Rhupus Syndrome Presenting as Interstitial Lung Disease: A Case Report

Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA) are characterised by two distinct immunopathological activities, the T-helper 2 cells play a vital role in pathogenesis of SLE while T-helper 1 cells play an important role in RA. Organ involvement in Rhupus syndrome is relatively rare. Here, authors present a case of 59-year-old female who came with complaints of multiple joint pain (involving small and large joints) for a year and dyspnoea for 6 months without co-morbidities, on examination she had pallor, impaired percussion note and velcro crepitations in bilateral infrascapular region, her Pulmonary function test revealed a restrictive pattern and High-Resolution CT (HRCT) chest revealed sub-pleural reticulations involving lower lobes, she was diagnosed as RA with Interstitial Lung Disease (ILD) and started on hydroxycholoroquine, sulfasalazine and prednisolone. During follow-up after 6 months she developed a hyperpigmented rash over cheeks and bridge of nose, non-painful oral ulcers with Anti-Nuclear Antibodies (ANA) showing speckled positivity and Extractable Nuclear Antigen (ENA) panel showing positive anti-ds DNA and negative anti-histone, here with, we present a case of Rhupus syndrome presented with ILD. Recognising this condition is important as treatment varies between Rhupus syndrome and SLE or RA

Knowledge attitude and practice towards prevention and early detection of chronic kidney disease among high risk patients

Background: It is well recognized that chronic kidney disease (CKD), if left, untreated would  slowly progress to end-stage renal disease (ESRD)., A targeted approach is to enhance the knowledge of CKD among the public, especially in high risk population, and encourage them to practice a healthy attitude and practice that may help in early detection and thereby better management of CKD. Such a study  to assess the baseline data has not been done in India. Aims and Objectives: To inculcate the knowledge attitude and practice towards prevention and early detection of CKD among high risk patients attending a tertiary care centre. This Observational study was carried out on all patients with diabetes and/or hypertension attending General medicine out-patient or in-patient  in a given period of time. Patients more than 18 years of age with diabetes and/or hypertension were included while patients with chronic kidney disease were excluded. Methodology: A standard questionnaire obtained from an author of similar study is given to patients fulfilling the inclusion criteria. Is this National Kidney Foundation's Kidney Disease Outcome Quality Initiative (KDOQI)? If so mention it.&nbsp