±1.63) F Oxygen saturation(mean ±SD) 80 (88.5± 7.17)% Hypoxia* 31 38.75 Wheeze on auscultation 31 38.75 Crepitation on auscultation 49 62.25 Respiratory support Need of nasal prongs 70 87.5 Need of simple facemask 61 76.25 Need of non rebreathing face mask 16 20 Need of CPAP 7 8.75 Need Ventilator 6 7.5 *Hypoxia defined by WHO as oxygen saturation <90% The above table shows clinical characteristics of study population. Mean duration of cough was 5.15 (± 2.89) days , mean duration of fast breathing was 2.687( ± 1.24) and mean duration of chest in drawing was 1.74 ( ± 0.977). Among 80 children 18.7% had refusal to feed during the illness meanwhile 67.5% children presented with fever. Mean duration of fever was 3.36 days (± 3.34). Thirty one children were hypoxic at presentation. Examination of chest revealed crepitation in 61.25% and 38.75% had wheeze. All study population required oxygen support. Mean time required for weaning oxygen was 4.22 days and mean time for complete discontinuation was 4.93 days. Among the eighty patient 87.5% required nasal prongs and 76.25% children required simple facemask. CPAP was given in 8.75% children and 7.5% children required mechanical ventilation. Table 5: Prevalence of hyponatremia in study population n=8-0 Variables characteristics Frequency Percentage Serum sodium level Hyponatremia 38 47.5 Normal Sodium 42 52.5 Hyponatremia(n=38) Severity of hyponatremia Mild (131-135) 25 65.79 Moderate( 126-130) 10 26.31 Severe (less than 125) 3 7.89 The above table 6 shows prevalence of hyponatremia in the study population.Among the study population38 (47.5%) had hyponatremia. Among hyponatremic children 25 (65.79%) had mild hyponatremia followed bymoderate 10 (26.31%) and severe hyponatremia (7.89%). Table 6: Association of hyponatremia with need of non-rebreathing face mask n=80 Sodium Need non-rebreather p* No Yes Total 0.001 Hyponatremia 23 15 38 Normal Sodium 41 1 42 Total 64 16 80 * Chi square test was used to find association of hyponatremia with need of non-rebreathing face mask Above table shows association of hyponatremia with need of non-rebreathing facemask. Total sixteen patients required non rebreathing face mask. Among them 15(93.75%) patients with had hyponatremia needed non rebreathing facemask however only 1(6.25%) patients had normal sodium . Association of hyponatremia with need of non rebreathing face mask was statistically significant (p= 0.001) Table 7: Association of hyponatremia with need of CPAP n=80 Sodium Need CPAP p* No Yes Total Hyponatremia 34 4 38 0.702 Normal sodium 39 3 42 Total 73 7 80 * Fisher exact test was used to find association of hyponatremia with need of CPAP Above table 7 shows association of hyponatremia with need of CPAP. Total seven children needed CPAP. Four cases with hyponatremia needed CPAP howeverthree patients with normal sodium also needed CPAP. Association of hyponatremia with need of CPAP was not statistically significant (p=0.702). Table 8: Association of hypoponatremia with need ventilator n=80 Sodium Need ventilator p* No Yes Total Hyponatremia 32 6 38 0.009 Normal sodium 42 0 42 Total 74 6 80 * Fisher exact was used to find association of hyponatremia with need of ventilator Above table 8 shows relation of hyponatremia with the need of ventilator. Among eighty children, six patients were ventilated and all of them had hyponatremia. Therefore association of hyponatremia with need of ventilator was highly significant (p=0.009). Table 9: Association of hyponatremia with outcome Serum sodium level Outcome Total p* Mortality Improved Hyponatremia 4 34 38 0.047 Normal Sodium 0 42 42 Total 4 76 80 * Fisher exact test test was used to find association of hyponatremia with outcome The above table 9 shows association between hyponatremia and outcome. Among the study population, 4 patients with hyponatremia had mortality and none of the patient with normal sodium expired. Association of hyponatremia with outcome was statistically significant (p=0.047). Table 10: Association of hyponatremia with Duration of stay n=80 Sodium Duration of stay p* 7days Total Hyponatremia 22 16 38 0.002 Normal sodium 37 5 42 Total 59 21 80 * Chi square test was used to find association of hyponatremia with duration of stay Above table 10 shows association of hyponatremia with duration of stay. Duration of stay was divided into more than and less than 7 days. Among eighty patient 59(73.75%) patient had duration of stay less than 7 days and21 (26.25%) had stay more than 7 days. Sixteen patients with hyponatremia had stay more than 7 days and 5 patients with normal sodium had stay more than 7 days. Association of hyponatremia with duration of stay was statistically significant (p value= 0.002). Table 11: Association of hyponatremia with oxygen saturation Level of Sodium Saturation p* 90% Total 0.13 Hyponatremia 18 20 38 Normal sodium 13 29 42 Total 31 49 80 * Chi square test was used to find association of hyponatremia with oxygen saturation The above table shows association of hyponatremia with oxygen saturation level at presentation. Association of hyponatremia with oxygen saturation level was not statistically significant (p=0.13). The mean time required for resolution of hypoxia in children with hyponatremia with severe LRTI (4.5 days) was more compared to mean time required for resolution of hypoxia in children with normal sodium with severe LRTI (2.58 days). Table 12: Association of severity of hyponatremia with need of CPAP of study population n=80 Characteristics Need CPAP p* No Yes Total Sodium level Mild hyponatremia 21 4 25 0.534 Moderate hyponatremia 10 0 10 Severe hyponatremia 3 0 3 Normal sodium 39 3 42 Total 73 7 80 * Fisher exact test was used to find association of severity of hyponatremia with need of CPAP Above table 12 depicts association of hyponatremia with need of CPAP. Among 80 patients, 7 patients required CPAP. Among seven patients only 4 i.e. (57.1%) with mild hyponatremia required CPAP however 3 i.e. (42.9%) with normal sodium also required CPAP. Severity of hyponatremia with need of CPAP was not significant (p=0.534). Table 13: Association of severity of hyponatremia with need of non-rebreathing facemask n=80 Characteristics Need non rebreathing facemask p* No Yes Total Sodium level Mild hyponatremia 15 10 25 0.001 Moderate hyponatremia 8 2 10 Severe hyponatremia 0 3 3 Normal sodium 41 1 42 Total 64 16 80 *Fisher exact test was used to find association of severity of hyponatremia with need of non-rebreathing facemask Among the eighty study population sixteen patients required non rebreathing facemask. Among 16 patient 10 (62.5%) had mild hyponatremia followed by 2 (12.5%) moderate and 3(18.75%) severe hyponatremia, all three patients with severe hyponatremia required non rebreathing face mask. Therefore association of severity of hyponatremia with need of non-rebreathing face mask was highly significant (p=0.001). Table 14: Association of severity of hyponatremia with need ventilator of study population n=80 Characteristics Need ventilator p* No Yes Total Sodium level Mild hyponatremia 24 1 25 0.01 Moderate hyponatremia 7 3 10 Severe hyponatremia 1 2 3 Normal sodium 42 0 42 Total 74 6 80 *Fisher exact test was used to find association of severity of hyponatremia with need of ventilator Above table 14 shows association of severity of hyponatremia with need of ventilator, among 80 patient 6 patient required ventilator support. Among the ventilated children 3 (50%) had moderate hyponatremia, 2 (33.3%) had severe hyponatremia and 1 (16.67) % had mild hyponatremia. Association of severity of hyponatremia with need of ventilator was statistically significant significant (p=0.01). Table 15: Association of severity of hyponatremia with outcome n=80 Characteristics Outcome p* Mortality Improved Total Sodium level Mild hyponatremia 0 25 25 0.001 Moderate hyponatremia 3 7 10 Severe hyponatremia 1 2 3 Normal sodium 0 42 42 Total 4 76 80 *Fisher exact test was used to find association of severity of hyponatremia with outcome Above table 15 depicts association of severity of hyponatremia with outcome. Among 80 patients four patients expired. Among four expired patient 3 (75%) patient had moderate hyponatremia and 1(25%) had severe hyponatremia. Association of severity of hyponatremia with outcome was statistically significant (p=0.001). Table 16: Association of severity of hyponatremia with duration of stay n=80 Characteristics Duration of stay p* 7 days Total Sodium level Mild hyponatremia 17 8 25 0.001 Moderate hyponatremia 5 5 10 Severe hyponatremia 0 3 3 Normal sodium 37 5 42 Total 59 21 80 *Fisher exact test was used to find association of severity of hyponatremia with duration of stay Above table 16 depicts association of severity of hyponatremia with duration of hospital stay. Discussion Lower respiratory tract infection is associated with electrolyte abnormalities like hyponatremia, hypernatremia, hypokalemia, hyperkalemia. Among them hyponatremia is the most common electrolyte imbalance( 17 ). This study was conducted to find association between hyponatremia and adverse outcome of severe lower respiratory tract infection in children between 2 month to 16 year admitted in Emergency, ward and PICU of Tribhuvan University Teaching Hospital. The study was conducted over 12 months duration from September 1 st 2017 to September 1 st 2018. Total 80 cases were enrolled. In current study, 47.5% of the study population presenting with severe lower respiratory tract infection at admission were found to have hyponatremia. Most of them (65.78%) had mild hyponatremia. Association between hyponatremia and need of non-rebreathing facemask (p=0.001), need of ventilator (p=0.009) and clinical outcome (mortality or improvement) (p=0.047) was statistically significant (P<0.05). During the course of hospital stay, the mean time required for resolution of hypoxia was found higher in children with hyponatremia (4.5 days) as compared to the children with normal sodium (2.58 days). Association of hyponatremia with oxygen saturation at presentation was not significant. Children with hyponatremia had prolonged hospital stay compared to children with normal sodium and the association was statistically significant (p=0.047). Age and gender of study population In this research mean age of study population was (2.3± 1.4) years and 66.25% of study population were boys. In a study conducted by Chaitra et al had similar results. The study was conducted in 91 patients suffering from LRTI admitted in PICU of Kempegowda Institute of Medical Sciences, Banglore in children age 2 months to 16 years. The mean age of study population was 2 years and 59% of the children were boys( 1 ). In the cross sectional study done to see prevalence of hyponatremia in children admitted at Kenyatta national hospital with pneumonia in 135 children aged between 2 month to 12 years, the mean age was 1.8 + 2.3 years and 54.8% of the study population were boys( 35 ). Prevalence of hyponatremia In present study 47.5% of study population had hyponatremia. When evaluated for severity of hyponatremia, 65.79% had mild hyponatremia followed by 26.31% children with moderate and 7.89% with severe hyponatremia. In a study conducted by Chaitra et.al in Bangalore, India to find frequency of hyponatremia in 91 children from July, 2014 to December, 2014, prevalence of hyponatremia was 46.7%. Among children with hyponatremia, 20 (71%) had mild, 6 (21.4%) had moderate and 2(7%) had severe hyponatremia. These findings are similar to the present study( 1 ). Hospital based cross sectional study was carried out at Assam Medical College and Hospital, Dibrugarh from April 2012 to March 2013 to find frequency of hyponatremia in pneumonia. They found hyponatremia in 46.7% with bronchopneumonia. In the majority of cases, 71% had mild hyponatremia, 21.4% had moderate and 7% had severe hyponatremia. The results were consistent with current research( 37 ). The findings of the present study are also consistent with the study conducted by Sakellaropoulou et al in Bielanski hospital in Warsaw, Poland. The study was conducted from January 2009 to December 2010 to find prevalence of hyponatremia in pneumonia. Nineteen children (35.18%) with pneumonia had hyponatremia at admission of whom 18(33.3%) had mild hyponatraemia and 1 (1.9%) had moderate hyponatremia.( 36 ) In a study done by Shingi S et.al to determine the frequency of electrolyte disturbance in pneumonia in 264 hospitalized children in Chandigrah, India, hyponatremia was present in 27% children with pneumonia. The percentage of moderate and severe hyponatremia was 27% and 4.5% respectively, results are consistent to our research( 17 ). In the cross sectional study to find prevalence of hyponatremia in children admitted at Kenyatta national hospital with pneumonia in 135 children, 71.9 %( 97) children had hyponatremia. Among patients identified with hyponatremia, 40.6% had severe, 28.1% had moderate while 31.3% had mild hyponatremia. The result is higher compared to current finding. This may be because most of the children studied in Kenyatta national hospital presented late in hospital and they were critically ill and most of them also had associated complications( 35 ). Outcome – Need of respiratory support During this study, 38.75% patients were hypoxic at presentation. All patients were provided either noninvasive or invasive oxygen support. Noninvasive supports were nasal prongs, simple facemask and non-rebreathing facemask. Invasive respiratory support included bubble continuous positive air pressure (CPAP) and mechanical ventilation. Oxygen was provided via nasal prongs in 87.5% patients and via simple facemask in 76.25% during their hospital stay. Non re-breathing facemask was required 20% patient, CPAP in 8.75% patient. Total 6 (7.5%) patients were mechanically ventilated. Association of hyponatremia with the need of non-rebreathing facemask (p=0.001) and mechanical ventilation (p=0.009) was significant. However it was not statistically significant with the need of CPAP (p=0.702). The reason behind it may be, use of conventional bubble CPAP was not feasible in older children. Multi centered prospective cohort study was conducted by Hasegawa et al in United States to find association between hyponatremia in children with bronchiolitis and use of respiratory support admitted in pediatric intensive care unit. The study was conducted from winter of 2007 to 2010. In that study, children with hyponatremia had more risk of mechanical ventilation compared to children with normal sodium (58% vs 40%, p=0.04). In our study also all mechanically ventilated patient had hyponatremia ( 40 ). In our study, 31 children were hypoxic at presentation. Among them 58% children had hyponatremia and 42% had normal serum sodium level. Association of hyponatremia with oxygen saturation level at admission was not statistically significant (p=0.13). The mean time required for resolution of hypoxia in children with hyponatremia with severe LRTI (4.5 days) was more compared to children with normal sodium (2.58 days). In a study conducted by Basnet et al at Kanti children hospital, Nepal on 610 Nepalese children, aged 2 – 35 months from February 2006 to June 2008, hypoxia was a significant predictor for time till recovery in children with severe pneumonia( 50 ). In our study also hypoxic children with LRTI required more time for recovery than children with normal oxygen saturation. Outcome- Duration of stay In the study conducted by Patil et.al. in 300 children in Assam Medical College and Hospital, Dibrugarh, India from April 2012 to March 2013 with objective to compare duration of stay in hyponatremic and normonatremic patient with pneumonia. The mean duration of hospital stay of patient with hyponatremia in pneumonia was around 9.54 ± 2.63 days however in patient without hyponatremia was 6.43±1.16 days. Association of hyponatremia with duration of stay was significant (p value <0.01). The result is consistent with our findings( 37 ). In a retrospective study was done in 312 children with pneumonia from January 2009 to December 2010 in Bielanski Hospital, Warsaw, Poland , the duration of hospital stay was longer (9 days vs. 8 days, p= 0.01) in the hyponatremic children compared with the children without hyponatremia. These findings are similar to results derived from present study (38). A retrospective cross sectional study done by Lavagno et.al in Cheil General Hospital and Women’s Health Care Center, Seoul South Korea in 3938 children with respiratory infections between March, 2011, and February, 2014 is also consistent with present study. In this study, the duration of hospital stay in children with hyponatremia was 4.5±1.5 days and4.3±1.5 days in children with normal sodium ( p=0.020)(39). Another study was done by Kaneko et.al in Department of Pediatrics, Juntendo University Urayasu Hospital,Chiba, Japan. Medical record of 138 children was reviewed retrospectively in the year 2004. Objective of the study was to found the relation of hyponatremia and duration of hospital stay. Duration of hospital stay was 7.00± 3.38 days (mean ± standard deviation) for the hyponatremic patient and 6.04± 3.82 for normonatremic patient and comparision was statistically not significant (P>0.05) .