53 yr old man, 168 m height, 80 kg, with gradual progressive arthritis on multiple asymmetrical joints (pain, swelling, redness and hotness), no stiffness, but limitation of movement and limitation to daily activities, more than one joints affected on each episode, high fasting blood sugar on June (150 mg/dl), Uric acid 6.0, Blood cholesterol...lower limit of normal. Living in refugee camp and no access to any specialist, including Rheumatologist or orthopaedic surgeon.