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Rheumatoid Arthritis: Early Signs And Symptoms.

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1 in 100 people today may be suffering from RA in the community, according to senior rheumatologist Dr Anand Malaviya. Read here to know about this condition which is commonly known for causing pain and stiffness in joints.

Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disorder of the joints. The condition begins insidiously with nonspecific aches and pains in the musculoskeletal system of the body that come-and-go. The symptoms progress over a period of time, within weeks or even some months when actual joint swellings become visible along with increasing stiffness and pains.

According to  , Senior Rheumatologist, “approximately 1 in 100 people may be suffering from RA in the community. The condition usually occurs in people between 20 years to 60 years of age.”

He says, “RA affects small and large joints in the arms and the legs in a symmetrical distribution (on both sides of the body).This is in contrast to the other very common joint disease (of elderly persons) called osteoarthritis. Osteoarthritis usually begins at a later age and most commonly affects one knee and then the other knee over time. RA is 5 times more common in women than men.”



The exact cause of RA is not known. However, it is well understood that the synovial tissue (the inner lining) of the joints become inflamed due to an autoimmune response (the immune system of the body becomes imbalanced and starts self-attack).

The cause of the autoimmune response is multifactorial including certain genetic risk factors and several environmental factors including smoking, poor oro-dental hygiene.

There are several additional risk factors that enhance the possibility of a poor treatment outcome in RA. These include obesity, lack of regular exercise and imbalanced diet. Eating plenty of fruits, green vegetables, and a balanced high-fibre diet helps in the control of RA.

Rheumatoid arthritis affects the lining of your joints, tissues surrounding the joints, as well as connective tissues at other places in the body.

Drinking baking soda daily may help reduce the destructive inflammation of autoimmune diseases like rheumatoid arthritis, say scientists

The main symptoms of RA are morning stiffness (stiffness after a period of rest that may take 30 minutes to an hour before improving), pain and swelling in the small joints of the hands-fingers. But, almost all the other small and large joints in the body may get affected including wrists, elbows, shoulders, the knees, the ankles and the joints in the feet, in a symmetrical distribution.

However, spine involvement does not occur in RA (except in the upper neck) as also the hip involvement that is uncommon. Symptoms of RA are characterised by persistence (persists beyond 6 weeks), therefore, it is characterised as a form of chronic inflammatory arthritis).

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“A person suffering from RA is likely to wake up with stiff joints in the morning. They experience severe pain in different joints of the body like joints of hands, wrists, elbows, foot and ankle joints. They also experience visible swelling in these joints”, says Dr Malaviya. “People with RA experience fatigue, tiredness, unexpected weight loss, swelling in joints of hands, wrists and elbows. These people find it difficult to perform day-to-day activities”, he added.

RA can lead to the joints becoming swollen and tender with restricted movement especially small joints and joints of upper extremities. One may also have fatigue, flu-like symptoms, loss of appetite and lack of sleep, weight loss etc. It is important to know that symptoms of RA are likely to fluctuate in severity over time.

Occasionally, the disease may ‘flare-up’ (a period during which inflammation and other symptoms increase and become more severe without any obvious cause). The ‘flare’may last for some days, or even months, unless treated appropriately.

A person suffering from RA is likely to wake up with stiff joints in the morning. They experience severe pain in different joints of the body like joints of hands, wrists, elbows, foot and ankle joints. They also experience visible swelling in these joints”

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Here’s how rheumatoid arthritis affects different organs

1. It causes gritty sensation, pain and dryness in eyes, may cause some degree of impaired vision and sensitivity to light.

2. Dryness of mouth, infection and gum irritation are also common in patients with RA.

3. ‘Rheumatoid nodules’ (mostly seen in RA patients who smoke) a hard small – to – medium size nodules subcutaneously seen near the olecranon process and the adjacent extensor surface of the forearm. They may also be seen (occasionally) as small hard nodules near the affected small joints in the fingers.

4. Prolonged uncontrolled inflammation in RA may lead to the involvement of the lungs causing difficulty in breathing. Shortness of breath and scarring of lungs are one of the most serious complications of RA that is often seen in those who do not take proper medicines from the beginning of the disease.

