Mortality rate of chronic obstructive pulmonary disease (COPD) is more than 3 million people every year, making it 3rd largest cause of death in the world. It has been estimated that by the year 2030. chronic obstructive pulmonary disease will become the third biggest cause of death. chronic obstructive pulmonary disease (COPD) is a progressive irreversible airway disease characterized by emphysema and chronic bronchitis, resulting in breathlessness, cough and sputum as the disease progresses, subjects with COPD experience increasing deterioration of their health-related quality of life (HRQOL), with greater impairment in their ability to work and declining participation in social and physical activities. Hence practicing pursed lip breathing exercise in their daily routine will improve their breathing pattern and quality of life. Objectives: To assess the breathing pattern of chronic obstructive pulmonary disease patient. To assess the effectiveness of selected breathing exercises among the chronic obstructive pulmonary disease patients. To associate the effectiveness of selected breathing exercises among chronic obstructive pulmonary disease patient with their demographic variables. Materials and Methods: The research approach used for the study was interventional evaluatory approach. The study was conducted in respiratory unit at Wardha City Maharashtra, India, using one group pre test post test design without control group. Non probability purposive sampling technique was used for selecting 60 COPD patients. On the first day pre test assessment of breathing pattern with the help of borg rating scale and provided pursed lip breathing exercise for 20 minutes, 2 times in a day and it was continued for 15 days followed by post test on the 15th day. The data collected, tabulated and analysed in terms of objectives of study using descriptive and inferential statistics. Results: The mean post test score. The overall comparison of selected breathing exercise among COPD patients at rest pre test score was higher 3.48 with SD of ±1.25 when compare with at rest post test score which was 0.91 with SD of ±0.85.The statistical Student’s paired t test implies that the difference in the selected breathing exercise among COPD patients was found to be 18.98 which is statistically significant at 0.05% level of significance. Also the overall comparison of selected breathing exercise among COPD patients during activity pre test score was higher 7.95 with SD of ±1.50 when compared with during activity post test score which was 2.76 with SD of ±1.02. The statistical Student’s paired t test implies that the difference in the selected breathing exercise among COPD patients was found to be 18.98 which is statistically significant at 0.05% level of significance. Hence it is statistically interpreted that effectiveness of selected breathing exercises among COPD patients at rest and during activity in post test was effective. The tabulated values was much higher than the calculated’ values at 5% level of significance, also the calculated ‘p-value which was much higher than the acceptable level of significance i.e. ‘p’=0.05. Hence the association of effectiveness of selected breathing exercises is statistically not associated with demographic variables. Conclusion: According to the results of this study, patients with Chronic Obstructive Pulmonary disease patients who practiced pursed lip breathing exercise 20 minutes, 2 times a day for 15 days had improvement of the breathing pattern which was statistically proved. Hence pursed lip breathing exercise was cost effective, non invasive, and highly feasible. Hence the researcher concluded that pursed lip breathing exercise can be practice as an effective intervention on improving breathing pattern among chronic obstructive pulmonary disease patients.

Typhoid fever is a major health problem globally. Typhoid fever is an enteric fever characterized by systemic illness along with abdominal pain and fever in a "step-ladder" pattern. Typhoid fever is one of the major causes of mortality and morbidity in overcrowded and unhygienic areas though comprehensive research and public health interventions have decreased the occurrence. Patient is having sign symptoms as gastrointestinal symptoms, malaise, hepatomegaly, and high liver enzymes presented with a two-week fever. As a differential diagnosis, a Widal test  is done and two blood cultures were requested; both came out positive, confirming the diagnosis of typhoid fever caused by Salmonella typhi. Treatment with ceftriaxone and metronidazole was stared prior to confirmation of the diagnosis, with a partial response; later, pharmacological therapy was altered based on ciprofloxacin susceptibility testing, with a satisfactory clinical response. We look at how to diagnose and treat enteric fever, with an importance to typhoid fever. Symptoms or important clinical finding:- A 6 year old male was admitted in A.V.B.R.H on date 12/03/2021 with chief complaint of abdominal discomfort, malaise, problems such as  fever since 2 weeks, gastrointestinal symptoms, lethargy, hepatomegaly, and an increased liver enzyme. Diagnosis therapeutic intervention and outcome: A case is diagnosed as Typhoid Fever. After physical examination and investigation, doctor was detected a case of 6 week. Therapeutic intervention and outcome: Also provide a calcium supplements and iron supplements present case was stable but according to ultrasonography finding. Outcome- Good sanitation, improved water supply, and a suitable sewage waste matter system, as well as the successful use of existing typhoid vaccinations, can all help to avoid typhoid fever. Nursing Perspective: Administration fluid replacement .i.e DNS and RL monitored vital signs per hourly. Maintained temperature chart 2 hourly strictly, maintained intake output chart properly. Tablet paracetamol, antibiotics given as per doctor’s order. Conclusion: Good sanitation, improved water supply, and a suitable sewage waste matter  system, as well as the successful use of existing typhoid vaccinations, can all help to avoid typhoid fever.

