Background: Medications used to manage Asthma is delivered via inhaler devices. Proper usage of these devices are required for effective medication delivery. Aim of this study is assess the degree of proper inhaler technique and adherence to treatment among adult asthma patients.Methods: Patients using inhalers were identified and interviewed regarding inhaler use. Checklists were used to document the adherence to manufacturers’ directions for each respective inhaler, and data were then tabulated and assessed for the types of inhalers used, incorrectly performed steps in using the inhalers, as well as demographic information of patients.Results: Out of 120 patients that taken as subjects, twenty-four percent of inhalers (29/120) used incorrectly, with the most common errors being improper priming, lack of proper exhalation prior to inhaling the medication, and absence of rinsing mouth following the use of inhaled corticosteroid. Furthermore, only 60% of the patients are adherent to asthma medications.Conclusions: Inhaler technique among adult patients is substandard and is considered a key area for physicians to more proactive in educating patients. For obtaining most accurate therapeutic advantage among patients with inhalers, proper instruction and demonstration regarding inhaler use need to be given to all patients, particularly elderly patients.

Background: Diabetes mellitus (DM) is a known risk factor for tuberculosis (TB). The aim of this study was to evaluate the effect of DM on clinical presentation and treatment response of sputum positive pulmonary tuberculosis patients.Methods: The present retrospective study was carried out in department of Pulmonary Medicine, Sree Gokulam Medical College and Research Foundation, Trivandrum, between January 2014 to December 2016.Results: Out of 205 subjects enrolled for this study, 73 were diagnosed with DM and 132 patients had no history of DM and were having HbA1c less than 6.5%. Mean HbA1c in DM group at presentation was 10.5 and in patients without DM group was 5.6. Low BMI was more in DM patients. Clinical characteristics at presentation were similar in both the groups. Patients with DM presented after long duration of symptoms (>8 weeks duration) and also with more atypical symptoms. On radiological examination, lower zone involvement and cavity lesions were more in patients with DM which was statistically significant. Clinical picture at the end of 6 months showed improvement in both the groups but radiological improvement was more in patients without DM compared to the other group.Conclusions: Uncontrolled DM is associated with high prevalence of Tuberculosis. Atypical symptoms and atypical radiological findings are more common in DM patients which lead to delayed presentation. Strategies are needed to ensure that optimal care is provided to patients with both diseases.