5. There are several other complications in patients with RA who have not received appropriate treatment. These include blockage in the arteries of the heart causing premature heart attacks, osteoporosis (brittle bones) causing fractures, skin lesions, reduced haemoglobin, tingling and numbness (neuropathy; entrapment syndrome), and many others.

RA can result in decreased range of motion in the affected joints. Inflammation in joints causes laxity of the supporting ligaments and tendons that causes deformities. With the progression of the disease, joint disabilities increase and the person may not be able to carry out normal routine functions including self-care, house-hold chores, job-related to her/his profession and loss of all the leisure-time activities.

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24 Hours Across Africa

India doctors embark on strike aimed better security

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Source: Reuters

Thousands of doctors across India went on strike on Friday to demand better security at hospitals days after junior doctors in the city of Kolkata were attacked, leaving services in many government-run health facilities paralyzed.

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The state of West Bengal, of which Kolkata is capital, has been the worst hit by the strike with at least 13 big government hospitals affected.

The protests were sparked by an attack at the NRS Medical College in Kolkata on June 10 that left three junior doctors seriously injured after a dispute with a family whose relative had died.

Doctors demanding better security began a strike but their action was confined to the state until West Bengal Chief Minister Mamata Banerjee condemned them on Thursday, saying police did not strike when one of their colleagues was killed.

Banerjee’s remarks, which included a warning that junior doctors would be evicted from their college hostels if they did not go back to work, triggered a nationwide reaction.

The Indian Medical Association said the “barbaric” attack at the NRS reflected a national problem, and called for a countrywide protest. It also demanded legislation to safeguard doctors.

Nearly 30,000 doctors were on a one-day strike on Friday, most in West Bengal, New Delhi and the western state of Maharashtra, according to figures proved by medical associations.

The federal health minister, Harsh Vardhan, tried to calm the furor, promising better security at hospitals and calling on Banerjee to withdraw her ultimatum.

“I urge doctors to end their strike in the larger interest of society. I will take all possible measures to ensure a safe environment for them at hospitals across the country,” Vardhan said on Twitter.

India spent an estimated 1.4% of its gross domestic product on healthcare in 2017/18, among the lowest proportions in the world. Many millions of Indians depend on the cheap but inadequate public health system.

Saradamani Ray, whose 77-year old father is a patient at the NRS Medical College, said she would have to move him because of the strike.

“I will have to take my father somewhere else for his dialysis, maybe a private hospital,” she told Reuters.

“It will cause a lot of financial strain, but there’s nothing I can do. I will have to pay.”


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24 Hours Across Africa

Ebola still a nightmare in Congo

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Source: BBC

The head of a major medical research charity has called the latest outbreak of Ebola in central Africa “truly frightening”.

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Nearly 1,400 people have died in the Democratic Republic of Congo.

Dr Jeremy Farrar, the director of the Wellcome Trust, said the epidemic was the worst since that of 2013-16 and has showed “no sign of stopping”.

Two people have also died in neighbouring Uganda, the first cases of Ebola reported in the country.

A five-year-old boy infected with the virus died on Tuesday and his 50-year-old grandmother died on Wednesday, the Ugandan health ministry said.

The Ugandan government has reported at least six other suspected cases of the virus.

In a statement, Dr Farrar said the spread was “tragic but unfortunately not surprising”. He warned that more cases were expected, and a “full” national and international response would be needed to protect lives.

“The DRC should not have to face this alone,” he said.

Since the first case of Ebola in DR Congo last August, nearly 1,400 people have died – around 70% of all those infected.

The outbreak is the second-largest in the history of the disease, with a significant spike in new cases in recent weeks.

Only once before has an outbreak continued to grow more than eight months after it began – that was the epidemic in West Africa between 2013-16, which killed 11,310 people.

Efforts to contain the spread have been hindered by militia group violence and by suspicion towards foreign medical assistance.

Nearly 200 health facilities have been attacked in DR Congo this year, forcing health workers to suspend or delay vaccinations and treatments. In February, medical charity Médecins Sans Frontières (MSF) put its activities on hold in Butembo and Katwa – two eastern cities in the outbreak’s epicentre.

In Uganda, a five-year-old boy died of the virus on Tuesday, according to the World Health Organisation (WHO).


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