బిగ్ బాస్ గుట్టు విప్పిన ప్రొఫెసర్ కె నాగేశ్వర్|Prof K Nageshwar on Big...

బిగ్ బాస్ గుట్టు విప్పిన ప్రొఫెసర్ కె నాగేశ్వర్|Prof K Nageshwar on Big...

బిగ్ బాస్ గుట్టు విప్పిన ప్రొఫెసర్ కె నాగేశ్వర్|Prof K Nageshwar on Big...

WATCH OUT FOR POST-CHILDBIRTH DEPRESSION.

Severe depression, mania and delusion experienced by women after child-birth call for immediate attention. Clinical estimates state that 40 percent of women get depressed after child-birth. One in 1,000 new mothers displays severe disturbance of behaviour, moods, perception and thought, which is an emergency psychiatric situation called postpartum psychosis. It is a mental illness and occurs due to hormonal imbalance, family history and also violent abuse in close relationships.

What is postpartum psychosis? Postpartum psychosis is when there is a dramatic shift in the mood post-child-birth. The mother can get very excited, be very happy or go into severe depression or mania within a span of a few hours. Its onset is in the first 48 or 72 hours after childbirth. The mother has delusionary beliefs about the infant and harming the child is a major risk in these cases. Studies carried out in South India have shown that postpartum psychosis in women is due to poor marital relationships, gender-based factors of intimate partner violence, unhappiness about the gender of the child, poverty and the thought of living with a female child and rearing.

First cousins are at risk: First-degree relatives are found to be at a major risk of developing postpartum psychosis if they have a family history of bipolar disorder, depression, anxiety disorder and previous history of psychosis. Dr. Priyamvada Reddy, Consultant Obstetrics and Gynaecologist at Apollo Hospitals said, "In these cases, it is the mother who has to get immediate attention and care hence she requires hospitalisation and there has to be a trained personnel to take care of the baby. It is very important to not handover the baby to the mother when she is going through an episode of depression as it can be very harmful for the child. Breastfeeding has to be withheld in acute cases where the mother is very delirious. Also, while selecting medication for the psychiatric treatment, care has to be taken that it does not harm the production of breast milk".

Difficult to recognise symptoms: Recognising the symptoms of postpartum is very difficult for the relatives as they don't know whether it is unusual. Some of them take it as trauma after delivery and do not consider it as mental illness. Dr. Neelima T., Senior Gyneacologist of Krishna Institute of Medical Sciences Hospital said, "Often the partner and relatives realise only after harm is done to either mother or child. This is very dangerous and can prove fatal at times. Hence, it becomes important for the gynaecologist and the team of paramedics to be alert and also guide the relatives when such episodes are noted in the hospital set-up".

Disturbance in relationship: Hormonal imbalance during pregnancy and childbirth are some of the reasons for this psychosis but it is not completely proven. Family history of the patient where the mother or aunt has suffered from a condition like this is found to be one of the reasons. Dr. A Bhavani, Chief Gynaecologist at Sunshine Hospital, said, "Social factors are also found to play a major role apart from family history and hormonal imbalance. Relationship disturbances with partner and family are reasons for the women to suffer from an episode of psychosis. Complicated pregnancies and delivery, incomplete pregnancy episodes and past history of poor parenting can also cause these problems". The common symptoms to watch out for are frequent crying, rapid changes in mood, not able to carry out regular tasks, hallucinations, delusions and a constant anxiety that someone or something is going to harm the mother and the baby. Dr. Bhavani added, "In some cases we have found that the woman displays anxiety and delusion at night and is very normal in the morning. It is for the husband, caregiver and close family member to identify this situation. It becomes important that people understand that it is a mental illness and can be cured".

[Based on an article written by Kaniza Garari, published in Deccan Chronicle dated 10th May, 2016 (Tuesday)].

-Challapalli Srinivas Chakravarthy-

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'LIFT' BUT WITH CAUTION.

Cosmetic surgery is entirely focused on enhancing a patient's appearance.But the thing with cosmetic or plastic surgery is that it impacts the body immensely. And it's important to know what to do when and when to stop. Cosmetic surgery is good when done in moderation.

