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Aim of the Study: To assess the effectiveness of self-instructional module on healthy sleep hygiene habits on quality of sleep, among arthritis patients. Study Design: The design that will be used in the study is One Group Pre Test Post Test research design. Methodology: A study used a pre-test post-test design with no control group and a pre-experimental design. The study will be conducted during December 2021 to May 2021.The impact of self-instructional module on healthy sleep hygiene habits on quality of sleep, among arthritis patients will be assessed using the purposive sampling technique. In this study Evaluatory research approach will be used. Selected 140 arthritis patients will be assessed primarily for knowledge by giving structured questionnaires regarding healthy sleep hygiene habits and then self-instructional module on healthy sleep hygiene habits on quality of sleep, will be given to the selected sample developed by researcher as intervention. Expected Results: To assess the effectiveness of self-instructional module on healthy sleep hygiene habits on quality of sleep, among arthritis patients. In this study self-instructional module on healthy sleep hygiene habits on quality of sleep will be useful in improving the arthritis patient’s knowledge. Conclusion: The conclusion will be drawn from the results and will be published in per review journal.

Background: In Indian women, breast cancer is the most frequent type of cancer. Breast cancer affects 30 out of every 100,000 women in India. Case Report: A female patient of 70 years old was admitted to Female surgery Ward-33, Unit-3, AVBRH on 19th January with a chief complaint of lump in upper outer quadrant of the right breast, hardness and non-tenderness of right breast since 2 months. The patient was ok. She had complained of a lump in the upper outer quadrant of her breast for 2 months, and it had appeared gradually. During a physical examination, some clinical findings were obtained i.e., lump in a breast was gradually progressive, and non-tenderness and a nonmobile lump in upper outer quadrant of right breast, no history of fever, nausea vomiting, bloody discharge from a nipple. After that patient was undergone on the routine investigation in that Haemoglobin- 8.4gm% was decreased, Total Red Blood Cell count 2.88 cumm decreased, Total Leucocyte Count -17800 cumm increased. Fine needle aspiration cytology show metastasis of breast and ultrasonography shows an irregular strangulated hypoechoic mass of approximately 3.5*1.9 cm at the outer upper quadrant of the right breast. After histopathology report revealed that patient having metastasis of right breast and she was undergone on treatment of chemotherapy. Conclusion: This case report was of great relevance for academics, its provided to improve knowledge about breast cancer, to encourage the practice of BSE making women aware of the importance of this exam.

Background: In the United States, the hemolytic–uremic syndrome of childhood typically follows gastrointestinal infection with Escherichia coli O157:H7. It is presumed that the absorption from the gastrointestinal tract of Shiga toxins 1, 2, or both (formerly called Shiga-like toxins) produced by E. coli O157:H7 causes microangiopathic hemolytic anemia as a result of endothelial-cell injury. Shiga-toxin–producing E. coli belonging to serotypes other than O157:H7 can also cause the hemolytic–uremic syndrome. However, even though such organisms have been implicated as causes of sporadic cases or outbreaks of gastroenteritis, they are not believed to be important causes of the hemolytic–uremic syndrome in this country. Hemolytic uremic syndrome (HUS) is a kidney disease characterized by damaged and inflamed small blood vessels. As a result of the damage, clots in the vessels may form. Clots impede the filtration function of the kidneys, causing renal failure, which can be deadly. Clinical Finding: Hemolytic uremic syndrome, nephropathy and thrombocytopenia, pallor, jaundice, edema. After eight hours of stomach and left-flank pain, vomiting, and dysuria, a previously healthy six-year-old girl was seen. The day before, an enema had been used to alleviate constipation. The child had not had diarrhoea during the two weeks before evaluation. On examination, the patient had an oral temperature of 39.8°C, a pulse rate of 120 per minute, and a blood pressure of 111/59 mm Hg. There was tenderness of the suprapubic area and left costovertebral angle. The white-cell count was 23,400 per cubic millimeter (58 percent neutrophils, 23 percent band forms, 9 percent lymphocytes, and 10 percent monocytes), the hematocrit was 40 percent, and the platelet count was 293,000 per cubic millimeter. Urine obtained by catheterization had a specific gravity of 1.028 and a ph of 5, and dipstick analysis was positive for leukocyte esterase (++), protein (++), ketones (++), and blood (+++). The urinary sediment contained 21 to 100 red cells, more than 100 white cells, 1 to 5 renal tubular cells, and 1 to 5 granular casts per high-power field. Many bacteria were observed by microscopy. The left kidney showed attenuation of fat and a possible collection of fluid on abdominal ultrasonography; the right kidney was normal. Before starting ceftriaxone medication, blood was taken for culture. Diagnostic Evaluation: HB-5.7 g/dL, total protein-7.4 g/dL, total Alcaline phosphatase -123 U/L , total platelet count-2,93,000 per cubic millimeter, total bilirubin-3.2 mg/dl, WBC 23400 per cubic meter, CRP 5.58 mg/L, Sodium level 136 mg/dl, potassium level 3.92mg/dl. Therapeutic Intervention: Tab Amlodepin 10 mg BD, Tab Prednisolone 10 mg TDS, Tab Envas 2.5 mg OD, Metropenum 340 mg BD, Inj. Pantop 20 mg OD. Outcome: The medication has started for thrombocytopenia, the patient is on dialysis and If is given to patient for movement of body because of patient is obese. The patient was sent home after 20 days of hospitalization. Three weeks later, a voiding cystourethrogram was normal, and six weeks later, ultrasonography revealed that the focal abnormality in the left kidney had disappeared. The patient's blood urea nitrogen and serum creatinine concentrations, iothalamate clearance, and blood pressure are all normal two years later, and her urine is protein and blood-free. She has not experienced a recurrence of a urinary tract infection or hemolytic–uremic syndrome. Conclusion: The atypical hemolytic uremic syndrome is an uncommon condition that must be diagnosed with a high index of suspicion. It's an exclusionary diagnosis. A better outcome will be achieved if the disease is detected early and treated promptly. In all patients with thrombotic microangiopathy, the atypical hemolytic uremic syndrome should be evaluated.

