Psoriatic arthritis is a chronic, systemic inflammatory disorder. It has been classified in spondyloarthropathies group which shares clinical, radiologic, serologic features, familial and genetic relationship. Up to 5-30% of patients with psoriasis may go on to develop psoriatic arthritis, usually within 5-10 years. Adalimumab (ADA) is the first human monoclonal antibody against TNF-α. ADA is a biologic agent effective in both skin lesions and joint signs. Anti-TNF agents are powerful immunmodulating drugs with potentially side effects. Our (...) case is 38 years old woman complaining about swelling and pain in hand joints. In physical examination she has asymmetrical arthritis in wrist, proximal (PIP) and distal interphalangeal (DIP) hand joints and right knee joint. In laboratory; sedimentation rate: 80 mm/h, C-reactive protein: 17 mg/l, rheumatoid factor (RF): 8.7 IU/ml and HLA B27 was positive. Radiologically, erosions and narrowing were determined in PIP and DIP hand joints and grade 3 sacroiliitis bilaterally. In clinical monitoring, psoriaform lesions progressed in her scalp, so we diagnosed psoriatic artritis. We started ADA therapy 40 mg subcutaneously every two weeks. She developed periorbital infection in left-sided in tertiary month following. Streptococcal proliferation was seen in lesion culture, so we began amoxicillin-clavulanate therapy. She benefit antibiotic therapy, infectious signs regressed. ADA therapy discontinued, instead of it, etanercept 50 mg twice weekly subcutaneous and methylprednisolone 12 mg/daily oral therapy is started. We purposed to declare our case with literature selection. (shrink)

Background: Arthritis is very common but is not well understood. Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. People of all ages, sexes and races can and do have arthritis, and it is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of (...) class='Hi'>arthritis. It is most common among women and occurs more frequently as people get older. Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints. Objectives: The main goal of this expert system is to get the appropriate diagnosis of disease and the correct treatment and give the appropriate method of treatment through several tips that concern the disease and how to treat it and we will see it through the application on the expert system. Methods: in this paper the design of the proposed Expert System which was produced to help Orthopedist in diagnosing Arthritis disease through its symptoms such as: pain on pressure in a joint , Inflammation indicated by joint swelling, Stiffness especially in the morning , Loss of flexibility of joint, Limited, joint movement, Deformity of the joints , Weight loss and fatigue , Non-specific fever and Crepitus. The proposed expert system presents an overview about Arthritis disease is given, the cause of diseases is outlined and the treatment of disease whenever possible is given out. SL5 Object Expert System language was used for designing and implementing the proposed expert system. Results: The proposed Arthritis disease diagnosis expert system was evaluated by Orthopedics students and they were satisfied with its performance. Conclusions: The Proposed expert system is very useful for Orthopedist, patients with arthritis and newly graduated Orthopedics students. (shrink)

Tyler Burge's (1979) famous thought experiment concerning 'arthritis' is commonly assumed to show that all ascriptions of content to beliefs and other attitudes are dependent for their truth upon facts about the agent's social and linguistic environment. It is also commonly claimed that Burge's argument shows that Putnam's (1975) result regarding natural kind terms applies to all general terms whatever, and hence shows that all such terms have wide meanings.1 But I wish to show here, first, that neither Burge's (...) initial thought experiment nor a second type of example that Burge describes supports either of these conclusions. Second, I will identify the proper conclusion to draw from Burge's discussion and show that this conclusion does not really pose a serious problem for individualism about the mental. And finally, I will argue that Burge's discussion does not in fact provide a conclusive reason for believing its proper conclusion. (shrink)