(1). Liposuction: Liposuction is perhaps the most common cosmetic surgery that is performed in India today. It is a safe, effective outpatient procedure, but patient selection is important. There are several myths that revolve around this procedure. Liposuction cannot help you lose weight instantly. It only helps in spot reduction of fat or contouring of the body. It takes a minimum of six months for the body to recover post-liposuction due to the fluid loss. After the procedure, compression garments need to be worn for best results. The notion that liposuction can be done frequently is not true. More than one liposuction a year is not advisable, except under medical advice only. There is a downtime of up to two weeks minimum and best results at three months after all the inflammation settles.

(2). Tummy Tuck or Abdominoplasty: Abdominoplasty is a surgical operation that removes excess flesh from the abdomen. Tummy tuck surgery works on tightening the abdomen muscles and skin, working through the layers to pull back the weakened muscle into position. This surgery should never be done before an event. Post-surgery one should not lift heavy weights for three months. Once the surgery is done results need to be maintained through exercise as muscle tone needs to be maintained. The recovery time is two to four weeks. 

(3). Boob Lift or Breast Augmentation: Breast Augmentation involves using breast implants or fat transfer to increase the size of you breasts. Popular myths that surround breast augmentation is that it can cause cancer. However, there is no evidence. Breast implants are safe and can tolerate pressure. The key is to go with the size that is right for you and not much bigger, as it's not better.

(4). Rhinoplasty or Nose Job: Rhinoplasty is a plastic surgery procedure for correcting and reconstructing the form, restoring the functions, and aesthetically enhancing the nose. Filler injections can be used for milder corrections. Nose jobs can be done with or without implants. Ideally, the nose must be corrected at one go as continuous nose jobs will result in thinning of the bone,making the nose weak. Post surgery, the downtime for rhinoplasty is about two weeks.

(5). Brow Lift: A brow lift is a cosmetic surgery procedure used to elevate a drooping eyebrow. By 50s, most people notice a descent in the brows and this is the ideal time for a brow lift. The brows need to be positioned to suit your face and according to the beauty laws. Higher brows are not always better.

-Challapalli Srinivas Chakravarthy-

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CANCER AMONG KIDS DOUBLED IN HYDERABAD IN LAST TEN YEARS: EXPERTS.

Cancer specialists on 14th February, 2018 (Wednesday) said cancer cases among children in Hyderabad have doubled over the last ten years, with five percent childhood cancer recorded in 2017. In India, there are close to 50,000 new cases of childhood cancer every year with leukemia - a form of blood cancer having the highest incidence. On the eve of World Childhood Cancer Day, doctors pointed out that in many cases of paediatric cancers the symptoms are often overlooked by parents and even healthcare practitioners. Experts say it is commonly assumed that cancer is a disease affecting adults, but lately more children are being diagnosed with cancer every year. If provided proper treatment, paediatric cancers have good prognosis as compared to adult cancers. "In most cases, the symptoms are ignored by parents and even doctors do not suspect cancer; so the diagnosis gets delayed. It is important for parents to know that cancer in children is not common, but it's important to get the child checked by a paediatrician if some unusual symptoms are persistent or recurrent", said Dr. Preethi Sharma, consultant paediatrician at KIMS Cuddles in Kondapur. She added that survival rates of childhood cancer are high (80%) in developed countries, but hovers near 30% in India.

"In India, the diagnosis and treatment of childhood cancer needs to be strengthened and be more accessible. There is need for more dedicated cancer hospitals and awareness among general public regarding childhood cancer", said Dr. Sharma. Doctors said unusual lumps or swelling, increasing or sudden paleness and loss of energy, easy bruising or bleeding, ongoing pain in an area of the body like bones, joints and back, limping or easy fractures, unexplained fever or prolonged illness and frequent headaches are a few symptoms.

-Challapalli Srinivas Chakravarthy-

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FACE THOSE METAL-URGINGS.

