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PATIENT DEMOGRAPHIC DETAILS:-

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SOAP ANALYSIS:-

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 LAB INVESTIGATION:-
COMPONENT RESULT REFERENCE

HEAMOGLOBIN 11.3mg/dl 12-15

TOTAL WBC 11700cells/mm3 4000-10000

RBC 3.5millions/mm3 3.8-4.8

HCT 33% 36-46

PLATELETS 3lakhs/mm3 1.5-4.1

MCV 80fl 83-101

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  DIAGNOSIS:-

Parameter Result Reference

Rheumatoid 40 20U/ml
factor

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  X-ray
 MRI
 USG
 ECG
 RENAL FUNCTION TEST
 LIVER FUNCTION TEST
 LUNG FUNCTION TEST

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ASSESSMENT:-
 From the subjective and objective
evidence, it is conformed that the patient
is suffering from the RHEUMATOID
ARTHRITIS

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  RHEUMATOID ARTHRITIS:-
Rheumatoid arthritis is a chronic
inflammatory disease characterized by symmetric
polyarthritis and joint changes, including erythema,
effusion, and tenderness.

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 TREATMENT:-

DRUG GENERIC NAME CATEGORY DOSE FREQ D1 D2

SALAZOP SALFASALAZINE METHOTRE 500mg BD + +

YRIN EN ATE

DICLOFE ANALGESIC 50mg TID + +

NAC

DOLO PARACETAMOL ANTIPYRET 1g QID + +

IC

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Planning-
 Salazopyrin- salicylic acid moiety
release is absorbed and has anti-
inflammatory action
 Adr's-Nausea, vomiting, rashes, liver
dysfunction

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PATIENT COUNSELLING
 Heat must be applied at the site of
inflammation with the help of moist heat
packs
 Regular exercise
 Cold ïs applied at the joints whïch
reĺieves pain
 Broccoĺi, sprouts, garlic should be taken
 Red meat sugars, alcohoĺ, processed
foods should be avoided.
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