Systemic juvenile idiopathic arthritis is classified as an autoimmune entity and a subtype of juvenile idiopathic arthritis, although it has many features of autoinflammatory-type of diseases. This review article will elaborate on the disease’s pathogenesis and its proposed relation to autoinflammatory diseases including defective innate immunity and phagocytosis response leading excessive cytokine release. It also explains the disease’s epidemiology, clinical phenotype, diagnostic challenges, complications and current advancements in the treatment of systemic juvenile idiopathic arthritis, such as IL-1 (...) and IL-6 antagonists and their impact on the disease trajectory. Care of patients with systemic juvenile idiopathic arthritis requires a comprehensive multidisciplinary team to optimize the care and avoid complications of the disease itself such as growth impairment, macrophage activation syndrome or the complications of immunosuppressant and immunomodulatory treatments. (shrink)

I suggest a solution to a conflict between semantic internalism – according to which the concepts one expresses are determined by one's use of representations – and publicity – according to which, if two subjects successfully communicate or are in genuine agreement, then they entertain thoughts constituted by the same concepts. My solution rests on the thesis that there can be successful communication and genuine agreement between thinkers employing distinct concepts as long as there is a certain relation (of conceptually (...) guaranteed sameness of extension) between them. In section 2, I motivate semantic internalism and show how it conflicts with publicity. In section 3, I carve the logical space of possible solutions to the conflict into liberal and conservative solutions. Section 4 assesses Wikforss's conservative solution to Burge's arthritis thought‐experiment and concludes that it fails for more than one reason. Section 5 introduces a new case study involving a deferential concept. This case serves as the backdrop for my positive account offered in section 6. The conclusion of the article is preceded by a comparison of my view with another recently proposed by Recanati (section 7) and some replies to possible objections (section 8). (shrink)

Brandom (Citation1994) made inferentialism an intensely debated idea in the philosophy of language in the last three decades. Inferentialism is a view that associates the meaning of linguistic expression with the role said expression plays in inferences. It seems rather uncontroversial that the correct theory of meaning should distinguish between linguistic correctness and factual correctness. For instance, speaker S can be wrong in saying ‘I have arthritis’ in two distinct ways: (i) S fails to apply a word correctly to (...) make a true statement due to having made a factual error, and (ii) S uses an expression incorrectly because they are wrong about its meaning. In this paper, I show that properly understood normative inferentialism can make room for such a distinction. I propose that linguistic correctness is a structural issue: linguistic mistakes stem from the improper or insufficient acquisition of an inferential role. Factual correctness, on the other hand, is a one-off issue of the correct application of inferential rules to a particular situation. I argue that, by tying the issue of correctness to the game of giving and asking for reasons, inferentialism can establish a reliable method for distinguishing between two types of correctness (and mistakes). (shrink)

Objective: To determine the prevalence of the accessory sacroiliac joint (ASIJ) on both computed tomography (CT) images and dry bones and ultimately, to contribute to the literature. -/- Materials and Methods: CT images archived in the Radiology department of Gaziantep University Medical Faculty obtained from 145 individuals (104 males and 41 females) as well as 92 sacral bones were examined. -/- Results: The prevalence of ASIJ among 92 sacral bones was 15.2%. The ASIJ was more commonly (52%) located at the (...) posterior portion of the SIJ at the level of the second dorsal sacral foramen. In 48% of the bones, ASIJ was identified just above the first dorsal sacral foramen. Unilateral ASIJ was observed in 10.8% and bilateral ASIJ in 4.4% of the sacral bones. On CT images, ASIJ was found in 7.8% of the males and 7.2% of the females. The total prevalence of sacroiliac joint variations was 28.9%, and 6.8% of them were ASIJs. -/- Conclusion: It should be kept in mind that ASIJ may be a source of arthritis and chronic hip pain. The presence of ASIJ should be sought through imaging studies for early diagnosis of ASIJ. (shrink)