Summer of 2018 is here! And what better way to show your daring side than by trying out metallic makeup? It's time to bring out the metallics and brush up on your skills for that glitzy look. From gold embellishment to silver shadow or gilded lips, heavy metal makeup is wearable without going overboard on the shimmer.

For Eyes:

--Dust gold or copper pigments to the centre of your eyelid. This is a perfect alternative for a smokey look and it works wonders with warm undertones. Silver can be added to get the cooler undertones. Gun metal works very well for a smouldering, night time cocktail effect.

For Face:

--To achieve a gorgeous glow and radiant look, mix a drop or two of strobe cream into your foundation, and finish off by dusting copper or rose gold highlighters onto cheek-bones, temples and down the bridge of your nose. You can even use some gloss as highlighters on your cheek-bones, or just under your eyebrows.

For Lips: 

--Although metallic lips are seen mostly on the runways, one can achieve this look when done subtly. For a shiny, sparkly pout, add some shimmery gloss or a metallic pigment to the centre of the lips to create dimension and fake plumpness.

Tips To Watch Our For:

--Apply enough shimmer without going overboard.

--Focus on one area at a time and try not to combine the eyes, face and lips or you may end up looking like a shiny robot.

-Challapalli Srinivas Chakravarthy-

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WANT TO LOSE WEIGHT? DON'T DIET, SAY RESEARCHERS.

Eating regularly may prove to be a safer bet for healthy weight loss. The researchers of the study also added that dieting may instead make you gain extra pounds in the long run. Dieting may not be the route to sustainable weight loss, says a new study. Eating regularly may prove to be a safer bet for healthy weight loss. The researchers of the study also added that dieting may instead make you gain more pounds in the long run. The new study published in the journal, "Eating Behaviours", claimed that observing regular eating habits could be essential to successful weight management in both women and men.

"Generally speaking, weight management guidance often boils down to eating less and exercising more. In practice, people are encouraged to lose weight, whereas the results of our extensive population study indicate that losing weight is not an effective weight management method in the long run", said Ulla Karkkainen, a researcher and nutritional therapist at the University of Helsinki in Finland.

"Often, people try to prevent and manage excess and obesity by dieting and skipping meals. In the long term, such approaches seem to actually accelerate getting fatter, rather than prevent it", Karkkainen added.

For the study, the team included nearly 5,000young men and women. The participants were made to answer surveys mapping out factors impacting weight change when they were 24 years of age, and again 10 years later at the age of 34. Between the ages of 24 and 34, the mean gain in women was 0.9 kgs. per year, while in men, the corresponding gain was one kg.

"Even though dieting may seem a logical solution to weight management problems, it can actually increase weight gain and eating problems in the long run", Karkkainen noted.

In a bid to lose weight one is often appealed towards taking shortcuts. Crash dieting and starving may seem promising, but they are far from delivering sustainable results, if anything, they would only make your condition worse. The research findings prove that instead of losing weight, it is more important to focus on eating regular meals, taking care of one's well-being and finding a more general sense of meaning in life. Our metabolism is dependent upon our feed. One has to have regular and sufficient meals to support the natural biological functions of the body. This practice would also help in managing one's eating habits and weight management in the long term, noted the researchers. While the study group was large enough, the findings of the study were based on the data collected by questionnaires, which is said to be a major limitation of the study. The study also did not specifically pin point the kind of diets that are especially bad.

-Challapalli Srinivas Chakravarthy-

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HYPERTENSION? FIVE FRUITS THAT MAY HELP YOU MANAGE HIGH BLOOD PRESSURE NATURALLY.