( 40) Outcome- Mortality In this study, 4 patients with hyponatremia had mortality, none of the patient with normal sodium expired. Association of hyponatremia with outcome was statistically significant (P=0.047). Among 4 expired patient, 3 (75%) patient had moderate hyponatremia and 1 (25%) had severe hyponatremia. Association of severity of hyponatremia with outcome was statistically significant (p=0.001). The finding is consistent with the single-center retrospective cohort study done in Children’s Hospital Colorado, USA done by Luu et.al. One hundred and two children were studied from January1, 2011 to July1, 2011 to characterize the relationship between hyponatremia and clinical outcomes in children ages 1 month to 2 years admitted to the pediatric intensive care unit (PICU) with bronchiolitis. Thirteen percent of patient with hyponatremia expired, however none of children with normal sodium expired. The association was significant (p=0.001)( 18 ) Conclusion Hyponatremia was found in 47.5% of children with severe lower respiratory tract infection. Among hyponatremic children, 65.79% had mild hyponatremia 26.31% had moderate and 7.89% had severe hyponatremia. Hyponatremia in severe lower respiratory tract infection is significantly associated with need of non-rebreathing facemask, need of ventilator and mortality. Children with hyponatremia in severe lower respiratory tract infection had prolonged hospital stay. Abbreviations ADH: Anti Diuretic Hormone, ARI: Acute Respiratory Infections, AVP: Arginine Vasopressin, CPAP: Continuous Positive Airway Pressure, DOHS: Department of Health Services, ICU: Intensive Care Unit, IV: Intravenous, LRT: Lower Respiratory Tract Infection, NDHS: Nepal Demographic Health Survey, PICU: Pediatric Intensive Care Unit PRESS: Pediatric Respiratory Severity Score, SIADH: Syndrome Of Inappropriate Antidiuretic Hormone, SD: Standard Deviation, SPSS: Statistical Package for Social Sciences, URTI: Upper Respiratory Tract Infection, WHO :World Health Organization Declarations Acknowledgement: The authors extends their sincere appreciations to the department of pediatrics, IOM, Maharajgunj Medical Campus and to all the participants of study for their cooperation during study. Authors Contribution : Guide of research paper: Prof. Dr. Laxman Shrestha, Co-guide: Dr. Luna Bajracharya, and Co-author: Ms. Archana Bagale (assisted during whole study and prepared the whole manuscript) Funding : The authors received no any specific grant from any funding agency in public, commercial or nonprofit sectors. Availability of data: data sheet was prepared by researcher by entering the respondents informations including outcomes of treatment obtained during data collection on excel for analysis of results. It is attached in section of additional file. Ethical approval and consent to participants The ethical clearance was taken from the Institutional Review Board of Institute of Medicine, Maharajgunj Medical Campus. Initial stabilization of patient was done immediately after presentation. The parents/ guardians of children fulfilling the inclusion criteria explained about this study and approached for consent. After informed consent was obtained, the child was enrolled in the study. Participation was voluntarily taken. Informed (verbal and written) consent was taken from each participant’s parents/guardians. Confidentiality and anonymity was maintained by writing code number instead of name of participants. Competing interests: The authors declare that they have no competing interests. Consent for publication : Not applicable Author Detail: Corresponding author : Dr. Machhindra Lamichhane, Department of Child Health, Maharajgunj Medical campus ,Institute of Medicine Tribhuvan University ,Kathmandu, Nepal, email: [email protected] : currently working as Consultant Pediatrician at Dhaulagiri Zonal Hospital, Baglung, Nepal Co-authors Prof. Dr. Laxman Shrestha, Head of Department, Department of Child Health, Institute of Medicine, TUTH [email protected] m Dr. Luna Bajracharya, Assistant professor, Department of Child Health, Institute of Medicine, TUTH, email: [email protected] Ms. Archana Bagale, Lecturer, Yeti Health science Academy( M.Sc Nursing (Maternal Health Nursing, MA Child Development and Gender Socialization) email: [email protected] References Chaitra K, Mohan N, Reddy S. Hyponatremia in lower respiratory tract infections. International Journal of Contemporary Pediatrics. 2016;3(2):381-4. Wardlaw TMJ, White E.,Hodge, Matthew. Pneumonia: the forgotten killer of children. World Health Organization; UNICEF2006. World Health Organization,Pneumonia Factsheet. 2016. Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bulletin of the World Health Organization. 2008;86(5):408-16. Nepal demographic health survey. 2016. Ventre K. MHaCD. Surfactant Treatment for Bronchiolitis in Critically Ill Infants. Cochrane Database of Systematic Reviews. 2006;3. Margolis P, Gadomski A. Does this infant have pneumonia? JAMA. 1998;279(4):308-13. Chibuk TK,Cohen E, Robinson JL, Mahant S. Paediatric complicated pneumonia: Diagnosis and management of empyema. Paediatr Child Health. Aug-Sep 2011;16(7). Gereige RS, Laufer PM. Pneumonia. Pediatrics in Review. 2013;34(10):438-56. 10 Willson DF, Landrigan CP, Horn SD, Smout RJ. Complications in infants hospitalized for bronchiolitis or respiratory syncytial virus pneumonia. The Journal of Pediatrics. 2003;143(5):142-9. Eisenhut M. Extrapulmonary manifestations of severe respiratory syncytial virus infection--a systematic review. Critical care (London, England). 2006;10(4):R107. Upadhyay A, Jaber BL, Madias NE. Incidence and prevalence of hyponatremia. The American journal of medicine. 2006;119(7 Suppl 1):S30-5. Moritz ML, Ayus JC . Disorders of WaterMetabolism in Children:Hyponatremia and Hypernatremia. Pediatrics in review. 2002;23 no 11:371-80. Sankaran RT, Mattana J, Pollack S, Bhat P, Ahuja T, Patel A, et al. Laboratory abnormalities in patients with bacterial pneumonia. Chest. 1997;111(3):595-600. Geriigk M,Gnehm HE, Rascher W . Arginine vasopressin and renin in acutely ill children: implication for fluid therapy. Acta Paediatrica. 1996;85(5):550-3. Van Steensel-Moll HA, Hazelzet JA, van der Voort E, Neijens HJ, Hackeng WH. Excessive secretion of antidiuretic hormone in infections with respiratory syncytial virus. Archives of disease in childhood. 1990;65(11):1237-9. Singhi S, Dhawan A. Frequency and significance of electrolyte abnormalities in pneumonia. Indian Pediatr. 1992;29(6):735-40. Luu R, DeWitt P, Reiter P, L Dobyns E, Kaufman J. Hyponatremia in Children with Bronchiolitis Admitted to the Pediatric Intensive Care Unit Is Associated with Worse Outcomes2013. 163(60: 1652-56. Park K. Acute respiratory infections. In:Park’s text book of preventive and social medicine, 20th Ed Jabalpur, M/s BanarasidasBhanot publishers. 2013:158-64. WHO. Revised WHO classification and treatment of childhood pneumonia at health facilities. 2014. Annual report. Department of health services,Nepal. 2073/2074. Rodriguez-Roisin R, Roca J. Mechanisms of hypoxemia. Intensive care medicine. 2005;31(8):1017-9. Kennetmcintosh MD. Community acquired pneumonia in children. N Engl J Med. 2002;346(6):429-37. Fretzayas A, Moustaki M. Etiology and clinical features of viral bronchiolitis in infancy. World J Pediatr. 2017:1-5. Shawn L. Ralston M, Allan S. Lieberthal M et al. Clinical Practice Guideline: The Diagnosis, Management,and Prevention of Bronchiolitis. American Academyof Pediatrics. 2014. 134:e1474-e1502 Patwari A. Risk Factors for Mortality in Children Hospitalized with Pneumonia. Indian pediatrics. 2012;49:869-70. Sehgal V, Sethi GR, Sachdev HP, Satyanarayana L. Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections. Indian Pediatr. 1997;34(3):213-9. Reid-Adam J, Hyponatremia. Pediatrics in review. 2013;34. (9): 417-19 29 Mastorakos G, Weber JS, Magiakou MA, Gunn H, Chrousos GP. Hypothalamic-pituitary-adrenal axis activation and stimulation of systemic vasopressin secretion by recombinant interleukin-6 in humans: potential implications for the syndrome of inappropriate vasopressin secretion. The Journal of clinical endocrinology and metabolism. 1994;79(4):934-9. Farber MO, Roberts LR, Weinberger MH, Robertson GL, Fineberg NS, Manfredi F. Abnormalities of sodium and water handling in chronic obstructive lung disease. Archives of Internal Medicine. 1982;142(7):1326-30. Reihman DH, Farber MO, Weinberger MH, Henry DP, Fineberg NS, Dowdeswell IR, et al. Effect of hypoxemia on sodium and water excretion in chronic obstructive lung disease. The American journal of medicine. 1985;78(1):87-94. Van Steensel-Moll HA, Hazelzet JA, Van der Voort E. Excessive secretion of antidiuretic hormone ininfections with respiratory syncytial virus. Archives ofDisease in Childhood. 1990;65:1237-9. Miyaji Y, Sugai K, Nozawa A, Kobayashi M, Niwa S, TsukagoshiH et al. Pediatric Respiratory Severity Score (PRESS) forRespiratory Tract Infections in Children. Austin Virol and Retrovirology. 2015;2(1):1-6. World Health Organization. Technical bases for the WHO recommendations on the management of pneumonia in children at first-level health facilities. 1991. Ndirangu EN. Prevalence of hyponatremia in children admitted at Kenyatta National Hospital with pneumonia. 2009. Sakellaropoulou A, Hatzistilianou M, Eboriadou M, Athanasiadou-Piperopoulou F. Hyponatraemia in cases of children with pneumonia. Archives of Medical Science : AMS. 2010;6(4):578-83. Patil J. Hyponatremia in pneumonia: hospital based cross sectional study. Journal of drug discovery and therapeutics. 2015;3(30):17-22 Wrotek A, Jackowska T. Hyponatremia in children hospitalized due to pneumonia. Advances in experimental medicine and biology. 2013;788:103-8. Park SW, Shin SM, Jeong M, Cho D-H, Lee KH, Eisenhut M, et al. Hyponatremia in children with respiratory infections: a cross-sectional analysis of a cohort of 3938 patients. Scientific Reports. 2018;8(1):16494. Kaneko K, Kaneko Ki. Hyponatremia in children with respiratory tract infection. Pediatric Nephrology. 2009;24(8):1595. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-11048","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":317581,"identity":"b6791f8a-c7b7-4fd5-b1c2-162e62352355","order_by":1,"name":"Machhindra Lamichhane","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABN0lEQVRIie3PsUrDQBjA8QsHcUnImlBsX+FCIEUKvohLitAsPUVcAtZ6LudS94iSvkKLEDomHKTLVVfBwXTpJggu6SB4EbuYBuImkv9wBx/34/gAqKv7m8nftyIDB0AAdi6JlXliACGpSBQWnQKeE6kCATnRe867RPPJdqLdslW6nu0faFeLJF3OOsca6Zv3J8G5mAiSeeFPoj/02uY1P8Q+P3JRl7t7fsQt6yacY59JRBrx58I3XJF1lUJMnhRb71KGQDyykRommAgCJVogLUGMD3qBxxvSYko7U+8SPC4hSJCGShmebAhKZMdSyQBPSojJZbuxS+d4yvs5cZHJYWT6SYSngsRbdmlyuDJe6RkO5tw21rSDmi9Lgt4GQxw8sjjNvOL6ZbGvM6r8XjT8zeO6urq6/90nFqh7MLBJuHMAAAAASUVORK5CYII=","orcid":"","institution":"Dhaulagiri Zonal Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Machhindra","middleName":"","lastName":"Lamichhane","suffix":""},{"id":317582,"identity":"d13383a0-567a-490b-9e01-e4407af490af","order_by":2,"name":"Laxman Shrestha","email":"","orcid":"","institution":"Institute of medicine, Maharajgunj Medical Campus","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Laxman","middleName":"","lastName":"Shrestha","suffix":""},{"id":317583,"identity":"e79b111f-0d36-40e7-bd31-be3c0a059e4a","order_by":3,"name":"Luna Bajracharya","email":"","orcid":"","institution":"Maharajgunj Mediacl Campus, Kathmandu","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Luna","middleName":"","lastName":"Bajracharya","suffix":""},{"id":317584,"identity":"319afaa2-a51d-436e-b046-ce7cf1b4c035","order_by":4,"name":"Archana Bagale","email":"","orcid":"","institution":"Yeti Health Science Academy","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Archana","middleName":"","lastName":"Bagale","suffix":""}],"badges":[],"createdAt":"2020-01-07 14:40:09","currentVersionCode":2,"declarations":"","doi":"10.21203/rs.2.20441/v2","doiUrl":"https://doi.org/10.21203/rs.2.20441/v2","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.36348/sjm.2022.v07i04.001","type":"published","date":"2022-04-03T05:20:24+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":416196,"identity":"46563c75-5faa-4b7a-94de-88487a8baab9","added_by":"auto","created_at":"2020-01-28 12:57:03","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":24282,"visible":true,"origin":"","legend":"Flow chart of screened and enrolled cases in the study","description":"","filename":"1.PNG","url":"https://assets-eu.researchsquare.com/files/3af757d1-b936-44ab-ac5c-d518d84f006d/v2/1.PNG"},{"id":416197,"identity":"7c024e25-5584-4890-a213-8a5b559d2032","added_by":"auto","created_at":"2020-01-28 12:57:04","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":19547,"visible":true,"origin":"","legend":"Age of study population","description":"","filename":"2.PNG","url":"https://assets-eu.researchsquare.com/files/3af757d1-b936-44ab-ac5c-d518d84f006d/v2/2.PNG"},{"id":416198,"identity":"34861ff2-bc5b-48ab-89aa-88c55dfc9ca4","added_by":"auto","created_at":"2020-01-28 12:57:04","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":25072,"visible":true,"origin":"","legend":"Sex of study population","description":"","filename":"3.PNG","url":"https://assets-eu.researchsquare.com/files/3af757d1-b936-44ab-ac5c-d518d84f006d/v2/3.PNG"},{"id":20171501,"identity":"39a65821-55b8-4bc4-9185-22413cb8edfd","added_by":"auto","created_at":"2022-04-11 05:20:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1209291,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-11048/v2/fff0687d-3c9c-4922-b13f-568b8e255a64.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eHyponatremia As A Predictor Of Adverse Outcome In Children With Severe Lower Respiratory Tract Infection In Tribhuvan University Teaching Hospital (Tuth), Nepal\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eLower respiratory tract infection (LRTI) is infection below the level of the larynx and it includes bronchiolitis, pneumonia and empyema. It is inflammation of the airways/pulmonary tissue,\u0026nbsp; commonly due to viral, bacterial or fungal\u0026nbsp; infection(\u003ca href=\"#_ENREF_1\"\u003e1\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eARIs are the major cause of mortality among children aged less than 5 years especially in developing countries. Worldwide, 1 million (16%) mortality among children aged less than 5 years is attributed to respiratory tract infections predominantly pneumonia associated. Southeast Asia stands first in number for ARI incidence accounting for more than 80% of all incidences together with sub-Saharan African countries(\u003ca href=\"#_ENREF_2\"\u003e2\u003c/a\u003e, \u003ca href=\"#_ENREF_3\"\u003e3\u003c/a\u003e). Children with ARI account for 30% to 50% of the children attending outpatient clinics and 20% to 40% of admissions into hospitals(\u003ca href=\"#_ENREF_4\"\u003e4\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eAccording to Nepal demographic health survey 2016, prevalence of symptoms of ARI among children under age 5 in Nepal fell from 5% in 2011 to 2% in 2016. Prevalence of symptoms of ARI was the highest among children age 6-11 months and age 12-24 months (4% each), followed by children age 24-35 months (2%)(\u003ca href=\"#_ENREF_5\"\u003e5\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eLRTI comprises bronchiolitis, pneumonia and \u0026nbsp;empyema. Bronchiolitis is one of the common childhood illness and Respiratory \u0026nbsp;syncytial virus is the\u0026nbsp; most common etiologic agent. Hospitalization due to bronchiolitis is required in approximately 1% of affected children, primarily because of associated dehydration, inadequate oral intake, or respiratory insufficiency. Among those admitted, 10-15% requires intensive care due to impending respiratory failure(\u003ca href=\"#_ENREF_6\"\u003e6\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003ePneumonia is a form of acute respiratory infection that affects the lungs Pneumonia is usually preceded by upper respiratory tract infection, which promote invasion of lower respiratory tract by virus, bacteria or other pathogens that trigger an immune response. (\u003ca href=\"#_ENREF_7\"\u003e7\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eEmpyema is defined as collection of pus in pleural cavity. Common pathogens are\u0026nbsp;Streptococcus pneumonia , Staphylococcus aureus\u0026nbsp;and\u0026nbsp; Streptococcus pyogenes. Empyema starts as moderate to large exudative parapneumonic effusion, which can progress to being loculated with further development of a fibrinous peel. This can be\u0026nbsp; associated with fever, fast breathing and respiratory distress(\u003ca href=\"#_ENREF_8\"\u003e8\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eLRTI can be complicated as lung abscess, pneumatocele, pneumothorax, apnoea, hyperinflation, atelectasis, respiratory failure. Complications beside respiratory include sepsis, meningitis, pericarditis, endocarditis, osteomyelitis, septicarthritis, and electrolyte imbalance(\u003ca href=\"#_ENREF_9\"\u003e9\u003c/a\u003e, \u003ca href=\"#_ENREF_10\"\u003e10\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eFluids and electrolytes are the main pillars in the maintenance of body homeostasis. Most important among electrolytes is sodium which is the abundant cation of the extracellular fluid. Hyponatremia is the most common electrolyte abnormality seen in the intensive care unit (ICU), with an incidence as high as 30% in some reports(\u003ca href=\"#_ENREF_11\"\u003e11\u003c/a\u003e, \u003ca href=\"#_ENREF_12\"\u003e12\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eHyponatremia is defined as serum sodium (Na) concentration of less than 135mEq/L (9-10).A major consequence of \u0026nbsp;hyponatremia is influx of water into the intracellular space, resulting in cellular swelling that can lead to cerebral edema and encephalopathy. The clinical manifestations\u0026nbsp; of hyponatremia are primarily neurologic and related to cerebral edema caused by hypo- osmolality(\u003ca href=\"#_ENREF_13\"\u003e13\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eHyponatremia associated with pediatric pneumonia is most commonly due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This syndrome is characterized by hyponatremia and hypo-osmolality. It results from the inappropriate and continued secretion and/or action of antidiuretic hormone despite normal or increased plasma volume (\u003ca href=\"#_ENREF_14\"\u003e14\u003c/a\u003e, \u003ca href=\"#_ENREF_15\"\u003e15\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eHyponatremia associated with bronchiolitis is due to hyperinflation of lungs. Hyperinflation reduces blood flow to the right atrium and stimulates the release of vasopressin(AVP)from the posterior pituitary causing accumulation of intravascular fluid leading to dilutional hyponatremia(\u003ca href=\"#_ENREF_16\"\u003e16\u003c/a\u003e,).\u003c/p\u003e\n\u003cp\u003eIn a study done by Shingi S et.al to determine the frequency of electrolyte disturbance in pneumonia in 264 hospitalized children in chandigrah, India found hyponatremia \u0026nbsp;in 71(27%) children with pneumonia. It was associated with two fold increase in complications and 3.5 times higher mortality(\u003ca href=\"#_ENREF_17\"\u003e17\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eSingle-center retrospective cohort study was done in Children\u0026rsquo;s Hospital Colorado, USA comprising children age 1month to 2 years admitted to the PICU between January 2009 and April 2011. Study was done to characterize the relationship between hyponatremia and clinical outcome in bronchiolitis. One hundred and two children with bronchiolitis were enrolled. Twenty-three patients (22%) were diagnosed with hyponatremia. Mortality (13% vs 0%;\u0026nbsp;P\u0026nbsp;= .011), ventilator time (8.41 \u0026plusmn; 2 days vs 4.11 \u0026plusmn; 2 days;\u0026nbsp;P\u0026nbsp;= .001), duration of stay in the PICU (10.63 \u0026plusmn; 2.5 days vs 5.82\u0026nbsp;\u0026plusmn; 2.09 days;\u0026nbsp;P\u0026nbsp;= .007), and noninvasive ventilator support (65% vs 24%;\u0026nbsp;P\u0026nbsp;= .007) were significantly different between subjects with Hyponatremia than\u0026nbsp; those without (\u003ca href=\"#_ENREF_18\"\u003e18\u003c/a\u003e).