RESUMO
Background: Coronary artery disease (CAD) has emerged as a major health burden in developing countries. Many recent reports concluded that women with CAD have a worse prognosis than men and also with regards to invasive interventions when compared to men. In this study, author determined the comparative outcomes of ACS in women when compared with men.Methods: This study was conducted in a tertiary care hospital from November 2016 to March 2018. History taking, ECG, cardiac enzymes, 2D-Echo and angiogram were done to diagnose ACS and the appropriate treatment was given. The severity was assessed and compared the outcomes along with complications.Results: The total of 112 patients were treated for ACS, in which, 55 were females and the remaining 57 were males. Majority of the patients in both genders was between the ages of 51-60. In males, STEMI noted 50.8%, NSTEMI in 36.8%, UA in 12.2%. In females, STEMI is noted in 62%, unstable angina in 32.7%, NSTEMI in 27.2%. Six patients (11%) had mortality in the women group and one (1.8%) had died among men.Conclusions: Atypical presentation of ACS was more common in females. Women with ACS had higher complications and higher mortality than men.
RESUMO
Background: Strengthening exercises for pelvic floor muscles (SEPFM) are considered the first approach in the treatment of stress urinary incontinence (SUI). UI has a devastating effect on women's quality of life in the physical, social, sexual and psychological spheres. Women restrict or diminish their activity and social participation, with serious implications. In SUI, there is an association between physical exertion and urinary loss. Increased intra-abdominal pressure triggered by physical exertion leads to increased intra-vesical pressure and, if it exceeds intraurethral pressure, in the absence of contraction of the detrusor muscle, the resulting urinary leakage is referred to as SUI. Aim of the study: To identify the protocol and/or most effective training parameters in the treatment of female SUI. Materials and methods: 100 patients with stress urinary incontinence attending the out-patient department were thoroughly evaluated and randomized into 2 groups of 50 patients each, both groups were taught Kegels exercises and instructions to perform them at home. The experimental group (A) received additional strategies to enhance the efficacy of PFME in the form of reminder bindis to be placed in areas of the home frequented by the patient like the kitchen and its appliances. Patients in the control group (B) did not receive any additional reminders. Both groups were asked to maintain an T. Srikala Prasad, Jessima Subahani, B. Amirtha. Assessment of efficacy of home available reminders to aid in the adherence and effectiveness of home-based pelvic floor muscle training in the management of stress urinary incontinence. IAIM, 2019; 6(9): 7-12. Page 8 exercise diary and allowed to continue their routine medications for comorbidities if any. They were reviewed on Day 15, Day 30 and physiotherapy sessions are given. Later on Day 90 the patients of both groups were reviewed and evaluated with a questionnaire for improvement in symptoms and adherence to PFME. Results: Among the total 100 patients who were trained to do PFME, 23 (14 from group A and 9 from group B) were completely dry by 90 days, 51 (29 from group A and 22 from group B) patients had reduction in the leak and 26 (7 from group A and 19 from group B) patients showed no improvement. Assessment from the exercise diary showed good adherence and symptom relief in most patients in the trial group. Conclusions: Adherence to PFME was better in the trial group in whom indigenous reminders were used which in turn translated into clinical improvement. In this time and era as PFMT is the first management modality in patients with stress and mixed incontinence implementation of such strategies to improve adherence to treatment is suggested especially in tertiary care setups.