Rheumatoid Arthritis

Clinical Features:

• 1)Pain or aching in more than one joint.
• 2)Stiffness in more than one joint.
• 3)Tenderness and swelling in more than one joint.
• 4)The same symptoms on both sides of the body (such as in both hands or both knees)
• 5)Weight loss.
• 6)Fever.
• 7)Fatigue or tiredness.
• 8)Weakness.
• Swan neck deformities
• Rheumatoid nodule

investigations:

• 1)Urine RME
• 2)CBC with ESR
• Increase 
• 3)RA test
• positive
• 4)Anti CCP antibody
• positive
• 5)X-ray affected joint
• osteopenia
• Narrow of joint space
• soft tissue swelling
• 6) serum Uric acid 
• 7) RBS

Investigation before start DMARDs:

• Serum creatinine
• SGPT 
• HBsAg
• ECG

Rx:

1.Tab. Meth(Methotrexate) (10 mg)

• 1 tablet every friday night ......continue

2.Tab. Indomet SR(indomethacin) (75mg)

• 1+০+1 (after meal)…..contine
  

3.Tab. Cortan([post id="479" title="Prednisolone"]) (5mg)

• 1+০+০..(after meal)…..continue
  

4.Tab.Folison(Folic acid) (5mg) 

• 1-2 tablet every saturday night ...........continue

5.Tab.Calcin-0

• 0+1+0…………...1 month

6.Tab.Rivo([post id="474" title="Clonazepam"]) (0.5mg)

• 0+0+1….15 days
  

7.Tab. Pantonix([post id="393" title="Pantoprazole"]) (20mg)

• 1+০+1...…..15 day ( 30 min before meal)

উপদেশঃ

• Don't skimp on sleep. Sleep is not a luxury—it's essential to your physical and mental well-being.
  
• Eat an anti-inflammatory diet.
  
• Learn how to manage your stress. 
  
• Make room for moderate exercise.

Follow -up 

দেড় মাস পর নিচের রিপোর্ট সহ দেখা করবেন 

• CBC 
  
• Serum creatinine 
• Serum ALT