\u003cbr /\u003e Acute respiratory tract infection is one of the serious health problems leading to hospitalization and mortality. In\u0026nbsp; developing countries, 7 out of 10 deaths happen due to ARI in under 5-year age group(\u003ca href=\"#_ENREF_19\"\u003e19\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eAcute respiratory infection\u0026nbsp; is classified by World Health Organization (WHO) as no pneumonia(child presenting as cough and cold), pneumonia(child with cough an fast breathing and or chest indrawing) and severe pneumonia or very severe disease( child with cough, fast breathing, chest indrawing and danger signs like unable to drink, convulsions, stridor)(\u003ca href=\"#_ENREF_20\"\u003e20\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eIn Nepal, according to the most recent Annual Health Report by Department of Health Services (DOHS), in fiscal year 2073/74, a total of 1,810,722 ARI cases were registered, out of which 10.5% were categorized as pneumonia cases and 0.29% were severe pneumonia cases. The incidence of pneumonia at national level was 66 per 1000 under five children(\u003ca href=\"#_ENREF_21\"\u003e21\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePneumonia\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePneumonia is a form of acute respiratory infection that affects the lungs. (\u003ca href=\"#_ENREF_7\"\u003e7\u003c/a\u003e). The physiological intrapulmonary\u0026nbsp; shunting of de-oxygenated blood and ventilation perfusion mismatch following\u0026nbsp; these pathological changes results in hypoxemia(\u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eCauses of pneumonia in children are Bacteria- Escheriichia coli,Group B Streptococcus Listeria monocytogens in birth to 20days, Bacteria-Chlamydia trachomatis,Sterptococcus pneumonia Viruses Adenovirus,Influenza, Parainfluenza virus 1,2,3 from 3 weeks to 3 months, Bacteria-Chlamydia pneumonia,Mycoplasmapneumonia,Streptococcus pneumonia from 4 months to 5 years and from 5 years to adolescence Bacteria-Chlamydia pneumonia,Mycoplama pneumonia,Streptococcus pneumoniae(\u003ca href=\"#_ENREF_23\"\u003e23\u003c/a\u003e) Etiology of Bronchiolitis(\u003ca href=\"#_ENREF_24\"\u003e24\u003c/a\u003e)\u003cu\u003e:\u003c/u\u003eRespiratory syncital virus(50%cases), Rhinovirus, Adeno virus, Influenza, Parainfluenza, Human metapneumovirus, Human Bocavirus, Mycoplasma pneumoniae, Chlamydophila pneumonia, Chlamydophila trachomatis.\u003c/p\u003e\n\u003cp\u003eBronchiolitis is a common cause of illness and is the leading cause of hospitalization in infants and young children. RSV infection is common in children older than two years(\u003ca href=\"#_ENREF_25\"\u003e25\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eHypoxia, co-morbid condition such as diarrhea, age below 1 year, inability to feed, presence of loose stools and severe malnutrition are known factors for adverse outcome in children with lower respiratory tract infection. These factors increases duration of stay at hospital and if not managed properly can lead to death (\u003ca href=\"#_ENREF_26\"\u003e26\u003c/a\u003e, \u003ca href=\"#_ENREF_27\"\u003e27\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHyponatremia\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1: Severity of hyponatremia\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 17.4pt;\"\u003e\n\u003ctd style=\"width: 46.78%; border: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.4pt;\" width=\"46%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003eSeverity of Hyponatremia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.22%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 17.4pt;\" width=\"53%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003eSodium(mEq/L)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 17.85pt;\"\u003e\n\u003ctd style=\"width: 46.78%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 17.85pt;\" width=\"46%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003eMild\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.85pt;\" width=\"53%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e131-135\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 17.4pt;\"\u003e\n\u003ctd style=\"width: 46.78%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 17.4pt;\" width=\"46%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.4pt;\" width=\"53%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e126-130\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 21.45pt;\"\u003e\n\u003ctd style=\"width: 46.78%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 21.45pt;\" width=\"46%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003eSevere\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.45pt;\" width=\"53%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u0026lt;125\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHyponatremia is defined as serum sodium (Na) concentration of less than 135 mEq/L. The effect of ADH on plasma osmolality depends on intact kidney function, which is required for appropriate retention or excretion of free water. (\u003ca href=\"#_ENREF_28\"\u003e28\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;SIADH syndrome is characterized by hyponatremia \u0026nbsp;and hypoosmolality and results from the inappropriate and continued secretion and/or action of antidiuretic hormone despite normal or increased plasma volume presumably due to inflammatory cytokines, such as interleukin-6 (\u003ca href=\"#_ENREF_29\"\u003e29\u003c/a\u003e), stress, and hypoxemia(\u003ca href=\"#_ENREF_30\"\u003e30\u003c/a\u003e, \u003ca href=\"#_ENREF_31\"\u003e31\u003c/a\u003e). Hyperinflation of the lungs, a hallmark of the bronchiolitis, wheezing, reduces blood flow to the right atrium and stimulates the release of vasopressin(AVP)from the posterior pituitary causing accumulation of intravascular fluid leading to dilutional hyponatremia(\u003ca href=\"#_ENREF_32\"\u003e32\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePediatric Respiratory Severity Score (PRESS score)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis score was devised for a study done in National Hospital Organization Yokohama Medical center, an urban emergency hospital in Japan, in 2010-2011 to establish and examine the utility for assessing severity in children with respiratory symptoms (\u003ca href=\"#_ENREF_33\"\u003e33\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eThe World Health Organization has suggested that children suspected of having infective illnesses and presenting not only with drowsiness,\u0026nbsp; feeding difficulties, vomiting, convulsion but respiratory complains as dyspnoea should be hospitalized quickly(\u003ca href=\"#_ENREF_34\"\u003e34\u003c/a\u003e). For calculating the score, objective signs such as respiratory rate, wheezing, retraction (accessory respiratory muscle use), SpO2, and feeding difficulties are assessed\u0026nbsp; with each component given a score of 0 or 1, and total scores classified as mild (0\u0026ndash;1), moderate (2\u0026ndash;3), or severe (4\u0026ndash;5). Using PRESS score, hospitalization rate was higher in moderate to severe cases and duration of oxygen therapy was significantly longer in severe cases compared with mild and moderate cases.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Table 2 : Pediatric Respiratory Severity Score ( PRESS ) \u003c/strong\u003e\u003cstrong\u003e(\u003c/strong\u003e\u003ca href=\"#_ENREF_33\"\u003e\u003cstrong\u003e33\u003c/strong\u003e\u003c/a\u003e\u003cstrong\u003e)\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 36.4pt;\"\u003e\n\u003ctd style=\"width: 26.18%; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 36.4pt;\" width=\"26%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eScore component\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.14%; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 36.4pt;\" colspan=\"2\" width=\"62%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eOperational definition\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.68%; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 36.4pt;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp; 0 or 1\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 31.45pt;\"\u003e\n\u003ctd style=\"width: 26.18%; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 31.45pt;\" rowspan=\"4\" width=\"26%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eRespiratory rate\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43.74%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 31.45pt;\" width=\"43%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; Month\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 31.45pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eRR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.68%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 31.45pt;\" rowspan=\"4\" width=\"11%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35.95pt;\"\u003e\n\u003ctd style=\"width: 43.74%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 35.95pt;\" width=\"43%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026lt; 12\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 35.95pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026gt;60\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 34.65pt;\"\u003e\n\u003ctd style=\"width: 43.74%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 34.65pt;\" width=\"43%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e12- 36 months\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 34.65pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026gt;40\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 32.5pt;\"\u003e\n\u003ctd style=\"width: 43.74%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 32.5pt;\" width=\"43%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026gt;36 months\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 32.5pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026gt; 30\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 38.95pt;\"\u003e\n\u003ctd style=\"width: 26.18%; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 38.95pt;\" width=\"26%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eWheezing/ Crepitations\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.14%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 38.95pt;\" colspan=\"2\" width=\"62%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eBased on auscultation\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.68%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 38.95pt;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 53.95pt;\"\u003e\n\u003ctd style=\"width: 26.18%; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 53.95pt;\" width=\"26%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eAccessory muscle use\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.14%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 53.95pt;\" colspan=\"2\" width=\"62%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eSubcostal retraction, intercostal recession, suprasternal recession\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.68%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 53.95pt;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: red;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 33.8pt;\"\u003e\n\u003ctd style=\"width: 26.18%; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 33.8pt;\" width=\"26%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eSpo2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.14%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 33.8pt;\" colspan=\"2\" width=\"62%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eLess or more than 95 %\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.68%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 33.8pt;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: red;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 6.85pt;\"\u003e\n\u003ctd style=\"width: 26.18%; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 6.85pt;\" width=\"26%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eFeeding difficulties\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.14%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 6.85pt;\" colspan=\"2\" width=\"62%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eRefusing feedings or not\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.68%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 6.85pt;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; text-autospace: none; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: red;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Methodology","content":"\u003cp\u003e\u003cstrong\u003eResearch Design: \u003c/strong\u003eProspective Cross sectional Study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch Method\u003c/strong\u003e\u003cstrong\u003e: \u003c/strong\u003eQuantitative\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eType of study:\u003c/strong\u003e Observational study\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Population/Sampling Frame\u003c/strong\u003e: Children of age 2 month to 16 years with severe lower respiratory tract infection admitted in TUTH during duration of data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy site\u003c/strong\u003e: Emergency, ward and PICU of Tribhuvan University Teaching Hospital.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Sampling Method: \u003c/strong\u003ePurposive sampling technique was used to select patient with lower respiratory tract infection admitted in emergency, Pediatric ward and PICU of Tribhuwan University Teaching Hospital.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size: \u003c/strong\u003e80\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003eChildren 2 months to 16 years admitted at TUTH with cough(\u0026lt;3 weeks), fast breathing and chest indrawing.\u003c/li\u003e\n\u003cli\u003ePRESS score 4-5\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eDuration of the Study\u003c/strong\u003e: 1 year\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Management and Statistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were entered in Microsoft Excel and converted into SPSS 20 version for statistical analysis. The descriptive data were expressed in frequency, percentage, mean, standard deviation, median etc. along with graphical and tabular presentation.Descriptive statistics was used to analyse data like mean, median and mode and standard deviation (SD).\u003c/p\u003e\n\u003cp\u003eInferential statistics i.e. Chi square test, Fisher exact test were used at 95% confidence interval where p value\u0026lt;0.05 was considered statistically significant to assess association of hyponatremia with selected outcome variables and to assess association of socio-demographic variables.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study was conducted over a period of 12 month from September 1\u003csup\u003est\u003c/sup\u003e 2017 to September 1\u003csup\u003est\u003c/sup\u003e 2018. \u0026nbsp;Total 90 cases were screened, 10 cases were excluded. Among the excluded case 5 cases were of congenital heart disease, two patients came after receiving IV fluids , 2 cases had cough for more than 3 weeks and\u0026nbsp; 1 patient had PRESS score of less than 4.Total 80 children were enrolled. Thirty eight patients had hyponatremia at presentation. Patients were admitted in pediatrics ward or pediatric ICU. Serum sodium was sent during IV cannulation after stabilizing the patients, patients were followed till discharge or mortality. Outcome evaluated were need of non invasive and invasive respiratory support, time taken for hypoxia to resolve, discharge of the patient or mortality\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFig 1: Flow chart of screened and enrolled cases in the study\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSociodemographic variable of study population\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFig 2: Age of study population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFigure 2 shows age of study population.\u0026nbsp; Out of 80 children, majority of the children were infant accounting for 41.3% followed by toddler and preschool children.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFig 3:\u0026nbsp; Sex of study population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFigure 3 shows the sex distribution in study population. Out of 80 children 66.25%were boys and rest were girls.