Despite political issues, let us create some space for free flow of academicians and research scientists- Dr. Liaquat Ali

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Third SAFES SUMMIT at Dhaka, Bangladesh-I

Despite political issues, let us create some space
for free flow of academicians and research
scientists- Dr. Liaquat Ali

We must find ways and means of serving the patients and
ensure accessible, affordable treatment - Prof. Hajera Mehtab

Disease risk due to Endocrine Disruptors is
under estimated – Dr. Faruque Pathan

From Shaukat Ali Jawaid

DHAKA (BANGLADESH): South Asian Federation of Endocrine Societies (SAFES) is a young society. We can achieve excellent results if we walk together. We should learn from each other. Clinicians, professional health workers, activists should join hands. It is not only the guidelines which are important but we must take the agenda forward. Despite the political situation, we must create some space for free flow of academicians and research scientists between our countries. This was stated by Prof. Liaquat Ali Vice Chancellor Bangladesh University of Health Sciences who is also General Secretary of Bangladesh Endocrine Society while speaking in the inaugural session of Second SAFES SUMMIT held here from April 24-26, 2015. The conference attracted a large number of Diabetologist and Endocrinologists from India, Pakistan, Sri Lanka and Nepal besides Bangladesh.

Continuing Prof. Liaquat Ali said that we share many factors. Prevention is the only way to control these diseases. Diabetic Association of Pakistan has made tremendous contribution towards providing care to the patients with diabetes and we must learn from its success. We can deliver excellent care if we walk together.  We are faced with an epidemic of Non-communicable diseases which account for almost 60% of the disease burden. Developed countries have succeeded in prevention of NCDs to a great extent. Insulin resistance, high prevalence of metabolic syndrome can all be solved with united efforts, he remarked.

Prof. Hajera Mehtab Chairperson of the SAFES SUMMIT organizing committee in her speech said that Bangladesh was hosting the SAFES Summit for the second time.  The conference will provide us an opportunity to exchange our knowledge and experience which will help to serve the humanity better. Endocrine is a specialized area and it is expensive for the patient. We must aim at early diagnosis and provide accessible means of taking care of these patients better. We must find ways and means of serving the patients and ensure treatment which is not only accessible but also affordable.  Diabetes and Thyroid disorders dominate in this area. Bangladesh Diabetic Association has succeeded in establishing diabetes care programme all over the country, it has sixty affiliates spread all over Bangladesh which work independently, are self supporting but we all work together, she remarked.

Sarita Bajaj Founder President of SAFES in her speech said that born in Colombo in 2013, SAFES was lovingly nourished in Hyderabad India where the First SAFES SUMMIT was held on August 17-18, 2013 beginning an exciting South Asian collaboration in the field of endocrinology. That meeting had over 440 faculty members from India, Pakistan, Bangladesh, Nepal and Sri Lanka besides sixty foreign delegates.  We drafted the position statement on “South Asian Women with Diabetes: Psychosocial Challenges and Management”. India has started a Certificate Course in Gestational Diabetes. This is globally recognized and accredited model to train primary care physicians, obstetricians and gynecologists in management of GDM. For the next two years our focus of activities will be Gestational Diabetes Mellitus (GDM). We must not forget the challenge of diabetes. There are millions of patients with diabetes in rural South Asia who are at present denied the benefits of diabetic care, she remarked.

Dr. Faruque Pathan President of the Organizing Committee in his brief address said that this SUMMIT will focus on delivering new and novel information in all areas of interest in endocrinology. It is a diverse specialty composed of various sub-specialties like diabetes, pituitary adrenals, reproductive health etc. He hoped that the meeting will offer excellent opportunities to learn, interact, exchange and socialize to further their aspirations. Scientific programme covers a wide range of topics of interest to everyone.

Dr.  Syed Abbas Raza Vice President SAFES addressing the gathering said that we wish to work together. We can develop our own guidelines. We all have joined hands to work in the region. We must think how we can interact better in educational programmes, come up with position statements. We all are working for the battement of endocrine and looking after the endocrine diseases.

