Karnataka is suffering from an acute shortage of rheumatologists, leading to delayed diagnosis for patients suffering from crippling diseases like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus and vasculitis, with many of them being forced to travel long distances to avail of medical treatment. This was said by renowned specialists in rheumatology on occasion of the launch of Institute of Rheumatology and Clinical Immunology at Vikram Hospital, Bengaluru.
Said Dr. BG Dharmanand, Consultant Rheumatologist, Vikram Hospital, Bengaluru: “There are only 32 rheumatologists in Karnataka, out of which around 25 are based in Bengaluru. Children also suffer from arthritis and other rheumatological conditions, but there are only five pediatric rheumatologists in the entire state, three of whom are in Bengaluru. As a result, patient load is huge for rheumatologists and patients have to book days in advance for an appointment. Due to the dearth of trained specialists and investigation facilities, diagnosis of rheumatological diseases also gets delayed in majority of cases.”
Explaining the rationale behind setting up the new Institute of Rheumatology & Clinical Immunology, Dr. Somesh Mittal, CEO, Vikram Hospital, Bengaluru, said: “Karnataka does not have many training opportunities for medical specialists to learn rheumatology. This Institute, the first of its kind in the state, intends to bring senior rheumatologists under one umbrella to facilitate proper treatment for patients with rheumatological diseases. The aim is build a center of excellence in managing rheumatological diseases. Also, we intend to train the next generation of doctors in rheumatology through fellowship programs, so that they can confidently practice in different parts of the state. Another objective of the Institute is to promote rheumatology clinical research since there is very less data about rheumatological disease in Karnataka.”
Rheumatological diseases are not restricted to the joints. They are systemic inflammatory diseases which can affect any part of the body, including kidney, heart and even the nervous system. With early diagnosis and appropriate treatment, damage to vital organs can be prevented along with consequent death. Said Dr. Ramesh Jois, Consultant Rheumatologist, Vikram Hospital, Bengaluru: “About 80 percent of all rheumatological patients are women, who usually fall in the child-bearing age. These diseases do not spare children too. These are chronic disorders and long-term care is required. With increasing population in cities, we are now seeing more and more people falling to rheumatological diseases like arthritis. Early diagnosis is essential to being treatment as soon as possible and prevent damage to the body.”
Though there may not be a direct environmental risk factor, rheumatological diseases tend to occur following an environmental insult such as a viral infection, in a genetically predisposed individual. Diseases like rheumatoid arthritis and psoriatic arthritis usually cause severe pain, swelling and loss of function in various joints. If left untreated, they can result in permanent joint damage. Diseases like lupus and vasculitis can cause minor symptoms such as skin rash, joint pain, hair loss or mouth ulcers. However, it can also affect major organs of the body such as kidney, lungs, nervous system and heart.
Said Dr. BG Dharmanand, Consultant Rheumatologist, Vikram Hospital, Bengaluru: “With the advancement of science and better understanding of rheumatological diseases, their treatment has significantly changed in recent years. Pain control was the main objective in the past whereas now the goal post has moved to disease control and prolonging life without major organ damage. There have been many breakthroughs in the treatment of these diseases, such as the advent of biologic drugs which have reduced the need for administering steroids and painkillers. Safer drugs are now available with lesser side effects. These effectively control the disease and help in a patient’s long-term therapy.”