Hypertension or High Blood Pressure is emerging to be one of the biggest cause of concern in the global health and nutrition circuit. According to the WHO, High Blood Pressure causes close to 12.8% of total deaths in the world. The normal range of blood at rest is measured between 100-140 millimeters mercury (mmHg) for systolic pressure and 60-90 (mmHg) for diastolic pressure. A person is said to have hypertension when the blood pressure range exceeds the above mentioned range. Hypertension, if left untreated may trigger stroke or heart attack and in worst cases even cause death. While maintaining a healthy lifestyle and exercising regularly are some of the primary ways to keep lifestyle diseases in check, there are some dietary tweaks too that may help hypertension patients manage the condition better. High blood pressure patients must take extra care of their diet. Too much of sodium intake may cause the pressures to surge. High BP patients should also steer clear of heavily fried foods or foods that are laden with trans-fats. So, what is it that one should have to prevent the surge. Loading up on fruits may help. Potassium rich fruits, or fruits high in Vitamin C are said to curb the rise in BP levels.

Here are fruits that may help level BPlevles naturally.

(1). Banana: Bananas are extremely low in sodium; and very rich potassium, which happens to be a win-win combination for your high BP levels. You can have them alone, or add it to your cereal, cake, bread, smoothies and milkshakes.

(2). Avocados: Avocados may also do wonders for your soaring BP levels. Avocados are packed with oleic acid, which can reduce high BP and Cholesterol levels. Avocados are also rich in potassium and folate, both of which are good for heart. An antioxidant treasure trove, Avocados are loaded in Vitamin A, K, B & E and fibre too.

(3). Watermelon: The summer favourite, water melon contains an amino acid called L-citrulline, which has proven to lower BP. Watermelon has heart friendly fibres, lycopenes, Vitamin A and potassium. You can add them to salads and blend them in smoothies. Watermelon seeds are highly nutritious super-foods too. 

(4).Beetroot: Beetroot is rich in nitrates. Nitrates help relax blood vessels and improve blood flow.Beetroot juice is believed to lower systolic BP in just a matter of few hours.

(5). Oranges: Packed with a tangy citrusy flavour and several antioxidants, oranges could help lower your BP too. the fruit is high in heart-healthy fibres and Vitamin C.It is more advisable to have the whole fruit over the juice, to make sure you don't lose out on healthy fibres.

So what are you waiting for? Include fruits in your diet and see the change for yourself.

-Challapalli Srinivas Chakravarthy-

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DOCTOR NATURE.

(1). Lime Lip Balm: Add coconut oil, cocoa butter, beeswax and almond oil to a double boiler over medium heat. Stir frequently until melted. Remove from heat. Add lime essential oil and stir. Pour into jars and cool for one hour before putting on the lid. Use within three months. 

(2). Raspberry Lip Balm: Grind 1/2 tsp freeze dried raspberry until you get a fine powder. Melt 1 tbsp of coconut oil and 1/2 tsp beeswax over a double boiler. Add ground raspberries and stir to combine. Transfer to a container with a lid and let it harden.

(3). Coconut Rose Lip Balm: Add 1/8 cup of coconut oil and shea butter, 1/4 cup rose petals and beeswax, 1 tsp coconut extract and 1 tsp almond oil into a pan and heat on low flame. Pour the mixture into sanitised containers and they are ready to use.

-Challapalli Srinivas Chakravarthy-

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WOMEN ARE LESS LIKELY TO RECEIVE CARDIO-PULMONARY RESUSCITATION (CPR) THAN MEN: ARE WE LETTING GENDER PREJUDICE COME IN THE WAY OF SAVING LIVES?

[Based on an article written by Vanita Arora, Director of Cardiac Electro-physiology Lab & Arrhythmia Services, Max Super Speciality Hospital, published in The Times of India dated 06th February, 2018 (Tuesday), An Ecstasy of Ideas, p. 12].

Cardio-pulmonary resuscitation (CPR) is a word hard to pronounce, difficult to spell, and even more difficult to ingrain in people's minds. It is estimated that ninety-eight percent of Indians don't know about CPR. Most of the times CPR is used as a pretext to introduce mouth to mouth breathing, invoking humour and romance in the movies, where one of the lead pair of actors is seen saving the other after a brave rescue from drowning. The importance of the act and the technical nature of performing it go for a toss. In real life, things are very different. CPR is not only effective while saving someone from drowning. It is also the most vital first aid that can be offered to anyone who is fainting or has suffered cardiac arrest. On average 3,10,000 Americans die every year owing to cardiac arrest, and those who receive hands-on CPR have twice to thrice higher chances of surviving. In India due to the lack of data it gets difficult to drive the point home similarly. But wait! India happens to be the capital of cardiac diseases, diabetes an obesity. The fact that our nation is scoring high on the major factors that lead to cardiac arrest suggests that mortality due to cardiac deaths would be one of the highest here as well. 