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Sociodemographic variable of study population\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 102.96%; border-collapse: collapse; border: none;\" width=\"102%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 22.0pt;\"\u003e\n\u003ctd style=\"width: 27.7%; border: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.0pt;\" width=\"27%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eVariables\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 28.74%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 22.0pt;\" width=\"28%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eCharacteristic*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 22.56%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 22.0pt;\" width=\"22%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eFrequency \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 21.02%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 22.0pt;\" width=\"21%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003ePercentage (%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 25.75pt;\"\u003e\n\u003ctd style=\"width: 100.0%; border: solid black 1.0pt; border-top: none; padding: .75pt .75pt .75pt .75pt; height: 25.75pt;\" colspan=\"4\" width=\"100%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eAge of study\u0026nbsp; population\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e(mean\u003cspan style=\"color: #222222; background: white;\"\u003e\u0026plusmn;SD)=(2.3\u0026plusmn; 1.4) years\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 79.75pt;\"\u003e\n\u003ctd style=\"width: 27.7%; border: solid black 1.0pt; border-top: none; padding: .75pt .75pt .75pt .75pt; height: 79.75pt;\" width=\"27%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eFather\u0026rsquo;s\u0026nbsp; education\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 28.74%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: .75pt .75pt .75pt .75pt; height: 79.75pt;\" width=\"28%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Lower secondary\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eSecondary\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eHigher secondary\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eUniversity level\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 22.56%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 79.75pt;\" width=\"22%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 18\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e23\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e11\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e28\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 21.02%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 79.75pt;\" width=\"21%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u003cbr /\u003e22.5\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e28.8\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e13.8\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e35\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 81.75pt;\"\u003e\n\u003ctd style=\"width: 27.7%; border: solid black 1.0pt; border-top: none; padding: .75pt .75pt .75pt .75pt; height: 81.75pt;\" width=\"27%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eMother\u0026rsquo;s education\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 28.74%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: .75pt .75pt .75pt .75pt; height: 81.75pt;\" width=\"28%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eLower secondary\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eSecondary\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eHigher secondary\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eUniversity level\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 22.56%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 81.75pt;\" width=\"22%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e18\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e27\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e14\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e21\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 21.02%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 81.75pt;\" width=\"21%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e22.5\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e33.8\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e17.5\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e26.3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 83.35pt;\"\u003e\n\u003ctd style=\"width: 27.7%; border: solid black 1.0pt; border-top: none; padding: .75pt .75pt .75pt .75pt; height: 83.35pt;\" width=\"27%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eFather\u0026rsquo;s occupation\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 28.74%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: .75pt .75pt .75pt .75pt; height: 83.35pt;\" width=\"28%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eTechnical/professional\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eSales/service\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eagriculture\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003elabor\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eabroad\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 22.56%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 83.35pt;\" width=\"22%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 26\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e26\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e8\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e16\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 21.02%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 83.35pt;\" width=\"21%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e32.5\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e32.5\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e20\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 76.6pt;\"\u003e\n\u003ctd style=\"width: 27.7%; border: solid black 1.0pt; border-top: none; padding: .75pt .75pt .75pt .75pt; height: 76.6pt;\" width=\"27%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eMother\u0026rsquo;s occupation\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 28.74%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: .75pt .75pt .75pt .75pt; height: 76.6pt;\" width=\"28%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eTechnical/professional\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eSales/service\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eagriculture\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003elabor\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003ehousewife\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 22.56%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 76.6pt;\" width=\"22%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e62\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 21.02%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 76.6pt;\" width=\"21%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e12.5\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e7.5\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e1.3\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e1.3\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 2.0pt 0in 2.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e77.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Characteristics of parent\u0026rsquo;s education and occupation according to NDHS 2016\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbove table 3 depicts sociodemographic variable of study population, about one third of father had university level education followed by 28.8% in secondary level. Among mothers about one third that is 33.8% mothers had education upto secondary level followed by 26.3% university level. Occupation of most of the fathers was technical/ profession and sales/service each 32.5% and 77.5% of the mothers were housewife.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Clinical characteristics of study population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 21.85pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.85pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eCharacteristics\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 21.85pt;\" width=\"14%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eFrequency\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 21.85pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eValue\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 21.85pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003ePercentage (%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 21.1pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 21.1pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;Cough (mean\u003cspan style=\"color: #222222; background: white;\"\u003e\u0026plusmn;SD)\u003c/span\u003e\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.1pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.1pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e5.15 ( \u003cspan style=\"color: #222222; background: white;\"\u003e\u0026plusmn;\u003c/span\u003e 2.89)days\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.1pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 21.55pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 21.55pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eFast breathing (mean\u003cspan style=\"color: #222222; background: white;\"\u003e\u0026plusmn;SD)\u003c/span\u003e\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.55pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.55pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e2.687( \u003cspan style=\"color: #222222; background: white;\"\u003e\u0026plusmn;\u003c/span\u003e 1.24) days\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.55pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 25.15pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 25.15pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eChest indrawing (mean\u003cspan style=\"color: #222222; background: white;\"\u003e\u0026plusmn;SD)\u003c/span\u003e\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.15pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.15pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e1.74 (\u003cspan style=\"color: #222222; background: white;\"\u003e \u0026plusmn;\u003c/span\u003e 0.97)days\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.15pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 22.9pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eRefusal to feed\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e15\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e18.7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 22.9pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; tab-stops: center 83.1pt; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eFever\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e54\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e67.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 26.35pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eRespiratory\u0026nbsp; rate(mean)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-indent: -.25in; line-height: 130%; margin: 3.0pt 0in .0001pt .25in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: Symbol; letter-spacing: -.2pt;\"\u003e\u0026middot;\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/span\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eInfant\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-indent: -.25in; line-height: 130%; margin: 3.0pt 0in .0001pt .25in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: Symbol; letter-spacing: -.2pt;\"\u003e\u0026middot;\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/span\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eToddler\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-indent: -.25in; line-height: 130%; margin: 3.0pt 0in .0001pt .25in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: Symbol; letter-spacing: -.2pt;\"\u003e\u0026middot;\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/span\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003ePreschool\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-indent: -.25in; line-height: 130%; margin: 3.0pt 0in .0001pt .25in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: Symbol; letter-spacing: -.2pt;\"\u003e\u0026middot;\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/span\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eSchool going\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-indent: -.25in; line-height: 130%; margin: 3.0pt 0in .0001pt .25in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: Symbol; letter-spacing: -.2pt;\"\u003e\u0026middot;\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/span\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eAdolescent\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e33\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e15\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e14\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e9\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e(64.69\u0026plusmn;5.62)/min\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e(58.33\u0026plusmn;10.96)/min\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e(36.28\u0026plusmn;3.22)/min\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e(47.22\u0026plusmn;15.98)/min\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e(44.22\u0026plusmn;12.46)/min\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 26.35pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eTemperature(mean\u003cspan style=\"color: #222222; background: white;\"\u003e\u0026plusmn;SD)\u003c/span\u003e\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e(99.13\u003cspan style=\"color: #222222; background: white;\"\u003e\u0026plusmn;1.63) F\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 26.35pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eOxygen saturation(mean\u003cspan style=\"color: #222222; background: white;\"\u003e\u0026plusmn;SD)\u003c/span\u003e\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; color: #222222; letter-spacing: -.2pt; background: white;\"\u003e(88.5\u0026plusmn; 7.17)%\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 26.35pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 23.35pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 23.35pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eHypoxia*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 23.35pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e31\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 23.35pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 23.35pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e38.75\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.25pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 15.25pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eWheeze on auscultation\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.25pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e31\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.25pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.25pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e38.75\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 20.65pt;\"\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 20.65pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eCrepitation on auscultation\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 20.65pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e49\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 20.65pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 20.65pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e62.25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 25.15pt;\"\u003e\n\u003ctd style=\"width: 16.42%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 25.15pt;\" rowspan=\"5\" width=\"16%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eRespiratory support\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 21.52%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.15pt;\" width=\"21%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eNeed of nasal prongs\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.15pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e70\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.15pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.15pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e87.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 25.6pt;\"\u003e\n\u003ctd style=\"width: 21.52%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.6pt;\" width=\"21%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eNeed of simple facemask\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.6pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e61\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.6pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.6pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e76.25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 21.1pt;\"\u003e\n\u003ctd style=\"width: 21.52%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.1pt;\" width=\"21%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eNeed of non rebreathing face mask\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.1pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e16\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.1pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 21.1pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e20\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 22.9pt;\"\u003e\n\u003ctd style=\"width: 21.52%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" width=\"21%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eNeed of CPAP\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 22.9pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e8.75\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 18.85pt;\"\u003e\n\u003ctd style=\"width: 21.52%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 18.85pt;\" width=\"21%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003eNeed Ventilator\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.94%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 18.85pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.66%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 18.85pt;\" width=\"23%\"\u003e\n\u003cp style=\"line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 23.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 18.85pt;\" width=\"23%\"\u003e\n\u003cp style=\"text-align: center; line-height: 130%; margin: 3.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 130%; font-family: 'Times New Roman',serif; letter-spacing: -.2pt;\"\u003e7.