M.SARIM SHAFIQUE BPD01093173

5TH CUNIVERSITY OF LHR.

TOPIC I AM GOING TO PRESENT IS :

GOUT

DISEASE OF KINGS/GOUT :

GOUT GOUT is a result of prolonged, untreated and high uric acid level in the bloodstream. The condition is also referred to as the 'Disease of Kings' or the 'Rich Man's Disease’Mostly observed in the men but also affects women with menopause and other body parts or joints as well.

CHARACTERIZED BY:

It is accompanied by fever, intense joint pain and inflammation of the tissues , in and around the affected joint. Gout attacks the big toe, heel, ankle, wrist, knee , fingers, elbow and/or the spine. There have been cases where the condition has arisen out of immobility caused to joints due to a previous injury. Similarly , hyperuricemia patients also develop tophi or uric acid crystal deposits in tissues such as observed in the pinnae of the ear.

Different joints that may be involve in gout. But at a time only one joint is involve in gout.

The most common joint involve is METATARSOPHALANGIAL

JOINT OF BIG TOE.

EFFECT ON JOINT ..

REASONS :PRIMARY REASONS/GOUT:

Primary gout is due to the high level of uric acid in blood that is hyperuricemia which may be due to kidney problem and /or intake of protien-rich food(purine rich food) , alcohol and/or other herediatry factors causes obesity , diabetes, hypertension and heart diseases.

PURINE RICH FOODS ARE ..

PURINE CATABOLISM TO URIC ACID:

REASONS :

SECONDRY REASONS/GOUT:

That arise from other medical conditions like metabolic syndrome and blood cancer or leukemia.Diuretics can also cause gout.

MECHANISM OF DISEASE …

1..In human, sodium urate is the end product of purine metabolism.

2.Deposition of urate crystals initiates an

inflammatory process.

3.Granulocytes phagocytize urate

crystals , lysosomal enzyme evoke an

inflammatory response.

4.Production of lactate in synovial fluid.

5.Local decrease in pH fosters further

deposition of urate crystals.

MECHANISM OF GOUT …

DIAGNOSIS : Gout is suspected when a patient reports a history of attacks of painful arthritis, particularly at the base of the toes. Ankles and knees are the next most commonly involved joints in gout. Gout usually attacks one joint at a time .

TESTS FOR GOUT …

  .

The most reliable test for gout is finding uric acid crystals in a sample of

the joint by joint aspiration.

Microscopic analysis of uric acid crystals ….

X-RAY image analysis…

BLOOD URIC ACID LEVEL ..

Normally the blood uric acid level is less than 6.8mg/dL.

TESTS FOR GOUT ..

And the other test which also help to diagnose gout is

BLOOD URIC ACID LEVEL ..

Normally the blood uric acid level is less than 6.8mg/dL . .

TREATMENT :HOME REMEDIES FOR

GOUT .

TREATMENT :FOODS TO BE AVOIDED IN GOUT

.

DRUGS ACTION TO DECREASEHYPERUR-ICEMIA :

AND THAT DRUGS ARE ..

1.URICOSTATICS:

2.URICOLYTICS:

3.URICOSURICS:

E.G .. Allopurinol

E.G .. Febuxostat

E.G .. Probenecid , Sulfinpyrazone

DRUGS TO REDUCE INFLAMMATION ARE:

1.COLCHICINE: Inhibit leukocytes migration to joints .

2. NSAID’S :Like Indomethacin, Mefenamic Acid