Rheumatology
What is Rheumatology/संधिवात?
Rheumatology/संधिवात is a complex branch of internal medicine, about which only a few are aware that joint disorders require special consultation preferably with Rheumatologists.
Rheumatology is a branch dedicated to the study of diseases of the joints, muscles and connective tissues. Just as many causes of fever such as cough, diarrhoea, and tuberculosis, there are hundreds of causes for pain and inflammation in the joints. Rheumatic or muscles – skeletal diseases – in simple terms, have many reasons. The science of finding out the reason and then investigating and treating such conditions is Rheumatology. Rheumatology is a relatively new branch. Diseases such as Rheumatoid arthritis, lupus, gout, osteoporosis, fibromyalgia are not even heard of by many people. Due to lack of knowledge in this field, till recently, patients with Rheumatic diseases were treated only with painkillers or steroids. As a result patients were either mislead, took improper treatment, fell prey to quacks or kept taking toxic over-the-counter medicines. In the bargain they suffered many complications and led a very poor quality of life. However, with proper Rheumatological treatment and care, these patients are leading a healthier, happier and pain free life. There are about 200 joints in the body and there are multiple causes for the pain and swelling of joints. Rheumatoid arthritis is a prototype of Rheumatological diseases, affecting a large population. In India approximately 1-2% i.e. millions suffer from this disease. Though it can affect any age, it targets mainly the prime of life, the young and the middle-aged being largely affected. Women are most affected. It can be hereditary. It is a long-term disease which causes inflammation of joint and over time, these joints may lose their range of motion, unable to act and eventually cause permanent deformities. It mainly affects the wrists, fingers, knees, feet and toes. In extreme situations, patients are unable to do their daily chores of life such as combing hair, buttoning their own clothes, holding onto anything or even moving around. Apart from the extreme pain, they get dependant on others for their daily activities. In short, life becomes worse than death. No wonder, these patients go into severe depression. With timely diagnosis and Rheumatologic treatment, these problems can be prevented and treated. Thus, a Rheumatologist improves quality of life of patients suffering from these Rheumatologic diseases.
Who is a Rheumatologist?
A Rheumatologist is a medical doctor who is a physician and has then undergone training to specialize in Rheumatology. Rheumatologist deals mainly with clinical problems involving joints, soft tissues, autoimmune diseases, vasculitis and heritable connective tissue disorder. He is skilled to diagnose, and treat the signs and symptoms properly. Whereas an Orthopaedic consultant deals with surgical problems of bones and joints, Rheumatologists treat many of these diseases medically.
What conditions does a Rheumatologist treat?
Arthritis-There are many forms of arthritis, which affect various joints of the body. Rheumatoid Arthritis typically manifests with pain and swelling of the affected joints. The joints and limbs are stiff particularly early in the morning, and become painful following prolonged inactivity. It can be a disabling and painful condition which can lead to substantial loss of function and mobility if not adequately treated. Some other common forms of arthritis are Osteoarthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Gout and Reactive Arthritis.
Autoimmune diseases-autoimmune diseases are diseases where the body’s immune system fights against itself. It is a situation similar to where a guard is kept protecting the property and attacks its owner and inflicts damage on him. Common autoimmune diseases are Lupus (SLE), Dermatomyositis, Polymyositis, Giant cell Arteritis (Temporal Arteritis), Wegener’s Granulomatosis, Vasculitis, Behcet’s disease, etc. soft tissue disease Such as fibromyalgia, chronic fatigue syndrome, metabolic muscle diseases, muscle pains and other related disorders. Infection of joints. Osteoporosis- This causes the bones to become brittle and break (fracture) easily. There are multiple causes for this condition, but the result is a fractured bone. Fracture of spine or hip can result from a minor fall or trauma. This can result in severe pain, disability and eventually dependence on others for the activities of daily living. About 20% of these patients die within a year after a fracture. Whereas an orthopaedic surgeon fixes a fractured bone, Rheumatologist strengthens the bones to prevent further fractures.
Metabolic bone diseases- Can result from various reasons such as vitamin deficiency, calcium deficiency, parathormone problems, some medications and kidney diseases. Dr. Praveen Jadhav is Rheumatologist In Nashik
Dr. Jadhav achieved the prestigious European School of Rheumatology (EULAR) Certification in 2016.
Cardiovascular disease refers to diseases of heart and blood vessels, including coronary artery disease (angina and heart attacks), heart valve disorders, abnormal heart rhythms (arrhythmias), and heart conditions present at birth (congenital heart disease), congestive heart failure and other heart conditions. Most of the heart diseases can be life threatening and can cause premature death. Prevention is the most important treatment of heart diseases. Heart diseases, especially heart attacks can be prevented if you’re evaluated early.