Dr. Noel Somasundaram Vice President from Sri Lanka said that each country has developed some model to deal with the endocrine diseases.  We must work together to find a solution to the problems that we face in this region. We can have joint research programmes, translation of research in clinical setting to find solution to our problems.

Dina Shreshta Vice President from Nepal said SAFES was born timely to address our regional problems. We need local experience and guidelines rather than following the West. Dr.A.K.Azad Khan  said that many endocrine disorders particularly Type 2 Diabetes Mellitus have common etiological background in this region. The meeting will provide an opportunity to share ideas and device strategies to tackle these problems.

National Professor M.R.Khan who was the chief guest on this occasion said that endocrine specialists of five countries have joined hands to share their common goal of working to improve the care of endocrine diseases in the region. Late Prof. Mohammad Ibrahim was the pioneer of BIRDEM. He was a successful man and a good organizer. I can already see some changes in the inaugural session. There is no central table, flags of all the five countries are flying on the stage and academic accomplishments and personal highlights of the speakers are being projected on the screen. Dr. Tofail Ahmed Secretary of the SAFES SUMMIT also briefly addressed the meeting and thanked various committees for making it a success. He hoped that it will facilitate unified action to address the common endocrine disorders through effective collaboration of the endocrine societies in this region. Working together we can improve the dissemination of research and best evidence based and value based practices in endocrinology.

Dr. Faruque Pathan in his presentation discussed at length   Challenges with Endocrine System, Development and Growth, Reproduction and Sexual difficulties besides maintenance of environment and regulation of metabolism. He also talked about congenital hypothyroid, undescended testis. We have young children who are not attaining growth and mental development. Hence we need to create awareness about these problems among physicians. Hirsutism, loss of pregnancy, retarded growth, young child having obesity, premature ovarian failure, infertility, and menopause are all very important. We must see how the patients live in our families. Senior people suffer more from osteoporosis. We should look after them. We are faced with Pollution and plastic toys, sanitation and   waste material management problems. On the whole we are exposed to one lac chemical substances in our life every day. Global production of plastic material is increasing. He then talked about the Endocrine Disrupting Chemicals. They alter formation of hormonal system. He also referred to the industrial production of many chemicals. Changes in hormone system may have affect on fetal life and affect future generations.

Continuing Dr. Faruque Pathan said that there are many endocrine disruptors. We must find out from where do they come? What are their harmful effects on human exposure and what is their mechanism of action? Assessment and testing of these endocrine disruptors should be improved. There are over one thousand chemicals which are known or suspected to affect hormone receptors which can have different consequences in fetus, childhood and adulthood. Exposure to these endocrine disruptors, Dr. Faruque Pathan opined can have affect during gestation,  puberty and reproductive life. Speaking about the adult onset of diseases, he talked about altered puberty, fibroids, obesity and infertility.

Speaking about endocrine diseases, he referred to short stature, hypothyroid and diabetes mellitus and then discussed the effects of endocrine disruptors. He then talked about congenital malformation, causes of neonatal deaths, increasing rate of hypospadiasis and Cryptorchidism which is one of the common birth defects. Children lead to short stature, there is delayed puberty, and chemicals also affect sexual life. Chemicals also result in PCOS and Type-I diabetes. Primary and secondary infertility is increasing and the prevalence of obesity is 0.20% in Asia. He concluded his presentation by stating that disease risk due to endocrine disruptors is underestimated. We need strong knowledge and take action rather than pretend and preserve our environment.

This was followed by a brief Video on late Prof. M.Ibrahim- the life of a Legend.  It was pointed out that in 1952 not many people knew about diabetes. He started his journey to diabetic care to serve humanity. He established Diabetic Association in Bangladesh in 1956 and also established Diabetic Clinic in Pakistan in 1966.  He was a legend in the diabetes world. His motto was no diabetic should die untreated, unfed or unemployed even if he or she is poor. He established BIRDEM which is a state of the art diabetes care institution know the world over.