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- Rheumatoid arthritis.
- Rhinitis.
- Rubella.
Rheumatoid arthritis
Rheumatoid arthritis is due to an abnormal reaction of the body's immune system to the joints. It can also
attack other parts of the body like the muscles, lungs, skin, blood vessels, nerves and eyes. It is most
commonly seen in people between the ages of 40 and 60, especially in women.
Which joints are affected?
Rheumatoid arthritis often affects the small joints, especially of the wrists, hands and feet. It causes pain,
stiffness and swelling which is worst in the morning. Later, other joints like the shoulders, elbows, hips, knees
and ankles may also be involved. The affected person may find difficulty in gripping eating utensils, turning taps,
dressing or writing.
What is the Treatment?
Occupational Therapy and Physiotherapy: Occupational therapy and physiotherapy help to improve your
ability to function independently. Your occupational therapist can teach you how to use specially designed tools like
large-handled spoons to carry out your daily activities.
Heat/Cold Treatment and Medication: For stiff joints, warm water or a heating pad can help. With a hot, painful joint,
cold packs or water may be better. Treatment for rheumatoid arthritis involves taking medicines which reduce the pain and
swelling of the joints. Other medicines to slow down the progress of the disease may be added later.
Surgery: In the later stages, surgery may be needed to repair and replace badly damaged joints.
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Rhinitis
Rhinitis describes a condition which consists of a group of symptoms that include a runny nose, itchiness and sneezing,
that are caused by irritation and congestion in the nose. Excessive exposure to environmental irritants e.g. cigarette
smoke, chemicals, changes in temperature, exercise and stress may provoke symptoms of rhinitis in persons who are susceptible
such as those who have allergies or abnormalities of the nose e.g. a deviated septum.
When symptoms last less than six weeks, it is described as acute rhinitis and is usually brought about by a cold or other infection.
Chronic rhinitis persists for a longer period and is usually caused by allergies, chronic infection and structural abnormalities.
Chronic Rhinitis:
Allergic and non-allergic rhinitis is the cause of chronic rhinitis.
Allergic Rhinitis: An allergic response occurs when there is over response of the immune system (overproduction of antibody IgE)
to specific non-infectious particles (antigen) e.g pollen, moulds, house dust mites, animal dander, chemicals, foods, etc. These
antibodies attaches to mast cells found in the skin, lungs and mucous membrane. The mast cells release histamines which causes
dilation of blood vessels, redness of skin and swollen membranes. When this occurs in the nose, the symptoms of allergic rhinitis
is manifested.
Allergic rhinitis could be seasonal or perennial (year round). Seasonal rhinitis is due to pollen or mould spores. Perennial rhinitis
are due to allergens such as house dust mites, animal dander or moulds found on carpets or furniture upholstery.
Non-allergic rhinitis: can also be triggered by cigarette smoke and many other air pollutants, strong odours, exposure to cold and
alcohol. Smoking and air pollution may also cause symptoms by damaging the cilia (hair cells) which moves mucus through the air passages.
Vasomotor rhinitis: (Idiopathic/irritant rhinitis) occurs as a result of a response of the nasal membrane to irritants such as smoke,
changes in temperature and stress. Other causes of chronic rhinitis are blockage in the nose e.g. nasal polyps, enlarged adenoids and a
deviated septum that impede mucus drainage and restrict air flow.
Medications can cause rhinitis or worsen it in people with allergies, vasomotor rhinitis or a deviated septum. Prolonged use of nasal
decongestants can worsen rhinitis. Some blood pressure medications such as beta blockers and vasodilators can cause rhinitis.
Hormonal changes in pregnancy cause "Rhinitis in Pregnancy". The expecting mother will recover once the baby is delivered.
Prevention/Treatment:
Avoidance of allergens is the best treatment. Complete avoidance of environmental allergens may be impossible but it can be
minimised for example removing carpets and pets.
Anti-histamines provide good relief for mild to moderate symptoms. Newer antihistamines that are long-acting and less likely to
cause drowsiness have been found to be useful. Decongestants may also be helpful in reducing symptoms such as nasal congestion.
Corticosteroids in the form of nasal spray reduce the immune response and may be prescribed to reduce severe symptoms. Nasal polyps,
enlarged adenoids and deviated septums can be corrected with surgery.
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Rubella
Rubella is a disease caused by a virus that is spread through the air or by close contact. It can also be transmitted to a foetus by a
mother with an active infection. The disease is usually mild and may even go unnoticed.
Children may have few symptoms, but adults may experience a prodrome (warning symptom) of a fever, headache, malaise, runny nose, and inflamed
eyes, that lasts from 1 to 5 days before the rash appears. A person can transmit the disease from 1 week before the onset of the rash until 1
week after the rash disappears. Lifelong immunity to the disease follows infection.
The disease is potentially serious because of its ability to produce defects in a developing foetus if the mother is infected during early pregnancy.
As many as 10 to 15% of women in their childbearing years are susceptible to infection. Congenital rubella syndrome occurs in 25% or more of infants
born to women who acquired rubella during the first trimester of pregnancy.
Defects are rare if the infection occurs after the 20th week of pregnancy. One or more defects may occur in an infected foetus and include deafness,
cataracts, microcephaly, mental retardation, congenital heart defects, and other defects. A miscarriage or stillbirth may occur. Risk factors include
lack of immunization and exposure to an active case of rubella.
Symptoms:
A child with rubella may not look or act sick, but symptoms may include:
- A low-grade fever and swollen glands behind the ears and at the back and sides of the neck.
- Loss of appetite, irritability, loss of interest in personal care.
- Rash, which appears in only about half the cases of rubella. When it does appear, it starts on the
face and torso and spreads to the arms and legs, lasting 3 to 5 days.
- Rare complications, such as joint pain and arthritis (more common in adult women).
Treatment:
Your child should stay at home while sick or up to a week after the rash disappears.
Conventional Medicine: No medical treatment of a child with rubella is required. If you are pregnant and are exposed to rubella, you should contact
your doctor immediately. The risk of birth defects is higher the earlier the exposure occurred in your pregnancy. In some cases, your doctor may advise
you to consider a therapeutic termination of your pregnancy.
At Home Care: Keep your child quiet, especially if she has a fever; confinement to bed is not necessary. Children should be kept at home while any
rash is visible and for a week thereafter. Cool sponging will help relieve fever and discomfort from a rash. An acetaminophen-based pain reliever may
also help.
Pregnancy Concerns:
If you are pregnant, and uncertain of your immunity to rubella, and suspect you have been exposed, contact your doctor immediately. There is a risk the
virus can be passed to your unborn child. If your child has rubella, notify any at-risk individuals who have had contact with your child during the illness
and up to 10 days before symptoms appeared, so they can seek appropriate care.
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