Demelash GezahegneGadissa Birhanu2025-03-202025-03-202024-12-05https://etd.aau.edu.et/handle/123456789/5167Treatment of severe and acute hyponatremia is challenging in emergency departments of resource-limited setup. Methods: A single-center, cross-sectional retrospective study was conducted. We selected 148 patients from the emergency department using simple random sampling. Data were collected from laboratory results, patient charts, and electronic medical records (EMR) and analyzed using SPSS. Non-parametric tests, regression analysis, and Kaplan-Meier survival analysis wereperformed. Result: From a total of 148 patients, 13(8.8%) were under-corrected, 99 patients (66.9%) achieved normal correction, and 36 patients (24.3%) were overcorrected. The Related-Samples Friedman's Two-Way Analysis oVariance by Ranks revealed a highly statistically significant (p-value=0.000effectiveness in using a calculated dose of the locally made 3% enteral table salt solution for treating severe and/or acute hyponatremia in our study. The Independent-Samples Kruskal-Wallis Test showed that hypokalemia notably affected Day 1 serum sodium levels, causing greater variability (p < .001). Overcorrection was strongly associated with lower initial serum sodium levels (aOR=0.912, CI=0.860,0.966) and hypokalemia (OR=0.008, CI=0.002,0.031) and slightly associated with the total amount of the 3% solution administered on Day 1 (aOR=1.005, CI=1.001, 1.008). Undercorrection was significantly associated with the total amount of 3% solution taken on Day 1 (aOR=0.995, CI=0.0991, 0.998). Patients with undercorrection had a higher association with death (aOR=9.825, CI=1.927, 50.106). Osmotic Demyelination syndrome (ODS symptoms were associated with hypokalemia (aOR=6.929,CI=2.904,16.530), initial serum sodium level (aOR=0.933, CI=0.8810,0.987), and overcorrection (aOR=16.022, CI=6.194, 41.443). The Kaplan-Meier curve illustrated sharper increase for under-correction. Conclusion and Recommendation Using 3 % locally made enteral table salt solution is effective in treatment of severe and/acute hyponatremia management in resource limited setup. Calculating the solution using Edelman Equation is essential and effective for the management by reducing the risk of overcorrection. There was no association b/n the ODS symptoms and rate of death. There was no correlation between the principal diagnosis and comorbidities of patients who died. Undercorrection was the only statically significant component for the deaths in the study. We can consider giving a calculated locally made 3 % enteral table salt for patients with severe and/or acute hyponatremia management in resource limited setup where there are challenges in obtaining standard 3 % hypertonic solution. But a further and higher level of study is warranted, possibly an RCT that will compare our enteral table salt solution with the standard 3 % hypertonic solution.en-USPrevalencemanagement and associatedThesis