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    Rheumatology Procedure

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    The various procedures undertaken by the rheumatology department at Sakra are

    • Application of disease modifying drugs like Methotrexate, sulfasalazines, azathioprine

    • Pulse therapy of Steroids, Cyclophosphamide, etc

    • Biologicals like Infliximab, Rituximab, Tocilizumab, Abatacept, Eternacept

    • Cognitive Behavior Therapy

    • Chronic pain management

    • Trigger point manangement

    • Comprehensive care for all rheumatological and multisystem autoimmune disorders

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    Dr. Shweta Singhai

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    Blogs related to

    • Systemic Lupus Erythematosus (SLE): Diagnosis and Treatments

      Systemic Lupus Erythematosus (SLE) is the most common form of lupus and autoimmune disease. In this disease your immune system attacks its own tissues, resulting in widespread inflammation and tissue damage in the affected organs.

      Read More

    • Ways of Staying Active and Managing Arthritis from Home During the Pandemic

      The raging pandemic has brought about a massive disruption in our daily life activities and has caged all of us indoors. Life has become difficult for all but the worst hits have been those who

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    • Silent Epidemic: Osteoporosis has affected 200 million women worldwide

      Osteoporosis is estimated to affect 200 million women worldwide - approximately one-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and two-thirds of women aged

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    Systemic Lupus Erythematosus (SLE): Diagnosis and Treatments

    Systemic Lupus Erythematosus (SLE) is the most common form of lupus and autoimmune disease. In this disease your immune system attacks its own tissues, resulting in widespread inflammation and tissue damage in the affected organs. It can affect the kidneys, skin, brain, joints, lungs, and blood vessels. There is no cure for lupus, but some lifestyle changes and medical interventions can help control it.

    It is a chronic condition that can have phases of worsening symptoms that alternate with periods of mild symptoms. Most people with systemic lupus erythematosus are able to live a normal life with treatment.

    How serious is SLE?

    The seriousness of systemic lupus erythematosus can range from mild to life-threatening. The condition should be treated by a doctor or a team of expert surgeons who specialize in the care of SLE patients. People with lupus who receive proper medical care, prevention, and education can significantly improve their function and quality of life.

    What are the symptoms of SLE?

    The symptoms of SLE can vary from person to person. Common symptoms may include:

    • Severe fatigue

    • Joint pain

    • Joint swelling

    • Anemia

    • Blood-clotting problems

    • Headaches

    • Hair loss

    • Sensitivity to sunlight

    • A rash on the nose and cheeks, which is known as a “butterfly rash”

    • Fingers turn white or blue and tingle in cold, which is known as “Raynaud’s phenomenon”

    Other systemic lupus erythematosus symptoms vary depending on the area of the body the disease is attacking, such as the gastrointestinal tract, heart, or skin.

    The symptoms of lupus are also the symptoms of many other diseases, which makes diagnosis tricky. Consult your doctor if you have any of these symptoms. Your doctor may recommend some tests to collect the information needed to make an accurate diagnosis

    What are the causes of SLE?

    The specific cause of SLE is unknown, but a number of factors have been associated with the disease.

    Genetics

    The disease isn’t linked to a specific gene, but people with lupus disorder often have family members with other autoimmune diseases.

    Environment

    Environmental triggers can include:

    • Ultraviolet Rays

    • Certain Medications

    • Viruses

    • Physical or Emotional Stress

    • Trauma

    Sex and Hormones

    SLE is more common in women than in men. Women may also experience more worst symptoms during pregnancy and throughout their menstrual periods. Both of these observations have led some medical experts to believe that the female hormone estrogen may play a vital role in the development of SLE. However, more research is still required to prove this theory.

    How is SLE diagnosed?

    SLE is diagnosed by health care specialists using physical examination, symptom assessments, X-rays and lab tests. SLE may be tough to diagnose because its initial signs and symptoms are not specific and can appear as signs and symptoms of other conditions. If only a blood test is used for diagnosis, it may be misdiagnosed. Because diagnosis can be challenging, it is necessary to consult a surgeon specializing in rheumatology for a final diagnosis.

    What is the treatment for SLE?

    There is no cure for SLE. The aim of systemic lupus erythematosus treatment is to reduce the severity of symptoms. Treatment depends on the severity of your symptoms and which part of your body is affected by SLE. The following treatments include:

    • Steroid creams for rashes

    • Corticosteroids are used to reduce the immunological response

    • Antimalarial drugs are used for joint and skin problems

    • For more severe cases, disease-modifying medicines or immune system targeting therapies may be used.

    • Anti-inflammatory medications are used for joint pain and stiffness, such as these options available online

    Talk with your health care specialist about your diet and lifestyle habits. Your health care specialist might recommend eating or avoiding particular foods and minimizing stress to reduce the chances of triggering symptoms. You may need to have screenings for osteoporosis because steroids can thin your bones. Your physician may also suggest preventive care, like immunizations that are safe for people with autoimmune disorders and cardiac screenings.

     

    Ways of Staying Active and Managing Arthritis from Home During the Pandemic

    The raging pandemic has brought about a massive disruption in our daily life activities and has caged all of us indoors. Life has become difficult for all but the worst hits have been those who are mandatorily required to be physically active. For example, the ones suffering from acute or chronic arthritis. Managing the condition from within the four walls of the home has become a mammoth task. Marking World Arthritis Day on October 12, here are a few ways which can help in tackling arthritic pain during the pandemic days. Staying active, eating healthy, maintaining social distancing and having a positive attitude can certainly work wonder in providing relief from the pain. 

