Effect of patient counseling on quality of life of hemodialysis patients in India.

UNLABELLED: End stage renal disease (ESRD) is a growing problem. The effect of patient counseling is to be defined on health-related quality of life. OBJECTIVE: The purpose of this study was to find out the impact of patient counseling in health related quality of life (QoL). METHODS: In this prospective interventional study, the Karnofsky Performance Status (KPS) for QoL questionnaire was used in test and control groups for data collection. The same data collection method was used during six months to study the effect of patient counseling. RESULTS: Health related quality of life in test group showed a consistent improvement of 2% in six months. Improvement of awareness by patient counseling was also improved. CONCLUSION: As part of medication therapy management (MTM), patient counseling focusing on dialysis compliance, diet and medications are an effective way to improve health-related QoL and awareness in ESRD. Such services should be made mandatory by law in India to improve outcomes in chronic illness.

Placental mesenchymal dysplasia associated with hepatic mesenchymal hamartoma in the newborn.

Placental mesenchymal dysplasia is an uncommon disorder in which the placenta is enlarged with abnormal, large, and often cystic villi with dilated and/or thick-walled vessels. These placental changes can mimic a partial hydatidiform mole but in contrast to a partial mole can coexist with a fully viable fetus. Fetal anatomical and vascular anomalies frequently coexist with placental mesenchymal dysplasia. In this case, placental mesenchymal dysplasia was associated with preterm labor at 33 weeks' gestation, fetal compromise, and a large abdominal mass with a large hepatic cyst that was de-roofed at exploratory laparotomy. The neonate remained critically ill with hypoxic ischaemic encephalopathy and coagulopathy and died despite intensive care. Biopsy and autopsy findings showed a large cystic mesenchymal hamartoma affecting the left lobe of the liver. This appears to be the 3rd histologically confirmed association of placental mesenchymal dysplasia with mesenchymal hamartoma of the liver in the English language literature.