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Do not Diagnose Fibromyalgia in ‘Three’ Types of Patients
O P Kapoor
 

Fibromyalgia syndrome is extremely common in private practice. These patients have multiple symptoms involving many systems of the body. These patients are never satisfied with any treatment. There is all the more reason, why a wrong diagnosis should not be made.

Do not diagnose fibromyalgia in the following ‘3’ types of patients:

  1. Do not diagnose fibromyalgia, if the patient is very young, especially below 20 years of age.
  2. Never diagnose fibromyalgia, if ESR is significantly increased (greater than 35-40 mm at the end of 1 hour).
  3. If a patient cannot afford to spend for all the investigations including CBC, ESR, CRP, TSH, Serum Calcium, Alkaline Phosphatase, Vitamin D3 levels, PTH, ANA, HIV, Rheumatoid factor, ASO Titre, HBsAg, Anti HCV, etc., never diagnose Fibromyalgia syndrome.
 

COMPLEMENTARY MEDICINE MUST PROVE ITS WORTH

Complementary and alternative therapies should be required to demonstrate their clinical effectiveness to the same standard as conventional medical treatments, says a new report from the US Institute of Medicine.

“Since 1990 the growth in the use of complementary and alternative medicine by the public has been dramatic”.

But the use of complementary and alternative therapies should depend on whether they are safe and effective, and this mandates their evaluation.

The report recommends a priority system to determine which therapies to evaluate.

BMJ, 2005; 330 : 166.

MALARIA AND HIV-1 PROGRESSION

HIV-infected people are more likely to have symptoms of malaria and to have higher parasite densities than those without HIV infection’

An increase in HIV viral load in blood has been associated with accelerated disease progression and increased transmission of infection. James Kublin and colleagues did a prospective study in Malawi to assess the effect of malaria on concentrations of HIV in blood. Their findings show that the concentration of HIV-1-RNA increases significantly with malaria, and these levels can be reversed with adequate anti-malarial treatment. In a Comment paper, James Whitworth and Kirsten Hewitt discuss the public-health implications of these findings.

BMJ, 2004; 196, 233.