Summary Background It has already been shown that patients with more severe CLE activity have a poorer quality of life (QoL). Racial and ethnic disparities have been reported in disease activity and outcomes in SLE, but similar information is not available in CLE. Objective The main objective of the current study was to evaluate the impact of lupus-related skin damage on skin-specific QoL, as well as differences stratified by ethnic backgrounds. Methods Data collected included sex, race, diagnosis, CLASI scores, and Skindex-29. These parameters were analysed at the initial and last visits. CLASI damage scores (dyspigmentation and scarring) and CLASI activity scores were collected, grouped by ethnicity, and correlated with Skindex-29. 223 patients were analysed at baseline, with 141 of these patients completing more than one study visit. Results The majority were Caucasians (63.7%), followed by African Americans (29.1%) and Asian Americans (4.0%). African American patients accounted for a disproportionate percentage of both localised (50% of cases) and generalised (48.9% of cases) DLE. Median CLASI damage scores significantly differed between our African American, Caucasian, and Asian American patients, at both first (8.5, 4.0, 7.0) (Kruskal-Wallis p<0.0001) and last visit (10.0, 6.0, 8.5) (Kruskal-Wallis p<0.01) (Dunn's Multiple Comparison p<0.0001, p<0.01). CLASI damage scores in African Americans correlated with CLASI activity scores (Spearman's r=0.45, p=0.0003). Conclusion There was no significant correlation between CLASI damage scores and Skindex domains overall. Individually, dyspigmentation and scarring also did not have a significant effect on QoL. In conclusion, disease damage does not affect QoL, as measured by the Skindex-29. Ethnic differences in CLE patients were found: African American patients with CLE, do exhibit a high rate of DLE, experience damage early in their disease course, frequently in conjunction with disease activity.

Introduction:Hyponatremia is a common electrolyte disorder encountered in patients of neurological disorders which is usually either due to inappropriate secretion of Antidiuretic hormone (SIADH) or cerebral salt wasting syndrome (CSWS). We conducted this study in a tertiary care hospital to determine the incidence and etiology of hyponatremia in patients of stroke admitted in the hospital.Materials and Methods:It was a prospective study done over a period of two years that included established cases of stroke diagnosed on the basis of clinical history, examination and neuroimaging. 1000 stoke patients were evaluated for hyponatremia (serum sodium <130 meq/l). The data was analysed using Chi-square test using SPSS (Statistical package for social science) software.Results:Out of 1000 patients, 353 patients had hyponatremia. Out of this 353 patients, 238 (67%) had SIADH and 115 (33%) had CSWS. SIADH was seen in 83 patients who had ischemic stroke and 155 patients of hemorrhagic stroke. CSWS was found in 38 patients with ischemic stroke and 77 patients with hemorrhagic stroke. Statistical analysis revealed that hyponatremia significantly affects the outcome of stroke especially when it is due to CSWS rather than SIADH.Conclusion:Incidence of hyponatremia in our study population was 35%. In patients of hyponatremia 67% were having SIADH and 33% were having CSWS. Overall hyponatremia affected the outcome of stroke especially when caused by CSWS. Therefore close monitoring of serum sodium must be done in all patients who are admitted with stroke and efforts must be made to determine the cause of hyponatremia, in order to properly manage such patients thereby decreasing the mortality rate.

Idiopathic intracranial hypertension (IIH) is a disorder defined by clinical criteria that include signs and symptoms isolated to those produced by increased intracranial pressure (ICP; e. g., headache, papilledema, and vision loss), elevated ICP with normal cerebrospinal fluid (CSF) composition, and no other cause of intracranial hypertension evident on neuroimaging or other evaluations. The most common signs in IIH are papilledema, visual field loss, and unilateral or bilateral sixth cranial nerve palsy. Here we report a case of IIH presenting as headache with vision loss, papilledema, complete ophthalmoplegia with proptosis in one eye, and sixth cranial nerve palsy in the other eye. Patient was managed with acetazolamide, topiramate, and diuretics. Symptoms remained static and she was planned for urgent CSF diversion procedure.

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Wasp and bee sting are commonly encountered worldwide. Local reactions are more common, generally are self-limiting and settle within a few hours. Multiple stings can lead to various clinical manifestations like vomiting, diarrhea, dyspnea, generalized edema, hypotension, syncope, acute renal failure, and even death. Rarely, they can cause vasculitis, serum sickness, neuritis, and encephalitis. We are reporting a case of 40-year-old male who presented with stroke, right hemiparesis with severe multi-organ dysfunction due to multiple wasp stings.