Introduction: Ectopic pregnancy is a complication of pregnancy in which the embryo implants outside the uterus. Abdominal discomfort and vaginal bleeding are common signs and symptoms, but only around half of the women who are affected experience both. The discomfort can be severe, dull, or crampy. If there is bleeding into the abdomen, pain may radiate to the shoulder. A rapid heart rate, fainting, or shock may occur as a result of severe bleeding. The foetus, with a few exceptions, is unable to live. Obstetricians and gynaecologists face a number of obstacles when dealing with emergencies in Jehovah's Witnesses. Main symptoms and/or important clinical findings: She is a 20-year-old woman who had an emergency diagnostic laparotomy for a ruptured ectopic pregnancy with pyosalpinx and septicemia on February 14, 2021. Her diagnostic Ultrasonography has been completed. A complete blood investigation has been completed. She was moderately symptomatic before 8 days, when she was primigravida with 2 months of pregnancy, and then she got abdomen cramps that worsened with time. The main diagnoses, therapeutic interventions and outcomes: She is a 20-year-old woman who had a post-surgical case of Explore Laparotomy For Ruptured Ectopic Pregnancy with pyosalpinx and septicemia, as well as acute abdominal pain. Her treatment began on the day of admission with IV fluids, antibiotics and injectables. Started, advised for Zonac suppository PR, and finished all necessary research. Nursing Perspectives: Laboratory techniques are urgently required. In order to limit the development of treatments to enhance the outcome. Conclusion: Although it is rare for an ectopic pregnancy to go past the first trimester, it does happen. Thus, it is necessary to rule out ruptured ectopic pregnancy in all cases of surgical abdominal urgency during pregnancy, as it is life-threatening to the mother if proper diagnosis and care are delayed. Despite the fact that early intervention saves lives and minimizes morbidity, ectopic pregnancy still accounts for 4 to 10% of all pregnancy-related deaths and is associated with a high rate of ectopic site gestations in subsequent pregnancies.

Background: Kidney disease results in some loss of renal function and can lead to kidney failure, which is Renal failure is defined as the full loss of kidney function. Renal failure is the last stage of kidney disease, at which point dialysis or a kidney transplant are the only treatments available. The prevalence rate of kidney disease among hypertensive patients in India is 29.8% [1]. Objective: 1. To evaluates the kidney function test by using serum creatinine, blood urea nitrogen and uric acid among hypertensive patients. To associate the demographic variables with the selected kidney function test among hypertensive patients. Methodology: It is a cross sectional, analytical hospital based study. The patients of hypertension has selected for the study. Patients are chosen based on inclusion criteria, and the nature and aim of the study are explained in detail and the written and informed consent, from the subject will be taken before data collection by the investigator after that the blood and urine samples will be taken from the hypertensive patients for further investigation respectively. The setting of the study is selected hospitals of Vidarbha Region. Expected Results: There may be a possibility of occurrence of kidney disease among hypertensive patients Conclusion: Following the end of data gathering, the statistical analysis will be used to develop conclusions.

Introduction: It's an extremely uncommon cancer. First, the epidermis, soft tissues, and connective tissues are impacted. Breast benign spindle cell lesions include a wide range of tumor-like or malignant fibroblastic and myofibroblastic entities. They should be made up entirely of Spindle cells (pure spindle cell lesions) are defined as lesions with no mixed epithelial component. Clinical Finding : Most Common Symptoms Of Spindle Cell Sarcoma. • Bone ache. The most frequent sign of spindle cell sarcoma is bone discomfort. The most often afflicted bones by spindle cell sarcoma are those of the... Swelling And Tenderness. Reduced Mobility. Fatigue And Malaise. Lump Or Mass. Diagnostic Evaluation: HB-6.7, TLC:-16, 200, PLT:-15, 000, MCV:-67.0, SR. BILIRUBIN:-0.7 Therapeutic Intervention – Tab. Allopuraznol 300mg BD, Inj. Emset:- 1.8mg TDS. Inj. Pantop 12mg BD, Inj. Ceftraxon 20ml NS 1 mg BD. Outcome- Spindle cell tumours are uncommon cancers that develop in the peripheral and deep tissues of the body. According to a CT scan, a massive tumour encompassed the whole abdomen and pelvis. According to a CT scan, a massive tumour encompassed the whole abdomen and pelvis. Conclusion: The patient is admitted to Acharya vinoba bhave rural hospital sawangi (meghe) wardha, under the USG department, where he will get ongoing medical and nursing care, and his health is currently stable and under monitoring.

