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I am Pinki Sanjay Kumar. I was undergoing through Post Streptococal reactive artharitis under Doctor Bimlesh Pandey. I am continuing medicine since July 17 2014. Earlier i was having pain in right hand shoulder and elbow. Now I have pain in left hand elbow also. I have consulted one Rhematologist who has recommended for blood test, result is expected within two weeks. Please advice me any change in medicine is required what i am taking presently. I have attached my complete report for your reference.

Category: Rheumatologist

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Category: Internal Medicine Specialist
Dr. Bimlesh Dhar Pandey is online now

Expert:  Dr. Bimlesh Dhar Pandey replied 4 Days.

Thank you for your query at DoctorSpring.com
Kindly revert back with ESR, CRP, Blood culture 3 samples to be taken from three sites each at interval of 1 hour, ASO titres and Repeat ECHO.
Your reactive arthritis is unique in a way that you also have abnormality of mitral leaflet and ASD.
Please take naprosyn 500 mg twice a day.
After the culture samples have been taken please start ZOCEF CV 500 twice a day for 5 days.
Continue your previous treatment till reports are available and revert back

Patient replied :

Dear Doctor saheb Here she got blood test for ANA, SSB, came normal while ESR is 62 and CRP-32, CBC LEVER ENZYMES AND CREATININE are fine Regards Sanjay

Expert:  Dr. Bimlesh Dhar Pandey replied 3 Days.

Thanks for getting the investigation. what is the present echo report vis a vis last echo?
Kindly send both the old and the new echo reports, for comparison sake.
For the time being continue the same medicines.

Patient replied :

Dear Doctor Saheb, I have undergone through Echo test, Please find attached both report for reference. Presently I feel better now. Now i am having minor pain in right hand only not taking any pain killer. I am taking medicine as follows - 1. DAFF 6 MG alternate days
2. IROBISH daily one tablet
3. VRX Gold Q10 daily one tablet
4. HCQ 200 daily one tablet
5. Folictrax 15 MG Weekly
6. Folic acid Weekly
I would like to know whether any change in medicine is required. I have taken appointment in Hammad Hospital for cardiac issues.
Regards Pinki

Expert:  Dr. Bimlesh Dhar Pandey replied 2 Days.

The report is fine, there is no vegetation, I am relieved.
Please continue the same medicine nothing serious and i am convinced that there is no vegetation.
Get in touch with ESR, CRP, CBC, LFT every month

Dr. Bimlesh Dhar Pandey
Category: Internal Medicine Specialist
Senior Residency: Rhematology, All India Institute of Medical Schiences, New Delhi, 2009
Post Graduate, Junior Residency: MD (Internal Medicine), Rajendra Institute of Medical Sciences, Jharkhand, 2006
Residency: Physiology, Institute of Medical Science, Banaras Hindu University, Varanasi, 2003
Internship: Government Medical College, Trichur, 2001
Medical School: MBBS, Calicut University, 2001
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