Effect of designing and implementing a teaching program for patients undergoing coronary artery bypass graft surgery on their quality of life

Coronary Artery Bypass Graft surgery has become established as a powerful therapy for prolonging survival and improving the quality of life of certain subsets of patients with coronary artery disease. Patient education is a vital component of cardiac rehabilitation. It aims to improve quality of life, ensure continuity of care and promote adherence to health care treatment plans. Aim of the study was of there folds, designing, implementing a teaching program and evaluating its effects on the quality of life of patients with coronary artery bypass graft surgery. A quasi-experimental research design. The research was conducted at the Department of Thoracic and Cardiovascular Surgery, Ain Shams University Specialized Hospital. Sixty patients undergoing coronary artery bypass graft surgery. Patients were divided into two equal groups [the study and control group]. The study group was exposed to the designed patient teaching program and quality of life index scale was measured for both group, pre, immediate postoperative and three months after operation. The study group patients demonstrated total improvement in their quality of life index score [183.5 +/- 68.5] preoperatively to [243.5 +/- 68.3] three months after operative. A highly significant difference was documented between study group quality of life index score [243.5 +/- 68.3] versus [201.4 +/- 54.1] for the control group subjects three months after operative. The patients who participated in the teaching program demonstrated an improvement in their cognition, and practices of self-care and quality of life index score compared with the control group. A further research is recommended to study the effect of patient education program on the cost effectiveness, decreasing hospital readmissions and hospital stays, improving the personal quality of life and minimizes complications of illness and therapies

Surgical management of pulmonary hydatidosis

Echinococcus disease is prevalent in certain villages in Egypt, with a rate of occurrence ranging between 3,4 to 11.2 per 100,000. During a 11-year period [1980 to 1991] we operated on 174 adult patients [+16 years] for pulmonary hydatidosis. Chest roentgenography was the clue to diagnosis in all patients .The main symptoms were cough [92%], hemoptysis [82%], hydatid vomica [3%] and anaphylaxis [2%]. Only 8% of the cases were asymptomatic Ultrasonography of the abdomen showed that 9.8 d of the cases had concomittant liver cysts. Eosinophilias was elicited in 38.5% of the cases. performed serological tests included Casoni test [Sensitivity 60%], indirect pssive haemagglutination test [84%] and complement fixation test [100%]. Among the total of 201 of surgical procedures performed, all the cysts have been enucleated by Barren's technique except 10 [5.7%] in whom resection techniques were used. There were bilateral cysts in 27 [13.2%] and multiple cysts in 13 [7.5%] cases. Seventeen [9.8%] had concomittant liver cysts. There were no postoperative omplications or deaths in this series. These data suggest that Barrett's technique is a quite safe and reliable technique in enucleation of hydatid cysts

Initial experience in valvuloplasty for mitral valve disease at Ain-Shams University, Cairo

From Feb., 1989, through Dec., 1990, 47 patients with mitral valve disease [mean age 31 +/- 18 years] were subjected to comperehensive mitral valvuloplasty. Twenty-eight patients had pure or predominant regurgitation. Mitral valve insufficiency was due to rheumatic disease in 42 patients [89%] and degenerative disease in 5 [11%]. The patients were divided into three functional groups: type I [normal leaflet motion], groups: leaflet motion], 5 patients [11%]; type II [leaflet prolapse], 28 patients [49%]; and type III [restricted leaflet motion], 14 patients [30%]. Almost all patients [80.5%] were in New York Heart Association Functional Class III or IV and 20% had atrial fibrillation. The techniques used included commissurotomy with or without splining of chordae and/ or papillary muscle [24 patients], shortening plasty of anterior leaflet chordae tendineae [15 patients], resection of secondary, tertiary, and basal posterior leaflet chordae [15 patients], prosthetic ring annuloplasty [8 patients], quadrangular resection of mural leaflet with sliding leaflet technique [8 patients], transposition of chordae [6 patients], and sliding plasty of papillary muscles [5 patients], anterior transposition of posterior papillary muscle [1]. Additional procedures were performed in 29 patients including tricuspid repair in 19 and aortic valve replacement in 10. Valve function after valvuloplasty was assessed clinically and echocardiographically. Eighty-four percent of the patients had a good immediate result. Current operative mortality is 4.25%, and no late mortality. Reoperation was required in two patients [4.25%], mostly in the first three months. Neither thromboembolism nor infective endocarditis were present. There have been no late recurrences of insufficiency. Mitral vavuloplasty is an excellent alternative to valve replacement in patients with mitral valve disease