CPR is fairly easy to administer and can be done by anybody, till professional help arrives. But the state of ignorance is huge. People who are willing to give CPR in public places often guess their way through the technique and hope it works. Even those who know how to give CPR do not necessarily understand when to give it. They may easily miss the signs of cardiac arrest. They need to know that mouth to mouth breathing is not considered an essential part of CPR anymore. In fact the focus has shifted to only hard pressing on the chest. In movies and TV programmes, which influence people far more easily than the educational leaflets promoting CPR, we so often see the person administering CPR hesitate, and the person receiving it become self-conscious on regaining consciousness. Even as we shift the focus from mouth to mouth breathing to chest compression, we need to accept that there is hesitation, and we need to know why.

Research has shown that women are less likely to receive CPR than men - due to the gender bias prevailing i society. Public spaces in India are still dominated by men. The differently formed chest of women and various notions attached to it makes men hesitate in administering CPR to women. There is the fear of being misunderstood, of the heavy compression of a woman's chest being misjudged by the bystanders. The hesitation is less in indoor spaces for homes. International studies have suggested that there is almost no discrepancy in women receiving CPR at home in comparison to men. The rate for women was reported to be 35% compared to the 36% men who received CPR. Hesitation is less with people familiar to us. However, the same cannot be said in the Indian scenario, as many conservative notions surround Indians even in their families. Levels of physical intimacy and ease are different from the West.

With women, people even hesitate to remove or adjust their clothing to administer CPR. Actually, it does not need the pressure to be built on the breasts but in between, where the sternum is places. This boosts the blood circulation and prevents the pulse from giving way. This aspect of CPR is also ill-known. Or the fact that if the patient is feeling nauseated and wants to vomit, she needs to be turned over to one side to avoid aspiration in the lungs, where fluid or vomit can enter the airways and cause difficulty in breathing. We need to spread awareness about CPR as a purely medical intervention, associated with medical and biological science rather than social constructs of sex. It's an act which prevents the brain from dying due to lack of oxygen - whether performed by a known person or a stranger. Indeed the age, sex, caste, class or creed of the person administering CPR is immaterial to the saving of life, and that is what needs to be focussed upon.

It is important for all of us to be trained in  administering CPR. This is especially true for the people who are working in public spaces, such as traffic police and emergency services. With a rising number of heart patients, India is sitting on multiple bombs, any of which can burst any moment, and knowing CPR can then save someone's life.  

-Challapalli Srinivas Chakravarthy-

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SYMPTOMATIC STONES: MONITOR KIDNEY FUNCTIONING AFTER FORTY YEARS.

The increased use of CT scans and ultrasounds are helping to identify kidney stones that are symptomatic in nature. Symptomatic kidney stones are those which are not painful but slowly develop inside the kidney. An individual who has stones will not have any symptoms of pain or recurrent urinary tract infections or even difficulty while urinating. Dr. G.P. Srinivas, urologist, explained that symptomatic kidney stones are identified in those who come for health check ups or patients with co-morbid conditions such as diabetes and hypertension. "These people are being identified with the disease early. There is still a vast majority of patients who some to the clinics only when there is pain or problems of infections in the urinary tract", he said. The prevalence of chronic kidney disease is a shigh as 10 percent in India. With screening being seen as a tool to check and prevent the development of stones and also failure of the kidney, experts state that early diagnosis can go a long way. 

The functioning of kidney has to be monitored after 40 years of age where research has found that its functioning slows down by one percent in every advancing year. Dr. R. Shekar, nephrologist, explained that higher intake of calcium supplements are found to cause kidney stones. "The condition was earlier seen between 30 to 50 years of age in adults. But now we are seeing it as early as in 20 years also. These are patients who are identified with the disease during health check-ups are counselled and later evaluated", he said.  