Introduction: Sickle cell anemia is a kind of severe hemolytic anemia caused by the sickle haemoglobin (HbS) gene, which results in a faulty haemoglobin molecule. The term "sickle cell disease" refers to a set of genetic illnesses affecting red blood cells. People with sickle cell disease have irregularly formed red blood cells, which might be troublesome since they don't stay as long as healthy blood cells once they reach the state of blood arteries. Clinical findings: Progressive Anemia Mild jaundice Fever Headache Growth retardation Superaded bacterial infection Enlarge hurtNon healing ulcer Organ failure Abdominal pain with distension Joint pain Diagnostic Evaluation: Abdominal pain, fever, Hb (8.5 gm%), Abdomen swelling, Increase abdominal girth, pain in joint and irritability. Ultrasonography: Abdominal USG. Therapeutic Investigation: Inj. Ceftriaxone 1mg BD, Inj pantoprazole 20mg OD, Inj. Neomole 30ml SOS, Inj. Tramadol 0.4mg TD S, Cap. Hydra 500mg OD, syr. syncoria 5ml OD, Tab. Folic Acid 5mg OD. Outcome: All the investigation of the patient is done and the patient is diagnosed as sickle cell anemia. He showed significant progress after receiving therapy, and the treatment was kept ongoing until my last date of care. Conclusion: A male child of 8 yrs was brought to AVBRH on by his parents with a complaint of abdomen pain with distension, Pain in joints, irritability and he was admitted to pediatric ward. All the investigation of the patient is done and the patient is diagnosed as sickle cell anemia. He improved dramatically after receiving therapy, and the treatment was continued until my final date of care.

Introduction: Ebstein anomaly, also known as Ebstein malformation, is a congenital (existing at birth) heart defect that affects a small percentage of people. The tricuspid valve (the valve that connects the chambers on the right side of the heart) does not close properly in people with Ebstein abnormality [1]. Patient History: A 25-years female patient was admitted in Acharya Vinoba Bhave Rural Hospital in medicine ward. She was admitted with the complaint of breathlessness on exertion, and weakness since 2 months. patient is a known case of severe ASD since birth. After coming to the ward all investigations done like blood test, ECG, 2D Echo, chest x-ray etc. then final diagnosis is conformed as severe ASD with Ebstein anomaly. Past History: Patient is a known case of ASD. And not having any other history of communicable disease, asthma, tuberculosis. Management: Tablet- Lasilactone (20/60)) A diuretic, Tablet- Neurobion Fort, Tablet- Pan 40mg a antacid are prescribed the doctor . Nursing Management: vital sign checked and documented, comfortable position given as patient having breathing difficulty. Fowlers position given. intake and output of patient recorded. Assessed the patient for anxiety, depression. Conclusion: Patient was admitted to the hospital with the major complaints of trouble breathing and generalised weakness, and her situation was critical. Immediate treatment was initiated by a member of the health team, and all available treatments were administered, and the patient's condition has improved.

Background: COVID-19 is a unique pulmonary ailment due to coronavirus, producing extremely severe pulmonary illness. On March 11, 2020, WHO declared the SARS-CoV-2 incident a pandemic because of its deadly global spread. Objectives: To assess the myths and misconceptions about Novel COVID-19 outbreaks among the general population and associate the findings of the Novel COVID-19 outbreak with the selected demographic variable. Materials and Methods: This descriptive research paper was undertaken to assess the perceived myths and misconceptions about novel COVID-19 outbreaks among the general population at Paloti, district Wardha. The sampling technique was used Non – Probability Convenient. A total of 150 members of the general population who met the inclusion criteria were chosen for this study. To assess their perceived myths and misconceptions, a Likert Scale was constructed. Results: Findings of the study, 1.33% of general populations have disagreed, 10% were undecided, 50.67% of them were agreed, and 38% of them were strongly agreed about myths related to Novel COIVD-19. The Minimum perceived myths score was 19, and the maximum score was 48. The mean perceived myths score was 37.83±6.07, and the mean percentage of myths score was 75.66±12.14.0.67% of general populations were disagreed, 2% were undecided, 29.33% of them were agreed, and 68% of them were strongly agreed about misconceptions related to Novel COIVD-19. The minimum and highest misunderstanding scores were 18 and 49, respectively. The mean misunderstanding score was 83.179.09, while the mean misconception score was 41.584.54. There is no correlation between demographic factors and myths and misconceptions. Conclusion: According to this study, myths and misconceptions related to the novel COVID-19 are surprisingly low among the general population.

When the electrical signal normally does not travel from the atria, the upper chambers of the heart, to the ventricles, or lower chambers, full heart block occurs. During surgery, the atrio ventricular (AV) node is weakened and complete heart block can result. Often, complete heart block occurs naturally without surgery [1]. Patient History: Heart block is an irregular heart rhythm where the heart (bradycardia) beats too slowly. In this condition, between the upper chamber (atria) and the lower chamber (ventricles), the electrical signals that tell the heart to contract are partially or completely blocked. Present history- The patient 71-year old male who was admitted to hospital on date 25/11/2019 with the chief complaint was severe chest pain, breathlessness, excessive palpitation, vertigo, and sweating since in 4 months. Conclusion: The patient was admitted in the hospital with the chief complaint of severe chest pain, breathlessness, excessive palpitation, vertigo and sweating since 4 months and his condition was very critical and the patient was admitted in AVBR Hospital and immediate treatment was started.

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.

Alcohol is a natural product made by reacting lactose fermentation with yeast spores. Because it includes calories. With no nutritional value, alcohol is used as a source of energy Different sugar sources are used for fermentation to create a variety of alcoholic beverages. Patient Present History:-On September 3rd, 2020, a 32-year-old male patient was admitted to hospital with a specific complaint of abdominal pain for the past three years. He began drinking alcohol on a daily basis. Initially, he only drank at night, but later he began drinking during the day. Clinical Finding: Mood irritable, social withdrawal, mental confusion, seizure, vomiting, mood changes, lethargy and vomiting. Diagnostic Evaluation: Hb - 11.9 mg%, MCV – 87 cum/micron, MCH- 28.9 pico/gm, Total Bilirubin- 1.47.USG –He is appearance was natural once more. There was no localized lesion or oblivious mass lesion in the pelvis.

