RANDOMIZED, OPEN LABEL, ACTIVE CONTROLLED STUDY TO ASSESS AND COMPARE HEALTH RELATED QUALITY OF LIFE WITH MOMETASONE & FORMOTEROL VERSUS FLUTICASONE & FORMOTEROL DRY POWDER INHALER IN MILD TO MODERATE PERSISTENT ASTHMA

ABSTRACTObjectives: The present study was under taken to assess and compare the improvement in HRQoL among mild to moderate persistent asthmabetween Mometasone & Formoterol versus Fluticasone & Formoterol using dry powder inhaler using Asthma HRQoL questionnaire which is diseasespecific32-item instrument including 4 domains: symptoms, emotions, exposure to environmental stimuli and activity limitations where impairmentsexperienced during the previous 14 days and respond on 7-point scale.Methods: The present study was conducted in Preventive Medicine Unit and Chest & TB diseases OPD, KIMS & RC, Bangalore during March 2011 toFebruary 2012. 60 patients were recruited in each group based on inclusion and exclusion criteria. PFT was done pre and post bronchodilator withSalbutamol nebulization with Spirometry. Study medications were randomized and were given for 12weeks. HRQoL questionnaire was administeredbefore and after the medications and outcome was compared between them. Statistical test used were descriptive statistics, t- test.Results: There was a significant improvement in HRQoL from baseline to the end of 12 weeks in all domains (symptoms, emotional, exposure toenvironmental stimuli and activity limitations) in both the groups. The overall improvement in the HRQoL was better in Mometasone & Formoterolgroup compared to Fluticasone & Formoterol group but this difference was not statistically significant, which revealed both combinations wereequally effective in improving HRQoL in mild to moderate persistent asthma.Conclusion: Both Mometasone & Formoterol and Fluticasone & Formoterol combinations are equally effective in improving HRQoL in mild tomoderate persistent asthma patients.Keywords: Health-related quality of life, Mild to moderate persistent asthma, Dry powder inhaler

Contact Tracing and Quarantine for Covid 19: Challenges in community surveillance

Covid 19 caused by SARS-coV-2 is a novel corona virus. This began in Wuhan city, China at the end of December 2019 and had spread to the rest of the world. World Health Organization (WHO) declared Covid 19 as Public Health Emergency of International Concern (PHEIC) on 30th Jan 2020 and later declared as pandemic on 11th march 2020. 1 The disease is mainly spread from human to human through small droplets from nose or mouth when a person with Covid 19 coughs or exhales and through the surface contact. Community surveillance plays significant role in prevention of spread of disease. It includes isolation of the positive case, quarantine of the high risk and low risk contacts and community disinfection.1, 2             The period of communicability is estimated with the current data to be from 2 days before the onset of symptoms and up to 2 weeks after onset. Hence the initial few asymptomatic days turns out to be crucial period in containing the spread of infection. By the time a Covid 19 patient is diagnosed and isolated, there are quite a number of primary and secondary contacts. Government of India focus has been on Community Surveillance activities which mainly comprises of Contact Tracing and Quarantine.3, 4 This article focuses on the various measures taken to trace the contacts, quarantine measures and on the challenges faced

Randomized, Open Label, Active Controlled Comparative Study to Assess Safety, Efficacy of Mometasone & Formoterol Versus Fluticasone & Formoterol Dry Powder Inhaler in Treatment of Mild to Moderate Persistent Asthma

Background: This study conducted to assess and compare the safety and efficacy of Mometasone & Formoterol versus Fluticasone & Formoterol. in patients with mild to moderate persistent asthma on symptom control and rescue medication usage. Method: The present study was conducted during March 2011 to February 2012. 120 patients were randomized in to two groups and were given Mometasone & Formoterol to group 1 and Fluticasone & Formoterol to group 2 for 12 weeks. Result: Out of 60 patients recruited in each group 7 were lost to follow up in Fluticasone group and 4 in Mometasone group. Out of 53 patients in Fluticasone group, 11 developed adverse reactions. Whereas in Mometasone group out of 56 patients- 7 developed adverse reactions. The overall improvement in Spi- rometry parameters was better in Mometasone group com- pared to Fluticasone which was not statistically significant suggesting both were equally efficacious. There was reduction in dosage of rescue medication used from baseline to the end of 12 weeks in Mometasone group compared to Fluticasone group. Conclusion: Both combinations were safe and equally effica- cious in treating mild to moderate persistent asthma patients

Short-acting β2-agonists over-prescription in patients with asthma: An Indian subset analysis of international SABINA III study

Objective: The SABINA (SABA use IN Asthma) program was initiated to describe short-acting β2-agonists (SABA) prescription patterns and assess the impact of its over-prescription on exacerbation risk and asthma control. We evaluated SABA prescription patterns in patients with asthma in the Indian cohort of SABINA III. Methods: This multi-centre, observational, cross-sectional study included retrospective and real-time electronic data collection. Data were extracted from medical records of patients with asthma (aged >12 years) having >3 consultations with the same healthcare practitioners between March 2019 and January 2020. The data included prescriptions of SABA and other asthma treatments and over-the-counter (OTC) purchases of SABA. SABA prescriptions were categorized by the number of SABA canisters prescribed in the 12 months preceding the study visit. Results: A total of 510 patients with asthma were included from specialist care (mean age 49.1 years; 57.65 females), with 8.2% classified with mild asthma and 91.8% with moderate-to-severe asthma. SABA as monotherapy and add-on to maintenance therapy was prescribed to 4.5% (n = 23) and 44.9% (n = 229) of patients, respectively. While ICS monotherapy and ICS/LABA were prescribed to 5.1% (n = 26) and 93.3% (n = 476) of patients, respectively. SABA was found to be over-prescribed (≥3 SABA canisters/year) among 21.6% of patients (n = 110). Additionally, 8% of patients (n = 41) purchased SABA OTC without prescription. Conclusions: Nearly one-fourth of patients with asthma in India were over-prescribed SABA. Educational programmes targeted at national and regional levels should be expanded to raise greater asthma awareness and encourage the adoption of guideline-directed asthma treatment plans among healthcare practitioners.</p