Background: Study of risk factors help make patients aware about them and they can be taught to take proper precautions to prevent the exacerbation of asthma. Objective was to study factors influencing bronchial asthma exacerbations with special emphasis on inhaler usage.Methods: A hospital based cross sectional study was carried out over a period of three months among 218 eligible patients with asthma who could give written informed consent and willing to participate in the present study and the data was recorded in a pre tested, semi structured study questionnaire. The data was recorded in the Microsoft Excel Worksheet and analyzed using proportions and mean+2SD.Results: We found that advanced age, exposure to dust, fumes and allergens, lower social class, presence of other co-morbidities, irregular use of inhalers, and not demonstrated the technique of proper inhaler use were significantly associated with exacerbation of bronchial asthma. Other factors like mean duration of illness, mean duration of use of inhalers, gender, presence of allergic rhinitis, type of device used for inhalation and taking consultation from pulmonologist were not significantly associated with exacerbations of asthma.Conclusions: Demonstrating and teaching the patient on how to use the device of inhaler plays a significant role in reducing the risk of exacerbation of bronchial asthma.
Background: More than fifty percent of the cured cases of pulmonary tuberculosis develop some form of chronic pulmonary dysfunction. It can present with varying degrees of lung damage, ranging from minimum functional abnormalities to severe forms of dysfunction that can be an important cause of death. Objective of the study to identify the various Post Tuberculosis Lung Diseases (PTBLDs) and to study impact of the patient and disease related factors on its occurrence.Methods: Cross-sectional, observational study was conducted in 134 adult, post tuberculosis patients, aged between 18-65 years, who have completed at least one year after the end of anti-tubercular treatment. All symptomatic post TB lung disease patients coming to the pulmonology out-patient clinic at the Apollo Institute of Medical sciences and Research were included in the study.Results: Majority were more than 50 years (35.3%) and males (59.4%). Majority were from urban areas (70.7%), low social class (72.2%), and unskilled workers (56.4%). Most common symptom was cough in 74.4% cases. Majority of the cases had symptoms from one week to one month i.e. 47.4%. Only eight cases were found out to be very prompt in reporting their symptoms. 39 cases had some or the other co-morbidity. Current chest X-ray status was normal in only three cases. Mean FEV1 was 1.38 which increased to 1.52; mean FVC was 1.23 which increased to 1.58; mean FEV1/FVC was 67.37 which increased to 72.76 after giving the bronchodilator. 78(58.6%) cases had obstructive and 27(20.3%) had restrictive lung disease. In 30 cases the disease was reversible. Majority of the cases were of pulmonary fibrosis followed by bronchiectasis.Conclusion: Further studies are needed to develop approaches for the prevention, care and treatment of patients with post TBLD.
BACKGROUNDBronchial asthma and chronic obstructive pulmonary disease are the Common Respiratory Diseases (CRD's). Drugs delivered through inhaler devices are the backbone for treatment of CRD's. Inhaler technique errors are common even after more than 60 years of introduction of these devices.The aim of the study is to explore the faulty inhaler techniques among patients with asthma and chronic obstructive pulmonary diseases. Health education has significant impact on improving the inhaler technique thereby achieving better disease control and also brings out regularity of inhaler usage by patients. MATERIALS AND METHODSAll the relevant information including patients profile and usage of inhalers was collected by a prepared questionnaire from 242 patients with asthma or COPD attending our OPD. The patient's inhaler technique was assessed using a standard checklist for proper use of a Metered-Dose Inhaler (MDI) or Dry Powder Inhaler (DPI). All the participants were asked to demonstrate their inhaler technique, which was assessed and documented. Education was given to all patients about the correct inhalational method and they were also counseled to adhere to it. Inhaler technique was reassessed in all the patients after a month and reinforcement of the correct technique was done. Statistical Analysis-Using the chi-square test, P-values of each variable like age, gender, education, duration of illness, etc. were derived. P value of less than 0.05 was considered significant. Settings and Design-This is a cross-sectional study with an interventional component done on 242 patients with bronchial asthma or COPD attending the pulmonology OPD in Apollo Institute of Medical Sciences and Research. RESULTSOut of 242 patients studied on baseline evaluation in the first visit, only 46 patients (19.008%) were able to do the technique correctly, which after education on the correct inhaler technique increased to 134 patients (55.37%) in the follow up visit done after a month. CONCLUSIONErrors in inhaler technique still persist in patients with chronic respiratory diseases and the best way to counter this is by effective patient and physician education.
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