Chiari Malformation is a rare condition. A condition known as Chiari malformation occurs when brain tissue spreads into the spinal canal. When a portion of your skull is excessively small or malformed, it presses on your brain and forces it downward. Chiari malformation is a rare occurrence, although the increased use of imaging testing has resulted in more diagnosis. Case Presentation: A 18-year-old boy was admitted to the hospital with the following symptoms: Tingling sensation, numbness over left hand since 2 to 3 months. Neck bend toward right side, pain in left hand since 6 month. Difficulty during eating by hand since 2 to 3 month. On physical examination, indicated a bright attentive person with pale conjunctiva and no symptoms of icterus. He had a tachycardia, bilateral pitting pedal edema and a swollen abdomen with shifting dullness, all of which pointed to as cites. He had a history of intermittent abdominal pain. On admission he complaint of new onset of dyspnea on exertion, fatigue and abdominal swelling. The rest of all physical examination was normal, with no skin changes and an intact arterial pulses in all four extremities. Conclusion: The primary focus of this case study is on professional management and outstanding nursing care, which may provide the holistic care that Chiari Syndrome necessitates while also effectively managing the challenging case. After a full recovery, the patient's comprehensive health care team collaborates to help the patient regain his or her previous level of independence and satisfaction.

Introduction: A germ cell is a type of Tumor that arises from germ cell (GCT). Germ cell tumors are both cancerous and benign. The gonads contains majority of germ cell (ovary and testis). GCT that arise outside the gonads could be the result of embryo devlopment errors. Clinical Findings: Abdominal mass without pain, backache, and weight loss. Diagnostic Evaluation: HCG and alphafetoprotein level in the blood identifying women with malignant ovarian germ cell tumor is beneficial. Serum alphafetoprotein and HCG is elevated as condition progress. Therapeutic Intervention: Patient treated with inj. Bleomycin, inj. Cisplatin, inj.Etoposide, tab Pan 40 miligram and inj. Emset. Conclusion: A 3year old female was admitted in AVBRH Sawangi Meghe wardha with the major complaint of right abdominal swelling for 6 month, both when they observed abdominal mass without pain and swelling was small in size and backache and weight loss.

Introduction: The most common cause of tuberculous meningitis is a hematogenous spread of mycobacteria from the lungs. tuberculous meningitis is a fatal disease. Symptoms typically worsen over time, and there are three clinical stages to the disease (prodromal phase, phase of neurological symptoms and phase of paresis) Case Presentation: The chief complaint of a one-year-old boy was fever, irritability, vomiting, and Generalized Tonic-Clonic Seizure convulsions. The patient's pupils were found to be unequal on physical examination, prompting a repeat neuroimaging. It was done on MRI (magnetic resonance imaging) with T1 hyperintensity on T2 and restricted diffusion on DWI (diffusion-weighted imaging) he has not improved after taking treatment and the patient is on a ventilator as well, we nasogastric tube also. I was receiving treatment and will continue to do so until the end of my care. Conclusion: In our environment, tuberculous meningitis that presents late is not uncommon. It arrived late at our medical facility. After a full recovery, the patient's comprehensive health care team collaborates to help him regain his previous level of independence and satisfaction. This report is intended to raise clinician awareness of tuberculous meningitis' unusual clinical presentation. Tuberculous meningitis is treated holistically with a focus on medical and nursing management.

Background: The prevalence rate of chronic kidney disease (CKD) ranges from 1 < percent to 13% and recently international society of nephrology reported In India, the prevalence rate of chronic kidney disease was 17 % in 2015. Objective: 1. To assess the existing level of knowledge regarding hemodialysis care among professional staffs. 2. To assess the existing Practice regarding hemodialysis care among professional staffs. 3.To assess the effectiveness of nursing protocol on knowledge and practice regarding hemodialysis care among professional staffs. 4.To find out the correlation between knowledge and practice regarding hemodialysis care among professional staffs. 6.To associate the level of knowledge and practice regarding hemodialysis with selected demographic variable. Methodology: It is Quasi experimental one group pre-posttest research design will be used in this research study conducted on the professional staff in the selected hospital of Wardha. Non-probability purposive sampling technique will be used to select samples for analysis. This research study included 60 professional staff of selected hospital of Wardha district. Expected Results: Outcome includes To evaluate the nursing care for hemodialysis patients. Through, improve and evaluate the knowledge and performance of hemodialysis care among professional staff before and after the education and training interventions. To assess the existing practice of hemodialysis care and the generation of new evidence. Conclusion: Conclusion will be drawn from the statistical analysis.

Introduction: Wilm's tumor, also known as nephroblastoma, is a common complication in children with renal cancer. It was responsible for 6% of all malignancies. It almost always affects children under the age of five. 90% of cases are diagnosed before the age of three, with the peak incidence occurring between the ages of two and five years. The case of a 2-year-old girl with Wilm's tumor is shown below. The majority of cases are unilateral, but 5% to 10% of the time both kidneys are affected. Case Presentation: A 2-year-old girl was taken to the hospital with a chief complaint of a lump in the abdomen, fever, vomiting and fatigue, nausea, swelling, pain in the abdomen, weakness. On physical examination the patient has experienced in weakness the upper and lower limb, pain experiencing in the abdomen and presenting lumps in the abdomen S1 and S2 are heard in the cardiological system, and air entry is bilaterally equal in the respiratory system. Pupils are reflected light, tone, and a palpable smooth abdominal mass is frequently discovered by chance. The infant was never admitted to a neonatal intensive care unit (NICU). There had been no previous evidence of neonatal sepsis or jaundice. For a year, the girl was breastfed. The right side of the abdomen was where the first symptoms appeared. Small at first, but quickly grew larger and more asymmetrical.

