I do not think that your father is suffering from gout since you also mention that his uric acid level is normal. Usually, with gout or increased uric acid levels (hyperurecemia), one typically gets small joints inflammation-cum-swelling especially of the toes, ankle, and knee joints. There are incidences where people have increased uric acid levels but no symptoms, and others with lesser levels but with marked symptoms. It does run in the family, so a genetic or familial component is there. Basically, there is a deficiency of the enzyme ‘xanthine oxidase’ which breaks down uric acid that leads to its increased levels. Thus, it’s imperative to cut down on one’s purine diet of red meat, nuts and other high protein diet. Thus, in ancient times it used to be known as the rich man’s disease.
We must also understand that it is not only the joints that are affected but high uric acid levels also play a role in heart disease where the uric acid crystals gets imposed in the cholesterol deposits making them more difficult to break down during both pharmacotherapy and intervention therapy.
Yes, ankle swelling can be due to increased uric acid levels but that is normal in your father’s case. It could be due to the side effects of one of the medication which he is taking for hypertension too. Other causes of the leg swelling could be due to cardiac or renal reasons or simply dependent edema. Investigations like cardiac ECHO, abdominal ultrasound and renal blood parameters would have to be done to rule out these causes. The back and leg pain could very well be due to sciatica (compression of the sciatic nerve, the largest nerve in one’s body) or the lumbo-sacral syndrome where the spine bone prolapse or para spinal muscle spasm leading to the back pain.
Read this also
Citibank Inc. or Citi is an American multinational investment banking and financial services corporation headquartered in {New york|Ny}, New York City. Citibank was formed from one of the world's {most significant|major} mergers of all time by combining the {bank|savings|consumer banking} giant Citicorp and financial conglomerate Travelers Group in October 1998 (announced on April 7, 1998).[4][5][6] {Since|By} January 2015, it is the third {most significant|major} {lender|standard bank|loan company} holding company in the US by assets. {The|Their|It is} {most significant|major} shareholders include {money|cash} from the Middle East and Singapore. At {the|their|it is} height before the global financial crisis of 08, Citigroup was the {most significant|major} company and bank in the world as {assessed|scored|tested} by total assets, with 357, 000 employees. In 2007, Citigroup was one of many dealers in US Treasury securities.[9] Citigroup had the world's {most significant|major} financial services network, spanning 140 countries with approximately 16, {500|1000} offices worldwide. It {maintains|retains|will keep} over 200 million customer accounts in more than 140 countries.
Citigroup {experienced|endured} huge losses during the global financial crisis of 2008 and was {preserved|saved} in November 2008 in a massive stimulus {bundle|package deal|deal} by the U. {H|T|S i9000}. government.[10] {Upon|About|In} February 27, 2009, Citibank declared that the Circumstance. S. government would take a 36% equity {risk|share|position} in the company by converting US$25 billion in emergency aid into common stock with an US Treasury credit line of $45 billion to prevent the bankruptcy of the {most significant|major} bank in the world at the time The government guaranteed {deficits|loss|failures} on more than {three hundred|300 dollar} billion troubled assets and injected $20 billion immediately into the company. {In return|As a swap}, the salary of the CEO was set at $1 per year and the highest salary of employees was restricted to $500, 000 in cash. Any compensation amount above $500, 000 had to be paid with {limited|constrained} stock that could not be sold by the employee before the {crisis|unexpected emergency|urgent} government aid was {paid back|refunded|given back} in full.[12] The U. S. {authorities|federal government|govt} also gained control of half the seats in the Board of {Company directors|Owners|Administrators}, and the senior management was subjected to removing by the government if there were poor performance. By December 2009, the U. S. government {risk was|share was|position was} reduced from a 36% stake to a 27% stake, after Citibank sold $21 billion of common shares and {collateral|value|fairness} in the {most significant|major} {solitary|one|sole} share sale in Circumstance. S. history, surpassing {Lender|Standard bank|Loan company} of America's $19 {billion dollars|million} share sale one month prior. By December 2010, Citigroup repaid the {crisis|unexpected emergency|urgent} {assist in|help in} full and the U. S. government received {an extra|yet another|one more} $12 billion {income|revenue|earnings} to offer its {stocks|stocks and shares}. US Government restrictions on pay and oversight of the senior management were removed {following the|following your} US {authorities|federal government|govt} sold its remaining 27% stake {since|by} December 2010.
As of 2009, Citibank was one of the Big Four banks {in the usa|in america|in the us}, with Bank of America, JP Morgan Chase and Wells Fargo.
As of June 2012, the {12 months|yr|season} of Citi's 200th {wedding anniversary|birthday|everlasting nature}, Citigroup had built up an enormous cash {book|hold|preserve} in the wake of the financial crisis with $420 billion in excess liquid cash and {authorities|federal government|govt} securities. As of Q1 2012, Citi had a tier 1 capital {percentage|proportion|rate} of 12. 4%, making Citi one of the best-capitalized financial institutions on the globe after great of dollars in {deficits|loss|failures} from the {economic crisis|financial meltdown|financial disaster} This kind of was a result of selling more than {$250|500 usd|250 usd} billion of its special assets {put|located} in Citi Holdings, {that have been|that were|which are} guaranteed from losses by the US Treasury while under {federal government|national} majority ownership. {A unique|An exclusive|A particular} {INTERNAL REVENUE SERVICE|IRS . GOV|RATES} tax exception {provided to|directed at} Citi allowed the US Treasury to sell its {stocks|stocks and shares} at a profit, while it still owned Citibank shares, which eventually netted $12 billion. According to Treasury spokeswoman Nayyera Haq, "This (IRS tax) {guideline was|regulation was|secret was} designed to stop corporate raiders from using loss corporations to {avert|avoid} taxes, and was never intended to address the unprecedented situation {in which the|where|the place that the} {authorities|federal government|govt} owned shares in {banking institutions|banking companies|finance institutions}. And it was certainly not written to prevent {the federal government|the us government} from selling {the|their|it is} shares for {an income|a revenue|an earnings}. "[28] In 2016, Citigroup ranked twenty ninth in size under the Fortune 500 list.
No comments:
Post a Comment