Background: Cardiovascular disease is the most frequent cause of morbidity and mortality throughout the world. The aim of the study was to determine assessment of risk factors and impact of patient counseling in health-related quality of life of the patient.Method: This was a prospective observational study conducted in the department of cardiology. A suitably designed standard SF-36 questionnaire was given to all patients enrolled in the study before and after counseling. All information relevant to the study were collected in suitably designed proforma from case records and discussions conducted with the patients and bystanders during ward rounds. Proper counseling was given to patients and bystanders and the score was analyzed using SAS descriptive analysis.Result: The most common risk factors encountered in the study are diabetes mellitus, hypertension, dyslipidemia, irregular exercise, smoking, alcoholism, obesity and family history. The health-related quality of life of the patients were assessed, a total of 67 patients QOL was improved after counseling and 27 patients with no improvement. We found that patient counseling was effective for majority of patients.Conclusions: We can conclude that the role of clinical pharmacist has a significant role in improving the health-related quality of life of patients through proper counseling. And more than half of the patients have a modifiable risk factor which can be managed through lifestyle modifications.
Pediatric patients with temporomandibular joint ankylosis have difcult airway due to limited mouth opening making intubation challenging. However beroptic bronchoscopy becomes the gold standard during these situations. We describe here an alternate way of securing airway during difcult cannot intubate situation through beroptic bronchoscope . A bougie was passed through mouth into the glottis under vision through the beroptic bronchoscope inserted through the nostrils. Through which an ETT of 4.5cm was rail roaded under vision. Thus airway was secured without any complications.
Post coital vaginal tear or rupture is a well known entity to the gynecologist .Coitusinduced vaginal tear in a parous woman with no prior pelvic surgery or other risk factors is a rare clinical presentation. Here we present a case of Post coital vaginal tear which presented as a life threatening emergency. INTRODUCTION: Non obstetric vaginal lacerations differ greatly from lacerations sustained during childbirth and are generally classified into two types. The first type is relatively minor and is associated with normal sexual intercourse. These lacerations usually resolve with minimal treatment. The second type of laceration is deeper and more extensive, often resulting in significant vaginal bleeding. This condition can be life threatening and requires immediate intervention CASE PRESENTATION: Mrs. XX, 30 years old lady, P2L2, presented with the complaints of excessive bleeding per vagina since 4 hours to emergency OBG ward at night. She gives h/o passage of clots and had changed about 3 to 4 clothes which was fully soaked .Her previous menstrual cycles were regular 3-4 days/30 days LMP: day 1. She had both FTND at government hospital, P1-male 9 years, p2-female 6 years. She had undergone laparoscopic sterilization 6 year back. On General physical examination-she was moderately built and nourished and severely anaemic. Her Pulse rate was 120 bpm, feeble, low volume, and BP-systolic was 80 mm Hg, Her tongue was dry , extremities were cold, and tachypnea-20/min was present. Per Abdomen Examination was soft and non tender, and there was no organomegaly. Per Speculum examination revealed an Annular tear about 4 cm present at the cervicovaginal junction posterolaterally on the right side. On Bimanual examination Uterus was anteverted, normal in size, firm, mobile, fornices free and non tender.
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