ABSTRACT
Background: Dysregulated serum levels of Mannan binding lectin (MBL) has a probable role in Systemic Lupus Erythematosus (SLE) pathogenesis. Objective: To evaluate the association between serum MBL levels in SLE patients from western India with the severity of disease Methods: SLE patients (n=70) from Western India were included. Based on MBL levels, patients were classified into four categories, viz. low (<100 ng/ml), mild (100-500 ng/ml), moderate (500-1000 ng/ml) and high (>1000 ng/ml). Correlation of serum MBL levels with disease severity was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). MBL levels and circulating immune complex levels were detected by ELISA. C3, C4 and CRP levels were detected by nephelometer. Results: Serum MBL levels of SLE patients (1954 ± 202.4 ng/ml) was lower than that of healthy controls (2388 ± 205.0 ng/ ml). There was no significant correlation between MBL levels with severity of SLE on the basis of ACR criteria and SLEDAI scores (p> 0.05). No significant difference was observed among MBL levels and SLE patients with (1847 ± 246.7) or without (1900 ± 246.8) Lupus Nephritis. SLE patients without infections (n= 33) had low MBL levels (1700 ± 301.0 ng/ ml) as compared with SLE patients with infection (n= 37) (2189 ± 284.6 ng/ ml) (p=0.30) Conclusion: Present study indicated that low MBL levels were not associated with disease severity, haematological manifestations and infections among SLE patients from Western India.
ABSTRACT
Background: The aim of the study was to study the clinical profile of patients presenting with adverse drug reaction.Methods: The study was conducted in the Department of Medicine, IGMC Shimla from 01 July 2015 to 30 June 2016. A total of 129 patients were included in this study. A detailed history was taken followed by examination of patients. The routine investigations were done and special investigations as per need. For analysis patients detail, suspected drugs and the adverse drug reactions caused by them were used.Results: Bleeding from various sites was the most common event (39.5%), followed by symptomatic hypoglycemia 22.5% of events and symptomatic hyponatremia in 16.3% events. Amongst various drug classes anticoagulants were the most commonly involved drug class followed by oral hypoglycaemic agents, diuretics and antiplatelets. Type A was predominant ADR constituting (97.7%) of total ADRs and only (2.3%) of ADRs were of type B. After causality assessment, majority 86 (66.6%) were probable related and large number 127 (98.3%) of ADRs were serious which recovered after hospitalization.Conclusions: Our study revealed that ADRs are frequent and are easily recognized in clinical practice and are mostly preventable. Most ADRs are due to the use of drugs with high toxicity for example, warfarin often results in bleeding. It also shows that careful drug monitoring in hospitals may lead to reduction of many such ADRs, suggesting that some type A, ADRs may be due to inadequate monitoring of therapies and doses. This study will aid the development of interventions to reduce the impact of ADRs in hospital in-patients.
ABSTRACT
Kala-azar or Visceral leishmaniasis (VL) is a disease of low altitude (approximately 500 meters mean sea level). In India, however cases have been reported from sub-Himalayan region (350-960 meters MSL) of Kumaon region of Uttaranchal. We present two patients of VL, natives of tribal district of Kinnnaur (2000-3000 meters MSL), Himachal Pradesh, who had never visited known endemic area for Leishmaniasis. These are probably first indigenous cases of VL being reported from an area situated at an altitude of 3000 meters and 2300 meters MSL.