Assessing Attitudes and Perceptions of Obstructive Pulmonary Disease Patients towards Inhaler Therapy in a Low Income Country: A Cross Sectional Study

Chronic respiratory diseases (CRD) like asthma and chronic obstructive pulmonary disease (COPD) are one of the leading causes of morbidity and mortality worldwide. A patient's perception, about his or her medicine, may have an impact on adherence to medications. The purpose was to assess the attitudes and perceptions, regarding inhaler therapy use, among patients with obstructive pulmonary disease in Pakistan, a developing country. With a questionnaire developing this cross-sectional study was conducted at the Department of Medicine's outpatient clinic at Civil Hospital, Karachi from October 2013 to January 2014. We used SPSS version 19 for data entry. The number of patients included in the study was 202. Fifty eight percent (58%) of the patients concurred that they were not compliant with the usage of inhalers and frequently missed their doses. Thirty three percent (33%) patients had the misconception that inhalers are prescribed for severe diseases only. Almost forty percent (40%) patients said that they would prefer oral medicines over inhalers for the management of their lung diseases. Sixteen percent (16%) of the patients had problems using their inhalers. Twenty six percent (26%) of the patients believed that inhalers have side effects. Thirty eight percent (38%) of the patients believed inhalers are addictive. Misconceptions regarding inhalers and its usage in asthma and COPD patients are common in Pakistan. These misconceptions not only lead to poor compliance with medications prescribed but also to frequent visits to hospitals. There is a need to educate patients in the country regarding inhalers in order to improve not only their symptoms, but also to improve their quality of life.

Obesity with irregular menstrual cycle in young girls

Obesity is one of the leading causes of morbidity and mortality worldwide. Obese women are at increased risk of developing Type 2 Diabetes, cardiovascular diseases, hyperlipidemia, rectal carcinoma and gynecological problems including sub fertility, menstrual dysfunction and polycystic ovarian disease. The aim of this study was to assess relationship of obesity with menstrual irregularity in young girls that can help to create awareness among young girls about obesity and how it can affect fertility. It was a case controlled cross sectional study comprising of 220 participants from different colleges and universities of Karachi and from outpatients department of private clinic and Civil Hospital Karachi. A questionnaire was designed to assess the relationship of obesity with irregular menstrual cycle. Questionnaires were filled by co-authors after taking verbal consent. Data was collected from March 2013 to December 2013 and entered and analyzed on SPSS 16.0. Out of 220 participants obese and overweight were 67(30.4%) and 49(22.2%) respectively. Significant association was found between body composition and menstrual cycle irregularity as menstrual irregularity was present in only 9.5% when the BMI was normal and 14.09% and 24% girls in the overweight and obese categories respectively. Waist to hip ratio was found increased in 61.36% of girls. Sixty four point forty four percent (64.44%) of the girls with increased waist to hip ratio reported menstrual irregularity which makes 39.55% of the total sample population. Dysmenorrhea was reported by 63.6% of participants and family history was positive in 77.3%. Hirsutism was reported in 36.7% and 49.2%, acne in 34.6% and 43.2%, weight gain tendency in 85.7% and 98.5%, types 2 diabetes in 0% and 4.4% and hypertension in 8.16% and 31.3% of overweight and obese participants respectively. This study shows considerable association between overall and central obesity with menstrual cycle irregularity. This study provides the grounds on which foundation of health promotion and awareness programs can be laid for targeted age group.