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Hypoxia defined by WHO as oxygen saturation \u0026lt;90%\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe above table shows clinical characteristics of study population. Mean duration of cough was 5.15 (\u0026plusmn; 2.89) days , mean duration of fast breathing was 2.687( \u0026plusmn; 1.24)\u0026nbsp;\u0026nbsp;\u0026nbsp; and mean duration of chest in drawing was 1.74 ( \u0026plusmn; 0.977). Among 80 children 18.7% had refusal to feed during the illness meanwhile 67.5% children presented with fever. Mean duration of fever was 3.36 days (\u0026plusmn; 3.34). Thirty one children were hypoxic at presentation. Examination of chest revealed crepitation in 61.25% and 38.75% had wheeze. All study population required oxygen support. Mean time required for weaning oxygen was 4.22 days and mean time for complete discontinuation was 4.93 days. Among the eighty patient 87.5% required nasal prongs and 76.25% children required simple facemask. CPAP was given in 8.75% children and 7.5% children required mechanical ventilation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5: Prevalence of hyponatremia in study population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=8-0\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 24.15pt;\"\u003e\n\u003ctd style=\"width: 27.92%; border: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 24.15pt;\" width=\"27%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eVariables\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 28.26%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 24.15pt;\" width=\"28%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003echaracteristics\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.76%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 24.15pt;\" width=\"19%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eFrequency\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.06%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 24.15pt;\" width=\"24%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003ePercentage\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 20.65pt;\"\u003e\n\u003ctd style=\"width: 27.92%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 20.65pt;\" rowspan=\"2\" width=\"27%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eSerum sodium level\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 28.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 20.65pt;\" width=\"28%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eHyponatremia\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.76%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 20.65pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e38\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.06%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 20.65pt;\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e47.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 20.6pt;\"\u003e\n\u003ctd style=\"width: 28.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 20.6pt;\" width=\"28%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eNormal Sodium\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.76%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 20.6pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.06%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 20.6pt;\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e52.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 12.75pt;\"\u003e\n\u003ctd style=\"width: 100.0%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 12.75pt;\" colspan=\"4\" width=\"100%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eHyponatremia(n=38)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 12.75pt;\"\u003e\n\u003ctd style=\"width: 27.92%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 12.75pt;\" rowspan=\"3\" width=\"27%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eSeverity of hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 28.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.75pt;\" width=\"28%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eMild (131-135)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.76%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.75pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.06%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.75pt;\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e65.79\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 19.25pt;\"\u003e\n\u003ctd style=\"width: 28.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 19.25pt;\" width=\"28%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eModerate( 126-130)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.76%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 19.25pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.06%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 19.25pt;\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e26.31\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 19.25pt;\"\u003e\n\u003ctd style=\"width: 28.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 19.25pt;\" width=\"28%\"\u003e\n\u003cp style=\"line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003eSevere (less than 125)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.76%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 19.25pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.06%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 19.25pt;\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 120%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 120%; font-family: 'Times New Roman',serif;\"\u003e7.89\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe above table 6 shows prevalence of hyponatremia in the study population.Among the study population38 (47.5%) had hyponatremia. Among hyponatremic children 25 (65.79%) had mild hyponatremia followed bymoderate 10 (26.31%) and severe hyponatremia (7.89%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6: Association of hyponatremia with need of non-rebreathing face mask\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 39.35pt;\"\u003e\n\u003ctd style=\"width: 26.48%; border: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" rowspan=\"2\" width=\"26%\"\u003e\n\u003cp style=\"line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eSodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 37.94%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" colspan=\"2\" width=\"37%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eNeed non-rebreather\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.1%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.48%; border: solid black 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 39.35pt;\"\u003e\n\u003ctd style=\"width: 20.2%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"20%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eNo\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.74%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eYes\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.1%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.48%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" rowspan=\"3\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e0.001\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 39.35pt;\"\u003e\n\u003ctd style=\"width: 26.48%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"26%\"\u003e\n\u003cp style=\"line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eHyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20.2%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"20%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e23\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.74%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e15\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.1%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e38\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 39.35pt;\"\u003e\n\u003ctd style=\"width: 26.48%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"26%\"\u003e\n\u003cp style=\"line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eNormal Sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20.2%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"20%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e41\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.74%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.1%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 39.35pt;\"\u003e\n\u003ctd style=\"width: 26.48%; border: solid black 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"26%\"\u003e\n\u003cp style=\"line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20.2%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"20%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e64\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.74%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e16\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.1%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.48%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 39.35pt;\" width=\"18%\"\u003e\n\u003cp style=\"line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e* \u003c/strong\u003eChi square test was used to find association of hyponatremia with need of non-rebreathing face mask\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbove table shows association of hyponatremia with need of non-rebreathing facemask. Total sixteen patients required non rebreathing face mask. Among them 15(93.75%) patients with had hyponatremia needed non rebreathing facemask however only 1(6.25%) patients had normal sodium . Association of hyponatremia with need of non rebreathing face mask was statistically significant (p= 0.001)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7: Association of hyponatremia with need of CPAP\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"2\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eSodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.0%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" colspan=\"3\" width=\"50%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNeed CPAP\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"2\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 34.15pt;\"\u003e\n\u003ctd style=\"width: 19.24%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 34.15pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.32%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 34.15pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eYes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.44%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 34.15pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 44.5pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 44.5pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eHyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.24%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 44.5pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e34\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.32%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 44.5pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.44%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 44.5pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e38\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 25.0%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 44.5pt;\" rowspan=\"2\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0.702\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 39.1pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 39.1pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNormal sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.24%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 39.1pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e39\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.32%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 39.1pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.44%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 39.1pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 40.0pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 40.0pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.24%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 40.0pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e73\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.32%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 40.0pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.44%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 40.0pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 25.0%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 40.0pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e* \u003c/strong\u003eFisher exact test was used to find association of hyponatremia with need of CPAP\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbove table 7 shows association of hyponatremia with need of CPAP. Total seven children needed CPAP. Four cases with hyponatremia needed CPAP howeverthree patients with normal sodium also needed CPAP. Association of hyponatremia with need of CPAP was not statistically significant (p=0.702).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 8: Association of hypoponatremia with need ventilator\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 99.36%; border-collapse: collapse; border: none;\" width=\"99%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 26.5pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 26.5pt;\" rowspan=\"2\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eSodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.0%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in; height: 26.5pt;\" colspan=\"3\" width=\"50%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNeed ventilator\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in; height: 26.5pt;\" rowspan=\"2\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 11.2pt;\"\u003e\n\u003ctd style=\"width: 18.28%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 11.2pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNo\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.24%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 11.2pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eYes\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.48%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 11.2pt;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 28.3pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 28.3pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eHyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.28%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 28.3pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e32\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.24%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 28.3pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.48%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 28.3pt;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e38\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 25.0%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 28.3pt;\" rowspan=\"2\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0.009\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 26.95pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 26.95pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNormal sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.28%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 26.95pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.24%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 26.95pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.48%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 26.95pt;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 25.15pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 25.15pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.28%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 25.15pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e74\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.24%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 25.15pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.48%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 25.15pt;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 25.0%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 25.15pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e*\u003c/strong\u003eFisher exact was used to find association of hyponatremia with need of ventilator\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbove table 8 shows relation of hyponatremia with the need of ventilator. Among eighty children, six patients were ventilated and all of them had hyponatremia. Therefore association of hyponatremia with need of ventilator was highly significant (p=0.009).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 9: Association of hyponatremia with outcome\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 35.5pt;\"\u003e\n\u003ctd style=\"width: 24.72%; border: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 35.5pt;\" rowspan=\"2\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eSerum sodium level\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 32.96%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in; height: 35.5pt;\" colspan=\"2\" width=\"32%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eOutcome\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.6%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in; height: 35.5pt;\" rowspan=\"2\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.72%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in; height: 35.5pt;\" rowspan=\"2\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 25.85pt;\"\u003e\n\u003ctd style=\"width: 16.64%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 25.85pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eMortality\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.32%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 25.85pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eImproved\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 31.0pt;\"\u003e\n\u003ctd style=\"width: 24.72%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 31.0pt;\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eHyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.64%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.0pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.32%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.0pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e34\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.6%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.0pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e38\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.72%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.0pt;\" rowspan=\"2\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0.047\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 31.45pt;\"\u003e\n\u003ctd style=\"width: 24.72%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 31.45pt;\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNormal Sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.64%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.45pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.32%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.45pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.6%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.45pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 31.0pt;\"\u003e\n\u003ctd style=\"width: 24.72%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 31.0pt;\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.64%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.0pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 16.32%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.0pt;\" width=\"16%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e76\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 17.6%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.0pt;\" width=\"17%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.72%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 31.0pt;\" width=\"24%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e*\u003c/strong\u003eFisher exact test test was used to find association of hyponatremia with outcome\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe above table 9 shows association between hyponatremia and outcome. Among the study population, 4 patients with hyponatremia had mortality and none of the patient with normal sodium expired. Association of hyponatremia with outcome was statistically significant (p=0.047).