Pak J Med Sci
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We report a case of a 35 years old lady presenting with acute upper limb ischemia secondary to systemic lupus erythematosus (SLE), antiphospholipid syndrome (APLS) and infective endocarditis (IE). It is rare for SLE/APLS to present with acute limb ischemia (ALI) as the initial manifestation. The patient presented with high grade fever along with pain and numbness in her right upper limb. ⋯ After the patient's clinical deterioration and considering the severity of the ischemic condition, additional investigations were conducted, which ultimately led to the diagnosis of SLE with APLS. Management included antibiotic therapy for IE and high dose of IV steroids and anticoagulants for SLE/APLS, to which she responded well. This case emphasizes the significance of conducting a comprehensive evaluation of all possible causes of acute limb ischemia, while considering the patient's medical history and physical examination findings.
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This study evaluates the impact of metformin combined with liraglutide on the glucose and lipid metabolism, oxidative stress, and vascular endothelium of patients with type-2 diabetes mellitus (T2DM) and metabolic syndrome. ⋯ Metformin combined with liraglutide treatment is associated with better outcomes than metformin alone in patients with T2DM and metabolic syndrome. Combined treatment results in improved glucose and lipid metabolism, vascular endothelial function, and oxidative stress index values.