Macter's
Clinical Excellence & Leadership Program
Updates on Neurology and Psychiatry feature the fourth session of National CME Series
KARACHI:
The fourth 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 24 April and
was largely attended by family physicians from across
Karachi and different parts of Sindh. It may be mentioned
that more than 500 doctors have registered themselves
in this Series.
The fourth session was focused on Neurology and Psychiatry and was addressed by Dr Moin Ahmed Ansari, Consultant Psychiatrist, Dr Farrukh Shahab Khan, LNH's Head of Neurology, Dr Azra Zafar, Senior Registrar Neurology, and Dr Syed Ahmed Asif, Consultant Neurologist.
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.
Dr Moin Ahmed Ansari apprised the participants about the management of anxiety and said that anxiety was an emotion and is a normal response of the body that helps people to cope up with day to day occurring life stresses and to make decisions accordingly. He emphasized that it was necessary to differentiate between anxiety and anxiety disorders as the two are different entities and the former does not require any treatment. When anxiety becomes so much that it starts affecting personal life, family life, and social life and work than it becomes an anxiety disorder and should be treated, he added.
Talking about anxiety management, Dr Ansari stressed on cognitive behavioral therapy along with pharmacotherapy. He stressed on the need to develop good relation with patients and winning trust of patients to help them to cope up with these disorders and to help those who have become chronic users of anti-anxiety medications to reduce the dose of their medication.
Dr Farrukh Shahab Khan presented his lecture on Transient Ischemic Attack (TIA) and informed the audience that once the TIA has occurred, patients should be treated as per the stroke guidelines. Talking on the role of aspirin he told that aspirin was the first line drug for stroke prevention and to date no drug has shown to be better than aspirin. On preventive measures he informed the participants that cholesterol should be reduced to less than 160 mg/dl as a primary prevention.
To a question regarding the role of neurocholine in stroke, Dr Shahab answered that there was no established role of neurocholine in stroke patients.
Dr Azra Zafar's presentation consisted of case histories of headaches. She stressed upon differentiating primary headache from secondary headache which may be due to infections tumors and or hemorrhage as this helps in advocating correct management. She urged the participants to look for subarachnoid hemorrhage (SAH) when patient was coming with complains of severe headache and vomiting even if the CT was normal.
To a question regarding the diagnosis of headache, Dr Azra Zafar told that proper history taking and the CSF examination by an experienced anesthesiologist was the key to establishing the diagnosis of headache.
She further informed that inadequate pharmacotherapy, incorrect diagnosis and inadequate non-pharmacological treatment including psychotherapy and behavioral therapy can lead to treatment failure
Speaking on Epilepsy Dr Syed Ahmed Asif informed that 65% of epileptic seizures were idiopathic. He called upon the participants that it was an ethical duty of a doctor to clear the misperception which was prevalent in our society that every person suffering from seizures has a brain tumor. On the other hand the statistics reveal that only 4% of the epileptic patients have brain tumor.
About the treatment of epilepsy he informed that no medicine can cure epilepsy, rather they only can control it. While prescribing the treatment for epilepsy three goals should be borne in mind: 1. Decrease the frequency of attacks; 2. Avoid side effects of long term treatment; 3. Improve the quality of life of the patients.
To a question on which drug to be prescribed in pregnant women suffering from the disorder he told that carbamazepine is the drug of choice. He stressed on the need of doing LFTs before the initiation of therapy and periodically as all drugs affects liver in one way or the other.
Others who spoke on the occasion were Dr Salman Faridi, Consultant General Surgery, LNH, Dr Zakiuddin Ahmed, Medical Director, Macter International and Dr Abdul Malik, a leading family physician of Matli, district Hyderabad, and a regular participant of the National CME Series.
