Jatin Thukral

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with significant racial and ethnic disparities in prevalence, disease severity, and outcomes. Cardiovascular complications, including pericarditis, myocarditis, valvular disease, and conduction abnormalities, contribute to increased morbidity and mortality in SLE patients. This study examines racial and ethnic disparities in cardiovascular outcomes among hospitalized SLE patients in the United States. Methods: This retrospective study utilized the National Inpatient Sample (NIS) database from 2016 to 2021 to analyze hospitalizations of adult patients (≥18 years) with a primary or secondary diagnosis of SLE. Patients were stratified into racial/ethnic groups: White, Black, Hispanic, Asian, Native American, and Other. Primary outcomes include major adverse cardiovascular events (MACEs), which are a composite of in-hospital mortality, myocardial infarction (MI), sudden cardiac death, and other SLE-related outcomes including cardiac, pulmonary, and renal involvement. Statistical analyses included multivariable logistic regression models adjusted for demographic, socioeconomic, and hospital-related factors to assess racial disparities. Results: The study included 514,750 White, 321,395 Black, and 146,600 Hispanic patients, with smaller proportions of Asian, Native American, and Other racial groups. Black patients had significantly higher odds of in-hospital mortality (OR = 1.17, 95% CI = 1.08–1.26, p < 0.001) and sudden cardiac death (OR = 1.64, 95% CI = 1.46–1.85, p < 0.001) compared to White patients. Asian patients also exhibited increased mortality risk (OR = 1.37, 95% CI = 1.14–1.63, p = 0.001) as compared to Whites. Conversely, Black (OR = 0.90, 95% CI = 0.85–0.96, p = 0.01) and Hispanic (OR = 0.87, 95% CI = 0.80–0.96, p = 0.03) patients had lower odds of MI. Racial disparities in access to care, socioeconomic status, and comorbidity burden may contribute to these differences. Conclusion: Significant racial and ethnic disparities exist in cardiovascular outcomes among hospitalized SLE patients. Black and Asian individuals face higher in-hospital all-causes mortality and sudden cardiac death risks, while Black and Hispanic patients exhibit lower MI rates. Addressing social determinants of health, improving access to specialized care, and implementing targeted interventions may reduce disparities and improve outcomes in minority populations with SLE.

Objective: This article puts forward various ocular findings and its prevalence in hospitalized patients with confirmed Dengue serology. The aim is to spread awareness about these findings and call for complete eye examination in patients of dengue fever so that the ocular findings are not missed. Methods: This is a cross-sectional study, conducted on confirmed cases of 112 dengue patients in Dengue isolation ward in a tertiary care hospital, Government Medical College, Patiala, India, during and after the monsoon season. Results: Various fundus findings in dengue fever seen in our study are Dot blot hemorrhages, cotton wool spots, macular hemorrhages, macular edema, Roth spots, vascular sheathing, hard exudates, and sub-conjunctival hemorrhage. Cumulative prevalence of these findings was 9.82% in hospitalized patients of dengue fever. Blurring of vision was also a common symptom. Conclusion: Ocular findings do occur in dengue fever, along with other systemic manifestations such as fever, headache, myalgia, arthralgia, retro-orbital pain, hemorrhagic fever, and shock syndrome. Ocular examination should be undertaken in all patients with dengue fever so that these findings are not missed. Further studies are needed to ascertain its pathophysiology.