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ABSTRACT:Ankylosing spondylitis belongs to a group of diseases known as Spondyloarthritides characterized by inflammatory low backache. It is a chronic inflammatory disease of unknown etiology, mostly associated with HLA B27 positivity affecting skeletal (both axial and extra-axial) and extra skeletal system. In general population Ankylosing spondylitis is likely to develop in about 1% to 2% of HLA-B27+ who have a disease-associated B27 subtype and is much more common among HLA-B27+ first degree relatives of HLA-B27+ AS Patients. Positive family history is a strong risk factor for the development of the disease. Ankylosing Spondylitis is a disease which mostly affects young males and working population. It is a chronic illness with exacerbations and remissions and leads to debility and significant morbidity and hence affects the quality of life significantly. This study has been carried out in Medicine department of Rangaraya medical college GGH Kakinada, Sraddha Hospital, Visakhapatnam, Andhra medical college, KGH, Visakhapatnam, GEMS College and Hospital, Srikakulam with an aim to study the articular and extra articular manifestations of Ankylosing Spondylitis, factors affecting exacerbations and remissions. Correlation between disease activity and acute phase reactants, familial association, and to study the short term treatment outcomes.

The prevalence of human immunodeficiency virus infection in India is estimated to be around 2.4 million. 1 HIV infection can lead to involvement of various organs and Systems including endocrine glands. Alteration in endocrine functions may be due to the possible relationship between the immune and endocrine systems, direct involvement of the glands by the virus itself, opportunistic infections or malignancies, highly active antiretroviral therapy and drugs used to treat opportunistic infections. 2,3 Thyroid hormones play a fundamental role in metabolism regulation of the immune system, modulating humoral and cell mediated immunity. 4 Many studies have evaluated the possible relationship of thyroid dysfunction in HIV. This study has been carried out in Medicine department of Rangaraya medical college GGH Kakinada, Sraddha Hospital, Visakhapatnam, Andhra medical college, KGH, Visakhapatnam, GEMS hospital Srikakulam with an aim to see the incidence of subclinical hypothyroidism in HIV I positive patients and its effect on diseases and possibility of an early diagnosis of hypothyroidism. Out of 102 patients 86(86.27%) are Euthyroid and 14(13.72%) are sub clinical hypothyroidism. Highest incidence is seen in stage 4. High incidence of thyroid dysfunction seen with low CD4 count. 10 females and 4 males are found. Out of 10 females 8 are not under ART have subclinical Hypothyroidism. In view of above high incidence of Thyroid Dysfunction in HIV patients with low CD4 counts has to be considered for screening.

Hyponatremia in hospitalized patients can significantly alter the morbidity, mortality, especially in chronic neurological patients. Most commonly, it is attributed to SIADH, and in stroke it occurs due to AVP secretion inappropriate to the osmotic threshold. The suppressed proximal renal tubular transport in this condition can lead on to bicarbonaturia and hypouricemia. CSW, on the other hand, is essentially a volume depleted state, which occurs due to the combined effects of decreased sympathetic outflow and increased natriuretic peptides. This resultant natriuresis leads to volume depletion and an appropriate AVP response. The treatment for SIADH AND CSW varies, and the outcomes vary considerably too. Hence, we performed this study to study the clinical profile of stroke patients with hyponatremia, and to identify the factors associated with the same.