Introduction: In 1922, two doctors, Albert Mason Stevens and Frank Johnson, examined purulent conjunctivitis.” Background: Stevens-Johnson syndrome was named after them as a result of their study. The incidence rate is 7 cases per million populations per year. Case Presentation: Master Yash Ghudam was brought to AVBRH by his parents with chief complaints of fever since 5 days and erythematous lesions all over body since 3 days. History of present illness: Patient was apparently alright 5 days back, and then he started having fever which was of high grade and was not associated with chills and rigor. Patient was treated on OPD basis and the symptoms of an unexplained disease in two young boys, aged 7 and 8, who had "an unusual, generalised eruption of continued fever, inflamed buccal mucosa, and extreme some antibiotic was given, but there was no relief, after 2 days there was ulcers formation inside the mouth for which some ointment and syrup becosule was started. But lesions were increasing. 3 days back the lesions first appeared on chest then got spread to legs and hands. For which patient was admitted in Chandrapur hospital from were the patient was referred to AVBRH for further management. Interventions: The patient was treated the patient was started on intravenous and orally Cortecosteroids, Omnacortil 10mg, Antibiotics- Inj. Ceftriaxone1gm IV 12 hourly [100mg/kg/day], inj. Amikacin 150mg IV 12 hourly [15mg/kg/day], Syp. Mucaine gel 2tsp BD – swish and swallow), Syp. Cital  2.5ml TDS, Tab. Chymoral Forte  TDS, Inj. Pantop 20mg IV 24 hourly (1mg/kg/dose). Pandya’s Formula: Syp. Gelusil 5ml, Syp. Benadryl 5ml, Syp. Omnacortil 5ml.  Skin allograft: It has been planned. Conclusion: In this study, we mainly focus on medical management and outstanding nursing care helped prevent farther complication. Overall, the patient's reaction was positive, though recovery time from Steven johnson syndrome varies from person to person, taking weeks, months, or even years. However, only a small number of people completely recover, while some have long-term consequences. She took a long time to get back on her feet.

Background: The level of knowledge of glaucoma and their possible determinants in a group of people diagnosed with glaucoma and in a population based group without glaucoma. Studies performed on the prevalence of glaucoma have reported a high proportion of undiagnosed patients. Late diagnosis is related to increased risk of glaucoma associated with visual impairment and disability. Lack of awareness and non-availability of appropriate screening procedures are among the major reasons for non-diagnosis or late diagnosis of glaucoma. The present study has been undertaken to evaluate the level of awareness about glaucoma among the general population. Objective: 1. To assess the knowledge regarding glaucoma among general population. 2. To find an association between the level of knowledge with selected socio demographic variables. Materials and Methods: The study was conducted in selected hospital. Descriptive  research approach was used in this study. Hundred people in the general population were selected for the study. Structured knowledge questionnaire was used to collect the  data.  Results: The show that 1 (1%) had poor level of knowledge, 27(27%) were having an average level of knowledge. Fifty seven percent (57%) had a good level of knowledge, fifth teen present 15 (15%) had very good knowledge.  None exhibited excellent level of knowledge. The minimum score was 3 and the maximum score was 12, with the mean score for the test being 7.61 ±1.814 and mean percentage of knowledge was 50.73%.

A hiatus hernia occurs when a portion of the stomach protrudes into the chest cavity. It enters through the same entrance through which the food tube (oesophagus) travels to the stomach. A case of an 39-year-old male with a history of diabetic presented to the emergency room with acute onset shortness of breath, epigastric pain and chest pain. The stomach bulges up into the chest through that opening in a hiatal hernia (also known as a hiatus hernia). The client was having burning sensation in epigastric region since from 2-5 year, acid reflux after taking food, heartburn, nausea, regurgitation, vomiting, and abdominal pain and irritation. After the physical examination, history collection and investigations he was diagnosed as case of hiatus hernia.The study's main focus is on professional management and excellent nursing care, which may be able to give the holistic care that hiatus hernia requires while also efficiently treating the difficult case. Following a complete recovery, the patient's multidisciplinary health care team works together to help the patient reclaim his or her prior level of independence and contentment.