Background: “Chronic Kidney Disease” also known as a chronic renal failure, is one of the major health problems today. And infection is the second leading cause of morbidity and mortality in patients with chronic kidney disease, contributing around 30–36% of deaths among patients on dialysis. Overall, this condition is a threat to the life of the patients, hence to improve in the patient’s condition on dialysis and renal replacement therapy is a must. Here, early vaccination becomes must as primary treatment modalities to prevent the patients from communicable diseases like Hepatitis-B, Influenza, Pneumococcal diseases. Aim: To evaluate the effectiveness of the awareness program on selected vaccinations among chronic kidney disease patients. Methodology: Quasi experimental one group pre-test post-test research design will be used in this study and samples will be chronic kidney disease patients. Non probability purposive sampling technique will be used to select the samples. This research study included 100 chronic kidney disease patients of selected hospitals in Vidarbha region. Samples must select according to requirements for inclusion and exclusion criteria. For this study, Age between 18 to 65 years above, both male and female, Chronic kidney disease patients attending Nephrology and Medicine OPD/IPD and admitted patients in selected hospitals in Vidarbha region, able to read and write Marathi or Hindi, Willing to participate in study, available during data collection. Expected Results: 1. To access this information for educating and change the attitude of patients regarding selected vaccination among chronic kidney disease patients. And understand the importance of vaccination before the onset of dialysis and renal transplantation. Conclusion: Conclusion will be drawn from the statistical analysis.

Central line associated blood stream infection (CLABSI), is a substantial contributor to in-hospital morbidity and death, as well as increased cost and length of stay in the intensive care unit (ICU). CLABSIs are one of the most deadly for each infection is expected to have a mortality rate of 12-25 percent. CLABSI prevention is important, and nurses play a vital role. Nurses are required to complete initial training as well as annual competence tests for central venous catheter protocol and other skills to ensure that they are delivering direct care to patients using the most up-to-date evidence-based practices. Conclusion: CLABSI prevention bundles are the best method for implementing many interventions at once in addition to standardizing practice. Standard prevention bundles in addition to routine CLABSI education for staff are the most effective methods for preventing infection; it is inevitable that compliance with bundles will vary across healthcare institutions.

Introduction: Subarachnoid haemorrhage (SAH) is caused by intracranial bleeding into the cerebrospinal fluid-filled space between the arachnoid and pia mater membranes on the surface of the brain. Patient History: The 65-year-old female patient was hospitalised to AVBR hospital in neurosurgery ward on December 25, 2020 with the chief complaints of headache, vomiting and episodes of seizures since three days. The patients had episodes of seizures on 21/12/2020 and 24/12/2020. The day later she was admitted to the Intensive Care Unit.she underwent all routine investigations like blood tests, and CT scan. After a thorough examination, the final diagnosis was subarachnoid haemorrhage. Past History: Patient did not have any history of communicable disease, asthma, tuberculosis, or any hereditary disease. Patient was COVID – negative and did not have any significant surgical history. Pharmacology: Patient was treated with proton pump inhibitor, antiemetic, antiepileptic, calcium channel blocker, stool softener analgesic and antipyretic. Management: Inj. Levipril 500 mg, Inj.pan40-40mg, cap.nimodipine 60mg every four hourly, Inj.emset 4 mg, Inj. Neomol 100 ml, Syp. glycerol 30 ml, Syp. Zincovit 2tsp and Tablet Dolo 650mg. Nursing Management: Patient’s vital sign (including blood pressure) and neurological status were monitored with bed rest, pain management and assessment of risk of bleeding. Conclusion: Patient was hospitalised with a threeday history of headache, vomiting, and episodes of seizures actively managed; condition satisfactory.

Introduction: Child maltreatment and neglect are considered important issues in the US. However, parental-child violence is not studied enough to provide a comprehensive understanding of the underlying causes. Aim: To determine the parent's reported causes of actual children who are abusing the age bracket of 6 to 12 years. Methods and Materials: The descriptive survey study design was used with a quantitative research approach conducted in a selected community area of Wardha town. The sample size was 200 parents with children aged 6 to 12. Pre-tested and validated structured questionnaires were used. The data gathered was registered into the Microsoft Excel sheet. The statistical analysis ended up being done SPSS. The frequencies and percentages of categorical variables had been provided. Results: The parents reported causes for physical abuse among children of 6 to 12 years were seen into 4 categories, once in a week, sometimes, twice in a week, and never respectively. 37.5% of the parents reported twice in a week and 62.5% of them never reported causes. The mean score of parents who reported causes of physically abuse children in the age group of 6 to 12 years was 44.58 ± 4.66 and the range of the score was 32 to 56. Demographic variables such as age in years, gender, monthly income, education, area of residence, and relationship with parents were statistically associated with their reported causes. Conclusion: Community-based methods, such as house visits, are incredibly efficient in changing the behavior of parents at risk of misuse. Targeted programs for moms with mental disorders and substance abuse are also shown to be effective in stopping emotional abuse [1].

