Background: Lupus nephritis being the prime etiology of mortality in SLE patients not only alters the course of the disease but also causes exacerbation. So in search for a feasible and accessible biomarker, this study aims to determine the importance of serum ferritin as a surrogate of disease activity in lupus nephritis patients. Materials and methods: Number of SLE patients with and without lupus nephritis is 20 each; diagnosis was made based on SLICC criteria, enrolled in our study. They are subjected to SLEDAI-2k and rSLEDAI scores. Based on rSLEDAI score, SLE patients were categorized into group I, 20 SLE patients with lupus nephritis, and group II, 20 SLE patients without nephritis. Serum levels of ferritin were assessed by chemiluminescent immunoassay (CLIA). Biochemical and immunological tests were done, and the results were analyzed and correlated. Results: Group I exhibited higher but not statistically significant serum ferritin levels compared to group II (p = 0.07). Ferritin levels were also observed to have significant positive correlation with rSLEDAI scores (p <0.01, r = 0.6), SLEDAI scores (p <0.001, r = 0.7), and anti-ds DNA antibody levels (p = 0.013, r = 0.4). Conclusion: Serum ferritin is a promising, widely available and useful biomarker of disease activity in lupus nephritis.

Spinal tuberculosis is the most common form of skeletal tuberculosis, and it can be destructive and devastating to the patient. Most of the spinal tuberculosis cases involve thoracic spine, and cervical involvement is unusual and rare. This case series is about different presentation and treatment approaches of cervical spine tuberculosis in four healthy young girls without any comorbidities. Among them, three girls presented with severe neurological complications. All of them had a history of severe neck pain and stiffness. None had constitutional symptoms or tuberculosis exposure. Diagnosis was made with the help of magnetic resonance imaging (MRI) spine and histopathological and microscopy of biopsied skeletal segments. The three girls with neurological complications were treated with surgical debridement and cervical spine stabilization surgery along with antitubercular treatment (ATT). All the three girls remarkably improved neurologically with a combined approach. The one without significant neurological deficits was started on ATT alone and advised to follow up with serial neuroimaging.

Diabetic autonomic neuropathy (DAN) is an individual risk factor for nonfatal myocardial infarction, nonfatal stroke, cardiovascular death, other major cardiovascular events like hospitalization for angina, hospitalization for heart failure, urgent revascularization for unstable angina, and death from any cause. Diabetic autonomic neuropathy screening is of paramount importance for cardiovascular risk stratification in patients with and without cardiovascular disease; as a marker for patients requiring more intensive monitoring during the perioperative period and other physiological stresses; and as an indicator for more intensive pharmacotherapeutic and lifestyle management of comorbid conditions. The present review highlights the necessity of DAN screening in starting cardiovascular outcome trials for antidiabetic agents.

Immune thrombocytopenic purpura (ITP) is a common bleeding disorder, and it may be primary (no potential etiologies found) or secondary (underlying associated conditions). The association between ITP and Hodgkin disease (HD) is well recognized in literature. ITP may occur before, during concurrent, and after the diagnosis of HD. Here we report a case of 15-year-old young boy, diagnosed as having ITP, who presented with persistent fever for a period of around 6 months and pancytopenia, and subsequently, we diagnosed HD. He responded well after chemotherapy.

Increased serum triglyceride level is the third most common cause of acute pancreatitis. Although a rare entity but results in severe pancreatitis with life-threatening organ dysfunction if untreated; therefore it requires a high level of clinical suspicion to be accurately diagnosed. We discuss the case of a 42-year-old man who initially presented in emergency department with suspected acute pancreatitis but who did not respond to the conservative management. On taking detailed history and clinical examination showed an evidence of hyperlipidemia. Subsequent investigations revealed acute pancreatitis secondary to hypertriglyceridemia. In this report, we tried to highlight few causes of hypertriglyceridemia, and the role of plasmapheresis and euglycemic insulin therapy in the management of hypertriglyceridemia-induced acute pancreatitis.

Metronidazole (MTZ) is an antibiotic from nitroimidazole group, commonly used for various medical and surgical indications especially anaerobic bacterial infection. Though usually safe, it can result in serious toxicity with prolonged use. It can affect both central and peripheral nervous system. Neurotoxicity presents as features of encephalopathy, cerebellar ataxia, dysarthria, and symmetrical sensory-motor polyneuropathy. Here, we are presenting our patient with liver abscess who received MTZ for 6 weeks and developed neurological side effects with cerebellar ataxia and dysarthria accompanied by MRI features—hyperintense signals in dentate nucleus consistent with toxicity and also features of symmetrical sensory-motor polyneuropathy. Cerebellar symptoms reversed with stopping the medication—however, his peripheral neuropathy had a static course with minimal recovery.