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 10: Association of hyponatremia with Duration of stay\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 26.5pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 26.5pt;\" rowspan=\"2\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eSodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.0%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in; height: 26.5pt;\" colspan=\"3\" width=\"50%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eDuration of stay\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in; height: 26.5pt;\" rowspan=\"2\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 29.15pt;\"\u003e\n\u003ctd style=\"width: 20.2%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 29.15pt;\" width=\"20%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e\u0026lt;7 days\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 15.36%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 29.15pt;\" width=\"15%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e\u0026gt;7days\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.44%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 29.15pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 32.3pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 32.3pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eHyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20.2%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 32.3pt;\" width=\"20%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e22\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 15.36%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 32.3pt;\" width=\"15%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e16\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.44%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 32.3pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e38\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 25.0%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 32.3pt;\" rowspan=\"2\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0.002\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 29.6pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 29.6pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNormal sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20.2%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 29.6pt;\" width=\"20%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e37\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 15.36%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 29.6pt;\" width=\"15%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.44%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 29.6pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 33.65pt;\"\u003e\n\u003ctd style=\"width: 25.0%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 33.65pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20.2%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 33.65pt;\" width=\"20%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e59\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 15.36%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 33.65pt;\" width=\"15%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e21\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.44%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 33.65pt;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 25.0%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 33.65pt;\" width=\"25%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e*\u003c/strong\u003eChi square test was used to find association of hyponatremia with duration of stay\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbove table 10 shows association of hyponatremia with duration of stay. Duration of stay was divided into more than and less than 7 days. Among eighty patient 59(73.75%) patient had duration of stay less than 7 days and21 (26.25%) had stay more than 7 days. Sixteen patients with hyponatremia had stay more than 7 days and 5 patients with normal sodium had stay more than 7 days. Association of hyponatremia with duration of stay was statistically significant (p value= 0.002).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 11: Association of hyponatremia with oxygen saturation\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 28.56%; border: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"2\" width=\"28%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eLevel of Sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 57.18%; border: solid black 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" colspan=\"3\" width=\"57%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eSaturation\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.26%; border: solid black 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 19.52%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e\u0026lt;90%\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e\u0026gt;90%\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.44%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0.13\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 22.85pt;\"\u003e\n\u003ctd style=\"width: 28.56%; border: solid black 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 22.85pt;\" width=\"28%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eHyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.52%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 22.85pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e18\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 22.85pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e20\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.44%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 22.85pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e38\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 26.0pt;\"\u003e\n\u003ctd style=\"width: 28.56%; border: solid black 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 26.0pt;\" width=\"28%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNormal sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.52%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 26.0pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e13\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 26.0pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e29\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.44%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 26.0pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 19.7pt;\"\u003e\n\u003ctd style=\"width: 28.56%; border: solid black 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 19.7pt;\" width=\"28%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.52%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 19.7pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e31\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 19.7pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e49\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.44%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 19.7pt;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in 6.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e*\u003c/strong\u003eChi square test was used to find association of hyponatremia with oxygen saturation\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe above table shows association of hyponatremia with oxygen saturation level at presentation. Association of hyponatremia with oxygen saturation level was not statistically significant (p=0.13). The mean time required for resolution of hypoxia in children with hyponatremia with severe LRTI (4.5 days) was more compared to mean time required for resolution of hypoxia in children with normal sodium with severe LRTI (2.58 days).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 12: Association of severity of hyponatremia with need of CPAP of study population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 44.2%; border: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" colspan=\"2\" rowspan=\"2\" width=\"44%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eCharacteristics\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 37.2%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" colspan=\"3\" width=\"37%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNeed CPAP\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.6%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"2\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 15.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"15%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNo\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.5%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eYes\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 9.3%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"9%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 13.04%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eSodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003elevel\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.14%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eMild hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 15.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"15%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e21\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.5%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 9.3%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"9%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.6%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0.534\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.14%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eModerate hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 15.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"15%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.5%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 9.3%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"9%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 14.65pt;\"\u003e\n\u003ctd style=\"width: 31.14%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.65pt;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eSevere hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 15.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.65pt;\" width=\"15%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.5%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.65pt;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 9.3%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.65pt;\" width=\"9%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.14%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNormal sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 15.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"15%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e39\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.5%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 9.3%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"9%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 13.04%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.14%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 15.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"15%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e73\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.5%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 9.3%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"9%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.6%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 2.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e*\u003c/strong\u003eFisher exact test was used to find association of severity of hyponatremia with need of CPAP\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbove table 12 depicts association of hyponatremia with need of CPAP. Among 80 patients, 7 patients required CPAP. Among seven patients only \u0026nbsp;4 i.e. \u0026nbsp;(57.1%) with mild hyponatremia required CPAP however 3 i.e. (42.9%) with normal sodium also required CPAP. Severity of hyponatremia with need of CPAP was not significant (p=0.534).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 13: Association of severity of hyponatremia with need of non-rebreathing facemask \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 102.1%; margin-left: -8.75pt; border-collapse: collapse; border: none;\" width=\"102%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 39.55pt;\"\u003e\n\u003ctd style=\"width: 45.36%; border: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 39.55pt;\" colspan=\"2\" rowspan=\"2\" width=\"45%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eCharacteristics\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 36.42%; border: solid black 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in; height: 39.55pt;\" colspan=\"3\" width=\"36%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNeed non rebreathing facemask\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.22%; border: solid black 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in; height: 39.55pt;\" rowspan=\"2\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 12.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNo\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eYes\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.88%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 13.78%; border: solid black 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eSodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003elevel\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.58%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eMild hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e15\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.88%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0.001\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.58%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eModerate hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e8\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.88%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.58%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eSevere hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.88%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.58%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNormal sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e41\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.88%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 13.78%; border: solid black 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.58%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.26%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e64\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e16\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.88%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Fisher exact test was used to find association of severity of hyponatremia with need of non-rebreathing facemask\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAmong the eighty study population sixteen patients required non rebreathing facemask. Among 16 patient 10 (62.5%) had mild hyponatremia followed by 2 (12.5%) moderate and 3(18.75%) severe hyponatremia, all three patients with severe hyponatremia required non rebreathing face mask. Therefore association of severity of hyponatremia with need of non-rebreathing face mask was highly significant (p=0.001).