ABSTRACT
Introduction: Neuropsychiatric Systemic LupusErythematosus (NPSLE) is a disease with central andperipheral nervous system manifestations. The diagnosis ofNPSLE is often a diagnostic challenge though the criteria forNPSLE is well-established.Objective: To study the prevalence and pattern ofneuropsychiatric manifestations in SLE.Materials and Methods: This hospital based observationalstudy was carried out from Nov 2017 to June 2018. A total of58 cases of SLE were assessed clinically and investigatedaccordingly. Special emphasis was given to look forNeurological involvement. MMSE, HAM A and HAM D scaleswere used for assessment of cognitive dysfunction, anxiety anddepression respectively. The disease activity was measured bythe SLEDAI.Results: In a total of 58 patients with SLE evaluated, 92%were female. The most common age group was 21 to 30 years.Mean age was 25.6 years. Nervous system involvement wasfound in 37 (63.79%) patients. Headache was the mostfrequent manifestation, present in 32 (55.17%) patientsfollowed by Cognitive dysfunction in 8 patients (13.79%).Seizure disorder was present in 6 (10.34%), acute confusionalstate in 2 (3.44%), depression in 4 (6.89%), anxiety in 2(3.44%) and psychosis in 2 (26.31%) patients. Asepticmeningitis and peripheral neuropathy was found in 2 (3.44%)and 1 (1.72%) patients respectively. Many of the patients hadmore than one neurological involvement. SLEDAI score washigh in SLE patients with neurological manifestations.Conclusion: The frequency of Neuropsychiatric involvementwas found in the majority of the patients with SLE andheadache was the most common manifestation. Patients withNPSLE showed high disease activity.
ABSTRACT
Introduction: Hyponatremia, which is defined as a plasmasodium concentration less than (<) 135mmol/L, is a verycommon disorder and can occur in up to 22% of hospitalisedpatients. Its prevalence among non-hospitalised elderlypatients has been estimated to be between 7% to 11.4%,increasing to 11% to 22.5% among the hospitalised patients. Itis also the most common dyselectrolytemia seen in thegeriatric population which occurs due to impaired water andelectrolytes balance in response to diet, drugs andenvironmental changes.Aims and Objectives: The aims of the study were to describethe clinical features and different causes of hyponatremia inhospitalised elderly patients and to find out the types ofhyponatremia and to assess the short term outcomes duringhospital stay.Methods and Materials: The study was a hospital basedobservational study conducted in Medicine Department andGeriatric Regional Centre, Gauhati Medical College andHospital, Guwahati for a period of one year from August 2017to September 2018. Ethical clearance was obtained from theethical committee. A total of 106 patients with hyponatremiawere included in the study with aged greater than or equal to(≥) 60 years.Results and Observations: The mean age was 70.04 yearswith a standard deviation of 6.73 years. Male and Female ratiowas 1: 1.12. The mean serum sodium level was 124.8 mmol/Lwith a standard deviation of 5.8 mmol/L. Altered sensorium (48cases, 45.3%) was the most common presenting symptomfollowed by lethargy (21 cases ,19.8%). The most commonetiology was found to be SIADH (32 cases, 30.2%) followed byrenal failure (19 cases, 18%) and intake of drugs like diuretics(18 cases, 17%). Among SIADH majority of the cases werefound to have pneumonia (12 cases, 37.5%) followed by stroke(9 cases, 28.1%) and brain infections like meningitis andencephalitis (5 cases, 15.6%). In hyponatremia, majority of thecases was found to be in euvolemic status (55 cases, 51.9%).The overall mortality of hyponatremic patients was 8.5%. Shortterm outcomes in patients with comorbid condition like chronickidney disease was found to be significantly higher (pvalue=0.0396).Conclusion: Hyponatremia is a very common dyseletrolytemiaand clinical problem encountered in the elderly population andis associated with high morbidity and mortality particularlywhen associated with comorbidities.