Preventive measures & intervention at primary care level will be rewarding
KARACHI: Sir Syed College of Medical Sciences in collaboration with Paksitan Society of Internal Medicine organized a seminar to create awareness about cardio metabolic disorders here on Saturday August 31st 2024. The meeting was chaired by Prof. Javed Akram President PSIM and it was also attended by experts from different professional organizations besides office bearers of PSIM and Society of Gynaecology Oncology. Prof. Zaman Sheikh was the chief organizer of the session which was sponsored by HighQ Pharmaceuticals.
Prof. Javed Akram, Prof. Bikha Raam Devrajani and Prof. Zaman Sheikh(Chief Organizer) speaking at a seminar organized by Sir Syed College of Medical Sciences in collaboration with Pakistan Society of Internal Medicine to create awareness about cardio metabolic disorders on August 31st 2024 at a
local hotel in Karachi.
Prof. Bikh Raam Devrajani former Vice Chancellor Liaquat University of Medical & Health Sciences was the first speaker who spoke about acute and chronic disorders of nervous system especially peripheral neuropathy. He pointed out that almost 25% of patients feel burning of feet and peripheral neuropathy is also the major cause of amputation in diabetes. It starts with loss of sensation leading to deformity of foot. He also referred to autonomic neuropathy and stroke, micro and macro vascular complications of diabetes, retinopathy in detail. His advice to the participants was to emphasize upon the patients to keep their feet clean and dry. They can be careless about washing their face but never forget to regularly wash their feet, he remarked.
Prof. Syed Masroor Ahmed stated that one must make sure that the patient understands what you are saying. Life style modifications is extremely important. In cardio metabolic disorders circulation of blood supply to all the body organs is affected. Regular exercise offers many benefits. If no parks or place for exercise is available the patients should be advised to have some exercises within their home.
Dr. Abdul Mannan discussed diabetic nephropathy. In people with diabetes when the kidney shrinks, the patients, he said, have to be put on dialysis. Early detection and early protection slows progression of the disease. Acute renal failure is reversible but chronic kidney disease is not reversible. Patients should be advised to use low protein diet, potassium containing fruits like Bananas and Dates should be avoided. Similarly dairy products also needs to be avoided, control hypertension and diabetes. He laid stress on prevention of acute renal failure because treatment of chronic kidney diseases is very costly.
Prof. Nawaz Lashari discussed diabetes and hypertension. He pointed out that hypertension starts from infancy and then progresses to childhood and adults. Regular checkup of blood pressure is essential. The patients should be advised to ask the doctor to check blood pressure irrespective of the disease they are suffering from. It is also important that one should know how to check blood pressure. The patient must rest for at least ten to fifteen minutes in comfortable environment. Those having any complication must maintain their blood pressure of less than 130/80. Home blood pressure monitoring should be encouraged. Some patients might need Ambulatory Blood Pressure Monitoring as well if their blood pressure is not controlled. During sleep blood pressure goes down. Cardio metabolic syndrome needs multidisciplinary management.
Group Photograph taken during the seminar organized by Sir Syed College of Medical Sciences in collaboration with PSIM in Karachi recently shows Prof. Javed Akram President PSIM and Prof. Zaman Sheikh alongwith Prof Aftab Mohsin, Mr., Atif Iqbal from HighQ Pharmaceutical and other guests.
Prof. Khawar Kazmi speaking about diabetes and cardiovascular diseases stated that 60-70% of patients suffering from diabetes die due to cardiovascular diseases and their complications. People in South Asia are prone to develop diabetes and our diet has contributed to increase its prevalence. All chronic diseases like diabetes and hypertensions are most often diagnosed when the patients visit healthcare facility with some complication, hence one needs to prevent these complications. Prevention of diseases is my passion hence I always advocate to prevent the known risk factors. It is healthcare professional’s responsibility to educate the young generation to avoid junk food, sugary drinks, go for regular exercise and life style modifications.
Prof. Shabeen Naz Masood discussed diabetes in women, talked about early Gestational Diabetes Mellitus and GDM. She also talked about fetal origin of various diseases. If the mother is not taken care properly, children will develop all the diseases. Breast feeding is important. Asians are prone to develop diabetes. She emphasized the importance of early screening of all pregnant women for diabetes. She further highlighted that 70/30 combination of insulin should not be used in pregnant women suffering from diabetes as it does not control diabetes.
Dr. Akhtar Baloch spoke about obesity and said that it leads to numerous diseases including diabetes, hypertension, and gastrointestinal disorders, hence we should work on prevention and try to have ideal BMI. Dr. Zeeshan Ali discussed liver complications of diabetes and stated that it does affect liver as well. He also talked about hepatic insulin resistance, fatty liver disease and cirrhosis which can result in cancer. It is estimated that three out of four patients suffering from diabetes have hepatic diseases. It is important to pick up and diagnose these patients early. Patients should be given dietary advice and asked to ensure regular exercise. He also referred to the safety and efficacy of various anti-diabetic preparations like Glucophage, Metformin, and GLT2 Inhibitors. All diabetics must be screened for fatty liver disease, he remarked.
Dr. Shehla Naseem emphasized the importance of early screening, diagnosis and management of diabetes at the primary care level. Most patient’s first consult a General Practitioner/Family Physician hence it is important to educate and train the primary care physicians. College of Family Medicine initiated a Certificate course in Diabetes for these primary care physicians and so far thirteen hundred doctors have been trained. We have now started Diploma in Diabetes in collaboration with Malir University of Sciences and five hundred five doctors have qualified who are treating diabetes in primary care settings. She also highlighted the importance of ethical prescriptions. We also need to use social media to educate the people about diabetes and other chronic diseases, she added.
Mr. Atif Iqbal Chief Executive Officer of HighQ Pharma addressing the participants said that pharma companies are playing an important role in sponsoring academic activities. We need to save our future generations. We have lot of expectations from the new medical graduates. We need to screen children for different diseases at birth. We in the pharma industry are doing our best to make available all the latest molecules and produce quality drugs which should be affordable for the people of Pakistan. He promised continuous support of HighQ Pharma for all such academic activities in future as well.
Prof. Khalid Mahmood from Lahore said that reduction in weight will reduce blood pressure, minimize the chances of Acute Myocardial Infarction, Stroke and it will also reduce HbAIc. Life style modification has already been emphasized by various speakers. We also need to control consumption of salt. Prof. Aftab Mohsin said now life expectancy in Pakistan has increased to seventy years, remain happy and enjoy life. Prof. Farid Al-Zafar President of Society of Gynaecology Oncology encouraged the participants to have positive thinking which will ensure that you remain healthy. He also commended the PSIM leadership for its academic activities. Prof. Azizur Rehman also briefly addressed the participants and thanked the organizers for inviting them to the meeting.
Prof. Javed Akram President PSIM in his speech promised free registration to the medical students present today for the forthcoming international conference of the society scheduled to be held during February 2025. We will also help the new graduates to find Senior House Officers jobs in UK without PLAB. He emphasized the importance of intrauterine health of the baby so that they are protected from future diseases. If the mothers and infants are looked after well, they will be saved from many Non-Communicable Diseases. All chronic diseases needs to be prevented and we should all pledge to defeat diabetes. He appreciated the efforts of Prof. Zaman Sheikh for organizing this seminar to create awareness about cardio metabolic diseases.
Earlier Prof.Zaman Sheikh welcomed the guest speakers representing different disciplines for sparing their valuable time to make the seminar a success. He also thanked and commended the PSIM leadership for attending the meeting. Dr. Shabnam Naveed thanked all those who extended their valuable help and assistance in organizing this awareness seminar.
