Drug-induced lupus erythematosus is an autoimmune phenomenon where the drug exposure leads to the development of systemic lupus erythematous like clinical features. Drug-induced lupus erythematosus can be divided into systemic lupus erythematous, subacute cutaneous lupus erythematous, and chronic cutaneous lupus erythematous. Here, we report a case of a 29-year-old female presented with systemic lupus erythematous due to chronic use of proton pump inhibitors, which is considered to be very rare.

Introduction India is on the verge of diabetes mellitus (DM) epidemic. Within the near future, DM will put a big burden on India’s already vulnerable and resourced health care system. The objectives of the study were to (1) estimate DM treatment-related out-of-pocket expenditure (OOPE) among type 2 DM patients with complications from a tertiary care hospital and (2) estimate the economic burden on the household income of these patients due to DM treatment-related OOPE.  Methods A hospital-based cross-sectional study was conducted among known type 2 diabetic individuals with complications admitted in a tertiary care hospital. Using a structured pretested questionnaire required data, such as sociodemographic details, direct costs, and indirect costs in health care of DM, which were collected by a personal interview method. Results Males constituted around 57% of the 100 patients who participated in the study. The average age of the population was 56 ± 10.03 years. The mean monthly income of family (in Indian Rupees [INR]) was 10,375.00 ± 9,201.55. Total expenditure includes the cost of medication, investigation, consultation fee, transportation, and miscellaneous expenditure. The average monthly OOPE in the management of DM for government and private facilities was INR 74 and 1,540, respectively. Among the total cost, the highest share was accrued toward medicines followed by diagnostics, miscellaneous, and transportation. There were 22% of families incurring catastrophic expenditure at the highest threshold of 40%. Socioeconomic status, history of at least one hospitalization in the past 6 months, and type of medications were factors found to be associated with costs. Conclusion Heavy economic burden highlights the urgent need for the health care agencies and policy bodies to plan and prioritize local health policies and DM management schemes accordingly.

Background: Hypertension, an iceberg disease contributes significantly to the global health burden. This pan-endemic disease is a harbinger for cardiovascular events, especially life-threatening arrhythmias. A simple and cost-effective electrocardiogram serves as an effective tool to identify and evaluate hypertensives with high cardiovascular risk. QTc interval which indicates repolarization abnormality is one such effective tool. The study aimed at describing the prevalence of QTc prolongation among hypertensive individuals and also to assess the association of QTc prolongation with various co-morbidities.Methods: One hundred and fifty-nine hypertensive patients were evaluated in this cross-sectional study for six months. Demographic variables, biochemical parameters, blood pressure and electrocardiogram were recorded for all the patients. Data obtained were statistically evaluated.Results: The mean age of participants was 55.6 years (SD±6.76). There were 103 males (64.4%) and 43 females (35.6%). QTc prolongation was noted in 52.5% of the population studied. Statistically significant QTc prolongation among poorly controlled hypertensive was 59% when compared to that of controlled hypertensive at 37.5% was noted. About 26% of the participants were smokers, 27% were alcoholics and 60% had co-existing diabetes mellitus. Diabetes and gender were found to have a statistically significant association with QTc prolongation.Conclusions: The study found a positive correlation between prolonged QTc and hypertensives and hypertensives with coexisting diabetes. To mitigate the consequences of hypertension, the study recommends early diagnosis, stringent blood pressure control, efficient and effective use of QTc measurement, and preventive pharmacotherapy.

The incidence of acute myocardial infarction with nonobstructive coronary arteries in young age less than 20 years in India due to hereditary thrombophilia is uncommon. Combined protein S and protein C deficiency has an increased tendency for coronary artery thrombosis in very young individuals. Acute myocardial infarction in young individuals has different risk factors profile, clinical presentation, and prognosis when compared with elderly population and hence incites the need for different approach in the management. Here we report a case of 17-year-old boy who presented with acute inferior wall myocardial infarction with nonobstructive coronary arteries due to hereditary protein C and protein S deficiency.

Hirayama disease is a rare neurologic disease and is characterized by insidious unilateral or bilateral muscular atrophy and weakness of the forearms and hands without sensory or pyramidal signs. Our patient presented with bilateral upper limb wasting, which is a rarer variant of motor neuron disease. The diagnosis of Hirayama disease is based on dynamic magnetic resonance imaging (MRI). This case displays how dynamic cervical spine MRI can pick up dynamic cord compression and contributes to zero in the diagnosis of Hirayama disease.