Background Cardiovascular diseases are the leading cause of mortality in the Indian subcontinent, accounting for 38% of deaths annually. One cardiovascular disease in particular, heart failure, is a growing public health problem both in India and worldwide. Purpose Heart failure is a chronic, progressive disease with increasing rates of incidence and prevalence. This study was conducted to determine the influence of a nurse-led cardiac rehabilitation program on quality of life and biophysiological parameters in patients with chronic heart failure. In this study, it was hypothesized that participants in the cardiac rehabilitation program would report significantly more-positive changes in quality of life and biophysiological parameters than their peers who did not participate in this program. Methods In this randomized controlled trial, the participants were patients with chronic heart failure who had been admitted to a tertiary care hospital in India. The participants assigned to the intervention group received both nurse-led cardiac rehabilitation and routine care. In addition, intervention group participants received a booklet on cardiac rehabilitation, Healthy Way to Healthy Heart , at discharge and fortnightly telephone reminders about good cardiac rehabilitation practices. A standard questionnaire was used to collect targeted information on participants' general and disease-specific quality of life at 1 and 3 months postintervention. Biophysiological parameters such as body mass index, blood pressure, and serum cholesterol values were also measured. Results Two thirds of the participants in each group (65% in the intervention group and 66% in the control group) were between 51 and 70 years old. The mean score for the mental component summary of generic quality of life steadily decreased in the control group and steadily increased in the intervention group at the first and second posttests. Conclusions/Implications for Practice Nurses working in cardiology units play a pivotal role in educating and managing the health status of patients with heart failure. Providing cardiac rehabilitation to patients with heart failure benefits the quality of life of these patients. Nurses working in cardiology units should encourage patients with heart failure to practice cardiac rehabilitation for a longer period to further improve their quality of life.

Background: Breast abscess develops as a complication of lactational mastitis. Recently, there is an increase in the incidence of non-lactational breast abscess. The aim of the study was to analyse the microbial flora in the lactational and non-lactational breast abscess in the ED and to elucidate the susceptibility of flora to different antibiotics.Methods: This is a retrospective cohort study of breast abscess patients registered in the ED over two years. The case records of these patients were retrieved, and the details of their age, clinical presentation, investigation, and treatment were recorded. Specifically, the pus culture sensitivity and antibiotics used in the management of these patients were noted, and the pattern of microbiological flora analyzed.Results: A total of 124 patients were included in the study, with 97 women were categorized into lactational breast abscess, and 27 women were classified as a non-lactational breast abscess. Mean age was 24 years of age (Range 18 to 56 years). The majority of the women were young between 18 and 34 years of age (83%). The culture was grown in 92% of the patient pus specimens. Staphylococcus aureus (83%) was common organisms cultured in lactational breast abscess. Mixed Flora including Staphylococcus aureus and Group B Streptococci were grown in non-lactational breast abscess.Conclusions: Appropriate antibiotic choices are of immense importance in the management of breast abscess. Mixed flora is common in non - lactational breast abscess when compared with a lactational breast abscess. Staphylococcus Aureus is the most common isolate in both groups.

No abstract

Aim/Background: The study aims to identify the risk profile of patients aged above 65 years and to study the pattern of drug use and resource planning for interventions. Methods and Materials: A prospective observational study was conducted in the Department of Emergency and Critical Care, Sri Ramachandra Institute of Higher education and Research that offers health care services in Porur, Chennai. Eighty-four patients were watched during the study period of 6 months. After providing written and oral information, written informed consent or proxy content was obtained from every participant before inclusion. Results: We characterized adults older than 65 years attending the ED in urban tertiary health care teaching hospital and observed several parameters like demographic variables, admission and discharge details, Prolonged Length of Stay (LOS), reasons for admission to Emergency Department, diagnosis, comorbidities, polypharmacy and final disposition. Conclusion: The rate of hospitalization and the rate of admissions were higher for the geriatric population when compared to younger adults in the Emergency Department. These rates increased with increasing age, presence of comorbidities and acute illness severity. In our study, disorders of the circulatory system were the leading cause that led to admission, hospitalization and mortality of the elderly.

Aim: The aim was to evaluate the use of bedside sonographic measurement of the optic nerve sheath diameter (ONSD) in the assessment of elevated intracranial pressure in patients with head injury coming to the emergency department (ED). Methods: A prospective study of ED patients presenting with a history of acute head injury, an ocular ultrasound was performed for ONSD measurement, followed by a computed tomography (CT) of the brain. Three measurements were taken for each eye, then, the mean binocular ONSD measurement for each patient was obtained to ensure accuracy. A mean bipolar ONSD >5 mm was considered abnormal. Results: A total of 175 patients were considered for the study. Of 175 patients, only 56 (32%) had intracranial pathology detected on CT brain with mean ONSD of 5.7 mm (standard deviation [SD]: 0.59). The mean ONSD for 119 (68%) patients, who had normal CT brain, was 4.5 mm (SD: 0.42). The mean ONSD measured for the right eye was 4.86 mm with SD 0.88, and the mean ONSD for the left eye was 4.90 mm with SD 0.85. When comparing ONSD measurement with CT findings of raised intracranial pressure, the ONSD sensitivity was 87.5% (95% confidence interval [CI]: 85%–96%) and specificity was 94.1% (95% CI: 85%–96%), with a positive predictive value of 87.5% and a negative predictive value of 94.1%. The area under the receiver operator characteristic curve obtained was 0.90 (95% CI: 0.85–0.96). Conclusion: The study has shown a bedside measurement of ONSD through sonography as an efficient tool to assess elevations in intracranial pressure in head injury patients.