The symptoms of carpal tunnel syndrome , which include tingling and weakness in the hand, wrist, and arm, may also occur. GCA causes inflammation of the blood vessels, referred to as vasculitis, most commonly affecting the arteries within the scalp and the head. If untreated, GCA can lead to vision loss. While diagnosing PMR can be difficult, there are procedures that help when trying to identify the disease.
A doctor may recommend various blood tests during the diagnosis process. These might include the following tests:. In cases of PMR, findings might include an elevation in C-reactive protein and erythrocyte sedimentation rates, which indicate an inflammatory response.
Doctors may recommend other testing, such as imaging studies. If GCA is considered a cause of symptoms, a biopsy of the temporal artery is arranged, as soon as possible. Additional testing may be recommended on an individual basis and will be discussed by the healthcare team. Treatment for PMR can begin as soon as a diagnosis is made.
The goal of PMR treatment is to reduce the symptoms of pain, stiffness, inflammation, aching, fever, and tiredness with the use of certain anti-inflammatory medications and exercise.
Medications used to treat PMR are referred to as anti-inflammatory drugs and include corticosteroids like prednisone. During steroid treatment, the effect on inflammation is monitored with blood tests like ESR and C-reactive protein levels. Often, those being treated for PMR feel rapid improvement with steroid therapy. In rare cases, adding medications, such as methotrexate or azathioprine, may be recommended to make it easier to reduce the steroid dose gradually. The goal of treatment is to maintain symptom relief with the lowest dose of steroids as possible.
In very mild cases, non-steroidal anti-inflammatory drugs NSAIDs , such as ibuprofen and naproxen, may be sufficient. A regular exercise program with periods of rest may be recommended as part of the treatment plan. The goal of exercise is to maintain joint flexibility, strength, and function. While PMR is a treatable disease, complications may occur as a result of long-term steroid use. These complications include:. It is vital that those diagnosed with PMR report the onset of any new headaches, scalp tenderness, visual changes, and jaw pain immediately, so that they can be evaluated and treated for GCA.
With the lowest power-to-mass ratio, Class 1 is representative of vehicles driven in India. Selected parameters of the Class 1 cycle are given in Table 2, and the vehicle speed is shown in Figure 3. The reasons for this are:. Emissions and a number of other parameters are tested over the respective Class 3 Class 3a or Class 3b cycle, in both charge-depeting and charge-sustaining modes. The Guide provides both conceptual analysis and important practical lessons learned from implementing carbon taxes around the world.
This publication can be downloaded from the World Bank website h ere. Skip to main content. Related publications. Five discussion papers reflecting supply-side perspectives on how the voluntary carbon market can drive ambitious climate action.
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