ABSTRACT
Background: In 1972, Dr Sharp and colleagues described a new connective tissue disease, characterized by overlapping features of systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and polymyositis/ dermatomyositis (PM/DM) and by the presence of antibodies against the U1 small nuclear ribonucleoprotein autoantigen (U1 snRNP). This condition was termed mixed connective tissue disease (MCTD) and proposed as a distinct disease. Later, after observing the clinical evolution of MCTD patients, Sharp himself agreed that the original concept of MCTD had to be modified and that Internal organs were at risk for serious complications; patients were not always steroid responsive; prognosis was not always benign. Materials and methods: Patients in the age group of 15-50 years diagnosed to have connective tissue diseases were included. 8 patients in the age group of 15-50 admitted in Medicine department were taken and they were evaluated for the clinical profile of sharp syndrome by thorough clinical examination, routine laboratory tests and special investigations depending on the clinical profile. Results: 8 patients with connective tissue disease attending the medicine OPD were studied. Of these 8 patients were female patients. The median age of onset was 36 years, 8 patients met criteria by sharp and Alarcon-Segovia. The clinical features of patients at presentation are Raynaud抯 phenomena, Puffy fingers, esophagus dysmotility, skin rash, interstitial lung disease, arthritis, pulmonary hypertension, myositis, anemia. Conclusion: SHARP syndrome is a rare condition, as evidenced by the small series of cases reported to date. Diagnosis is based on clinical and paraclinical criteria. The evolution can be interspersed with various complications that can affect the short, medium and long-term prognosis
ABSTRACT
Background: Snake bite is an occupational and rural hazard because India has always been a land of exotic snakes. Although full burden of human suffering attributable to snake bite remains obscure, hundreds of thousands of people are known to be envenomed and tens of thousands are killed or maimed by snakes every year. This study is aimed at studying the clinical manifestations in snake bite at government general hospital.Methods: This Prospective Observational study was done from March 2019 to August 2019 in Government General Hospital Nalgonda. A total of 60 cases male and female admitted with snake bite were studied based on inclusion and exclusion criteria. All patients were done routine investigations, ECG was done to rule out cardiac anomalies. Patients below 12 years, pregnant women and patients with previous heart ailments were excluded from the study. The study was carried out in all patients fulfilling the inclusion and exclusion criteria.Results: A total of 60 patients 35 females and 25 males presented during the study period. Most of the patients presented with pain at the site 40(66%), Nausea 30(50%), Swelling 25(42%), Paraesthesia 25(42%), Bleeding 15(25%), Ptosis 15(25%), Sweating 10(17%), Cellulitis 10(17%) and dyspnoea 5(9%). Among the ECG manifestations- Tachycardia- 30(50%), Ischaemia 5(9%), Sinus arrythmia 2(4%), Myocardial Infarction-0.Conclusions: It was Observed from the study that the pt. had more of Haemolytic presentation than neuroparalytic presentation. Pain at the site was the most common presentation followed by nausea. Some patients developed neuroparalytic symptoms like cellulitis, and paraesthesia. Further it was observed that timely shifting to the Hospital and administration of Anti-Snake venom prevented major manifestations in the patients.