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Background: Writing a scientific manuscript is an important skill to acquire for junior doctors considering the mandatory requirement of research publications during post-graduate training and for career advancement in India. Methods: We conducted a one-day workshop on scientific writing and publication at Udaipur in November 2017, comprising both didactic lectures as well as hands-on evaluation of a dummy manuscript, and evaluated structured questionnaires filled pre- and post-workshop. Results: There were 120 attendees, most of whom were junior doctors with little or no prior experience in writing a scientific paper. A significant baseline knowledge deficit regarding the principles and processes of scientific writing (ranging from 20.9% to 77.3% participants for the different questions asked) could be identified before the workshop. This knowledge deficit was significantly improved in most areas as assessed after the workshop. We identified the need to discuss predatory publishing in greater detail in subsequent workshops, as 20.8% of respondents after the workshop professed that they might consider publishing in a predatory journal. As expressed in participant feedback, longer, more-specialized or advanced level workshops on scientific writing in the future could also consider including more details on appropriate statistical presentation and pictorial representation of data as well as longer time spent on hands-on exercises. Conclusion: There remains a need to conduct more scientific writing workshops by national societies and journals all over the country.

1Departments of Radiodiagnosis, 2Immunology, 3Neurology, 4Microbiology, Sanjay Gandhi postgraduate Institute of Medical Sciences, Lucknow, India. Correspondence: Dr. Vikas Agarwal, email: vikasagr@sgpgi.ac.in Dear Editor Cerebral infections are a major cause of morbidity and mortality in systemic lupus erythematosus (SLE).1 Susceptibility to infection may be due to abnormalities in complements, mannose binding lectin, phagocytes, T or B lymphocytes or due to immuosuppressive treatment.2 Patients are predisposed to viral, bacterial, and fungal infections.3 Cryptococcal meningitis has been rarely reported in SLE. It may mimic neuropsychiatric SLE.4 Because of the protean clinical manifestations, magnetic resonance imaging (MRI) may be performed early to detect possible aetiology. MRI is more sensitive than computerized tomography for the diagnosis of cryptococcal meningitis. However, MRI may be normal even during active CNS infection. Herein we present two cases of SLE with cryptococcal meningitis whose MRI was normal at presentation.

Sir,Anaemia in scleroderma may be due to disease activity,malabsorption secondary to bacterial overgrowth or gastro-intestinal dysmotility, nutritional, drug-related, associatedoverlap syndromes, association with autoimmune hemolyticanaemia, microangiopathic hemolytic anaemia secondaryto renal crisis and blood loss from the gut secondary to gas-tric ulcers or vascular ectasias. A 37-year-old female diagnosed for diffuse scleroderma 2 years back, with Reynaud’s phenomenon, skin thickening,digital ulcers, gastro-esophageal reflux and interstitial lungdisease. She was treated with cyclophosphamide for herlung disease. She presented with progressive dyspnoea ofNYHA Class III, generalised weakness and dizziness for 1 month. She had severe pallor, with pulse rate 120/min,blood pressure 110/70mmHg, respiratory rate 22/min, nor-mal JVP, normal heart sounds and coarse crepts in lowerzones of the lungs. Investigation revealed that her haemo-globin level was 3.2g/dL and microscopic hypochromic redblood cells. Stool for occult blood was positive. The uppergastrointestinal endoscopy revealed hiatus hernia, gastro-esophageal reflux disease and linear erythematous streaks

Results: Mean age of patients was 34.9 + 8.3 years and mean duration of disease was 8.1 + 5.8 years. Mean BASDAI and BASFI scores were 3.5 + 1.5 and 3.7 + 1.7 respectively. The mean BMD and T score in spine (L1–L4) were 0.915 + 0.160 and −1.643 + 1.375 respectively. The mean BMD and T score in neck femur were 0.8449 + 0.120 and −1.2418 + 1.142 respectively. The mean BMD and T score in femur trochanter were 0.6842 + 0.1171 and −1.1295 + 0.978 respectively. Osteoporosis was seen in 29 (36%) and osteopenia was present in 40 (50%) patients. One of the patients had wedge compression fracture (T12–L1) with associated cauda equine syndrome. Factors associated with osteoporosis were longer disease duration, higher CRP, BASFI and BASDAI. Conclusion: Osteoporosis is a significant problem in AS and needs to be dealt with at an early stage to prevent related problems.