<s>[INST] My mother suffering from rheumatic heart disease and recently had open heart surgery on oct14.before surgery she had taking an injection named penidure la-12 once in every 3 weeks from fast 30years. now operaction is sucussufully after  2months she getiing rumatic pains ..my doubt is could she continew the pendure 12 inject or not..could you pls help me out [/INST] Hello, I have gone through your question. Thanks for using Chat Doctor. Inj. Penidure LA 12 lack is usually given to all patients having Rheumatic valvular heart disease to prevent spell of rheumatic fever and to prevent further deterioration of valvular lesion. Irrespective of surgery we give Endure prophylaxis till age of 45 Yrs. Because incidence of recurrent streptococcal sore throat goes down after this age. In case of your mother please evaluate her for her joint pain by CBC, ESR , CRP and AS title. If these reports point towards active rheumatic fever then after completing course of 4 weeks of aspirin she should be give Endure till another 5 years. My best wishes Chat Doctor.  </s>