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This article explores the challenges of managing asthma in India, specifically in rural areas, where there are deficiencies in self-management and training for primary care physicians. The study aims to understand the perspectives of patients and primary care physicians on asthma and the barriers to treatment and engagement with health services. Interviews were conducted with patients and physicians in rural, semi-urban, and urban areas. The findings emphasize the need for interventions that are culturally appropriate for patients and training that is clinically focused for primary care physicians in order to improve asthma management in India. The study focuses on the understanding and management of asthma among adult patients in the Vellore district of India. It reveals that many patients have limited knowledge about asthma and its treatment, resulting in poor adherence to prescribed care. Financial constraints and limited access to mainstream health services are identified as additional obstacles to asthma management. Social stigma and a preference for alternative treatments also influence patient behavior. The study recommends interventions that are tailored to the cultural context, improved training for primary care physicians, and affordable treatment options for economically disadvantaged patients. However, it is important to note that the findings may not be applicable to other regions of India, and further research is necessary. [Extracted from the article]

AFS in our study was characterized by earlier age of onset, higher IgE levels and lower FEV1 We suggest AFS is worth considering in uncontrolled asthma and those with moderate-severe asthma There is a need to assess anti-fungal drugs as an adjunct to standard therapy in AFS To the editor, The biological role of fungi in the pathophysiology of asthma has attracted renewed attention during the last decade. Assessment of sensitization to aero-allergens including fungal allergens was performed by the skin prick tests using allergen kits by Hollister Stier Allergy (Jubilant Pharma LLC, USA). Patients with multiple fungal sensitizations had poorer ACT scores in comparison to those with sensitization to a single fungal allergen ( I p i < 0.001), that is the median ACT scores in subjects with no fungal allergen was 23.0 (22.0-24.0); with sensitization to one fungal allergen was 21.0 (19.0-22.0) and with sensitization to >=2 fungal allergens was 18.0 (18.0-20.0) (Figure 1C). (C) Box plot illustrating the relationship between ACT scores and sensitization to none, 1 or >=2 fungal allergens: The plot illustrates that sensitization to >=2 fungal allergens was associated with poorer asthma control. [Extracted from the article]

Nearly 60%-70% of patients have co-existing allergic rhinitis and asthma, and it remains unclear at present how well the allergic rhinitis is controlled amongst asthmatics. This editorial focusses on gaps in evidence and highlights "high-priority" areas and strategies for research in asthma and allergy in India. [Extracted from the article]