History uploaded by Ms Anamika Sharma, PCMS Medicine, Research Lab, Bhopal, Fall 2013"

Patient Particulars - Age- 30 year, height 5.5,,weight - 55,sex -female

History of Illness- jab meri pregnancy chal rahi thi tab. pregnancy chackup karaya to mujhe thyride nikla.or 2004 se mene thyride ki tablate lena start kar diya.mujhe bachapan se hi thyride the ,mujhe meri mammy ne bataya abhi 2004 me.

Or abhi 2011 me meri fingers me suddenly swelling a gai thi.figers me akdan type ki ho rahi thi.or kabhi kabhi dard bhi hota tha.mene socha ki shayad sheet ho gaya hai ya thand ki wajah se bhi ho sakta hai.fir 1 month tak mene ayurved docter ko dhikaya to bhi aaram nahi laga.fir mene people's hospital me checkup karaya to bataya gaya ki mujhe ganthhiyabad hai,tablate lene se mujhe aaram bhi mila par jab tablate lo tab tak aaram milta hai.or tablate lena band kar do to fir swelling or dard akdan hone lagti hai.saare joints me pain hone lagta hai.

PCMS physician's update (fall to early winter 2013):

The patient was diagnosed as rheumatoid arthritis during her first presentation to PCMS (at the time of Final MBBS University exams Spring 2013) and radiology of her hands revealed significant erosions. She was started on DMARDs (Methotrexate and Chloroquin) along with bridge therapy with prednisolone. Although the prednisolone was stopped on her subsequent prescriptions (last she was seen here twice on summer of 2013) and currently it seems she is still on prednisolone and examination reveals acneiform lesions and facial swelling suggestive of iatrogenic Cushing's. This time her steroids were put on a tapering dose again and she was counseled on regular follow up (and this web based record was created to facilitate the same). She was continued on her earlier DMARDs and NSAIDs sos.

Prescriptions pasted below:

(Fall to winter 2013)

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