We, at Omkar, stress on prevention of heart diseases. We have consultations and programs to check your heart, analyze the risk and treat so. Obviously, the risk of a cardiac event is different for each individual and calculated by various evaluated parameters. In general, you may prevent or improve your heart disease if you exercise, eat a healthy diet, quit smoking, maintain your blood pressure, regulate the cholesterol levels, and maintain a healthy weight. Read more about heart care in the individual programs.
We do treat various Cardiac Ailments, and have all the facilities for the same. However, the focus is more on preventing heart disease if you don’t have one (primary prevention) or prevent progression of heart problems if you have one (secondary prevention). Very soon we will be starting exercise, yoga and stress management programs for primary and secondary prevention of heart diseases.
Diagnostics
With the view of providing comprehensive care under one roof we established facility of Omkar Diagnostics around the same time. Various facilities such as pathological laboratory, X-ray, DXA scan, Echocardiography machine, etc. were added to the armamentarium. Due to background knowledge of attending doctors in the fields of medicine, surgery, cardiology, and Rheumatology, Omkar Diagnostics became a one-stop-shop for all diagnostic needs. Patients seeking consultation and treatment for Rheumatology, cardiac and surgical diseases find it very convenient to get all the facilities under one roof. Not only has it become popular in evaluation of cardiac, Rheumatological and surgical ailments, but also a popular cntre for evaluation of the health of people for insurance purposes. Currently, LIC, HDFC, ICICI, and others are associated with Omkar Diagnostics in evaluating their insurance patients. It is quite obvious that thorough honesty, accuracy in testing, regular quality checks, latest equipment and regular updates are responsible for patients, drug companies and insurance companies reposing their faith in Omkar Diagnostics alike.
Two dimensional echocardiography and Colour Doppler
(2D echo or echo)
An echocardiogram is a test in which ultrasound is used to examine the heart. Colour Doppler is an imaging technique which is used to provide visualization of the blood flow through the heart chambers. This test can be performed in a hospital or clinic as an outpatient procedure.
Cardiac Stress Testing (Treadmill testing, TMT)
It is an important test to evaluate the blood supply to the heart. Many times, there are no symptoms of cardiac disease such as chest pain at rest. This is because the blockage in the coronary circulation could be insufficient to cause disturbance in the blood supply at rest. Stress testing provides information about how your heart works and receives its blood supply during physical stress i.e. a state of increased demand.
Ambulatory Blood Pressure Monitoring (ABPM)
Blood pressure recording outside of the doctor’s office is recommended in most people who are suspected of having high blood pressure. This is because readings taken while people are going about their daily lives are more accurate than those taken in a doctor’s office.
Laboratory facility
Evaluation of pathology in blood, sputum and urine is an important aspect in diagnosing and managing any medical problem. The laboratory at Omkar is equipped with facilities to perform all tests that are required for diagnosis of Rheumatologic, cardiac or for that matter any medical disease. It is available round the clock for indoor patients and during office hours for out door patients.
Bone Mineral Densitometry (BMD or DXA scanning)
Bone density (or bone mineral density) is a medical term normally referring to the amount of mineral matter per square centimetre of bones. Bone density (or BMD) is used in clinical medicine as an indirect indicator of osteoporosis and fracture risk. Determining a person BMD helps a doctor decide if a person is at increased risk for osteoporosis related fracture. Osteoporosis is a “silent” disease, often not showing any warning signs until fractures occur. One in two women and one in five men over the age of 65 will develop fractures due to osteoporosis. The risk of woman getting a hip fracture is equal to the risk of breast, uterine and ovarian cancer combined. Left untreated, osteoporosis could result in pain, disfigurement, disability, loss of independence and even death.
Pulmonary function test
Pulmonary function tests are a group of tests that measure how well the lungs take in and release air and how well they move gases such as oxygen from the atmosphere into the body’s circulation.
Digital X-Ray
Digital X-ray is the oldest and most frequently used form of medical imaging. X-rays can produce diagnostic images of the human body that allow doctors to view and assess bones and soft tissues. Using Digital X-Ray (computed radiography) rather than the traditional film (conventional radiography), allows for:
* 90% less radiation exposure
* Faster X-Ray time for a patient
* Enhanced image quality with greater detail and ability for image manipulation
* A patient’s image can be transferred very easily to a referring doctor and may be stored indefinitely
Dr. Meera Jadhav, the other director of Omkar Healthcare is a qualified surgeon having trained at the prestigious K.E.M. and Sion Hospitals in Mumbai. She has been practising since 1996 in the area. She also learnt about the state of art skills in various surgeries when she spent a few years as an observer at the Deaconess Hospital in Boston. Being one of the very few women surgeons in Nashik, she has many of female patients who present with medical conditions. Her areas of interest include perianal surgeries and day care surgeries.