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Nowadays, kidney dysfunction is a common health issue due to the modernized lifestyle. Even though medications are commercially available to treat kidney diseases, early diagnosis is crucial and challenging. Clinically, measuring urine creatinine and pH has gained significant interest as a way to diagnose kidney diseases early. In the present work, we attempted to develop a low-cost, robust, accurate and naked-eye colorimetric method to determine both creatinine levels and pH variations in artificial urine samples using a simple 3D-printed hybrid microfluidic device. Creatinine was detected by the incorporation of the traditional Jaffe test onto the hybrid paper–PMMA microfluidic device and pH (4–8) was measured by a simple anthocyanin test. Notably, the tests were established without employing any sophisticated or costly instrument clusters. The developed 3D-printed microfluidic probe showed a limit of detection (LOD) of 0.04 mM for creatinine over a concentration range of 1–10 mM, with a regression coefficient (R2) of 0.995 in laboratory conditions. Interestingly, the experimental data obtained with artificial urine exhibited a wide linear range from 0.1 mM to 5 mM under different pH values ranging from 4 to 8 in the presence of matrices commonly found in urine samples other than proteins, indicating the potential use of this method in pre-clinical analysis. Since the wide linear range of urine creatinine in artificial urine samples falls well below the clinically relevant concentrations in humans (0.07–0.27 mM), the developed lab-on-chip device is further suitable for clinical evaluation with proper ethical clearance. This 3D-printed hybrid microfluidic colorimetry-based creatinine detection and pH indicator platform can be beneficial in the healthcare sector due to the on-site testing capability, cost-effectiveness, ease of use, robustness, and instrument-free approach. [ABSTRACT FROM AUTHOR]

Systemic lupus Erythematosus is an autoimmune disease in which organs and cells undergo damage initially mediated by tissue binding auto antibodies and immune complexes. Its presentation and course vary greatly ranging from indolent to fulminant. Here we present three cases of SLE with unusual presentations. In case 1 a 16 years old female presented with multiple swelling on the neck and loss of weight with generalized lympadenopathy. Routine investigations showed decreased haemoglobin and increased ESR. FNAC of cervical and axillary lymphnode shows reactive hyperplasia. Chest Xray showed bilateral pleural effusion, Ultrasound showed pericardial effusion and Ascites. Rheumatology work up was positive for ANA, anti RNP & anti SM. In case 2 a 13 year old girl presented with continuous low grade fever, shortness of breath, non productive cough. Chest Xray showed B/L effusion and fluid tapped was exudative, lymphocytic and was started on ATT empirically. Patient after 2 months came with dyspnea and hyperpigmented macules with scaling all over the body. Adverse drug reactions were ruled out after witholding ATT. Rheumatology work up was positive for ANA and dsDNA. In case 3 a 27 year old female presented with right sided shoulder pain, dyspnea and left cervical lymphnode enlargment. Chest Xray showed right mild pleural effusion. CT pulmonary angiogram showed thromboembolic occlusion of right lower lobe segmental pulmonary. FNAC of cervical lymphnode showed reactive hyperplasia. Connective tissue workup, was positive for APLA, anti RO/SSA. These case reports helps Pulmonologist recognise various presentations of SLE. [ABSTRACT FROM AUTHOR]