Afemale patient age 40year.she has R.A.Test.positive.Taking Rheumatologist tt since last 5years.which include HcQs +Deflacort6mg in tapering dose +folitrx5mg.+pain killer sos. Came my madhav baug opd today. She has swollen shoulder with deformity in same elbow joint. Also pain in other joint. On examination she has B. M. I 22.94.Bp130/90.No other complaints want to free from this arhritc pain. It is not possible to her to do her regular work without medicine. Ihave suggested following investigations cbc R. A. Test Uric acid sr creatinine. And also start medicine Flexit 2bd+rasna7 and advise her to come with blood report. So that meanwhile we discuss this case on askme For guidance for further tt. Please guide for further tt.
Primary Management : With history of Multiple joint pain, Soth ( Swelling) we have to treat patient like a case of Aamvaat. So first line of Rx is Pachan. I prefer to start with Amari Churna in high dose along with Flexit tab, Templex, Dolorex and Rasna 7. Anulax/AMari oil can be used for nitya virechan. Also advice swedan/hot fomentation at home preferably with valuka pottali Daily once. Reducing symptoms along with steroid dependency is imp.
In a 40 year female menstrual and Obs history is imp. If need for yoni sodhan is identified can add Dashmool kwath/Dashmoolarishta too.
CRP and ESR levels can be used to prognostically monitor this case. Given the medicine history monitor Sr Creat regularly.
Thanks sir for your kind guidance. I will follow this patient and discusswith you again after one month