Causes and symptoms of Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease, which is characterized by the inflammation of the joint lining and gives rise to pain, stiffness, warmth and redness in the joints. The inflammation occurs in the tissue that normally produces lubricating fluids for the joint. This condition is progressive in nature, and can cause the destruction of joints, leading to functional and locomotive disability.

Though rheumatoid arthritis is a disease that can last for years, patients may not experience any symptoms for a long time. In some cases, the disease may affect other parts of the body like the eyes, lungs, and the heart.

The severity and duration of the symptoms are unpredictable, and the symptoms experienced are:

- At times, people experience increased disease conditions called flare-ups.

- They may also experience alternating periods when the symptoms fade or diminish, which is referred to as remission.

- Some of the common symptoms of the disease include lasting pain and stiffness for more than an hour in the morning, inflammation, fatigue, fever, and a general sense of discomfort.

- Inflammation in the joints close to the hands like wrists and fingers and other parts like neck, shoulders, elbows, knees and hips can also be affected.

- In some cases, both sides of the body are affected at the same time, which is known as inflammation in a symmetric pattern.

Rheumatoid arthritis is usually caused by the body's weakened immune system, which produces antigens to attack itself. The trigger to this reaction is not yet clearly deciphered.

It is diagnosed by clinical examination (American association of Rheumatology criterion) supported by relevant Investigations.

Management

Management for Arthritis includes the following aspects:

1) To control disease activity and control of symptoms of pain, stiffness.

2) Medical treatment to prevent system effects of the disease.

3) Nonmedical treatments comprise of dietary therapy, physiotherapy, immunomodulation therapy.

4) Minimal surgical therapy like arthroscopic synovectomy to confirm the diagnosis as well as reduce disease activity. At times, with the advanced decline of joints, a major surgery like replacement therapy may be required for specific cases.

What's more important is to know that at any stage of the disease patient can adopt and live an active life with appropriate treatment.



What Really Causes Rheumatoid Arthritis?

Sleep is a vital component of the human construct. This is the time when the body restores  itself. While too little sleep can be dangerous for the body, new research has shown that too much sleep has its pitfalls too. Oversleeping is an indication of certain health risk. It also indicates few medical conditions that a person might have. Here is more on the risks of oversleeping:

Difficult to get pregnant: A study conducted by a Korean research team in the year 2013 found that out of a sample size of 650 women who were undergoing in-vitro fertilization, the ones who got pregnant had 7-8 hours of daily sleep. The study also suggested that sleep can affect menstrual cycles, circadian rhythms, and hormone secretion. While research is yet to find out a direct co-relation between sleep and infertility, a number of researchers are trying to break the jinx.
Risk of diabetes: A Quebec study conducted in 2013 clearly showed that a person who sleeps for more than eight hours in a day is more risk prone to suffer from type 2 diabetes and reduced glucose tolerance. On a six-period time frame, people who sleep for more than 7-8 hours, are more likely to suffer from diabetes related complication, even if they keep body mass under control.
Mental health and depression: Depression is a major symptom of oversleeping. While people with depression tend to suffer from insomnia, an estimated 15 percent patients suffering from depression tend to oversleep. Compared to regular sleepers, the ones who oversleep tend to suffer from anxiety symptoms and persistent depression. A recent study has revealed that sleeping too much can increase the chances of genetic heritability. Another study revealed that people who sleep for more than 10 hours can result in mental illness. Another research conducted at the John Hopkins Medical School revealed that an irregularity of the body s sleeping clock can lead to temporary mental depression.
Increased inflammation: Oversleeping can increase the risk of certain diseases such as the Alzheimer s disease, cardiovascular disease etc. A study conducted by a group of researchers revealed that women who slept for more than eight hours are likely to suffer from 44 percent higher C-reactive protein. Another study reported that C-reactive increased by more than 8 percent for every hour of additional sleep an individual takes.
More pain: While sleep and rest are often associated with healing, oversleeping can, at times, exacerbate symptoms. Spending too much time in bed can aggravate back and shoulder pain. Oversleeping is also associated with a higher frequency of headaches. Oversleeping often triggers one-sided migraine and increases the level of stress in a person.

Sleeping More Than 8 Hours - How It Can Put Your Health At Risk?