Introduction: Hydrocephalus is the accumulation of fluid in the cavities deep within the brain. The extra fluids cause the ventricles to expand, putting pressure on the brain. The brain and spinal column are bathed in cerebrospinal fluid, which usually flows into the ventricles. Excessive cerebrospinal fluid pressure caused by hydrocephalus, on the other hand, can harm brain tissues and result in a variety of cognitive impairments. Case Presentation: Here we have selected a case of hydrocephalus. In this case, when the complete history has been taken it found that patient having a history of NICU admission for prematurity and Low Birth Weight for 40 days. During history collection, it found that the child was all right until 4 months of age after which she started to notice that the child's head circumference was increasing at an abnormal rate and has now been brought to AVBRH for further management. After all investigation in MRI brain reveals extensive dilatation of ventricular system including bilateral lateral ventricle and III and IV ventricles associated with wide-open foramen of Luschka and Magendie with thinning of the adjacent cerebral cortex and cerebellar parenchyma. Features suggestive of communicating hydrocephalus. In the EEG record, the background record shows rhythmic synchronous > 13 Hz beta activity in the bilateral hemisphere. Abnormal EEG record. Then, the doctor planned for the Endoscopic Third Ventriculostomy with general anesthesia. Conclusion: In this study, we mainly focus on expert surgical management and excellent nursing care which leads to fast recovery of the patient. After a conversation with the patient, her response was positive and after nursing management and treatment, she was discharged without any postoperative complications and satisfaction of recovery.

Introduction: Complete Heart Block (CHB) occurs when the electrical signals can’t pass normally from the atria, the heart’s upper chambers, to the ventricles or lower chambers. This condition can develop because of congenital or secondary to cancers, myopathies or heart ischemia, infectious or endocrinological disorders and it needs comprehensive work-up to be excluded. Background: In the United States, the prevalence of third degree atrioventricular (AV) block that is complete heart block is 0.02 percent. The prevalence of third-degree AV blocks worldwide is 0.04 percent. With advancing age, the rate of AV conduction defects rises, resembling the age-related incidence of ischemic heart disease. Case Presentation: A case of 68 year old female admitted in cardiac ward on date 11 january 2021 with the chief complaint of breathlessness on exertion, restlessness, chest pain and loss of appetite since 2 month. The patient is a known case of hypertension since 5 year, Ischemic heart disease sine 1 year. after physical examination and other investigation like ECG, electrocardiogram the she diagnosed as a complete heart block with third degree. Interventions: The patient was treated by placing permanent pacemaker on dated 18 january 2021. After that started the antibiotic like inj. targocid, inj. ceftriaxone, tab. linezolid, tab. orabest, tab. telmed H and taking also the anticoagulant therapy. She also under the care of cardiologists and monitor by hourly, also monitor the electric activity of pacemaker. Provide health education about healthy diet, life style modification, yoga and exercised, control over blood pressure and regular follow up. Conclusion: This study mainly focusing on the medical and placement of permanent pacemaker which help the heart to do their normal function and passing a normal electrical signals throught the heart rhythm. A good nursing care needed for the patient who have complete heart block and surgical implementation in permanent pacemaker for continue monitored, no any complication can occur during or after pacemaker implantation. the patient response for the treatment was good and she recover rapidly.

Background: A typical manifestation of pancreatic tail cancer is large intestinal obstruction with perforation. Clinically the cancer of pancreas is usually complicated to diagnose. Most cancer patients are not having symptoms throughout during the initial stages of the cancer, which often leads to a delay in diagnosis. Treatment choices include surgery, chemotherapy, and palliative care. It is more common in African-Americans, slightly more common in men. Case Presentation: A female patient of 40 years from Wardha was admitted to Female surgery Ward, Unit-3, AVBRH on 18th December with a chief complaint of pain in epigastric region since 2weeks. Patient was apparently all right 2 months back then she was complaining of pain in the epigastric region which was insidious in onset, gradually progressive in nature, burning type of pain with radiating to left upper back. No history of fever, nausea vomiting, clay-coloured stools. After that patient was undergone on routine investigation in that total WBC count was increased i.e., 13000/cu mm and haemoglobin level were decreased i.e., 9.7gm%, liver biopsy revealed that metastasis of Adenocarcinoma probably of pancreatic origin, Computed tomography and ultrasound and it revealed that heterogenous iso-echoic mass in the tail of pancreas based on investigation she was diagnosed as a case of Carcinoma tail of pancreas and she was undergone on treatment of antibiotic before chemotherapy .after that chemotherapy treatment was done for management of pain. Conclusion: Pancreatic adenocarcinoma presents differently from large intestinal cancer and should be explored in the differential diagnosis of large intestinal obstruction.

Introduction: Covid-19 pandemic disease and its infections caused may be associated with bacterial and fungal co-infections. Case Presentation: A 61- year-old male patient, after Covid-19 disease admitted in hospital with the complaints of headache, right eye swelling, watering of right eyes, loss of vision since 2 days, also has history of loss of appetite, no history of febrile illness. Patient having history of diabetic mellitus but it was under control. As per physical examination left eye’s vision was reduced but eye movement was present. In right eye there was swelling of periorbital region, redness, watering of eyes was present and perception of light was negative due to damaged optic nerve. Loss of vision was found, eye movement was not present. Patient having mucormycosis fungal infection which was confirmed on culture test. All blood investigations were done. All reports were normal except white blood cells (WBC) were raised with 13400cu.mm. Random blood sugar (RBS) 250 mg%. Without delay medical treatment was started and patient was kept under strict observation.Spo2 were 97%, pulse rate 78 beats/ min. Conclusion: Here we would like to bring into notice that, Medical team members should know about the danger of secondary invasive fungal infection in a patient after Covid 19 disease. This type of cases can be prevented by using hygienic technique while handling of patient and proper standard treatment. It is necessary to prevent the spread of infection and its mortality and morbidity. Hence, medical practitioners should be aware of early clinical manifestation of the disease.

