study of avascular necrosis [osteonecrosis] in systemic lupus erythematosus patients and its relation to corticosteroid therapy

Avascular necrosis [AVN] of the femoral head has been reported to be one of the major problems during the course of SLE. In a retrospective study of 30 patients with SLE, four [13.3%] were found to have AVN all had been on corticosteroids. Of these, three [75%] had Raynaud's phenomenon, three [75%] took pulse steroid therapy, and three [75%] had thrombocytopenia. None of the patients abused alcohol or had chronic liver disease. A positive correlation was found between hyperelipidaemia as well as the presence of high titre of anticardiolipin antibodies [both IgMand IgG] and the occurence of AVN. Moreover, statistically significant differences were found between patients with and without AVN as regards the total duration of steroid intake, the total cumulative prednisolone dose or its equivalent as well as the daily dose with significantly higher levels in patients with AVN than in those without. So, it is suggested that corticosteroid therapy play the major role in the development of AVN in SLE patients in addition to lipid and haemostatic abnormalities

Prevalence of psychiatric disturbances among patients with thyroid dysfunction

This is a preliminary study of the pattern of psychiatric illness in thyroid dysfunction, using a semi-stuctured psychiatric interview and DSM-111R diagnoses. A total of 72 patients [42 hyperthyroid and 30 hypothyroid] were studied for sociodemographic characteristic and associated psychiatric diagnoses. The majority of the patients were under the age of 50 [82%] and the females dominated over males in the ratio of 2.6:1. thirty patents [42%] of the two groups encountered psychiatric illness; 15 patients of each group. Anxiety and phobic neuroses were the commonest psychiatric illnesses [26.7%], more in the hyperthyroid group [45%]. Depression was second [20%], but more in the hypothyroid group [26.7%]. The organic brain syndrome was absent and functional psychosis was rare. These and other results in our study were discussed with comparable studies abroad. A multidisciplinary approach to the problem of psychiatric illness in thyroid dysfunction is suggested