Abstract: Background: The pineapple (A nanas comosus) is a tropical plant with an edible multiple fruit consisting of coalesced berries, also called pineapples, and the most economically significant plant in the Bromeliaceae family. Pineapples may be cultivated from a crown cutting of the fruit, possibly flowering in five to ten months and fruiting in the following six months.[5][6] Pineapples do not ripen significantly after harvest. In 2016, Costa Rica, Brazil, and the Philippines accounted for nearly one-third of the world's production (...) of pineapples.[8] Pineapple damage is not taken quickly, it can lead to damage in the Pineapple. Objectives: The main goal of this expert system is to get the appropriate diagnosis of disease and the correct treatment. Methods: In this paper the design of the proposed Expert System which was produced to help Fruits Agricultural Specialist in diagnosing many of the Pineapple diseases such as : Phytophthora heart (top) rot, Base (butt) rot or Fruit let core rot (green eye, Pineapple Sprain, Turf Toe, Pineapple disease , Plantar Fasciitis, Warts, Bunion, Rheumatoid Arthritis, Gout, Heel Spur, Athlete's Pineapple , The proposed expert system presents an overview about Pineapple diseases are given, the cause of diseases are outlined and the treatment of disease whenever possible is given out. CLIPS Expert System language was used for designing and implementing the proposed expert system. Results: The proposed Pineapple diseases diagnosis expert system was evaluated by Agricultural students and they were satisfied with its performance. Conclusions: The Proposed expert system is very useful for Fruits Agricultural Specialist, patients with Pineapple problem and newly graduated Agricultural Specialist. (shrink)

The public health crisis is started with emergence of new coronavirus on 11 February 2020 which triggered as coronavirus disease-2019 (COVID-19) pandemics. The causative agent in COVID-19 is made up of positively wrapped single-stranded RNA viruses ~ 30 kb in size. The epidemiology, clinical features, pathophysiology, and mode of transmission have been documented well in many studies, with additional clinical trials are running for several antiviral agents. The spreading potential of COVID-19 is faster than its two previous families, the severe (...) acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV). Apart from clinical manifestation, comorbid status is playing key role for prevalence of COVID-19 infection and mortalities. The comorbid effects associated with COVID-19 are diabetes, cardiovascular, digestive, hepatitis-B, cerebrovascular, hypertension, liver injury, coronary heart disease, cancer, rheumatoid arthritis, and neurological impairment. Antimalarial drugs (chloroquine and hydroxychloroquine), remdesivir, Tocilizumab, clopinavir/ritonavir, convalescent plasma therapy, spike protein-angiotensin-converting enzyme 2 (ACE2) inhibitors, human monoclonal antibodies, mRNA-1273, mesenchymal stem cells, Indian and Chinese traditional medicine, small molecules antioxidant, natural products and dietary supplements, high doses of vitamin-E, -C, -D, minerals, flavonoids,and IFN-beta are therapeutic intervention running to develop treatment against COVID-19. Although clinical usage of these therapeutic agents against COVID-19 is well documented, cytokine storms, absence of appropriate animal model have limited its therapeutic use. This review explores the clinical information currently available on COVID-19 on the mechanisms of infection, prevention, management, comorbid status, and current drug treatment options. (shrink)

Polymyalgia Rheumatica (PMR) presents with a broad spectrum of clinical manifestations and almost exclusively occurs in the population aged over 50 years. After rheumatoid arthritis, PMR is the second most common autoimmune rheumatic disorder. Visual loss is the most feared complication in temporal arteritis, and extracranial arteries. No specific laboratory parameter exists for diagnosis of PMR. Imaging techniques such as ultrasonography, MRI or F-fluorodeoxyglucose PET may be helpful in the diagnosis and evaluation of the extent of vascular involvement in (...) these diseases. This paper presets an expert system for classification criteria for PMR, recent advances of diagnostic and therapeutic procedures. This expert System was written using SL5 Object Expert System Language. (shrink)

