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Chand, S.
- Tophaceous Gout with Multiple Unusual Large Tophi and Severe Joints Destruction–A Pictorial Case Report
Authors
1 Department of Medicine, Dr Yashwant Singh Parmar Govt. Medical College, Nahan, Distt-Sirmour, Himachal Pradesh - 173001, IN
Source
The Indian Practitioner, Vol 70, No 5 (2017), Pagination: 22-25Abstract
Gout is a chronic metabolic disease that can manifest as acute or chronic arthritis, and deposition of monosodium urate crystals in joint, bones, soft tissues and kidneys. It can either manifest as acute arthritis or chronic tophaceous gout. It usually affects the first metatarsophalangeal joint of the foot and less commonly other joints such as wrists, elbows, knees and ankles. We report a case of a 17 year old young boy with tophaceous multiarticular gout with unusual large tophi in hands, feet and knees. Severe joint destruction and ulcers due to tophaceous gout are currently uncommon considering the positive effect of medical treatment in controlling hyperuricemia. In this case we emphasize the disabling effects of undertreated hyperuremic arthropathy.Keywords
Tophaceous Gout, Tophi, Hyperuricemia, Arthritis.
References
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- Clinical Profile of Chronic Kidney Disease Patients:A Hospital Based Study
Authors
1 Department of Medicine, Dr. YS Parmar Govt. Medical College, Nahan, H.P., IN
Source
The Indian Practitioner, Vol 70, No 11 (2017), Pagination: 25-31Abstract
Introduction: Chronic kidney disease is an important non-communicable disease, which is affecting the whole world. Incidence of chronic kidney disease is increasing, affecting the health care system as well as economy of the country.
Aims and Objectives: To study the clinical profile of newly diagnosed chronic disease patients at Indira Gandhi Medical College and Hospital Shimla.
Material and Methods: This was a prospective study done over a period of one year. A total of 35 patients above the age of 18 years were included in the study. Glomerular filtration rate of every patient was calculated.. Patients with glomerular filtration rate < 90 ml/dl were divided into different stages of chronic kidney disease.
Results: Out of total 35 patients,16 patients were males and 19 patients were females. 29 patients were more than 40 years of age. Most common symptom was shortness of breath followed by generalised weakness, pedal edema, fever and chest pain. 26 of the patients had positive smoking history. Past history of hypertension was present in 19 patients and there was history of diabetes in 5 patients. 91.4% of patients were having haemoglobin <12 gm%. 26 of patients enrolled in the study were having Chronic Kidney Disease stage 5 at the time of diagnosis, others were in the stage 3 or 4 of chronic kidney disease.
Conclusion: Prevalence of chronic kidney disease is increasing. Hypertension and diabetes mellitus are two most important etiological factors. There is need of the community based programmes for the early detection and treatment of hypertension and diabetes mellitus. Early identification and appropriate treatment of chronic kidney disease is required to prevent its progression to end stage renal disease.
Keywords
Chronic Kidney Disease, Glomerular Filtration Rate, Pedal Edema, Hypertension, End Stage Renal Disease.References
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