Role of educational intervention with practical demonstration in improving inhaler technique

Background: Chronic respiratory diseases are among the leading causes of morbidity and mortality worldwide with chronic obstructive pulmonary disease (COPD) and asthma being the most common. There is under-utilization of the basic tools of inhalation therapy technique(s) in their management. Implementation of a personalized educational and demonstrational intervention by the attending physician during regular follow-up visits of these patients will substantially improve the treatment outcome.Methods: This prospective interventional study was conducted on 239 diagnosed cases of asthma and COPD. Inhaler technique was assessed in accordance to standard checklist and errors were corrected by a practical demonstration. A follow-up assessment was conducted for the same after 2 weeks. Data thus collected was evaluated.Results: Out of 239 patients, 47.6% (n=114) reported for follow-up assessment. Average reporting time for follow-up assessment was 27.4 days. Amongst them, an improvement of at least one step was found in 86.8% (n= 99) and about 28% (n=32) patients performed all steps correctly. Average number of steps improved was 2.1.Conclusions: Majority of the patients showed an improvement in the inhaler technique during follow-up assessment after an educational intervention and practical demonstration. Near perfection was achieved by about more than quarter of the patients. Regular practical demonstration of the inhalation technique during subsequent follow-up sessions unequivocally improves results.

Swyer-James-Macleod Syndrome: A Rare Entity.

Swyer-James-MacLeod syndrome is a radiological entity characterised by hyperlucency of one or more lobes or of the entire lung associated with decreased number and diameter of ipsilateral peripheral pulmonary vessels resulting in difficult visibility of the arterial network, and unobstructed bronchial system. We report the case of a 12-year-old girl who presented with chief complaint of pain in the chest. Chest radiograph (postero-anterior view) showed hyperlucent left lung field with increased lung volume and shift of the mediastinum to the right side. Contrast-enhanced computed tomography (CECT) of the chest showed hyperlucency and diminished vascularity in the upper lobe and lingula of left lung with hyperinflation of the pulmonary parenchyma. On the basis of clinical and radiological findings, the patient was diagnosed to have Swyer-James-MacLeod syndrome.

Prevalence of Diabetes Mellitus in Rural Population of Jammu.

Diabetes Mellitus (DM) is increasing in epidemic proportion globally. This curent observational hospital record based study was planned to estimate the prevalence of DM in various age groups in rural population of Jammu.Out of 4000 patients screened 194 were found to be having DM i.e. prevalence of DM was found to be 4.85%. Out of 2083 males screened 99 were suffering from DM i.e. prevalence of 4.6%. Whereas out of 1917 females screened 95 were suffering from DM i.e. prevalence of 4.9%. Prevalence of DM was maximum in age groups of 41 to 50 years i.e. 5.89%.Prevalence of DM in males was found to be maximum in age group of 41-50 years i.e. 5.4%. Prevalence of DM in females was found to be maximum in age group 41-50 years i.e.6.6%.Thus the current study recorded alarmingingly high prevalence of DM among rural population which should be a cause of concern for health care providers.

Idiopathic pulmonary artery aneursym.

Idopathic pulmonary artery aneurysm (PAA) is a rare lesion. Clinical experience with this condition is limited and current knowledge is mainly derived from autopsy findings. We report a patient who came to us with complaints of chest pain, breathlessness on exertion and pedal oedema and was diagnosed to have PAA.

HIV/AIDS in Families.

HIV/AIDS is a disease that affects families in a profound and tragic way affecting family structure by erasing decades of health, economic, social progress and reducing life expectancy. There is limited empirical data on HIV/AIDS affected families.The present one and half year prospective study was conducted to identify HIV/AIDS existing in families. HIV/AIDS cases were diagnosed as per the NACO, 2000 criteria.The present study enrolled a total 230 HIV/AIDS patients. 65.21 % (150) of the patients were married and 34.78% (80) were unmarried. Among total unmarried population 27.39% (63) and 6.52% (17) were adults and pediatric population respectively. Among total pediatric population 4 were orphan, 3 were partially orphan with mother alive and 10 were with both parents alive but both positive for HIV/AIDS. Among total married 13.04% (30) were widow/widowers who had lost their spouse, whereas those living with live partner were 52.17% (120) forming a total of 60 pairs of couples. Among these 60 couples 40 of them were both positive for HIV/AIDS, in 15, single partner was positive with interesting finding in one case where male was negative and female was positive and mode of transmission was unclear and in another 5 status of spouse was not known due to unknown reasons. Among 40 couples where both partners were affected, 3 couples were isolated where complete family ie all children were affected by HIV/AIDS; in another 20 couples children’s were not affected; in 4 couples children were partially affected i.e. some children’s were affected; in 9 couples status of their children’s were not evident and another 4 couples were without any issue.The results of present study suggest HIV/ AIDS affects whole family and not an individual and thus whole family should be screened, evaluated, treated and educated for HIV/ AIDS.