Kidney stones are formed due to:

--Diets that are very high in protein and sodium. 

--Obesity.

--High blood pressure.

--Issues with calcium absorption in the body after gastric bypass surgery or due to inflammatory bowel disease.

--Long term use of Vitamin D and calcium supplements.

-Challapalli Srinivas Chakravarthy-

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EIGHTY PERCENT NEWBORN DEATHS CAN BE AVOIDED: REPORT.

The number of new-born deaths in India is 25 per 1,000 live births, which constitutes nearly a quarter of the new-born deaths globally, according to 'Being Alive', a report released by UNICEF on20th February, 2018 (Tuesday). The report also stated that almost eighty percent of the deaths of new-born children could be avoided if proper medical care, nutrition during pregnancy for mothers, and facilities were available. India is ranked 12th of the 52 lower middle income countries when it comes to new born mortality rates. Gynaecologist Dr. T.S. Akshara, says, "We have been ranked higher than our less prosperous neighbours because most programmes implemented by the government for child safety and women's welfare are spread diversely with a few places reaping the benefit. We should ensure that new-born babies get the best of treatment while in the womb and outside".

Poor new-born mortality rate linked to lack of mother's education: As part of the Being Alive Campaign, UNICEF has asked all countries to up the cooperation between governments, healthcare providers and patients by ensuring the 4 P's: Power, i.e., ensuring community based health care facilities, followed by People, i.e., trained health staff, and Products, which is equipment and drugs needed for delivery. Another important aspect raised in the report is the 'quality' of services, i.e., not whether the resources or services exist, but how they are deployed. 'Quality is also about health workers believing that the life of every mother and baby is worth saving, regardless of income, age ethnicity, religion and social or cultural norms', states the report.

Dr. V.P. Jyotsna, a gynaecologist, says that according to WHO standards, basic minimum level of care must be provided to every woman. "People often avoid hospitals because of the stigma against C-sections but can a housewife or an untrained professional guarantee safety of the mother or baby when there is a mishap? Irrespective of caste, creed or economic condition pre-natal complications can arise. Just because of social differences, no woman should be denied medical care, treatment or facilities". The report also states that the poor new-born mortality rate is likely to lack of mother's education and economic background.

Gynaecologist S.K. Shilpi Reddy says, "The intention to access health care should firstly be present even in rural areas. Despite the government providing money for institutional deliveries and providing vaccines and protein powders free, people from rural areas do not visit hospitals until a complication arises. With proper check-ups and nutrition for the mother and screening of the foetus, we can ensure a healthy child. The neo-natal outcome will be successful only if ante-natal care is given". Another important aspect raised in the report was breastfeeding. The report states that some health-care workers do not have the time, knowledge or skills to overcome mis-conceptions about breast-feeding. Experts say that unless the benefits of breast-feeding are taught to mothers - that it contains antibodies to fight viruses and bacteria - the practice will not be widely followed.

UNICEF Report:   

--2.6 million babies die before they are one month old.

--2.6 million babies are still-born - 1.3 million babies out of this are alive at the start of labour.

--7,000 new-borns die on a daily basis.

--35% of health facilities in 54 countries, including India do not have water and soap for hand washing in hospitals.

New-born mortality rate / Deaths per 1,000 live births. 

India / 25.4; China /5.1; Pakistan / 45.6; Bangladesh / 20.1; Afghanistan / 40.

--41% deaths occur in cases where the mother has no education.

--31% where the mother just has no education.

--22% when the mother has secondary or higher education.

Causes of new-born deaths:

--Premature.

--Complications.

--Infections such as sepsis, meningitis and pneumonia.

--Stiil-born babies do not receive an official birth or death certificate.

Improvement:

--Under-five deaths in India reduced by 66% between 1990 and 2015.

--Under-five mortality in India dropped below one million for the first time in 2016 - 1.2 lakh fewer children below the age of five died in the country in 2016 than the previous year.

