The objective of this study is to assess the impact of pulmonary rehabilitation training in the management of asthma and chronic obstructive pulmonary disease patients. A 6-month prospective interventional study was conducted in a tertiary care hospital that included participants above 18 to less than 70 years of age admitted to the general medicine ward with the diagnosis of mild-moderate chronic obstructive pulmonary disease and asthma without any other comorbidity or concurrent illness. The rehabilitation procedure consisted of breathing exercises and endurance training. Parameters like FEV1, FVC, modified medical research council scale, modified BORG grade, 6-minute walk test, and questionnaire like SF-36 were measured and compared with post-training results. A total of 80 patients were enrolled in the study. The pre and post-rehabilitation comparison in both COPD and asthma patients showed significant results in terms of improved dyspnea (FEV1, FVC, FEV1/FVC ratio; p=0.001) evident with modified Medical Research Council scores and modified BORG grades followed by significant differences in distance covered during 6-minute walk test (p=0.001) and health-related quality of life (SF-36 scores; p=0.001). Conclusion: Pulmonary rehabilitation significantly improved exercise tolerance, perception of dyspnea, health-related quality of life, and psychosocial behavior. Inclusion of pulmonary rehabilitation in COPD and asthma patients is essential to palliate the disease burden, reduce the rate of hospitalizations and improves the quality of life of a patients.
Epidermolysis bullosa (EB) is a rare and genetically determined skin fragility disorders. It has many genetic and symptomatic variations, but all share the prominent symptom of extremely fragile skin that blisters and tears from minor friction to trauma. It is always painful, often pervasive and debilitating. Its affects 1 out of every 50,000 live births and those born with it are often called 'Butterfly Children' that is delicate and fragile as butterfly wings. As there is no standard protocol for the treatment of EB and clinic features remains multiple and varied, hence treatment for the disease remains a major challenge. Therefore the current therapy focuses on prevention of progression of disease, nutritional support, bandage dressing and psychological support to the parents/guardians. Hence the platform provides this is a scope for discovery and development new drugs/treatment strategic plans for the treatment of Eidermolysis bullosa in order to recede the innocent babies' agony.
Omeprazole is a substituted benzimidazole that has gained widespread use in the treatment of acidic and peptic ulcer diseases. Though the adverse events with the drug are rare and involve mainly skin inflammation, urticaria, pruritus, alopecia and dry skin have been reported in 0.5-1.5% of patients. There are very few reports linked to angioedema and urticaria pertaining to Omeprazole or class of PPI as an adverse reaction. Hereby a case of 26-year-old male with hypersensitivity reaction characterized by angioedema (Swelling of lips and fore head). The patient develops adverse drug reaction to Omeprazole may become a hypersensitivity to whole class of PPIs; hence it is to be safer to consider the change of class of drugs for his future correspondence. Simultaneously, all the prescribers should be aware of this possible phenomenon of angioedema while prescribing omeprazole for different clinical indications.
Phenylephrine, a sympathomimetic drug, is commonly used in eye examinations to dilate the pupil of the eye and to differentiate scleritis from episcleritis. It is extensively used as a mydriatic agent by ophthalmologists and may cause allergic contact reactions even though it is rare. Here is a case of 46 years old female patient with acute-onset edema and erythema of both eyes associated with watering, a burning sensation, and moderate discomfort characterized by contact dermatitis. The patient develops adverse drug reaction to an eye drop containing Tropicamide 0.8%w/v + Phenylephrine 5%w/v used prior to eye fundus examination. Although uncommon, cases of allergic reaction to Phenylephrine cannot be ruled out, hence it is advisable to all the clinicians/Ophthalmologist to encourage and conduct the sensitivity test for Phenylephrine allergy, in order to minimize the possible adverse effects and ruinous consequences.
Emphysematous pyelonephritis (EPN) is a rare necrotizing infection characterized by gas formation within or around the renal parenchyma. Clinical presentations include fever, abdominal pain, vomiting, septic shock, altered sensorium, and acute kidney injury. Uncontrolled diabetes and urinary tract obstruction are the most common risk factors, especially in women. Escherichia coli and Klebsiella Pneumoniae are frequently involved pathogens. The diagnosis is usually based upon computed tomography that shows gas patterns in renal parenchyma. Treatment modalities include conservative management with broad-spectrum antibiotics, glycemic control, prompt fluid resuscitation, and surgical intervention such as percutaneous drainage, double J stenting, and nephrectomy. The objective of this case report is to present a 72-year-old female patient with uncontrolled type-2 diabetes and recurrent urinary tract infection who was hospitalized with complaints of altered sensorium, hypoglycemia, hyperpyrexia, excessive vomiting, abdominal pain, and severe sepsis. The diagnosis was based upon computed tomography scan that showed an enlarged left kidney with gas patterns in the renal parenchyma, confirming emphysematous pyelonephritis. Surgical intervention was suggested by the urologist; instead conservative management was employed for the patient due to financial burden. The expected outcome was not achieved with conservative approach and the importance of surgical intervention was observed.
Background/Aim: Alcohol remains one of most common cause of liver disease in India, hence the present study was undertaken to assess the clinical profile and treatment chart review of alcoholic liver disease (ALD) patients. Materials and Methods: Hospital based prospective and observational study was carried out for a period of nine months in a tertiary care hospital of south India. All the patients of either gender diagnosed with ALD were enrolled in the study and patient consent was taken, the data related to the patients of ALD were documented in a structured patient data collection form and analyzed carefully. Results: ALD was mainly affected in male with age group of 41-50 years.Out of 130 patients 43.8% patients were suffered from Fatty Liver disease while 23.1% were suffered from Alcoholic Hepatitis and 33.1% were suffered from Cirrhosis of Liver. The secondary developments to ALD were portal hypertension (13.8%) followed by Ascities (10.8%) and Hepatitis (10%). The major risk factors involved in ALD was alcohol per se (52.3%) and, alcohol and smoking exaggerate the disease condition. The Periodic (61.5%) and regular basis (38.5%) of alcoholism for chronic period of time may land up with ALD. Polypharmacy is essential for the treatment of ALD as it inoved multiple secondary development to ALD. The patients were intervened and counselled on their individual basis for ALD consequences, and motivated for cessation of alcohol and smoking. Conclusion: The study enlightens that the early diagnosis and its beneficial outcomes that can exponentially curtail the mortality rate of ALD. Similarly the optimal drug therapy regimen and patient counseling may improve the patient’s quality of life. Keywords: Alcoholic Liver Disease; Optimal Drug Therapy; Patient Counselling; Improved Quality of Life
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