Egg yolk and cholesterol - is there a link?

Although egg is considered one of the most nutritious foods, people with high cholesterol avoid its consumption as they believe that eggs may increase cholesterol and risk heart diseases.

Is there a link between egg yolk and cholesterol?

Egg yolk is rich in dietary cholesterol. One large egg contains 185 milligrams of cholesterol. People with normal cholesterol levels require about 300 milligrams of dietary cholesterol and people with high cholesterol need 200 milligrams of dietary cholesterol from food.

Dietary cholesterol has the minimum impact on blood cholesterol as compared to saturated and trans fats which contain bad cholesterol. Hence dietary cholesterol present in egg yolk has minimal or no effects on increasing your cholesterol levels.

If you would like to consult with me privately, please click on'consult.

Egg Yolk and Cholesterol - Is There Really a Link?

Vertigo is that sensation when a person feels that the world is spinning around him. It is a feeling of off balance.

While having a Vertigo, people often complain about feeling dizzy, basic daily activities like walking or moving becomes really intense for them. These episodes can impact everyday life.

Is Vertigo common?

Experiencing Vertigo at least once during a lifetime is quite common. It is often seen in older people, but it can happen to anyone at any age. Women are a little more prone to experience an episode of Vertigo than men.

Types of Vertigo:

There are two major types of Vertigo:

Central Vertigo: Central Vertigo occurs when there is a sudden and temporary malfunction in the brain, precisely in an area called the cerebellum.

Peripheral Vertigo: Peripheral Vertigo occurs due to a problem in areas of vestibular nerve or the inner ear. This area connects the inner ear and the brain. Peripheral Vertigo is the most common type of Vertigo.

According to the American Institute of Balance, Peripheral Vertigo is generally a more serious and dangerous problem compared to Central Vertigo.

Recurrent Spontaneous Vertigo with Head-Shaking Nystagmus:

Recently, researchers discovered a new type of Vertigo called  Recurrent Spontaneous Vertigo with Head-Shaking Nystagmus  or (RSV-HNS).

To diagnose RSV-HNS, the patients need to sit in a room without lights. The examiner changes the position of their heads, first in forward direction, then in side to side direction for about 15 seconds. The camera records the patient s eye motions. It results in those who have RSV-HSN making an eye movement which lasts longer than the others. This movement is known as  nystagmus .

Compared to other types of Vertigo, RSV-HSN shows a more severe sensation of motion sickness. People with RSV-HSN experience things like nausea, headaches, vomiting, and an unwillingness to head motions. These symptoms can be experienced anywhere from a couple of times a week to once a year.

The reason behind RSV-HSN is still unknown. Doctors recommend that proper medication helps to improve the condition.

Treatment for Vertigo:

A major part of the treatment of Vertigo depends on the cause of the Vertigo. Often, Vertigo goes away without any treatment. The reason behind Vertigo curing itself is that people adapting to the inner ear changes and finding different mechanisms to maintain balance.

Why a neurologist is the right choice to consult for vertigo?

The patient of vertigo should not visit an ENT doctor and must consult a good neurologist as basically it's either a problem of brain or of abnormal signals from the vestibular nerve from the ear. In no way it is a problem of ear per se. A neurologist has the training and expertise to deal with it, not an ENT doc. Also, it's important to consult urgently as sometimes it can be a sign of brain stroke (specially if associated with imbalance). Importantly, to rule out brain lesions like cyst, tumor, clots and nerve infections, consulting a neurologist is the best option available.

Apart from this, these are a few treatments:

Medicines: Medication tends to give relief to symptoms like motion sickness associated with Vertigo.

Vestibular Rehabilitation: Under this treatment, doctors try to aim at the patient s vestibular strengths which send the signals to the body movement and head related to  gravity.

Canalith Repositioning Manoeuvres: In this treatment, a physical therapist suggests different head and body movements, which help to release the deposit out of the canal and into an inner ear which can be absorbed by the body. This treatment is quite effective to treat Vertigo.

Surgery: If the reason behind causing Vertigo is some serious internal problem like tumor or a head injury, then, in such circumstances, surgery is highly recommended.