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 14: Association of severity of hyponatremia with need ventilator of study population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 100.0%; border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt;\" width=\"100%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 45.5%; border: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" colspan=\"2\" rowspan=\"2\" width=\"45%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eCharacteristics\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 35.18%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" colspan=\"3\" width=\"35%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNeed ventilator\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.32%; border: solid windowtext 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"2\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 35.9pt;\"\u003e\n\u003ctd style=\"width: 11.9%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 35.9pt;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNo\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.82%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 35.9pt;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eYes\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.46%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 35.9pt;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 14.1%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif; color: black;\"\u003eSodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif; color: black;\"\u003elevel\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eMild hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.9%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e24\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.82%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.46%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.32%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0.01\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eModerate hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.9%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.82%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.46%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eSevere hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.9%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.82%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.46%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNormal sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.9%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.82%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.46%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 14.1%; border: solid windowtext 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.4%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.9%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e74\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.82%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.46%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.32%; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Fisher exact test was used to find association of severity of hyponatremia with need of ventilator\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbove table 14 shows association of severity of hyponatremia with need of ventilator, among 80 patient 6 patient required ventilator support. Among the ventilated children 3 (50%) had moderate hyponatremia, 2 (33.3%) had severe hyponatremia and 1 (16.67) % had mild hyponatremia. Association of severity of hyponatremia with need of ventilator was statistically significant significant (p=0.01).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 15: Association of severity of hyponatremia with outcome\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 102.12%; border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt;\" width=\"102%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 45.06%; border: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" colspan=\"2\" rowspan=\"2\" width=\"45%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003eCharacteristics\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 36.94%; border: solid black 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" colspan=\"3\" width=\"36%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eOutcome\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.0%; border: solid black 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"2\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 14.5%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eMortality\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eImproved\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.24%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 13.78%; border: solid black 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif; color: black;\"\u003eSodium \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif; color: black;\"\u003elevel\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eMild hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.5%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.24%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.0%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"18%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e0.001\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eModerate hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.5%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.24%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eSevere hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.5%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.24%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 31.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eNormal sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.5%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.24%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 13.78%; border: solid black 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.28%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"31%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 14.5%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"14%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.22%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e76\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.24%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"10%\"\u003e\n\u003cp style=\"text-align: center; line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 18.0%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"18%\"\u003e\n\u003cp style=\"line-height: normal; margin: 3.0pt 0in 3.0pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Fisher exact test was used to find association of severity of hyponatremia with outcome\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbove table 15 depicts association of severity of hyponatremia with outcome. Among 80 patients four patients expired. Among four expired patient 3 (75%) patient had moderate hyponatremia and 1(25%) had severe hyponatremia. Association of severity of hyponatremia with outcome was statistically significant (p=0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 16: Association of severity of hyponatremia with duration of stay\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003en=80\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 103.22%; border-collapse: collapse; border: none;\" width=\"103%\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 44.14%; border: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" colspan=\"2\" rowspan=\"2\" width=\"44%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eCharacteristics\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 36.78%; border: solid black 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" colspan=\"3\" width=\"36%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eDuration of stay\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.08%; border: solid black 1.0pt; border-left: none; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"2\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003ep*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 13.02%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e\u0026lt;7days\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.12%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e\u0026gt;7 days\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.64%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 13.68%; border: solid black 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif; color: black;\"\u003eSodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif; color: black;\"\u003elevel\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 30.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"30%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eMild hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.02%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e17\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.12%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e8\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.64%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.08%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" rowspan=\"4\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0.001\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 30.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"30%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eModerate hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.02%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.12%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.64%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid;\"\u003e\n\u003ctd style=\"width: 30.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"30%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eSevere hyponatremia\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.02%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.12%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.64%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 14.6pt;\"\u003e\n\u003ctd style=\"width: 30.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.6pt;\" width=\"30%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eNormal sodium\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.02%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.6pt;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e37\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.12%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.6pt;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.64%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.6pt;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"page-break-inside: avoid; height: 14.6pt;\"\u003e\n\u003ctd style=\"width: 13.68%; border: solid black 1.0pt; border-top: none; background: white; padding: 0in 0in 0in 0in; height: 14.6pt;\" width=\"13%\"\u003e\n\u003cp style=\"line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 30.46%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.6pt;\" width=\"30%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.02%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.6pt;\" width=\"13%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e59\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.12%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.6pt;\" width=\"12%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e21\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 11.64%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.6pt;\" width=\"11%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; color: black;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 19.08%; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; background: white; padding: 0in 0in 0in 0in; height: 14.6pt;\" width=\"19%\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; margin: 6.0pt 0in .0001pt 0in;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Fisher exact test was used to find association of severity of hyponatremia with duration of stay\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbove table 16 depicts association of severity of hyponatremia with duration of hospital stay.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eLower respiratory tract infection is associated with electrolyte abnormalities like hyponatremia, hypernatremia, hypokalemia, hyperkalemia. Among them hyponatremia is the most common electrolyte imbalance(\u003ca href=\"#_ENREF_17\"\u003e17\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eThis study was conducted to find association between hyponatremia and adverse outcome of severe lower respiratory tract infection in children between 2 month to 16 year admitted in\u0026nbsp;\u0026nbsp; Emergency, ward and PICU of Tribhuvan University Teaching Hospital. The study was conducted over 12 months duration from September 1\u003csup\u003est\u003c/sup\u003e 2017 to September 1\u003csup\u003est\u003c/sup\u003e 2018. Total 80 cases were enrolled.\u003c/p\u003e\n\u003cp\u003eIn current study, 47.5% of the study population presenting with severe lower respiratory tract infection at admission were found to have hyponatremia. Most of them (65.78%) had mild hyponatremia. Association between hyponatremia and need of non-rebreathing facemask (p=0.001), need of ventilator (p=0.009) and clinical outcome (mortality or improvement) (p=0.047) was statistically significant (P\u0026lt;0.05). During the course of hospital stay, the mean time required for resolution of hypoxia was found higher in children with hyponatremia (4.5 days) as compared to the children with normal sodium (2.58 days). Association of hyponatremia with oxygen saturation at presentation was not significant. Children with hyponatremia had prolonged hospital stay compared to children with normal sodium and the association was statistically significant (p=0.047).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAge and gender of study population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this research mean age of study population was (2.3\u0026plusmn; 1.4) years and 66.25% of study population were boys.\u003c/p\u003e\n\u003cp\u003eIn a study conducted by Chaitra et al had similar results. The study was conducted in 91 patients suffering from LRTI admitted in PICU of Kempegowda Institute of Medical Sciences, Banglore in children age 2 months to 16 years. The\u0026nbsp; mean age of study population was 2 years and 59% of the children were boys(\u003ca href=\"#_ENREF_1\"\u003e1\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eIn the cross sectional study done to see prevalence of hyponatremia in children admitted at Kenyatta national hospital with pneumonia in 135\u0026nbsp; children\u0026nbsp; aged between 2 month to 12 years, the mean age\u0026nbsp; was 1.8 + 2.3 years and 54.8% of the study population were\u0026nbsp; boys(\u003ca href=\"#_ENREF_35\"\u003e35\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePrevalence of hyponatremia \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;In present study 47.5% of study population had hyponatremia. When evaluated for severity of hyponatremia, 65.79% had mild hyponatremia followed by 26.31% children with moderate and 7.89% with severe hyponatremia.\u003c/p\u003e\n\u003cp\u003eIn a study conducted by Chaitra et.al in Bangalore, India to find frequency of hyponatremia in 91 children from July, 2014 to December, 2014, prevalence of hyponatremia was 46.7%. Among children with hyponatremia, 20 (71%) had mild, 6 (21.4%) had moderate and 2(7%) had severe hyponatremia. These findings are similar to the present study(\u003ca href=\"#_ENREF_1\"\u003e1\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eHospital based cross sectional study was carried out at Assam Medical College and Hospital, Dibrugarh from April 2012 to March 2013 to find frequency of hyponatremia in pneumonia. They found hyponatremia in 46.7% with bronchopneumonia. In the majority of cases, 71% had mild hyponatremia, 21.4% had moderate and 7% had severe hyponatremia. The results were consistent with current research(\u003ca href=\"#_ENREF_37\"\u003e37\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eThe findings of the present study are also consistent with the study conducted by Sakellaropoulou et al in Bielanski hospital in Warsaw, Poland. The study was conducted from January 2009 to December 2010 to find prevalence of hyponatremia in pneumonia. Nineteen children (35.18%)\u0026nbsp; with pneumonia had hyponatremia at admission of whom 18(33.3%) had mild hyponatraemia and 1 (1.9%) had moderate hyponatremia.(\u003ca href=\"#_ENREF_36\"\u003e36\u003c/a\u003e)\u003c/p\u003e\n\u003cp\u003eIn a study done by Shingi S et.al to determine the frequency of electrolyte disturbance in pneumonia in 264 hospitalized children in Chandigrah, India, hyponatremia was present in 27% children with pneumonia.\u0026nbsp; The percentage of moderate and severe hyponatremia was 27% and 4.5%\u0026nbsp; respectively, results are consistent to our research(\u003ca href=\"#_ENREF_17\"\u003e17\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eIn the cross sectional study to find prevalence of hyponatremia in children admitted at Kenyatta national hospital with pneumonia in 135 children, 71.9 %( 97) children had hyponatremia. Among patients identified with hyponatremia, 40.6% had severe, 28.1% had moderate while 31.3% had mild hyponatremia. The result is higher compared to current finding. This may be because most of the children studied in Kenyatta national hospital presented late in hospital and they were critically ill and most of them also had associated complications(\u003ca href=\"#_ENREF_35\"\u003e35\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOutcome \u0026ndash; Need of respiratory support\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring this study, 38.75% patients were hypoxic at presentation. All patients were provided either noninvasive or invasive oxygen support. Noninvasive supports were nasal prongs, simple facemask and non-rebreathing facemask. Invasive respiratory support included bubble continuous positive air pressure (CPAP) and mechanical ventilation. Oxygen was provided via nasal prongs in 87.5% patients and via simple facemask in 76.25% during their hospital stay. Non re-breathing facemask was required 20% patient, CPAP in 8.75% patient. Total 6 (7.5%) patients were mechanically ventilated.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Association of hyponatremia with the need of non-rebreathing facemask (p=0.001) and mechanical ventilation (p=0.009) was significant. However it was not statistically significant with the need of CPAP (p=0.702). The reason behind it may be, use of conventional bubble CPAP was not feasible in older children.\u003c/p\u003e\n\u003cp\u003eMulti centered prospective cohort study was conducted by Hasegawa et al in United States to find association between hyponatremia in children with bronchiolitis and use of respiratory support admitted in pediatric intensive care unit. The study was conducted from winter of 2007 to 2010. In that study, children with hyponatremia had more risk of mechanical ventilation compared to children with normal sodium (58% vs 40%, p=0.04). In our study also all mechanically ventilated patient had hyponatremia (\u003ca href=\"#_ENREF_40\"\u003e40\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eIn our study, 31 children were hypoxic at presentation.\u0026nbsp; Among them 58% children had hyponatremia and 42% had normal serum sodium level. Association of hyponatremia with oxygen saturation level at admission was not statistically significant (p=0.13). The mean time required for resolution of hypoxia in children with hyponatremia with severe LRTI (4.5 days) was more compared to children with normal sodium (2.58 days).