Systemic lupus erythematosus (SLE) is one of the commonest systemic autoimmune diseases that can present with variable clinical manifestations. Intravenous Immunoglobulin (IVIG) has been used as a salvage therapy for severe lupus with encouraging results though there is yet randomised trial to support the usage. This report highlights the efficacy and safety of high dose IVIG in SLE patients with multi-organ involvement particularly lupus nephritis. We also reviewed the literature on the usage of IVIG for lupus nephritis. However, more studies are needed to further clarify the optimal therapeutic dosage and regime for IVIG and to identify the group of patients who might benefit the most from this expensive therapy.

We describe a 29-year-old Para 1 post-Emergency Lower Segment Caesarean Section (EMLSCS) for fetal distress and Preterm Rupture of the Membrane (PROM) referred by the Obstetric team for persistent bradycardia. She had the typical features of Albright’s Hereditary Osteodystrophy (AHO). The laboratory investigation revealed hypocalcemia, hyperphosphatemia with a high Parathyroid hormone (PTH) level and low free Thyroxine 4 (fT4) with high Thyroid Stimulating Hormone (TSH). The patient was diagnosed with Pseudohypoparathyroidism (PHP) Type 1A associated with TSH resistance based on the somatic features of AHO present as well as biochemical and radiological abnormalities.

Dengue fever is a common mosquito-borne disease, which is endemic in tropical and subtropical countries. Bilateral optic neuropathy is a relatively unusual dengue-related ocular complication. Here, we present a case of bilateral optic neuritis with maculopathy complicating dengue infection.

Objective: To evaluate effects of docosahexaenoic acid-enriched phosphatidylcholine (DHA-PC) on cytokine production induced by lipopolysaccharide (LPS). Methods: The culture supernatants of splenocytes exposed to DHA-PC along with LPS were harvested to determine the production of Th 1 (IFN-γ and IL-2) and Th2 [IL-4, IL-5, IL-6 and IL-12/IL-23(p40)] cytokines. Cytokines were measured using ELISA. Results: Co-administration of DHA-PC with LPS resulted in significantly lower IL-2 expression compared to that observed with administration of only LPS (P<0.01). Treatment with DHA-PC and LPS significantly increased IL-5 expression (P<0.01). Moreover, co-administration of DHA-PC with LPS significantly decreased IL-6 and IL-12/IL-23(p40) expressions compared to that observed with administration of only LPS (P<0.01). Conclusions: Our results suggest that DHA-PC inhibits pro-inflammatory cytokines [IL-2, IL-6 and IL-12/IL-23(p40)] expression on induction of inflammation.

Objective: To evaluate the antioxidant activity of extracts and fractions from Stachys sieboldii Miq., and to examine its effect on the cellular reactive oxygen species (ROS) and glutathione (GSH) production and genomic DNA oxidation in HT-1080 cells.Methods: The ROS generation induced by H2O2 was measured by the dichlorofluorescein-diacetate assay. GSH levels were measured using a fluorescent method with mBBr. Genomic DNA oxidative damage was measured with levels of oxidative DNA induced by the reaction of ferritin with H2O2.Results: Then-hexane, 85％ aqueous methanol andn-butanol fractions (0.05 mg/mL concentrations) inhibited H2O2-induced ROS generation by 63％, 35％ and 45％, respectively. GSH levels were significantly increased in both acetone+methylene chloride and methanol extracts (P<0.05). Supplementation of cells withn-hexane significantly increased GSH levels at concentrations of 0.05 mg/mL (P<0.05). Both the acetone+methylene chloride and methanol extracts, as well as all fractions significantly inhibited oxidative DNA damage (P<0.05). Conclusions: These results indicate that cellular oxidation was inhibited by then-hexane fraction and this fraction may contain valuable active compounds.

We report here a case of a kidney transplant recipient in whom the ureter was initially implanted into the peritoneum. Excessive ultrafiltration volume and reversal of serum vs dialysate creatinine ratio when the patient was recommenced on continuous ambulatory peritoneal dialysis first suggested the diagnosis which was subsequently confirmed by a plain abdominal x-ray demonstrating placement of ureteric stent in the peritoneum. This rare complication was successfully corrected with surgical re-implantation of ureter into the bladder and 5 years later, the patient remains well with good graft function.
Cadaver ; Kidney Transplantation/*methods ; Postoperative Complications ; Reoperation ; Replantation ; Ureter/*surgery

INTRODUCTION: Psoriasis is a chronic inflammatory disease with a global prevalence of approximately 2% and significant psychiatric comorbidity. There is a great deal of existing literature assessing different aspects of psychology in psoriasis. We aimed to conduct an in-depth review of current evidence linking psoriasis to personality traits and psychiatric comorbidities, as well as factors that put these patients at risk of psychopathology. MATERIALS AND METHODS: A search of the PubMed database identified 1632 articles. We included articles studying psychological comorbidity in patients with psoriasis, looking especially at personality characteristics, and data linking psoriasis with increased risks of psychological distress, depression, anxiety and suicidality. In particular, we also evaluated subgroups in psoriasis found to be at risk. RESULTS: Patients with psoriasis are more likely to be alexithymic, lack body awareness and possess a Type D personality. Alcohol, but not illicit drug use, disorders are also more common in patients with psoriasis. Patient groups who are especially at risk of psychological distress include women, younger patients, patients with a younger age of disease onset, those who self-assess their psoriasis to be severe, and those with lesions on visible or sensitive areas. Adopting motivational interviewing skills and incorporating the use of learning materials during consultations have been found to be useful. CONCLUSION The knowledge of personality characteristics, "at-risk" groups, and early recognition of psychological distress among patients with psoriasis can help clinicians provide better holistic care and encourage a change in patients' behaviour.
Affective Symptoms ; epidemiology ; psychology ; Age Factors ; Age of Onset ; Alcoholism ; epidemiology ; psychology ; Anxiety ; epidemiology ; psychology ; Comorbidity ; Depression ; epidemiology ; psychology ; Humans ; Mental Disorders ; epidemiology ; psychology ; Motivational Interviewing ; Personality ; Psoriasis ; epidemiology ; psychology ; Sex Factors ; Stress, Psychological ; epidemiology ; psychology ; Substance-Related Disorders ; epidemiology ; psychology ; Suicidal Ideation ; Type D Personality

Cardiology ; Humans ; Myocardial Infarction ; blood ; diagnosis ; Sensitivity and Specificity ; Troponin ; blood