Ankylosing Spondylitis

Clinical Features:

• 1)Lower back pain and stiffness.
• 2)Hip pain.
• 3)Joint pain.
• 4)Neck pain.
• 5)Difficulty breathing.
• 6)Fatigue.
• 7)Loss of appetite and unexplained weight loss.
• 8)Abdominal pain and diarrhea.
• 9)Skin rash.
• 10)Vision problems.

Investigations: 

• 1)CBC with ESR
• increase
• 2)Bone mass density 
• Reduce
• 3)Serum Alkaline phosphatase
• 4)serum phosphokinase
• 5)CRP
• Raised
• 6) X-ray of affected joint
• Fusion of joint
• Narrow joint space
• Degenerative change
• 7) RA-Positive 
• 8)RBS 

Investigation before DMARDs :

• Serum Creatinine
• SGPT
• HBsAg 
• ECG

Rx:

1. Tab. Naprox ([post id="455" title="Naproxen"])(500mg)

• 1+0+1 (after meal)….14 days
  

2.Tab. Zulfidin(salfasalazine) (500mg)

• 1+০+০ - .....7 days(after meal) then
• 1+০+1 - ....7 days(after meal) then
• 1+1+1 ......7 days(after meal) then
• 2+o+2 - ....(after meal)......continue

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

• 4+2+0............ 7 days then
• 2+2+0..........7 days then
• 2+0+0.........7 days then 
• 1+0+0 - ( after meal).…...continue
  

4.Tab. pantonix ([post id="393" title="Pantoprazole"]) (20mg)

• 1+0+1 -(30 min before meal)…..1 month
  

5. Tab. Calcin-O 

• 1+0+0............2 months

If perpheral Arthritis:

1.Tab. Meth(Methotrexate) (10 mg)

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

2.Tab.Folison(Folic acid) (5mg) 

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

 Advice:

• Exercise regularly. Regular exercise is key to any healthy lifestyle plan. 
• Eat an anti-inflammatory diet.
  
• Make sleep a priority.
  
• Stop drinking and smoking.
  
• Find ways to reduce stress.