Conclusion:

There are many treatments and medicines available for Vertigo. They are totally dependent upon the cause, symptoms, and condition of the patient. This is why it is important to consult a doctor or specialist for the best treatment option.

Vertigo - Know The Types & Treatment Of Them!

Alternating between being happy and sad as you go through life's ups and downs is normal, but if you're sad most of the time, it could be a sign of being depressed.  Depression takes the joy out of all your activities, and can make merely getting through a day feel overwhelming. The first step to overcoming this problem is to understand its symptoms and causes.  Not everyone experiences depression the same way, but here are a few questions that can help tell you if you are depressed or not.

Do you feel helpless?
It is common for depressed people to feel helpless and that everything around them is out of their control. As a result, the person may either stop participating in activities all together or try to control things they can't. Both situations are cyclic and lead to further depression.

Have you lost interest in daily activities?
The feeling of helplessness is one of the main reasons depressed people lose interest in activities. Another reason is that activities that were once enjoyed now do not seem interesting enough. In most cases, this leads to the person isolating himself and withdrawing from all his family and friends.

Do you often feel angry or irritated?
Depression is almost always accompanied by irritability and anger. Small annoyances that would usually be overlooked quickly, take on an inappropriate significance. This can lead to poor impulse control, substance abuse and anxiety disorder. In most cases, anger and depression are related by the person trying to take accountability for things that are out of his control and hence feeling helpless.

Is there a change in your sleep pattern?
Your sleep quality is very closely related to the way you feel. Depressed people often suffer either from insomnia or oversleeping. Depressed people can have trouble going to sleep as well as staying asleep. This can cause drowsiness and lethargy during the day. Sleep apnea is also linked with depression. As you can imagine, if this is left untreated, it will only worsen your depression.

Do you feel tired?
When the body does not get adequate sleep, you begin the day feeling tired. Thus, depressed people often feel fatigued and complain of a number of muscle and joint pains.  This is because the body has not had enough time to regenerate cells during the night. This is usually complemented by complains of persistent headache and stomach aches, both of which are emotionally connected to the way you feel.

The nature of depression is such that it lowers a person's self-esteem to the point of interfering with his ability to seek help. Hence, if you have a positive response to the above questions, it is time to address your problem before it worsens.

How To Recognize Depression In Adults

Psoriasis is a chronic dermatosis characterised by an unpredictable course of remissionn & relapse. It is an non-infectious skin disaease chracterised by scaly, silvery patches mainly on the scalp and extensior surface of the body. Its exact cause is unkown. In ayurveda, it is closely resembles with ekakushta. The features of ekakushta explains in ayurveda classics resembles with the symptoms of psoriasis. Psoriasis is the challenge for modern science. There is no definite treatment for psoriasis in modern science till today. The drug available in the market use to treat psoriasis are not very effective and have local and systemic effects.

In ayurveda, vata pitta and kapha dosha is the main contributory factor for the disease. Due to vitiation of three dosha, the disease manifest and main line of treatment for psoriasis is panchkarma and internal medicine. It is considering the best approach for skin disorder in ayurveda. A case report of 42-year old male, presented with well demarcated red scaly, silvery patches mainly on both legs, hands, scalp, chest and back with itching, and also nail and joint involvement has been presented in this article.

Etiology of Psoriasis: 

Unknown but many factors have been associated-

Genetic: may be autosomal dominant

Triggers: physical trauma ,infection and drugs.

Biochemical change: like increase level of arachidonic acid and Cgmp.

Immunological factors: helper T cells PLAY A KEY ROLE.

Epidemiology: 

Roughly, 1% of population is affected. Can occur at any age and affected both sex. Most patients as worse in winters.around 7 million people are affected in developed country.

Histopathogenesis:

Increased epidermal cell proliferation.

Retention of nuclei in stratum corneum.

Proliferation of fibroblast.

Dilated and tortous capillary loops.

Shortened epidermal turnover time from normal of 60 to 10 days.

Clinical features: Usually chronic indolent lesions which persist for month. Lesions are mildly papule or plaque.erthematous plaque lesions with characteristic slivery, large, loose scales. The patients of psoriasis may also suffer from depression and low self-esteem.

In a patients with psoriasis always check for nail and joint involvement.