Introduction: There are two types of renal surgery i.e. partial nephrectomy and one other is total nephrectomy. Mostly, nephrostomy performs in malignant tumors of the renal. Sometimes it performs in kidney injury due to that no longer function and it may create any obstructive disorder in the renal system. Patient Information: A 45-year-old male patient presented with complaints of pain in the abdomen since 4 months. The patient was advised to ultrasonography abdomen and pelvis. Contrast-enhanced computed tomography (CE-CT) abdomen and pelvis were done. Previous treatment was undergone left-sided PCN for gross hydronephrosis of the left kidney. But after 4 months patient developed abdomen pain which was insidious in onset and progressive in nature. The pain was dull aching, in the left loin region, radiating to the back and intermittent. There are no aggravating or relieving factors associated with it and the patient is now referred to our hospital for further management patient was admitted to the male surgical ward. After the surgery planed left simple nephrectomy. Post-operative medication given, Inj. Revotaz (Piperacillin and tazobactam) 4.45 gm, Inj. Nirmet (Metronidazole) 100 ml, Inj Pantomay (Pantoprazole) 40 mg, Inj. Setron (Ondansetron) 4 mg, Inj tramadex (Tramadol hydrochloride) 100 mg, Inj temfix IV (Paracetamol) 100 ml. Discussion: Nephrectomy is one of the urologists conducting the most common ablative surgery. A non-functional kidney or an irreversibly impaired kidney is the commonest sign for a nephrectomy. Chronic infection, obstruction, calculus disease and serious traumatic injury are other typical indications for nephrectomy. Conclusion: In this case, the patient was on a closed monitor. To accomplish overall the situation during the time of surgery. Over all the patient response was positive for conservative and nursing management and after treatment the patient was discharged without any postoperative complications and satisfaction with full recovery.

Introduction: Coronary artery disease (CAD) involves the decrease flow of blood to muscle of the heart because of the to build-up of plaque (atherosclerosis) in arteries of the heart. It is one of the most common cardiovascular disease. Tiny branches off larger coronary arteries are get damaged and not able to dilate proper. Small vessels need to expand and also providing oxygen-rich blood to heart. Coronary arteries are damaged, blood flow to the heart decreases. Background: Coronary artery disease affected 110 million people and resulted in 8.9 million deaths. It makes up 15.6% of all deaths, making it the most common cause of death globally. In the developed country risk of death from CAD decreased between 1980 and 2010. Case Presentation: A case of 60 year old men admitted in the cardiac unit with complaints about the abdominal pain and Nausea, vomiting, weakness from the 2 days after examining and blood pressure is 110/70 mm of Hg. He had these complaints since 2 days. Interventions: The patient was treatment started with orally Tab. Ecosprin 150mg, Tab.Ultracet, Tab. Pantop 40 mg, Tab. Augmentin 625 mg. Patient is also undergone PTCA(Percutaneous Transluminal Coronary Angioplasty). Treatment consisted of medication, therapeutic exercise, and health education. Conclusion: In this study, we mainly focus on medical and surgical management and outstanding nursing care helped prevent further complication. Over all the patient response was good and improvement occur after PTCA.

Introduction: Urinary bladder cancer is a global health problem. Carcinosarcoma of bladder is a very rare abnormal growth of cells and tissues called as tumors and it consist of malignant epithelial and sarcomatoids components. It mostly occurs at aging. Presentation of disease with hematuria i.e. blood in urine and painful urination i.e. dysuria. Pelvic radiation and cyclophosphamide therapy are the risk factors responsible for carcinoma of bladder. Clinical Findings: Severe abdominal pain, fever (Temperature- 1000 F), weakness, Anemia (Hemoglobin- 10.6gm %). Diagnostic Evaluation: Blood test Hemoglobin -10.6 gram %, Total Red blood cell count- 3.4 million/cumm, Hematocrit- 21.45, Total White blood cells count- 12,000 per microliter. In ultrasonography it was found that, a mass present on the right lateral wall of the urinary bladder. Therapeutic Intervention: Hemoglobin was raised by blood transfusion, Inj. Ceftriaxone 1gm Intravenously BD, Inj. Pantoprazole 40 mg Intravenously BD, radiation therapy and chemotherapy. Outcome: As compared to prior condition patient’s present condition show improvement. Fever was reduced and relieved abdominal pain by treatment and procedure transurethral resection of bladder tumor. With the help of blood transfusion Hemoglobin % increased from 10.6 to 11.5gm%. Conclusion: My client was admitted to female surgery ward, at Acharya Vinoba Bhave Rural Hospital Sawangi (Meghe), Wardha with an unknown case of Ca bladder. On admission her condition was poor. So on clinical manifestation, specific and routine investigation was done and after proper treatment her condition was found improved than previous. Here we have to emphasize on early diagnosis and proper treatment strategies helps to improve patient’s prognosis. It also helps to prevent morbidity and mortality.

