Lung Function and Health Status in Patients of Chronic Obstructive Pulmonary Disease on Treatment with Tiotropium

Introduction: Chronic obstructive pulmonary disease (COPD) is a group of chronic and slowly progressive respiratory disordercharacterized by reduced maximum expiratory flow during forced exhalation. Tiotropium, a long-acting antimuscarinic agent,has well-known documented effect on improving lung function and quality of life (QOL). There are many studies globally ontiotropium and its effect on lung function, but limited studies available in our Indian set up. Hence, we planned this study.Materials and Methods: Patients were recruited from chest clinic and outpatient department from the Department of Medicineof University College of Medical Sciences and GTB Hospital. It was a prospective observational cohort study conducted fromNovember 2017 to April 2019. Tiotropium was given as meter dose inhaler in dose of 18 µg per dose, in schedule as prescribedby the Global Initiative for Chronic Obstructive Lung Disease-2017 guidelines. Patients were followed up for 3 months withperiodic assessment of lung functions, Saint George’s Respiratory Questionnaire (SGRQ) score, and symptoms assessment.Results: A total of 65 patients were recruited for study which included 57 (87.7%) males and 8 (12.3%) females. Among thepulmonary function tests measured, there is a significant change in mean forced expiratory volume (FEV1) at the end of followup period compared to FEV1 at baseline. There is a significant change in mean forced vital capacity at the end of follow-upstudy compared to start of the study. There was no significant change in mean SGRQ score after 1 month of start of drug,but significant statistical change observed at end of the 3rd month of the study compared to the 1st month that implies SGRQscore decreased and patients health status and QOL improved. There is a significant change in mean SGRQ score at the endof follow-up study compared to baseline. In our study, 16 patients (24.6%) complained of dry mouth, 7 (10.7%) complained ofpharyngitis or throat irritation, and 3 (4.6%) patients complained of constipation.Conclusion: There was a statistically significant change in lung functions and improvement in QOL scores as assessed bySGRQ at the end of the study compared to baseline by use of inhaled tiotropium in COPD patients

The 3-Question Approach: A Simplified Framework for Selecting Study Designs

Conventional algorithms for selecting study designs are difficult to use for a novice researcher, especially the postgraduate students. Aninherent limitation of using the existing algorithms is the requirement of a priori knowledge of the characteristics of various study designs.We propose a simple and novel 3-question approach to select study designs. The questions are asked in a stepwise manner with answersin ‘yes’ or ‘no’. The responses to each of these questions lead the researcher towards choosing the appropriate study design. We believethat this 3-question approach would be useful for unexperienced researchers in selecting study designs, besides serving as a tool toteach-learn selection of study designs

A Study on the Effect of Janani Suraksha Yojana on Antenatal Registration and Institutional Deliveries in the Agra District of Uttar Pradesh.

Janani Suraksha Yojana (JSY) was launched in April 2005, to promote institutional deliveries through provision of cash assistance, transport, escort, and referral services. An observational cross-sectional study was conducted to assess the antenatal registrations, postnatal checkups, and institutional deliveries, and to compare the various social groups. Married women of the reproductive age group, having at least two children, were interviewed regarding antenatal care, delivery, and postnatal care in both pregnancies, latest as well as previous. Post JSY implementation, antenatal registrations increased from 61.79 to 96.34%, Deliveries at the Government Health Facility increased from 25.20 to 53.25% and postnatal check-ups increased from 45.93 to 69.51%. In the post-JSY-implementation phase, the Government Health Facility was preferred more by Scheduled Castes (SC), Scheduled Tribes (ST), Other Backward Classes (OBC) (SC/ST = 56.87%, OBC = 60.2%, and general = 43.68%), educated (Illiterate = 17.39%, Primary = 88.14, and Middle or above = 81.94%) and the lower socioeconomic classes (Lower SEC 71.83% and Upper lower and above = 45.71%) for their deliveries. It appears that the socially backward groups have benefi ted more from JSY.

A study on infant and young child feeding practices among mothers attending an urban health center in East Delhi.

A cross sectional study was conducted to study the diet pattern of children less than 2 years with regard to certain infant and young child feeding (IYCF) indicators. A total of 374 children less than 24 months of age coming to the immunization clinic were studied using a standard pretested and prevalidated questionnaire. Exclusive breastfeeding was followed by 57.1% of children under 6 months of age. Minimum dietary diversity, minimum meal frequency, and minimum acceptable diet were seen adequate in 32.6%, 48.6%, and 19.7% of children between 6 months and 2 years of age, respectively.