In recent years, technology has evolved significantly to intervene in the treatment of diseases through diagnosis online before going to the specialist doctor, where it become possible for the patient to know the name of his illness, the specialist doctor who can treat him and the multiple treatment methods through specially designed systems called expert systems. The expert system is based on the principle of asking the user gradual questions about the symptoms he feels, leading him to the result of (...) diagnosing the illness, dealing with it quickly, and tips for permanent treatment. These systems may also help both trainee physicians and physiotherapists. This research paper is a living example of these effective applications, explaining in a simplified manner some of ankle diseases, how to deal with them and methods of physical therapy. The ankle is a small region in the leg. It is two joints, the first consist of three bones (tibia, fibula and talus underneath) which is called true ankle joint. The other is called subtalar joint have two bones: talus on top and calcaneus on the bottom. This tarsus between the end of the leg and the start of the foot facilitates the movement up-down and left-right with no problems in normal case, although, it needs a special case as Physiotherapist when gets injury. We have identified seven ankle diseases: Ankle Sprain, Fracture (of Fibula), Rheumatoid Arthritis, Rheumatoid Fever, Gout, and Osteoarthritis (Degenerative Joint) using SL5 Object Expert System Language in the work of the expert system. (shrink)

Semantic externalism Are the meanings of natural kind words, such as “water” or “tiger,” in the head or in the world? This question is pressing and controversial in contemporary philosophy. The nature of the meaning related to propositional contents and words of the natural kind raises a fundamental disagreement between two groups of philosophers: defenders of internalism and defenders of externalism. The two groups differ on how to define meaning. Internalists say that meaning is determined entirely by aspects that are (...) internal to the speaker, and mental contents are semantic contents that are in our minds or heads, their slogan is “Meanings are in the head or brain.” Externalists say that meaning is determined, at least in part, by aspects that are external to the speaker, and that contents are linguistic signs and exist in the outside world, and their slogan is “Meanings do not exist only in the head.” In this article, I want to shed explanatory light on this disagreement by examining its origins, explaining some of the arguments in support of externalism, and demonstrating the impact of this disagreement on understanding the nature of meaning. This article addresses several topics: 1. Various types of externalism 2. Description theory and causal theory 3. Hillary Betnam and Twin Earth thought experiment 4. Tyler Berg and arthritis argument 5. Donald Davidson and perceptual externalism 6. Andy Clark and David Chalmers: active externalism -/- هل معانى ألفاظ النوع الطبيعى، مثل "ماء" أو "نمر"، فى الرأس أم فى العالم؟ هذا السؤال ملح ومثير للجدل فى الفلسفة المعاصرة. فطبيعة المعنى المتعلق بالمضامين القضوية وألفاظ النوع الطبيعى يثير خلافًا أساسيًّا بين فريقين من الفلاسفة هم أصحاب النزعة الداخلية internalism وأصحاب النزعة الخارجية externalism. ويختلف الفريقان على كيفية تحديد المعنى. يقول الداخليون إن المعنى يتحدد كلية عن طريق جوانب تكون داخلية للمتكلم، والمضامين العقلية هى مضامين دلالية تكون فى عقولنا أو رؤوسنا، وشعارهم هو "المعانى توجد في الرأس أو المخ". ويقول الخارجيون إن المعنى يتحدد فى جانب منه على الأقل عن طريق جوانب تكون خارجية للمتكلم، والمضامين هى إشارات لغوية وتوجد فى العالم الخارجى، وشعارهم هو "المعانى لا توجد فى الرأس فقط". وأريد فى هذه المقالة أن ألقى ضوءًا شارحًا على هذا الخلاف، وذلك من خلال النظر فى أصوله، وشرح بعض الحجج المؤيدة للنزعة الخارجية، وبيان أثر هذا الخلاف فى فهم طبيعة المعنى. وتعالج هذه المقالة عدة موضوعات هي: 1- صور منوعة من النزعة الخارجية 2- نظرية الوصف والنظرية السببية 3- هيلارى بتنام وتجربة فكر الأرض التوأم 4- تايلر بيرج وحجة التهاب المفاصل . (shrink)