No abstract

Hoarding disorder is a chronic disorder defined as the persistent difficulty in parting with possessions and the need to save items, regardless of their actual value. Severe hoarding has largely been a hidden clinical problem, and awareness has mostly been limited to voyeuristic depictions of the plight of hoarders in popular media. Approximately 28% to 32% of individuals with attention deficit hyperactivity disorder (ADHD), especially the inattentive subtype, have been reported to have clinically significant hoarding. It has been hypothesized that patients with ADHD initially acquire objects impulsively and later develop emotional attachments or intrinsic meaning, resulting in a perpetuating cycle of reliance on hoarding as a coping mechanism. Treatment focused on impaired attention has shown improved prognosis, which further signifies the relationship between inattentive ADHD and hoarding. We discuss the case of a patient with ADHD (inattentive type), major depressive disorder, and hoarding traits.

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disorder of the synovium resulting in joint destruction. The knee is among the most commonly affected joints in RA and advanced arthritis of the involved joint is associated with poor prognosis contributing to patient pain and disability. In advanced disease, total knee arthroplasty (TKA) has proven to be the most successful intervention that reduces knee pain and improves physical function in RA patients. Materials and methods:A total of 34 total knee arthroplasties were performed in a tertiary care centre for rheumatoid arthritis of the knee joint with a posterior stabilized knee. Patients were regularly followed up and were assessed at the end of two years for the function of the knee joint, quality of life, ability to walk and perform routine daily activities, local signs of infection, activity of the disease and general condition. Results and conclusion:The difference in the average knee society score and the difference in the average knee available range of motion were found to be statistically significant at end of 3 years. There is a significant improvement in functional scores of the knee. However, there will be involvement of multiple joints, associated systemic complications and further progression of the disease. Because of the above said reasons overall functional outcome of the patient might not be significant improvement when compared to excellent clinical outcome of the operated knee.