ABSTRACT
Introduction : Systemic Lupus Erythematosus (SLE) is an Autoimmune Disorder with broad spectrum of clinical presentation and is associated with increased prevalence of Atherosclerosis and Cardiovascular events. Metabolic Abnormality, when present in SLE patients increases proinflammatory condition and increased Cardiovascular and Cerebrovascular morbidity and mortality. Objectives : The objectives of this study were to evaluate the prevalence of Metabolic Abnormality in SLE patients and to analyze the association with clinical and Demographic Factors. Methods: The study was a single center, hospital based, prospective, observational study for a span of one and a half years over one hundred patients. SLE was diagnosed by revised American Rheumatology Association Criteria for SLE and Metabolic Syndrome by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) Criteria. Data analyzed with SPSS 23.0 software. Results : The Metabolic Syndrome (MetS) was prevalent in SLE patients (56%). A statistically significant association is detected between MetS and SLE related variables - Serositis, Cutaneous manifestations, Oral Ulcer, Arthralgia, but no significant association found between MetS and QoL (Quality of Life) related variables like Age, Sex. The MetS components, Hypertension, Diabetes and Hypertriglyceridemia were significantly more prevalent in SLE. Conclusion : MetS contributes to long term Cardiovascular risk in SLE patients and thus identifying MetS can contribute to major benefit towards management of IHD risk.
ABSTRACT
Background: Tetanus is a major health problem in many developing countries, including India, with significant morbidity and mortality due to lack of environmental hygiene and health education, incomplete vaccination, high case prevalence and inadequate intensive care facilities. Objectives: To observe the demography, clinical profile and outcomes of tetanus patients. Materials and methods: A total of 282 tetanus patients were screened and closely observed prospectively from January 2010 to December 2011. Results: The mean age of the study patients was 31.15 years (± 14.26) and the majority were unvaccinated or incompletely vaccinated against tetanus. Patients were mainly farmers (140, 49.64%) and children (102, 36.17%). The sources of infection identified were mainly thorn/pin prick in 129 cases (45.7%), cut/lacerated injury in 83 cases (29.4%) and ear infection in 47 cases (16.7%), while definite injury was not detected/remembered in 42 cases (14.8%). The average duration of hospital stay was 17.2 ± (4.7) days and autonomic nervous system dysfunction was the most common complication observed in this study. Death was the outcome in a total of 58 patients (20.6%) mostly due to aspiration pneumonia-induced sepsis, respiratory failure or cardiac complications. Conclusion: Environmental hygiene, basic health education, increased in immunization coverage, proper wound care – even following minor injuries – and more facilities for intensive care units, may reduce the overall incidence of tetanus and mortality following onset of the disease.