Pulmonary Involvement in Systemic Lupus Erythematosus Patients in a Tertiary Care Hospital

Introduction: In half of the individuals with systemic lupus erythematosus (SLE), over the course of the disease, pulmonary involvement occurs frequently and is one of the parts in the array of presenting symptoms. But the published research and information on SLE have historically concentrated on renal, central nervous system (CNS), and dermatological manifestations, while the pulmonary effects of SLE have received very less attention. Objective: To know the extent and pattern of pulmonary involvement in SLE patients in a tertiary care hospital. Materials and methods: A cross-sectional observational study was conducted among 70 diagnosed SLE [who fulfilled the revised American College of Rheumatology (ACR) criteria for the classification of SLE] patients attending a tertiary care center. Seventy diagnosed SLE patients who met the updated ACR criteria for the classification of SLE and were enrolled in a tertiary care facility in West Bengal participated in a cross-sectional observational study. After informed consent, clinical examinations, general survey, respiratory examination, cardiovascular examination, and relevant investigations [chest X-ray, pulmonary function test, echocardiography and electrocardiography, and high-resolution computed tomography (HRCT)/chest computed tomography (CT) scan] were performed. Results: The majority of the study subjects belonged to the 21–30 years of age-group (45.7%) and were females. Most of the study subjects were treatment-naïve as they were newly diagnosed. Among the chief presenting complaints, the most common was cough followed by dyspnea and pleuritic chest pain. Chest X-rays showed pleural pathology in 37% of study subjects and pulmonary function tests were found to have a restrictive pattern in 4.3%. Echocardiography documented that 19.6% had pulmonary artery hypertension. HRCT revealed that 19.4% of subjects had definitive findings of interstitial lung diseases (ILD). Conclusion: A substantial contributor to morbidity and death, SLE is a potentially fatal, commonly debilitating autoimmune illness with pulmonary symptoms. Cough was the most common presenting complaint, and the most common radiological abnormality detected was pleural effusion. Spirometry revealed, as expected, a restrictive pattern in most of the cases. Around 29% of cases revealed features suggestive of or confirmatory evidence for intestinal lung disease. As a whole, the prevalence of lung involvement in SLE in the study was 67%. But this being a study with only 70 participants, a further longitudinal is recommended to study disease activity correlation with the incidence of early pulmonary involvement in SLE disease course.

Comparative Study of Antibiotics and Allium Sativum Against Coagulase Positive and Coagulase Negative Staphylococcus.

Garlic (Allium sativum) is a well known medicine used since ancient times. Its potency as an antibiotic without inducing drug resistance has been well documented. A very common pyogenic organism, namely Staphylococcus aureus, as well as its coagulase negative brethren, are very well known pathogens causing infections all over the world. Their ability to become multidrug resistant has become a matter of deep concern to medical personnels all over the world. We wanted to see that garlic, described in various literatures as antiviral, antibacterial, antifungal, antiprotozoal, antioxidant – held how much potency as an antistaphylococcal agent as well. Aims and Objectives: The study aimed at evaluating the antistaphylococcal activity of garlic, in the face of emergence of multidrug resistant forms of both coagulase positive and negative forms of staphylococcus. Materials and Methods: Raw garlic juice was extracted and was tested to be sterile. Pure cultures of coagulase positive and negative staphylococcus were prepared. A comparative study using six potent antibiotics as well as garlic against Staphylococcus and CoNS strains was done. At the same time, decreasing concentrations of garlic solution was used to show the effect on zone of inhibition. Discussion: Both S.aureus and CoNS strains showed significant inhibition by garlic extract. Garlic seemed to have greater antibacterial effect than all the antibiotics tested except linezolid, which persistently performed better. With decreasing concentration of garlic juice, zone of inhibition also decreased consistently.

Type I neurofibromatosis with pheochromocytoma.

Type 1 neurofibromatosis is a common neurocutaneous syndrome with various common and uncommon associations. The present case represents an uncommon association of type 1 neurofibromatosis and pheochromocytoma, which is probably due to mutation of NF-1 gene.

Organophosphate induced delayed polyneuropathy: An unusual presentation.

Organophosphate poisoning is an important cause of suicides in hospital admission. The present case is of a female presenting with loss of power in all four limbs two weeks following a suicidal attempt. Nerve conduction velocity test revealed axonal type of motor neuropathy in bilateral median and ulnar nerve and peroneal and tibial nerves were unexcitable bilaterally. Therefore, in all cases of neuropathy, ingestion of organophosphate, either accidental or suicidal should be looked for even if the initial phases of intoxication are not clinically well defined.