clinical significance of anti-Ro antibodies in patients with systemic lupus erythematosis

Systemic lupus erythematosus [SLE] is characterized by serum autoantibodies against protein components of small cytoplasmic ribo-nucleoproteins [scRNPs]. The origin and regulation of these anti-Ro/SS-A and anti-La/SS-B antibodies are not well understood. We attempted to define the association between the presence and absence of anti-Ro [SS-A] antibodies [Abs], and the criteria of SLE classification and non criteria manifestation of SLE, for better understanding of the disease course and prognosis. Ninety three SLE patients were included in the study. Retrospective analysis of their medical records was performed. 25% of SLE patients showed anti-Ro positive AB of which 91.3% were females. Anti Ro was significantly associated with lupus nephritis. While it showed a border line association with discoid rash and vasculitis. The presence of anti Ro antibodies with anti La antibodies increased the tendency of subcutaneous lupus to occur. Another interesting finding was the absence of antiphospholipid [APS] syndrome presentation [n=zero] in patients with anti Ro antibodies alone or in association with anti La positive antibodies versus seven patients detected with that syndrome in anti Ro and anti La negative group of patients [p=0.04]. Anti Ro is significantly associated with lupus nephritis. This may assist to predict renal involvement and to improve patient outcomes while simultaneously reducing disease costs. A paradox in disease severity may be suggested by a possible protective role against APL syndrome in these patients. The latter finding certainly warrants further investigations by studying larger population of patients

influnence of gender and level of education on the knowlege of adult diabetics on disease related issue and patients self care: the Abu Dhabi experience

To evaluate the basic knowledge of our adult patients with diabetes mellitus [DM] on disease-related issues and selfcare based on the level of education and gender. The General Medical and Endocrinology outpatient clinics in a referral general hospital in Abu Dhabi, the capital city of United Arab Emirates [UAE]. Over a 10 'week period, we randomly selected 219 adults with DM who have been attending these two clinics and divided them into two groups as educated or uneducated subjects, and also on their gender. All, then were invited to answer an 8-item questionnaire on various diabetes 'related issues, attitude and self-care. 127 [58%] were uneducated and female gender predominated [59%]. Greater number of educated patients were familiar with self monitoring blood glucose [SMBG] [p=0.001], and self-injection of insulin [p=0.04] than the uneducated. Interestingly however, 25.5% of educated patients believed in the superiority of herbal medicine over the conventional hypoglycemic agents as compared to the uneducated [10%, p=0.01]. Nearly 30% of all patients believed in honey as a useful remedy for DM regardless of their level of education. The females were marginally more aware of the hypoglycemic symptoms than their male counterparts [65% vs.52% respectively, p=0.047]. Based on the above parameters, the overall modest outcome of our study indicates the need for intensifying patient's education to all, irrespective of the gender, with special attention given to the uneducated subjects. Efforts should also be made to dismiss therapeutic misconception as well

Convulsions induced by ear suctioning

A patient with a history of chronic otitis media and cholesteatoma had a radical mastoidectomy continued having an ear discharge. During early manipulation of the ear, he experienced severe vertigo and on two occasions developed grand mal seizures during cleansing of the ear

Pendred's syndrome

A young Egyptian maIe, a deaf mute since early childhood, was discovered to be hypothyroid at the age of 15 years. Clinical and endocrine data, along with a positive perchlorate discharge test supported the diagnosis of Pendred's syndrome