70 yo with spontaneous hematoma on the chest, severe aortic stenosis with severe mitral regurgitation, decompensation of HF (SOB, edema of legs) hyperuricemia, joints deformation (wrists, knees, shoulders),generalized lympadenopathy, small hemorrhagic rash on face. Disease?

A 24 yrs old HM came to the OPD due to sudden swellings & tenderness of his phalyngeal joints 5 days back a/w pain on rt. great toe and mild pain in left elbow and shoulder and slight elevation precordium at apex region, I had done detailed CVS exam S1 S2 normal, no added sound , no murmur , patient is not having such history of similar illness, i ordered ASO,CRP,Sr urea,creatinine and TFT. any other measure i can take for the patient ?????

47 years old female presented with dryness of mouth (figures 1-3) with occasional slurring of speech and occasional dysphasia since last 4-5 years with dry eyes. Which syndrome is flashing on your mind? �

World Arthritis Day 2018 World Arthritis Day (WAD) was established in 1996 by Arthritis and Rheumatism International (ARI) to raise awareness of issues affecting people with rheumatic and musculoskeletal diseases (RMDs). It is celebrated every year on 12th October. 'Don't Delay, Connect Today' theme initiated in 2017 by the European League Against Rheumatism (EULAR) continues to give importance on early diagnosis and access to care in 2018. ‘Don’t Delay, Connect Today’ campaign calls on people including the public, physicians, health professionals and policy-makers to connect early for earlier diagnosis of RMDs and timely access to evidence-based treatment. The overall goal is to highlight RMDs as major public health problem globally and that early diagnosis and timely access to treatment can prevent further damage and burden on the individual and society. Why is early diagnosis important? Early diagnosis is important to prevent further damage, if not treated early daily activities are affected, reducing the quality of peoples' life and affecting physical abilities. Delay is often due to a lack of awareness hence it’s important to know the symptoms of RMDs and consult a healthcare professional early. RMDs are commonly divided into inflammatory and non-inflammatory types: Common non-inflammatory RMDs are degenerative spine diseases, osteoarthritis, osteoporosis and fibromyalgia Common inflammatory RMDs are rheumatoid arthritis, ankylosing spondylitis, reactive arthritis, connective tissue diseases and polymyalgia rheumatica. RMDs can be hereditary; can also be triggered by lifestyle factors such as smoking, excessive weight, sedentary lifestyles, increasing age and having occupations that lead to injury and overuse of joints/muscles; however, in some cases the causes are unknown. Early medical treatment of inflammatory RMDs, particularly in the first 12 weeks, can prevent joint and organ damage and improve long-term function. What is Arthritis? The word arthritis actually means joint inflammation; in public health arthritis is used as a shorthand term for arthritis and other rheumatic conditions. What are the most common types of arthritis? The most common forms of arthritis are osteoarthritis, gout, fibromyalgia, and rheumatoid arthritis. What are the symptoms of arthritis? Symptoms of arthritis in affected joint are- swelling, pain, stiffness, decreased range of movements. How does body weight influence arthritis? Maintaining a healthy weight reduces the risk of developing osteoarthritis. Health tips for living with RMDs/Arthritis- (a)Healthy living- Improve your wellbeing by keeping high on emotional wellbeing, self-management and motivation and by making healthy life style choices such as: Don't smoke. Avoid stress- As stress can alter behaviour, affect sleep patterns, change appetite and increase muscle tension therefore use relaxation techniques to help manage stress. Get adequate sleep- Get enough quality sleep to protect your mental and physical wellbeing and quality of life. Reduce alcohol intake (b) Healthy eating- Healthy and balanced diet is important for people with rheumatic and musculoskeletal diseases (RMDs). Control your salt and sugar intake: Try to reduce sugar intake as it is high in calories especially in soft drinks, ready meals and confectionery foods. Salt intake should be less than 5 grams per day for adults. Too much salt can cause high blood pressure, an increased risk of heart disease and osteoporosis. (c) Physical activity and fitness- Being physically active is good for general health and can have specific benefits for people with RMD/Arthritis. Consult your doctor or physiotherapist about the type of exercise most appropriate for your condition. Exercise may be in the form of cycling, dancing, walking, gardening, swimming, yoga etc. Source : NHP

pt is hvng fvr wth jnts pain since a month anable to lift her both uppr lmb