Introduction: Hydrotherapy is a warm water therapy used in relieving pain such as muscle pain, back pain and inflammation associated with the arthritis pain. In arthritic condition hydrotherapy helps to improving blood circulation. It is commonly used for treating muscle injuries and stroke and brain injuries. Objectives: To determine the effectiveness of mechanical hydrotherapy on pain management among patients with arthritis pain. Materials and Methods: In this study a quantitative research approach with an experimental pre-test post-test research design was used for the present study. Purposive sampling was the sampling method used to collect data from arthritis patients on the basis of standardized numerical pain rating scale (NPRS). The sample size was 70, for experimental group 35 samples and control group was 35 samples. For experimental group the mechanical hydrotherapy was given along with prescribed medicines and for control group only prescribed medicine was monitored. Results: The majority of participants were male 41 (58.57%) and female 29 (41.43%) as compared to male. In experimental group male were 22 (62.85%) and female were 13 (37.15%) and in control group male were19 (54.28%) and female were 16 (45.72%). Before intervention on day-1 pre assessment pain mean value was 7.51 and standard deviation was 1.46 in experimental group and In control group mean value was 7.91 and standard deviation was 1.12. On day-7 post assessment pain the outcome of an experimental group after mechanical hydrotherapy with reducing pain, mean value was1.80 and standard deviation was 1.07 and in control group mean value was 7.97 and 1.27. Statistically significant improvement seen in the level of pain regarding effectiveness of mechanical hydrotherapy on pain management among patients with arthritis pain. Conclusion: Hence it is statistically clear that, the mechanical hydrotherapy to arthritis patients is helpful in managing the pain effectively.

Introduction: Wilson’s disease (WD) is an autosomal recessive disorder involving cellular copper transport. A defect in biliary excretion leads to accumulation of copper in the liver, causing progressive liver injury and cirrhosis. Approximately 1 in 40,000 people have Wilson’s Disease. It affects both men and women equally. Symptoms appear between ages 5 and 35. Case Presentation: This is a case of 17 years old girl came with complained of dysphagia, irritability, breathlessness, weakness in both upper and lower limb at left side for 6 months. She had difficulty in going up and coming down a staircase and in getting up from the squatting position. She could walk with support for the first 6 months of his illness but later, had required crutches. After her admission diagnostic evaluation was done, and in the findings was chest x-ray was done which was normal. ECG showing normal sinus rate and rhythm. Ophthalmology call was done and slit lamp examination was noted which was showing KF ring was present bilaterally. MRI brain suggested symmetrical altered signal intensity lesion in bilateral thalami and lentiform nucleus, midbrain and pons appearing hyper intense on T2/FLAIR sequences in bilateral gangliocapsular region (mainly in putamen) and thalami as well as midbrain and dorsal aspect of pons as described above. A possibility of Wilson’s Disease can be considered, blood test show that Hb was decrease that is -9.7gm%, S.G.O.T was 34.0U/L, S.G.P.T was 32.0U/L, was normal at the time of discharge early ambulation, nutrition, psychological support was given. Therapeutic interventions and outcome: In the present case received syndopa 110/4, BD, orally. Tablet Zinc, OD, orally. Tablet Pan D, OD, orally., inj. Dexamethasone 2 mg I.V, T.D.S., Syrup Sumax, 10ml, BD. Now the patient condition is stable. Conclusion: This presented case of Wilson’s Disease is a rare disease condition. It is an autosomal recessive disease.In this case study, author mainly focus on expert medical management and excellent nursing care which leads to fast recovery of patient. After conversation with patient her response was positive and after nursing management and treatment she was discharged with satisfaction of recovery.

Background: Chronic renal failure (CRF) or Chronic kidney disease (CKD) is an irreversible progressive loss of kidney functions in which, kidney fails to sustain the metabolic waste, fluid and electrolyte balance in the body. The prevalence of chronic renal failure is 15% to 17 % in adult population in many developing countries. Objective: To find out the effectiveness of Self Support Group (SSG) for Chronic Renal Failure patients (CRF) and caregivers on their quality of life (QOL) Methodology: It is a single arm trial, interventional hospital based study. The patients of chronic renal failure of age group 18 to 50 years and caregivers age group above 18 years. Selection of patients and caregivers as per inclusion criteria, detail explanation about nature and purpose of the study, from the subject will be taken before data collection by the investigator after that the formation of groups for chronic renal failure patients and caregivers. Empowerments of the group with knowledge of chronic renal failure and its management, than evaluation quality of life (QOL) for patient and their caregivers with use of QOL scale. The assessments of quality of life for four times, it include day one to three months, six months and nine months respectively. The setting of the study is selected hospitals of Vidarbha Region. Expected Results: Formation of Self Support Group for CRF patients and their caregivers in Hospital Setting Improvement in knowledge regarding CRF of patients and their caregivers Improvement in QOL for both CRF patients and caregivers Conclusion: Conclusion will be drawn from the statistical analysis after completion of data collection.

Self-support groups bring the patients together who is suffering from the same kind of disease conditions or problems or illnesses to share their experiences. Chronic renal failure patients and other illness support groups are a growing need in many communities. When planning for the management for CKD (Chronic Kidney Disease) patient, if involve the patient or patient is participating actively, it will help in effective management of chronic kidney disease. It may aid in the patient's prognosis and can be postponed in part by self-management. Self-management of Chronic Kidney Disease is complicated due to the progressive nature of the condition and its progression. The management of Chronic Kidney Disease by a self-help group is difficult to assess, particularly over time. SMS (Self-Management Support) is important for this progressive disease because of the special nature of Chronic Kidney Disease self-management. SMS stands for the programmes that health-care providers provide to their patients in order to help them better control of their health. Dissemination of health information, patient education, telephone support, and participation in a support group are all part of you.