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Age: 34 Sex: M Weight-72 kg Investigations: HLA B-27 is positive. High-ESR, CRP Alkaline Phosphate, SGOT, RDW-SD, RDW-CV, PWD, MPV, PLCR, Antimony, calcium, Vanadium Low- PH, Iron, MCHC, Bismuth, 25-OH vitamin, Vitamin B-12, Haemoglobin All the Test Reports are Normal/ Negative associated with following symptomsincluding Immunoglobulin A, G, M, eGFR, ACCP, ANA (titre, screening), ANA, BUN, BUN/Creatinine ratio, Creatinine serum, Uric Acid, blood glucose, calcium, sodium, potassium, chloride, phosphorus, RA factor, ASO, Complement-3, Xray Chest Adult, whole abdomen ETC. Confirmed Ankylosing Spondylitis With (?) Fibromyalgia Bilateral sacroiliac joint show hypointensity along the iliac side on both T1-weighted and T2-weighted images in subarticular location suggestive of focal sclerosis. Small erosions seen along bilateral articular margins. Negative for local areas of T2 STIR hyperintensities to suggest local oedema. MRI SI joints with screening of lumbosacral spine shows: Features to suggest bilateral sacroiliitis as described. Symptoms: Musculoskeletal pain Color and smell of urine changes frequently. 3 .Mood swing and do not like rush, hard smell, noisy sound, light and party-function. Sensitivity to loud noises or bright lights. 4. Memory loss, cognitive difficulties, unable to concentrate. 5. Pain and swelling in any part of body (Especially in joint or near to joint). 6. Pain area may change in days, weeks or months (any two of neck, hip, lower back, upper back knee ,ankle, chest bone etc.). Affected Part’s temperature high. 7. Heatingaffectedpart, andproperdigestion,passinggasandbodymassagerelievesymptoms. 8. Chronic, diffuse, sharp, throbbing, or severe pain in muscles, tendons, and ligaments around the joints and near to joints. It migrates over the body. 9. Constipation, passing excessive amounts of gas always, gastrointestinal reflux diseases, foul smell from mouth, frequent urination 10. Feeling tired and weakness, fatigue, Unknown fear 11. Swelling is rational to pain intensity. If pain is superficial swelling disappear. 12. Muscle soreness, or muscle spasms 13 Sensitivity to cold ,weather change, stodger and other’s behavior, sleep and bowel movement, Irritability 14. Joint stiffness (sometimes joints stop complete movement of body part) 15. If problem persist more than a month weight gains 5 kg. History: All the problem persist from childhood. symptoms change per year. Intensity of problems increasing Rapidly in last 10 years. Father having same symptoms. (from age of 20 to 55)

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Do alcohol 2. Reduce body wt 3. No smoking/ tobacco 4. Diet - no ghee/ butter, have mix of vegetable oils - mustard, til, ground nut, olive oil, have more green vegetables and fruits, have whole grain atta, no fried. Fast. Spicy / processed/ junk food. Less sugar, potato, rice take more papaya and pine apple 5. 30 mts walk daily may be with help 6. Deep breathing exercise for 10 mts daily 7. Meditation daily for 10 mts. 6-8 hrs of sleep at night 8. Expose your body to sun for 15-20 mts daily after some oil massage to get vit d. 9. Take more water- proper hydration. 10. Laugh for 2 mts for medicine contact on private chat. Be positive and interact with friends and relatives .also do you have to improve your food habits do 1. Take 2/ 3 glass of warm water in the morning before brush 2. Take more water in day 3. Take meals at fixed hrs, chew food properly/ completely, no eating quickly 4. Take small amount of food at a time, take more frequent meals - may be five times a day. 5. No spicy/ fried/ fast/ junk/processed food. 6. No smoking, chewing gum, and carbonated beverages. 6. No milk for few days, can take curd, no uncooked salad 7. Avoid constipation 8. Use nibu pani (lemon water) 2/ 3 times a day 9. Do not drink/ store water in plastic bottles. 10.relax 11. Take enough rest- do not lie down immediately after eating. Take dinner 3 hrs before sleeping. No late nights 13. Avoid tea, coffee, alcohol 15. Reduce physical and mental stress. Maintain healthy life style. Do exercise regularly. 16. No unnecessary medicines for medicine contact on private consultation good luck..
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