Indian J Med Res
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Background & objectives Spirometric glycopyrronium responsiveness, a new advent, needs to be examined at in terms of degree and frequency in different obstructive-airway diseases diagnosed in real world practise. Methods Serial and willing symptomatic affected individuals of suspected airway disease underwent a pragmatic post-consultation spirometry-protocol on the same day with salbutamol followed by glycopyrronium bromide. The diagnosis of asthma (FEV1-reversibility ≥ 200 ml + 12%), chronic obstructive pulmonary disease (COPD) (FEV1/FVC<0.7 and FEV1-reversibility <200 ml and/or 12%), and 'unclassified' (neither asthma nor COPD) were determined on post-salbutamol changes. ⋯ While all the asthmatics, 9.83 per cent of 'unclassified' study participants, and none of the COPD affected individuals had significant FEV1 responsiveness to salbutamol, the glycopyrronium responsiveness for the three conditions were 38.3, 40.25 and 24.26 per cent, respectively. The combined reversibility for asthma, COPD, and unclassified were 401.5±173.9, 119.5±109.3, and 158.7±136.3 ml, respectively. Interpretation & conclusions Spirometry with serial salbutamol and glycopyrronium responsiveness may prove helpful in identifying syndromic diagnosis and choosing the bronchodilator treatment of airway diseases.
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Background & objectives Cancer is a leading cause of death worldwide and constitutes a public health priority. Delays in diagnosis and treatment of cancer can adversely impact survival, recovery, and cost of treatment. The objective of this study was to estimate the proportion seeking timely care among those having early warning signals for oral, breast or cervical cancer and to explore the facilitators and barriers to early detection. ⋯ Interpretation & conclusions Although very few people were identified to have early warning symptoms using CBAC, a substantial proportion of them sought medical care and underwent confirmatory diagnosis. Screen positivity rate and treatment-seeking behaviour were better among women undergoing opportunistic cervical cancer screening in the health centres. Measures need to be taken to improve health literacy among people to reduce diagnostic delay for cancers.