We report two cases which highlight the fact how poor communication leads to dangerously poor health outcome. We present the case of a 50-year-old woman recently diagnosed with rheumatoid arthritis from Southern Nepal presented to Patan hospital with multiple episodes of vomiting and oral ulcers following the intake of methotrexate every day for 11 days, who was managed in the intensive care unit. Similarly, we present a 40-year-old man with ileo-caecal tuberculosis who was prescribed with anti-tubercular therapy (ATT) and prednisolone, who failed to take ATT due to poor communication and presented to Patan Hospital with features of disseminated tuberculosis following intake of 2 weeks of prednisolone alone. These were events that could have been easily prevented with proper communication skills. Improvement of communication between doctors and patients is paramount so that life-threatening events like these could be avoided.
In view of preparing ourselves for the possible rise of Corona Virus Disease (COVID-19) cases, we have proposed a hypothetical model of disease course in COVID-19 patients admitted in Patan Hospital and the exit plan based on available evidences. This will give us a scientific basis of planning discharge of our future cases. According to it, patients are subjected to repeat Polymerase chain reaction (PCR) on day 20 of illness onset and then every 4 days till negative result. Patients with two negative PCR test repeated 24 hours apart are discharged and advised for 14 days’ home quarantine.
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