    The two-way approach in dealing with arthritis pain from home

    Exercise: Daily dose of specially designed exercise for those suffering from arthritis can help in easing out the pain. These exercises help in maintaining strength, reducing pain and preparing hip or knee for an upcoming joint replacement (in case that has got a little delayed during the pandemic). It is important for arthritis patients to be active that would allow the joints to find a variety of stretching, strengthening and range of motion exercises and decrease the pain. 

    Weight loss and diet: A majority of those with arthritis are seen to have extra weight and weight loss remarkably reduces the stress on the joints. It has been observed that every 5 kg of extra weight carried results in25 kg of weight-bearing pressure across the hips and knees. Thus, following a healthy diet plays a crucial role in shedding off extra weight and lessening joint pain. An anti-inflammatory diet including tomatoes, olive oil, green leafy vegetables, nuts, fatty fish, and seasonal fresh fruit, particularly blueberries, strawberries, cherries and oranges are great in reducing weight and joint pain among arthritis patients. Foods that should be avoided are white bread and pastries, french fries, soda, oily food and red meat.

    Creative ways of staying active at home 

    Gyms and parks might have shut down due to the Coronavirus outbreak, but one's rooms and private gardens may be turned into the most appropriate venue for exercising and keeping oneself active and arthritis at bay. All one must do is get a little smart with the ways of exercising. 

    Play indoor games, swim or take a masked walk to be active: Table tennis and golf at one's own garden are great ways of staying active. Swimming too could be a safe option as studies have shown that the risk of transmitting Covid-19 virus through water stands to be minimal. However, physical distancing must be kept in mind at an outdoor pool or other body of water. Going out for a walk with masks on and the hand sanitiser in the pocket is another wonderful way of being active and keeping the joints flexible. It also means getting some dose of fresh air and nature's touch. 

    Become pro with creative movements: Getting creative with movement is way too helpful in managing arthritis and making indoor exercise work. Leveraging technology and taking the help of online classes for exploring new and creative ways of keeping oneself active in the form of aerobic activities, Zumba, Yoga, strength training, Pilates are appreciable. Virtual Zoom dance classes or creative movement workshops are gaining immense popularity in terms of keeping oneself active from the comfort of homes. 

    Turn household chores, gardening into ways of being active: Apart from the regular exercise one does, it is essential to be smart and convert daily chores into modes of being active. Gardening, vacuuming or cleaning out the garage are great ways of staying active at home. 
     

    Pandemic has thrown a hard challenge, just not with the virus but also with other ailments. However, we must understand the necessity to adapt to the new normal and find out ways of remaining active at home and control arthritis effectively. 

    Silent Epidemic: Osteoporosis has affected 200 million women worldwide

    Osteoporosis is estimated to affect 200 million women worldwide - approximately one-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and two-thirds of women aged 90.Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds. Overall, 61% of osteoporotic fractures occur in women, with a female-to-male ratio of 1.6. Nearly 75% of hip, spine and distal forearm fractures occur among patients 65 years old or over. A 10% loss of bone mass in the vertebrae can double the risk of vertebral fractures, and similarly, a 10% loss of bone mass in the hip can result in a 2.5 times greater risk of hip fracture. In India: Expert groups peg the number of osteoporosis patients at approximately 26 million (2003 figures) with the numbers projected to increase to 36 million by 2013.In a study among Indian women aged 30-60 years from low income groups, BMD at all the skeletal sites were much lower than values reported from developed countries, with a high prevalence of osteopenia (52%) and osteoporosis (29%) thought to be due to inadequate nutrition. It is projected that more than about 50% of all osteoporotic hip fractures will occur in Asia by the year 2050.

    As osteoporosis has no obvious symptoms. Traditional X-rays can’t measure bone density, but they can identify spine fractures. Bone mineral density (BMD) has to be measured by more specialised techniques. A number of different types of BMD tests are available, but the most commonly used is DXA (dual-energy X-ray absorptiometry), capable of detecting quite small percentages of bone loss. It is used to measure spine and hip bone density, and can also measure bone density of the whole skeleton. While most limb fractures (such as at the wrist or hip) are obvious, spinal fractures can be more difficult to diagnose. This is because they might be painless, or if there is pain, a person may not know it is caused by a fracture due to the many different causes of back pain.  More obvious signs of spinal fractures are:

    • Loss of height

    • Development of a curved upper back (sometimes called a Dowager's Hump)

    Since there are usually no outward signs of osteoporosis developing, doctors will often recommend diagnostic testing depending on your age and if you have other risk factors for the disease.

    Prevention: Calcium and vitamin D supplementation reduces rates of bone loss and also fracture rates in older male and female adults, and the elderly. Ensure a nutritious diet and adequate calcium intake, Avoid under-nutrition, particularly the effects of severe weight-loss diets and eating disorders, Maintain an adequate supply of vitamin D, Participate in regular weight-bearing activity, Avoid smoking and second-hand smoking, Avoid heavy drinking.

    We in Sakra have started an “Osteoporosis Clinic” the first of its kind in Bangalore to tackle this silent epidemic on Monday, Wednesday and Friday afternoons under guidance of our Endocrinologist Prof.Dr.C.V.Harinarayan.

    Dr. C.V. Harinarayan
    Director - Diabetes & Endocrinology
    M.D. (Int. Med), D.M. (Endocrinology) (AIIMS) F.A.M.S., F.R.C.P.(Glasgow), F.R.C.P.(Edindurgh), F.R.C.P.(Lond), F.A.C.E.(USA)

     

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