--Development goals target for under-five mortality of 25 per 1,000 live births by 2030.

-Challapalli Srinivas Chakrvarhy-

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SHOULD I BE CHECKED FOR IRON LEVELS?

If you are older, you may be accumulating excess iron without knowing it. This condition is called Iron Overload. That's why a Serum Ferritin Test is so important. The healthy range for Serum Ferritin is 20 to 160 NG/Ml. The ideal range is 40 to 60. If you are below 20, you are iron deficient.

-Challapalli Srinivas Chakravarthy-

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RHEUMATOLOGY AND ITS SCOPE.

A Rheumatologist is a physician who has undergone further specialised training in the management of diseases related to bones, joints, soft tissues and auto-immunity. A rheumatologist differs from orthopedicians in that trauma related cases and surgeries are managed exclusively by orthopedicians. Auto-immune diseases are those where the body's defence mechanism which should normally protect the body from external infections and insults, attacks the body itself. These diseases commonly affect the joints also and hence the umbrella term arthritis may refer to auto-immune diseases.

Rheumatologic diseases commonly affect women more than men. However some diseases may be more common in men. Children may also be affected by these diseases, so no age or gender is immune from these conditions. There may be a genetic component in some diseases so a history of a family member suffering from similar complaints is an important clue to the diagnosis. In general, a rheumatologist should be consulted when there is joint pain, swelling or deformity, without preceding trauma history. As any organ can be affected by these diseases, other common symptoms include skin rashes, hair loss, fever, weight loss, decreased blood cell counts or in more severe cases, eye involvement, breathlessness, chest pain, numbness or weakness, seizures, loss of consciousness.

As females are prone to these diseases, pregnancy and rheumatologic diseases require special care and management by a rheumatologist and obstetrician. Common diseases which are managed by a rheumatologist include rheumatoid arthritis, lupus or SLE (Systemic Lupus Erythematosus), Systemic Sclerosis, Sjogren's Syndrome, Dermatomyositis, Vasculitis, Spondyloarthritis including Ankylosing Spondylitis, Psoriatic Arthritis, Reactive Arthritis, Gout, Crystal Deposit Diseases, Juvenile Idiopathic Arthritis, Sarcoidosis, Osteoporosis and other Metabolic Bone Diseases. On the first meeting with a rheumatologist, a detailed history and physical examination will be done to look at all possible symptoms and organs involved. Based on these and any available previous reports, a clinical diagnosis will be reached.

To confirm the disease, the rheumatologist may ask for specialised tests like rheumatoid factor, ANA, HLA B27, apart from other blood tests like blood counts, urine examination, liver and kidney tests. Required radiographs or other imaging may be done to confirm the disease and assess the extent of joint damage. The rheumatologist will then give a clear picture of the disease, the organs involved, the complications, plan of management and prognosis of the disease. Regular review is important for proper management and for early detection of complications of the disease or drugs and prevention. 

Drugs used in the management of rheumatologic diseases are commonly pain killers (NSAIDs), steroids (like prednisolone), and immuno-suppressive drugs like methotrexate, cyclophosphamide, azathioprine, etc. These drugs should be used under medical supervision only and require regular clinical review and regular clinical review and regular blood tests to assess the efficacy and possible adverse effects. A new class of drugs called biologicals are now available which have improved the treatment and prognosis of those diseases which have not responded to the initial medication. A healthy diet, regular exercise and stress management all help in improving disease control and quality of life.

As the cause of these diseases is not completely known, rheumatologic diseases do not have a definite cure. However with early diagnosis and appropriate management, they can be well controlled and people suffering with these diseases will be able to have no or minimal impact on their activities. Untreated, these diseases vary in their severity and the damage may be restricted to joints, leading to difficulties in daily life activities or may be organ threatening leading to permanent compromise in function or in more severe cases, may be life threatening.

Contact a rheumatologist early if you have any of the above mentioned symptoms. The earlier the disease is identified and treatment begun, the better the prognosis.

-Challapalli Srinivas Chakravarthy-

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