Heart disease due to valvular anomaly has increased prevalence along with increasing age. Rheumatic heart disease is a condition in which the heart valves have been permanently damaged post rheumatic fever. The operative management including reparation or substitution with prosthetic valve is the main therapy. Still becoming question mark either rehabilitation program is beneficence for the patient undergoing valvular surgery. We report a patient with severe mitral valve regurgitation, moderate mitral stenosis, moderate tricuspid regurgitation, and severe pulmonary artery hypertension secondary to Rheumatic Heart Disease. He underwent Mitral valve replacement surgery and advised post-operative physiotherapy which comprises 2 weeks of phase I cardiac rehabilitation, a home exercise program after discharge, and follow-up after 2 weeks. During follow up patient has a high level of independence, improvement in quality of life, and early return to work.
Pulmonary tuberculosis is a contagious disease of the lung caused by mycobacterium tuberculosis. The disease is curable and preventable, but its sequelae induce structural lung damage, physiological dysfunction resulting in disability, respiratory distress, and decreased exercise capacity affecting ADLs. Pneumothorax is considered to be a major complication of TB among all the known sequelae. In the present case, the patient complained of moderate dyspnea, chest pressure, and chest pain. Based on chest radiography and a previous diagnosis of pulmonary tuberculosis, the patient was diagnosed with secondary spontaneous pneumothorax (SSP). The pneumothorax was relieved by medical intervention, i.e. by intercostal drainage, but our goal was to increase the ventilation and oxygenation of the lungs, improve airways hygiene, improve the exercise tolerance and minimize the work of breathing so that the patient can go back to his normal day-to-day activities without any trouble. A comprehensive pulmonary rehabilitation plan was structured to suit the patient's goal and was implemented and routinely followed for 1 month. It included a range of interventions like breathing exercises, airway clearance techniques, physical mobility exercises, and posture retraining. The patient demonstrated significant functional improvement in aerobic capacity, endurance, exercise tolerance capacity, and increased shoulder joint mobility. In the present case, it has also been validated that medical management anchored with Pulmonary Rehabilitation will help in gaining better outcomes.
A small bowel obstruction is one of the most prevalent life-threatening situations. The most common clinical signs are vomiting, stomach discomfort, abdominal distension, and severe constipation. A 23-year-old girl presented to the multispecialty hospital with stomach pains that had persisted for two days. The patient experienced identical issues two months earlier and was treated conservatively. Radiography in the manner of abdominal X-ray and ultrasound were used to appropriately diagnose intestinal blockage. She underwent exploratory laparotomy for the same. Numerical pain rating scale, Incentive Spirometer (IS), mobility scale, anxiety and depression scale, independence measure were used as an outcome measure. Medical management was successful, but to return the patient to her normal daily routine activities without signs of dyspnea or early fatigue following abdominal surgery, a comprehensive rehabilitation program incorporating various respiratory techniques was developed, which proved to be effective and correlated with medically substantial gains in physical functioning and wellbeing.
Pulmonary tuberculosis is considered among the most common air-borne respiratory disease. TB is found almost all over the globe but it is also curable and preventable. However, it frequently has several negative consequences on the lung, which affects the patient's exercise tolerance capacity, everyday activities, and, ultimately, quality of life. The PTB is frequently associated with various subsequent problems. Few of which are presented in this case, along with their management. The current case involves a 36-year-old girl who had a history of pulmonary tuberculosis and was re-diagnosed with it, albeit with difficulties. She initially suffered pleural effusion, for which therapeutic tapping was performed, but it later progressed to empyema thoracis. She underwent thoracocentesis, which involved draining the fluid and breaking the fibrous septations, followed by the insertion of ICD drainage. Medical management was successful, but to return the patient to her normal daily routine activities without any signs of dyspnea or fatigue, a comprehensive rehabilitation program incorporating various respiratory techniques was devised, which proved to be an effective protocol in improving the patient's respiratory condition.
Dengue fever is a mosquito-borne sickness that has become a serious international public health issue in recent years.A 54 years old male patient, farmer by occupation came to rural hospital on 10TH September 2021 with complaint of fever associated with chills and rigors, slurring of speech 2 days back and 2 episodes of generalized tonic clonic seizures. Dengue was confirmed by the non-structural protein 1 (NS1) antigen and immunoglobulin M (IgM) antibody test. Radiological investigations revealed encephalitis and pneumothoraxfor which medical management along with inter costal drainage and collateral physiotherapeutic rehabilitation was administered.The goals of the physiotherapy rehabilitation were to reduce bronchospasm, to clear secretions lung fields, to regain full expansion of lungs and best possible functional recovery. Physiotherapy management has shown satisfactory results in regaining pulmonary function.After the completion of the treatment the patient gained maximum re-expansion of the lungs, had no breathing difficulties, the lungs were clear of sputum and was functionally independent.
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