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Background: Asthma is associated with high morbidity and mortality in India. This survey was undertaken to explore the perspectives of pulmonologists towards in-clinic management of patients with asthma. Methods: It was a cross-sectional survey of pulmonologists conducted across India. It was formulated to provide unbiased observations of real-world clinical practice focusing on methods of diagnosis of asthma and its treatment preferences. Results: The participants included 805 pulmonologists, with the majority primarily treating patients with asthma (62%), chronic obstructive pulmonary disease (19%) and allergic rhinitis (19%). More than 86% of pulmonologists consider clinical symptoms, history of childhood asthma, family history, and chronic allergic rhinitis for initial diagnosis. About 19-23% prefer spirometry alone or in combination with family history for confirmation of asthma. The preferred inhaled corticosteroids-long-acting bronchodilator (ICS-LABA) combination was budesonide-formoterol amongst 83% of pulmonologists. For both dry powder inhaler (DPI) and metered dose inhaler (MDI) devices, fine particle fraction per cent and delivered dose were ranked as the two most important attributes. Conclusions: Asthma is the most prevalent diagnosis among patients treated by pulmonologists on the basis of clinical presentation and medical history. The most commonly used pharmacotherapy for the treatment of asthma comprises ICS-LABA, with budesonide-formoterol being the preferred combination. Fine particle fraction per cent and magnitude of delivered dose influence the choice of asthma inhaler prescriptions the most.
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Background: Tobacco smoking is a global phenomenon, associated not only with health but also with other issues like employment, trade and revenue. However, the ill aspects of tobacco outweigh any productivity related to it. Various regulatory measures have been devised to control this menace at national as well as international level. In India, COTPA-2003 legislation intends to control and regulate tobacco consumption, advertisement and trade. Methods: The present study assessed the compliance of 157 points of sale and 59 tobacco products to the Sections 5,7,8,9 and 10 of the smoke free legislation using a structured observational checklist. Results: In total (41%) POS were advertising tobacco in one or other form with product showcasing (64%) being the most common modality of advertisement. Actual advertisement boards were seen at only 14.6% of POS. About 87% of the advertisement boards carried a health warning. Loose cigarettes were being sold at about 77% of the POS. All tobacco products available in the city were observed to display good compliance; however none of the smoke product displayed nicotine and tar content on the pack. Conclusions: Negligible number of PoS was seen to display an actual advertisement. Almost all tobacco products displayed good compliance to the Act. The striking shortcoming was the absence of nicotine and tar content on the package of the product even after 16 years of enactment. Discrepancies need to be addressed appropriately supplemented with aggressive monitoring of adherence to the Act in order to sustain the smoke free status of the city.
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Contact lenses are optical device that are supposedly safe to be used to correct refractive errors as well as for cosmetic purposes. However problems related to eye health do occur as result of contact lens wearers’ attitude of not following the guidelines prescribed by their eye care practitioners. A clinical survey on lens care was carried out amongst contact lens wearers in Kuala Lumpur. It was based on a set of 22 questions focused on lens care including methods of cleaning and disinfection, enzyme treatments, use of rewetting agents and the frequency of follow-up examinations. In addition there were six questions included to explore wearers’ knowledge related to contact lens care and safety. A total of 104 wearers participated in the survey. About 86% of them were females and their mean age was 24 ± 6 years. More than half of them wore disposable lenses. Almost all of them (98%) use chemical disinfection system. Sixty-eight percent (68%) of wearers surveyed cleaned their lenses prior to and after wearing their lenses. Thirty percent (30%) of wearers used re-wetting agents and 40% used protein tablets. Sixty-one percent (61%) of them said that they never went back for aftercare examinations. The mean correct responses for six questions assessing participants’ knowledge on contact lens care and safety was 61.4%. Our results implied that contact lens wearers were not well informed of the risks and consequences to their eye health as results of not following the strict regimes recommended by their practioners. Contact lens providers should reconsider strategies to ensure wearers’s compliance so that complications can be minimized