Nail: 10 to 15% of the patients have nail involvement. Pitting, nail plate thickening, subungual debris, discolouration of nail plate and oil spot seen in the nails.

Joints: 10% patients have joint involvement.

Sites: Scalp, pressor points & extensor. Sometimes generalised.

Chronic recurrent psoriasis is difficult to treat. Modern science treat with PUVA and corticosteroids but these drugs having local and systemic side effects like liver and kidney failure etc. So, it is the time to find out the effective and safe treatment for Psoriasis. Medicines which are used in ayurveda are safe and practised since many years. A huge numbers of drugs are prescribed in ayurveda for the treatment of kushta.

Case details: A 42-year old male patient, hindu brahman by religion, presented on 10 april 2016 with well demarcated raised red scaly, silvery patches on chest, back and both legs and hands. He complained of itching all over the body and on scraping, white powder like substances fall down and leaves a bleedy surface. On history, patients had complaints since 20 years and diagnosis of psoriasis by allopathic physician. Since 20 years he has been taking allopathy and homoepathy patients from various practioners of U.P and delhi. He is brahman and lives in well known temple of delhi and visit homes of peoples for religious ceremony. He is afraid that if the disease is spreading continously, then he is unable to work as priest because people neglect him due to disease. The disease is spreading all over his body and also involves nail and joint. Destruction of nail plates of hand and legs was also developed. For this, patients took allopathic treatment for such a long time but do not get relief.

The patients visit our clinic for the first time. He told use that his problem not solves since 20 years and spreading continuously. So, he is unable to trust us. So, we first give him counselling because reassurance and emotional support are invaluable. Physical and mental rest enhance the effects of the treatment. It is also important to tell him that the disease is not contagious and is benign.

SYMPTOMS OF THE PATIENTS :

Itching all over body

Silvery patches, especially, on legs ,chest ,back but now spreading in his hand and scalp.

Destruction on nail plates

Swelling and pain in left middle fingers and flexor deformity in proximal interphalangeal joint

Swelling in right middle metatarso phangeal joint and pain

Some blood test of the patients were done like CBC, LFT, KFT, SR, URIC ACID to assess outcome.

His general health was good and both physical and all blood test were within the normal limts.we advise patients for panchkarma and oral medication but patients refuse for panchkarma so we start his oral or internal medication. 

Investigation Done :

CBC(Complete Blood Count)

LFT(Liver Function Test)

KFT(Kidney function Test)

Sr. Uric Acid

Investigation was done to rule out any other pathology. Investigation were within normal limit.

Internal Medication :

Medication are given into two phase. In First Phase, we are given panchsakara churna - one spoon two times daily for anulomana and pachan, Panchnimba churna- one spoon two times daily with luke water, panchtikta ghrita gugulu - two tab two times daily, and one oil for local application containing jyotishmati,bakuchi, and chakramad for five days. We told patient to apply the oil firstly only on legs for 5 days. Patient taking the same for 5 days and come on 5th day, we see the fabulous result, the rashes which are developed within 4 to 5 months just disappear and other rashes are also subsiding.

After 5 days, in second phase, we continue the same treatment and also added haridra khand - one spoon two times daily, gugulu tiktam kashaya - three spoon two times daily (one hour before food for 15 days). The patient came back on 20th day, with great result, the rashes were almost 60 % subsiding and pain and swelling in finger and ankle also reduce to great extent. Now, patient is not taking any pain killer for pain. Patient also get improvement in nails of legs.

We prescribe the same medicine for one month that time and ask him to do some physiotherapy additional for finger deformity. After that patient came with 70 to 75 % relief in symptoms and patients also tell that during the treatment, he will not develop any additional rashes.

During the treatment, we also told the patients to follow some dietary changes and live according to the rules of Ayurveda.

Result: Psoriasis is a disease with unkown etiology and triggered by many factors. In modern science, treatment of psoriasis is a challenge. They do not have any safe and proper medicine for psoriasis. But, ayurveda treatment gives satisfactory results as well as the quality life to the patients. Ayurveda removes toxin out of the body and corrects the formation of aama. Ayurveda gives the prevention as well as the treatment. So, by following the dietary and lifestyle change we prevent the reoccurrence of the disease.

Ayurveda For Psoriasis 

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