Understanding the lived experience of idiopathic pulmonary fibrosis and how this shapes views on home-based pulmonary rehabilitation in Delhi, India.

OBJECTIVES: Pulmonary Rehabilitation (PR) is a high-impact intervention for individuals with idiopathic pulmonary fibrosis (IPF) but access is limited in India. PR barriers include distance to travel, lack of service provision and lack of healthcare professionals to deliver PR, thus it is disproportionate to the immense burden of IPF in India. We explored the lived experiences of people living with IPF, family caregivers (CGs) and healthcare workers (HCWs) as well as their views towards home-based PR (HBPR) in Delhi, India. METHODS: A qualitative study using semi-structured interviews with individuals with IPF (n = 20), CGs (n = 10) and HCWs (n = 10) was conducted. Data were analysed using codebook thematic analysis. RESULTS: Three major themes were generated: (i) Health impact, which included pathophysiological changes, range of symptoms experienced, disease consequences and impact of comorbidities; (ii) Disease management, which described strategies to control the progression and overall management of IPF, such as medications and exercises; (iii) Mode of Pulmonary Rehabilitation, which described perceptions regarding HBPR, comparisons with centre-based programmes, and how HBPR may fit as part of a menu of PR delivery options. CONCLUSION: People living with IPF, family caregivers and healthcare workers were positive about the potential implementation of HBPR and suggested the development of a paper-based manual to facilitate HBPR over digital/online approaches. The content of HBPR should be sensitive to the additional impact of non-IPF health issues and challenges of reduced interactions with healthcare professionals.

Effect of whole-body vibration after a resistance exercise bout on heart rate variability in hypertensive population.

OBJECTIVES: To investigate the effect of whole-body vibration (WBV) in the recovery phase after resistance exercise (RE) bout on heart rate variability (HRV) and blood pressure (BP) in a hypertensive population. METHODS: Twenty hypertensive males and females were randomly allocated into group A (RE bout), and group B (RE bout with WBV). Pre-test and post-test measure of HRV, systolic blood pressure, and diastolic blood pressure were taken before and after RE and placebo WBV in one group and in another group of RE with WBV in the recovery phase. RESULTS: There were no significant differences in both RE bout group and RE bout with WBV on HRV parameters but on BP it has shown significant improvement in both groups with a p value of SBP and DBP as 0.001 and 0.03 respectively but comparatively RE with WBV in recovery has greater improvement. CONCLUSIONS: Our data demonstrated that RE bout using WBV has no improvement on HRV but it has significantly improved BP in hypertensive population.

Benzodiazepine Use Among Resident Doctors In Tertiary Care Hospital.

BACKGROUND: Benzodiazepines (BZD) are some of the most common medications in the world. Benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal. Benzodiazepines are generally considered safe and well tolerated but are commonly misused and taken in combination with other drugs of abuse. The usage and prescription of BDZ in most developed countries are tightly regulated. This is however, not true in developing countries where these medicines are available over-the-counter (OTC). This study was carried out to assess the benzodiazepine use in Ayub Teaching Hospital Trainee doctors. METHODS: This was a cross sectional study carried out in Ayub Teaching Hospital between January and December 2018. Sample size was calculated to be 276 using WHO sample size calculator. These 276 residents and house officers were selected using stratified random sampling to ensure the representation from every year of residency. RESULTS: Hundred and nine (48.7%) participants responded positively to the use of BZD. Male doctors were more likely 57 (52.3%) to use BZD as compared to their female colleges. Most of the doctors 71 (65.1%) purchased BZD over the counter without prescription. Alprazolam was the most preferred benzodiazepine by doctors regardless of their specialty and year of residency except in specialty of Anaesthesia in which prevalence of Midazolam was the highest. This preference of Alprazolam by doctors of all specialty was statistically significant (p=0.007). CONCLUSIONS: Because of the knowledge about medicines and tendency to self-treat, doctors are prone to BZD abuse. Doctors working in psychiatry are more likely to use BZD with Alprazolam the BZD of choice.