Dr. Sanjay Alle
I am Dr. Sanjay Alle, Orthopedist. Today I will talk about gout. Gout is arthritis of a small joint caused due to uric acid. What is the cause of hyperuricemia in the blood? Most of the cases are idiopathic. We don't know the exact reason for happening this problem. But the secondary causes could be because of the under secretion of the uric acid or over-production. So, we see medical conditions like hypertension, hypothyroidism. A few of the drugs also cause a uric acid problem. This also happens because of the high content of unhealthy food. Some genetic conditions also cause hyperproduction of uric acid. And there are many conditions which cause hyperproduction of uric acid. So, what are the symptoms? Pain, swelling, inflammation in this condition. So, there are different stages for hyperuricemia. Now, we are having a routine examination of full body check-up. We normally find that there is a high level of uric acid. In the 2nd stage, the patient is having acute symptoms. We see that the patient has acute monoarticular pain and severe pain and inflammation.
In the 3rd stage, it will become chronic if we are not treating at the acute stage. This is very much similar to rheumatoid arthritis. What is the diagnostic investigation we have? In investigation, we get a needle-shaped monosodium urate crystals. Apart from that, we have blood investigations mainly uric acid level in the blood. We also have to do a premium profile just to rule out any nephropathy. This is very much common in the renal stone and what is the treatment as such? We divide the treatment into 2 parts. One is medical and another one is non-medical part i.e. dietary restrictions. We should not give a long list that we should not do this and that. We simply advise the simple basic steps like to avoid red meat, seafood and if they are alcoholic, then they should avoid alcohol, and the 4th is smoking. With these simple things, we get good control over hyperuricemia.
2nd is the medical part. The patient can be treated as per the stages. No medicines should be recommended in the initial stages. If they are overweight, then weight reduction. 2nd is dietary restrictions. Acute stages can be divided into 2 parts. We also give a short course of steroids. While giving steroids, we should be more cautious in diabetic patients. If the diabetes is not under control then w should refrain from using the glucose steroids. The only complication will be of diarrhea. If the patient is compatible with the symptoms of diarrhea then we can simply shift to the short course of steroids. We have to select the patient for long-term treatment. If the patient is having 2-3 episodes then the patient is for a long term treatment. So, what are the treatments? A few treatments are having a side-effect of hypersensitivity reaction. In renal conditions, we should customize the dose which is very difficult. So, our main is to reduce the uric acid level less than 6 in a normal patient and less than 5 in renal impairment patients. This is the basic information about hyperuricemia. I hope you have basic information about hyperuricemia. For more information, you can contact me through Lybrate.
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I am Dr Sanjay Alle and practicing orthopedic surgeon in area of Worli. So, today we will discuss some of the common problems in day to day life. So, I would be discussing most common patients who, the maximum patients who come to me like back pain, knee pain generally these are the common most common problems. And and the age group for this backache and knee pain is most of the working group as well as the old age groups. So, the reason for the different age groups is different. So, the most common problem nowadays because most of the persons are going to office going people. So, what they do is they are not exposed to sunlight as such, so because of that there is the there is a massive diff deficiency of Vitamin D3. So, that is one of the main cause for back pain in mainly the office going population. So, in that what happens is how we all know that calcium is most important to the body, for the bone basically. But, most of us are not, unaware of the vitamin D3. As we all know vitamin D3, food content is very much very very minimal. So, the main source of vitamin D3 is sunlight.
So, I always advise all of my patients to at least to go for 20 to 25 minutes in the sun exposure. So, there won't be a Vitamin D3 deficiency but considering the present scenario means all of the morning 9 to 5 there is a job so very minimal exposure sunlight is there so that is a practical problem. So, because of that there is a massive vitamin d deficiency and due to that there is a backache and everything. And lack of exercises also leads to most of the backache problems. In old age, it rather than most of the vitamin d deficiency in old age also we see vitamin d deficiency but along with that the osteoporosis, osteoporosis one of the main reason in the old age people. And because of the deficiency of calcium, because of the mainly hormonal changes, mainly in females after the menopause, there is a hormonal change and because of that the main reason for osteoporosis and because that will lead to the back pain of it.
So, all these conditions, medicines play a very minimal role, we normally prescribe medicines but apart from the medicines, the main role should be preventive medicines like preventive measures like what the preventive measure would be we should avoid forward bending which is one of the main reason of back pain. So, we should not forward bending should be avoided as much as possible. The second thing, sitting on the ground. Sitting on the ground is one of the major factors. We all see whenever we all for lifting the heavy weight by doing forward bending, so in osteoporosis we have seen multiple fractures also. So, we have to avoid we have to take care of the preventive measures like avoiding forward bending, sitting on the ground and for knee pain knee pain also sitting on the ground is very much it fastens the degenerative process. We all know the osteoarthritis of knee, the main reason for knee pain in old age.
So, it is an ageing process. Nobody can stop the ageing process. So, osteoarthritis is one of the ageing processes. So, what we need we need to do for that is if you ask me really, there are very minimal medicines for the knee osteoarthritis of the knee. There are different stages of the knee osteoarthritis mainly from simple grade 1 to grade 4. So, normally for the last stage we third stage or 4 stages, we advise for a surgery. But to avoid those things, to avoid the fastening the process of the osteoarthritis, we have to take some preventive measures like we should not do cross leg sitting, we should not sit on the ground, we always advise not to do some basic exercises they are not much, they don't take much of time but we have to do the basic exercises. If you want to take an expert opinion for that, it is always advisable to visit a physiotherapist for that. So, so both common problems I have told you back pain, knee pain and vitamin D deficiency. So, I hope this information will help you in tackling some common problem orthopaedic problems and for more information, you can contact me through Lybrate.
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