Q: My wife, 34 years old, is having arthritis from last 2 years. She is taking Delson (steroid) 10 mg daily since a year. Now, she is vomiting everyday since last 3 months. She has taken medicines for this but of no use. Her weight has reduced to 64 Kg from 79 Kg in 9 months. Most of the tests she has got done are normal except Rh factor is positive. What do we do?

A:Rh factor has nothing to do with arthritis. Arthritis means inflammation of joints. Thus it is a symptom and not a diagnosis. There are many types of arthritis such as rheumatoid arthritis, gouty arthritis, osteoarthritis, etc. I presume your wife is suffering from rheumatoid arthritis. In this disorder, there is atrophy of muscles leading to loss of weight. You have not given the results of blood tests such as RA factor, ESR, serum gammaglobulin, Hb, serum folate, serum ANA, serum CRP etc. Without such tests it is not possible to diagnose the specific arthritis. Depending on the stage and response, there are many treatments of RA. Generally aspirin is the initial drug. Other therapies for pain relief include an NSAID such as diclofenac (e.g. Doflex) one tablet 2-3 times daily. One can also use Disease Modifying drugs such as methotrexate (sold as Biotrexate) or hydroxychloroquin. Low dose prednisolone (Wysolone) 5-10 mg is also used. Anti-cytokine agents, such as infliximab, are also useful. However, these treatments have to be taken under close medical supervision, provided a firm diagnosis of Rheumatoid arthritis has been made. Delsone is the brand name, which contains prednisolone. The brand does not appear on the national or international databank of quality products.