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Aseptic meningitis is a rare presentation of systemic lupus erythematosus (SLE). High index of suspicion is crucial when there is suboptimal response to the initial standard meningitis treatment and presence of connective tissue disease symptoms. We report 3 cases of aseptic meningitis as the main initial presentation of SLE. The diagnosis of SLE as the underlying cause of the aseptic meningitis was supported by the clinical, laboratory and radiological findings. All patients showed good response after treated with immunosuppressant therapy.

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BackgroundOsteoporosis and osteoporotic fracture pose a major public health problem in our aging population. Osteoporotic hip fractures carry an increased morbidity and mortality, with some difference seen between men and women. While overall diagnosis and treatment for osteoporosis have improved, osteoporosis in men remain underdiagnosed and undertreated.AimWe aim to describe the difference in clinical characteristics between elderly men and women with osteoporotic hip fractures in Sarawak General Hospital.MethodsAll patients diagnosed with osteoporotic hip fracture admitted to Sarawak General Hospital from June 2019-March 2021 were recruited and demographic data and clinical features were obtained.ResultsThere were 140 patients with osteoporotic hip fracture, and 40 were men (28.6%). The mean age for males were 74.1 ± 9.5 years, while the mean age for females were 77.4 ± 9.1 years (p=0.06). The types of fracture consisted of neck of femur=78, intertrochanteric=61, and subtrochanteric=1. There were 20 men with secondary osteoporosis (50%), while 13 women (13%) had secondary osteoporosis (p<0.001). The causes of secondary osteoporosis among the men were hypogonadism, COPD, GIOP, renal disease, ADT, thyroid disorder, prostate cancer, and previous gastrectomy. There were two deaths among the men and four deaths among the women during the inpatient and 3 months follow up period. There was no statistical significance between the mortality rates between male patients (5%) and female patients (4%) (p=0.55). ConclusionThere were more females with osteoporotic hip fractures, and there were significantly more males with secondary osteoporotic hip fractures.Trial registration: This study (Male osteoporotic hip fracture in Sarawak General Hospital) was registered with the Malaysian National Medical Research Register (NMRR). Trial registration number: NMRR-19-323-46068 IIR