\u003c/p\u003e\n\u003cp\u003eIn a study conducted by Basnet et al at Kanti children hospital, Nepal on\u0026nbsp; 610 Nepalese children, aged 2 \u0026ndash; 35 months from February 2006 to June 2008, \u0026nbsp;hypoxia was a significant predictor for time till recovery in children with severe pneumonia(\u003ca href=\"#_ENREF_50\"\u003e50\u003c/a\u003e). In our study also hypoxic children with LRTI required more time for recovery than children with normal oxygen saturation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOutcome- Duration of stay\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;In the study conducted by Patil et.al. in 300 children in Assam Medical College and Hospital, Dibrugarh, India from April 2012 to March 2013 with objective to compare duration of stay in\u0026nbsp; hyponatremic and normonatremic patient with pneumonia. The mean duration of hospital stay of patient with hyponatremia in pneumonia was around 9.54 \u0026plusmn; 2.63 days however in patient without hyponatremia was 6.43\u0026plusmn;1.16 days. Association of hyponatremia with duration of stay was significant (p value \u0026lt;0.01). The result is consistent with our findings(\u003ca href=\"#_ENREF_37\"\u003e37\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eIn a\u0026nbsp; retrospective study was done in 312 children with pneumonia\u0026nbsp; from January 2009 to December 2010 in Bielanski Hospital, Warsaw, Poland , the duration of hospital stay\u0026nbsp; was longer (9 days vs. 8 days, p= 0.01) in the hyponatremic children compared with the children without hyponatremia. These findings are similar to results derived from present study (38).\u003c/p\u003e\n\u003cp\u003eA retrospective cross sectional\u0026nbsp; study\u0026nbsp; done by Lavagno et.al in Cheil General Hospital and Women\u0026rsquo;s Health Care Center, Seoul South Korea in 3938 children with respiratory infections between March, 2011, and February, 2014 is also consistent with present study. In this study, the duration of hospital stay in children with hyponatremia \u0026nbsp;was 4.5\u0026plusmn;1.5 days and4.3\u0026plusmn;1.5 days in children with normal sodium ( p=0.020)(39).\u003c/p\u003e\n\u003cp\u003eAnother study was done by Kaneko et.al in Department of Pediatrics, Juntendo University Urayasu Hospital,Chiba, Japan. Medical record of 138 children was reviewed retrospectively in the year 2004. Objective of the study was to found the relation of hyponatremia\u0026nbsp;\u0026nbsp; and duration of hospital stay.\u0026nbsp; Duration of hospital stay was 7.00\u0026plusmn; 3.38 days (mean \u0026plusmn; standard deviation) for the hyponatremic patient and 6.04\u0026plusmn; 3.82 for normonatremic patient and comparision was statistically not significant (P\u0026gt;0.05)\u003cstrong\u003e.(\u003c/strong\u003e40)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOutcome- Mortality\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, 4 patients with hyponatremia had mortality, none of the patient with normal sodium expired.\u0026nbsp; Association of hyponatremia with outcome was statistically significant (P=0.047). Among 4 expired patient, 3 (75%) patient had moderate hyponatremia and 1 (25%) had severe hyponatremia. Association of severity of hyponatremia with outcome was statistically significant (p=0.001).\u003c/p\u003e\n\u003cp\u003eThe finding is consistent with the single-center retrospective cohort study done in Children\u0026rsquo;s Hospital Colorado, USA done by Luu et.al. One hundred and two children were studied from January1, 2011 to July1, 2011 to characterize the relationship between hyponatremia and clinical outcomes in children ages 1 month to 2 years admitted to the pediatric intensive care unit (PICU) with bronchiolitis. Thirteen percent of patient with hyponatremia expired,\u0026nbsp;\u0026nbsp; however none of children with normal sodium expired. The association was\u0026nbsp; significant (p=0.001)(\u003ca href=\"#_ENREF_18\"\u003e18\u003c/a\u003e)\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eHyponatremia was found in 47.5% of children with severe lower respiratory tract infection. Among hyponatremic children, 65.79% had mild hyponatremia 26.31% had moderate and 7.89% had severe hyponatremia. Hyponatremia in severe lower respiratory tract infection is significantly associated with need of non-rebreathing facemask, need of ventilator and mortality. Children with hyponatremia in severe lower respiratory tract infection had prolonged hospital stay.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eADH: Anti Diuretic Hormone, ARI: Acute Respiratory Infections, AVP: Arginine Vasopressin, CPAP: Continuous Positive Airway Pressure, DOHS: Department of Health Services, ICU: Intensive Care Unit, IV: Intravenous, LRT: Lower Respiratory Tract Infection, NDHS: Nepal Demographic Health Survey, PICU: Pediatric Intensive Care Unit PRESS: Pediatric Respiratory Severity Score, SIADH: Syndrome Of Inappropriate Antidiuretic Hormone, SD: Standard Deviation, SPSS: Statistical Package for Social Sciences, URTI: Upper Respiratory Tract Infection, WHO :World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgement:\u003c/strong\u003e The authors extends their sincere appreciations to the department of pediatrics, IOM, Maharajgunj Medical Campus and to all the participants of study for their cooperation during study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Contribution\u003c/strong\u003e: Guide of research paper: Prof. Dr. Laxman Shrestha, Co-guide: Dr. Luna Bajracharya, and Co-author: Ms. Archana Bagale (assisted during whole study and prepared the whole manuscript)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e: The authors received no any specific grant from any funding agency in public, commercial or nonprofit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data:\u003c/strong\u003e data sheet was prepared by researcher by entering the respondents informations including outcomes of treatment obtained during data collection on excel for analysis of results. It is attached in section of additional file.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ethical clearance was taken from the Institutional Review Board of Institute of Medicine, Maharajgunj Medical Campus. Initial stabilization of patient was done immediately after presentation. The parents/ guardians of children fulfilling the inclusion criteria explained about this study and approached for consent. After informed consent was obtained, the child was enrolled in the study.\u0026nbsp;\u0026nbsp; Participation was voluntarily taken. Informed (verbal and written) consent was taken from each participant\u0026rsquo;s parents/guardians. Confidentiality and anonymity was maintained by writing code number instead of name of participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests: \u003c/strong\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e: Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Detail:\u003c/strong\u003e \u003cstrong\u003eCorresponding author\u003c/strong\u003e: Dr. Machhindra Lamichhane, Department of Child Health, Maharajgunj Medical campus ,Institute of Medicine Tribhuvan University ,Kathmandu, Nepal, email:[email protected]: currently working as Consultant Pediatrician at Dhaulagiri Zonal Hospital,\u0026nbsp; Baglung, Nepal\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCo-authors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eProf. Dr. Laxman Shrestha, Head of Department, Department of Child Health, Institute of Medicine, TUTH\u0026nbsp; \u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003em\u003c/p\u003e\n\u003cp\u003eDr. Luna Bajracharya, Assistant professor, Department of Child Health, Institute of Medicine, TUTH, email:[email protected]\u003c/p\u003e\n\u003cp\u003eMs. Archana Bagale, Lecturer, Yeti Health science Academy( M.Sc Nursing (Maternal Health Nursing, MA Child Development and Gender Socialization) email: \u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eChaitra K, Mohan N, Reddy S. Hyponatremia in lower respiratory tract infections. International Journal of Contemporary Pediatrics. 2016;3(2):381-4.\u003c/li\u003e\n\u003cli\u003eWardlaw TMJ, White E.,Hodge, Matthew. Pneumonia: the forgotten killer of children. World Health Organization; UNICEF2006.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization,Pneumonia Factsheet. 2016.\u003c/li\u003e\n\u003cli\u003eRudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bulletin of the World Health Organization. 2008;86(5):408-16.\u003c/li\u003e\n\u003cli\u003eNepal demographic health survey. 2016.\u003c/li\u003e\n\u003cli\u003eVentre K. MHaCD. Surfactant Treatment for Bronchiolitis in Critically Ill Infants. Cochrane Database of Systematic Reviews. 2006;3.\u003c/li\u003e\n\u003cli\u003eMargolis P, Gadomski A. Does this infant have pneumonia? JAMA. 1998;279(4):308-13.\u003c/li\u003e\n\u003cli\u003eChibuk TK,Cohen E, Robinson JL, Mahant S. Paediatric complicated pneumonia: Diagnosis and management of empyema. Paediatr Child Health. Aug-Sep 2011;16(7).\u003c/li\u003e\n\u003cli\u003eGereige RS, Laufer PM. Pneumonia. Pediatrics in Review. 2013;34(10):438-56.\u003c/li\u003e\n\u003cli\u003e10\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Willson DF, Landrigan CP, Horn SD, Smout RJ. Complications in infants hospitalized for bronchiolitis or respiratory syncytial virus pneumonia. The Journal of Pediatrics. 2003;143(5):142-9.\u003c/li\u003e\n\u003cli\u003eEisenhut M. Extrapulmonary manifestations of severe respiratory syncytial virus infection--a systematic review. Critical care (London, England). 2006;10(4):R107.\u003c/li\u003e\n\u003cli\u003eUpadhyay A, Jaber BL, Madias NE. Incidence and prevalence of hyponatremia. The American journal of medicine. 2006;119(7 Suppl 1):S30-5.\u003c/li\u003e\n\u003cli\u003eMoritz ML, Ayus JC . Disorders of WaterMetabolism in Children:Hyponatremia and Hypernatremia. Pediatrics in review. 2002;23 no 11:371-80.\u003c/li\u003e\n\u003cli\u003eSankaran RT, Mattana J, Pollack S, Bhat P, Ahuja T, Patel A, et al. Laboratory abnormalities in patients with bacterial pneumonia. Chest. 1997;111(3):595-600.\u003c/li\u003e\n\u003cli\u003eGeriigk M,Gnehm HE, Rascher W . Arginine vasopressin and renin in acutely ill children: implication for fluid therapy. Acta Paediatrica. 1996;85(5):550-3.\u003c/li\u003e\n\u003cli\u003eVan Steensel-Moll HA, Hazelzet JA, van der Voort E, Neijens HJ, Hackeng WH. Excessive secretion of antidiuretic hormone in infections with respiratory syncytial virus. Archives of disease in childhood. 1990;65(11):1237-9.\u003c/li\u003e\n\u003cli\u003eSinghi S, Dhawan A. Frequency and significance of electrolyte abnormalities in pneumonia. Indian Pediatr. 1992;29(6):735-40.\u003c/li\u003e\n\u003cli\u003eLuu R, DeWitt P, Reiter P, L Dobyns E, Kaufman J. Hyponatremia in Children with Bronchiolitis Admitted to the Pediatric Intensive Care Unit Is Associated with Worse Outcomes2013. 163(60: 1652-56.\u003c/li\u003e\n\u003cli\u003ePark K. Acute respiratory infections. In:Park\u0026rsquo;s text book of preventive and social medicine, 20th Ed Jabalpur, M/s BanarasidasBhanot publishers. 2013:158-64.\u003c/li\u003e\n\u003cli\u003eWHO. Revised WHO classification and treatment of childhood pneumonia at health facilities. 2014.\u003c/li\u003e\n\u003cli\u003eAnnual report. Department of health services,Nepal. 2073/2074.\u003c/li\u003e\n\u003cli\u003eRodriguez-Roisin R, Roca J. Mechanisms of hypoxemia. Intensive care medicine. 2005;31(8):1017-9.\u003c/li\u003e\n\u003cli\u003eKennetmcintosh MD. Community acquired pneumonia in children. N Engl J Med. 2002;346(6):429-37.\u003c/li\u003e\n\u003cli\u003eFretzayas A, Moustaki M. Etiology and clinical features of viral bronchiolitis in infancy. World J Pediatr. 2017:1-5.\u003c/li\u003e\n\u003cli\u003eShawn L. Ralston M, Allan S. Lieberthal M et al. Clinical Practice Guideline: The Diagnosis, Management,and Prevention of Bronchiolitis. American Academyof Pediatrics. 2014. 134:e1474-e1502\u003c/li\u003e\n\u003cli\u003ePatwari A. Risk Factors for Mortality in Children Hospitalized with Pneumonia. Indian pediatrics. 2012;49:869-70.\u003c/li\u003e\n\u003cli\u003eSehgal V, Sethi GR, Sachdev HP, Satyanarayana L. Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections. Indian Pediatr. 1997;34(3):213-9.\u003c/li\u003e\n\u003cli\u003eReid-Adam J, Hyponatremia. Pediatrics in review. 2013;34. (9): 417-19\u003c/li\u003e\n\u003cli\u003e29\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Mastorakos G, Weber JS, Magiakou MA, Gunn H, Chrousos GP. Hypothalamic-pituitary-adrenal axis activation and stimulation of systemic vasopressin secretion by recombinant interleukin-6 in humans: potential implications for the syndrome of inappropriate vasopressin secretion. The Journal of clinical endocrinology and metabolism. 1994;79(4):934-9.\u003c/li\u003e\n\u003cli\u003eFarber MO, Roberts LR, Weinberger MH, Robertson GL, Fineberg NS, Manfredi F. Abnormalities of sodium and water handling in chronic obstructive lung disease. Archives of Internal Medicine. 1982;142(7):1326-30.\u003c/li\u003e\n\u003cli\u003eReihman DH, Farber MO, Weinberger MH, Henry DP, Fineberg NS, Dowdeswell IR, et al. Effect of hypoxemia on sodium and water excretion in chronic obstructive lung disease. The American journal of medicine. 1985;78(1):87-94.\u003c/li\u003e\n\u003cli\u003eVan Steensel-Moll HA, Hazelzet JA, Van der Voort E. Excessive secretion of antidiuretic hormone ininfections with respiratory syncytial virus. Archives ofDisease in Childhood. 1990;65:1237-9.\u003c/li\u003e\n\u003cli\u003eMiyaji Y, Sugai K, Nozawa A, Kobayashi M, Niwa S, TsukagoshiH et al. Pediatric Respiratory Severity Score (PRESS) forRespiratory Tract Infections in Children. Austin Virol and Retrovirology. 2015;2(1):1-6.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Technical bases for the WHO recommendations on the management of pneumonia in children at first-level health facilities. 1991.\u003c/li\u003e\n\u003cli\u003eNdirangu EN. Prevalence of hyponatremia in children admitted at Kenyatta National Hospital with pneumonia. 2009.\u003c/li\u003e\n\u003cli\u003eSakellaropoulou A, Hatzistilianou M, Eboriadou M, Athanasiadou-Piperopoulou F. Hyponatraemia in cases of children with pneumonia. Archives of Medical Science : AMS. 2010;6(4):578-83.\u003c/li\u003e\n\u003cli\u003ePatil J. Hyponatremia in pneumonia: hospital based cross sectional study. Journal of drug discovery and therapeutics. 2015;3(30):17-22\u003c/li\u003e\n\u003cli\u003eWrotek A, Jackowska T. Hyponatremia in children hospitalized due to pneumonia. Advances in experimental medicine and biology. 2013;788:103-8.\u003c/li\u003e\n\u003cli\u003ePark SW, Shin SM, Jeong M, Cho D-H, Lee KH, Eisenhut M, et al. Hyponatremia in children with respiratory infections: a cross-sectional analysis of a cohort of 3938 patients. Scientific Reports. 2018;8(1):16494.\u003c/li\u003e\n\u003cli\u003eKaneko K, Kaneko Ki. Hyponatremia in children with respiratory tract infection. Pediatric Nephrology. 2009;24(8):1595.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Hyponatremia, Severe LRTI, TUTH","lastPublishedDoi":"10.21203/rs.2.20441/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.2.20441/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground Lower respiratory tract infection (LRTI) is one of the major causes of mortality in children with estimated 1 million deaths every year. Hyponatremia is the most common electrolyte abnormality seen in LRTI. \u003c/p\u003e\u003cp\u003eObjective To find association of hyponatremia (serum sodium\u0026lt;135meq/l) with severe LRTI. \u003c/p\u003e\u003cp\u003eDesign Prospective cross sectional study \u003c/p\u003e\u003cp\u003eSettings Pediatric Emergency, Ward and Pediatric Intensive Care Unit of Tribhuvan University Teaching Hospital(TUTH) \u003c/p\u003e\u003cp\u003eSubjects Children between 2 months to 16 years presenting with cough for less than 3 weeks, fast breathing and chest indrawing. \u003c/p\u003e\u003cp\u003eMethods Children between 2 month to 16 years of age having cough, fast breathing and chest indrawing admitted in emergency, ward or PICU of TUTH were screened and among them, children having pediatric respiratory severity score of 4-5 were enrolled in the study. Serum sodium was sent during admission and collected within 2 hours. Daily follow up was done to find need of respiratory support, duration to resolve hypoxia, total duration in hospital and final outcome of patient. Statistical test applied were Chi-square test and Fisher exact test. \u003c/p\u003e\u003cp\u003eResults 47.5% of study population had hyponatremia, of whom 65.79% had mild hyponatremia 26.31% had moderate and 7.89%had severe hyponatremia. Association of hyponatremia with need of non rebreathing face mask (p=0.001), ventilatio r (p=0.009), duration of hospital stay (p=0.047) were significant. The study also found the association of severity of hyponatremia with need of non rebreathing facemask (p=0.001),ventilator (p=0.01), outcome (p=0.001), duration of stay (0.002). Mean time to resolve hypoxia in children with hyponatremia (4.5 days) was longer compared to normal sodium (2.58 days). Four patients died during the study period and all of them had hyponatremia.\u003c/p\u003e","manuscriptTitle":"Hyponatremia As A Predictor Of Adverse Outcome In Children With Severe Lower Respiratory Tract Infection In Tribhuvan University Teaching Hospital (Tuth), Nepal","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2020-01-28 12:57:03","doi":"10.21203/rs.2.20441/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2020-01-09 19:43:36","doi":"10.21203/rs.2.20441/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4baa6545-f965-4402-9436-499e17df4371","owner":[],"postedDate":"January 28th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":48403,"name":"Pediatrics"},{"id":48404,"name":"Pulmonology"}],"tags":[],"updatedAt":"2022-04-11T05:20:24+00:00","versionOfRecord":{"articleIdentity":"rs-11048","link":"https://doi.org/10.36348/sjm.2022.v07i04.001","journal":{"identity":"saudi-journal-of-medicine","isVorOnly":true,"title":"Saudi Journal of Medicine"},"publishedOn":"2022-04-03 05:20:24","publishedOnDateReadable":"April 3rd, 2022"},"versionCreatedAt":"2020-01-28 12:57:03","video":"","vorDoi":"10.36348/sjm.2022.v07i04.001","vorDoiUrl":"https://doi.org/10.36348/sjm.2022.v07i04.001","workflowStages":[]},"version":"v2","identity":"rs-11048","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-11048","version":["v2"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}