Macter's Clinical Excellence & Leadership Program (CELP)

Management of Type-II Diabetes, Systemic Lupus Erythematosus and Lab Interpretation of Autoimmune Disorders discussed in the third session of National CME Series 2008 held at LNH

KARACHI: The third session of the National CME Series (Jan-Dec 2008) for family physicians under Macter's Clinical Excellence & Leadership Program (CELP) was held at Liaquat National Hospital, Karachi on 27 March and was attended by more than 350 family physicians from across Karachi and different parts of Sindh.

The session was focused on Endocrinology and Rheumatology and was addressed by LNH's Head of Endocrinology, Dr Zakir Alavi, Head of Rheumatology, Dr Mehfooz Alam and Consultant Rheumatologist, Dr Syed Raza Jafry.

This one-year certificate CME series—comprising 12 monthly sessions covering 16 key specialties in 33 lecture units—will offer latest updates on diagnosis and treatment of some of the most important medicine and allied topics and diseases seen by family physicians on daily basis. Each CME session will be held on the last Thursday of every month at LNH's main auditorium. It may be mentioned that more than 500 family physicians have registered themselves for all or specific sessions of the National CME Series.

In his presentation, Dr Zakir Alavi discussed in length the management of type-II diabetes and said that the risk of diabetic patient to have a cardiac event is equivalent to a patient who has already suffered a Myocardial Infarction. He emphasized that controlling BP is of greater benefit to patients with type-II diabetes along with the strict control of diabetes itself. He highlighted the significance of LDL cholesterol reduction and informed that 1 mmol/L of LDL reduction reduces the risk of major vascular events by one quarter during 5 years of treatment. He also said that Statin treatments prevent not only first but also subsequent major vascular events.

Dr Mehfooz Alam highlighted the misconceptions about Rheumatoid Factor (RF) and said that doctors generally misinterpret it is as Rheumatoid Arthritis (RA) factor which is misleading. On the other hand GPs extensively ask for RF factor investigation at very early stages which is not the requirement. He informed that in SLE management, Glucocorticoids are the mainstay of treatment and there is a need to educate the patients to remove the myth of steroids hazard and fear with which the patients come. He was of the view that Ibuprofen is not a good choice because the therapeutic anti-inflammatory dose required for the treatment of SLE is much higher which is intolerable for the patients.

Dr Syed Raza Jafry spoke on lab interpretation in diagnosing common autoimmune disorders. He said that Antinuclear Antibody (ANA) is a useful primary investigation test in evaluating SLE. He pointed out that RF lab investigation was usually misinterpreted for diagnosing rheumatoid arthritis. He also informed that only a small minority of positive HLA B 27 patients will ever develop spondyloarthropathy.

Others who spoke on the occasion were Dr Salman Faridi, Consultant General Surgery, LNH, Dr Zakiuddin Ahmed, Medical Director, Macter International and Bilal Sarwat, Macter's Business Unit Manager of Cardio/Metabolic Group.

The next CME session is scheduled to be held on 24 April 2008. It will cover issues and updates on Internal Medicine and will be addressed by Dr Syed Asim Noor, Dr Mashhoor Alam and Dr Naseem Salahuddin.