Macter's Clinical Excellence & Leadership Program (CELP)
Issues
and updates on Cardiology discussed
in the fifth session of CELP’s National CME Series 2008
KARACHI: The fifth 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 29 May
2008 and was attended by around 350 family physicians
from
across Karachi and parts of Sindh.
The
session was focused
on Cardiology and
was addressed by
renowned cardiac
consultants and
LNH faculty members
Dr Dan Jan Baloch,
Dr Faisal Ahmed
and Dr Chandar
Manglani.
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 is held
on the last Thursday
of every month
at LNH’s
main auditorium.
Dr Dan Jan Baloch, consultant cardiologist
and head of LNH’s cardiology department, comprehensively
described the physiology and pathology of Ischemic
heart disease (IHD) and acute myocardial infarction
(AMI).
He told the participants that MI was classified into
ST segment elevation MI and non-ST segment elevation
MI; the latter ends up in AMI. He explained how the
two were managed differently.
Dr
Jan said that ECG
was still the key
for diagnosing
AMI despite of
the availability
of a number of
advanced techniques.
He further said
that the introduction
of CCU had significantly
decreased the overall
mortality caused
by this life threatening
condition. He explained
the participants
that understanding
the pathophysiology
of AMI was of utmost
importance and
as a family physician
a doctor must identify
this grave condition
as early as possible;
as it the timing
of diagnosing and
initiating treatment
was a decisive
factor between
life and death.
The earlier the
treatment begins
the higher will
become the chances
of survival of
the patient and
better quality
of life, he added.
Dr
Jan laid stress
on the prevention
as it was the most
cost-effective
and significant
intervention. He
further informed
that the condition
was prevailing
in the younger
population of our
region with deteriorating
socioeconomic conditions
and unemployment
as the cause. Regarding
the treatment he
informed that aspirin
was the most cost-effective
treatment and it
dramatically improves
the condition along
with the thrombolytics.
Dr Faisal Ahmed, consultant cardiologist
and LNH faculty, spoke on hypertension. He informed
the participants that
according to latest guidelines systolic blood pressure
of <120 mm Hg and diastolic blood pressure of <80
mm Hg was considered normal regardless of age.
Talking
about the epidemiology
of hypertension
he revealed that
50 per cent of
hypertensive patients
in the world remain
undetected; 30
per cent of the
patients are identified
but remain untreated
or are inadequately
treated and only
20 per cent of
the patients get
proper treatment.
The situation
in Pakistan, he
said,
was even worse
as <10
per cent of the
hypertensive
patients were
controlled.
To
a question he replied
that completely
removing salt from
the diet was a
wrong practice
and the doctors
should educate
their patients
that by reducing
the salt intake
of only 25 per
cent of the normal
can significantly
improve the situation.
Regarding
the ideal treatment
combination he
stated that no
combination is
ideal, however
thiazide diauretics
and Ca+ channel
blockers work better
Dr
Chandar Manglani,
consultant cardiologist
LNH, updated the
participants on
the ECG interpretation
of various cardiac
diseases. His presentation
consisted of the
ECG strips showing
ECG changes in
different disease
states of the heart.
He
comprehensively
discussed the basics
of ECG and told
how to differentiate
various entities
of heart diseases
by interpreting
ECG changes. He
emphasized the
audience that the
ECG should always
be read in context
of the patient.
During the interpretation
of ECG the doctors
should always think
of the common heart
problems as this
will help avoid
skipping the basics.
In
the end a presentation
was given on Enhanced
External Counterpulsation
(EECP) by Dr BM
Rathore. EECP is
a new US-FDA approved
treatment therapy
for those angina
and heart patients
who were not suitable
candidates for
invasive cardiovascular
procedures.
A
video presentation
by CNN broadcaster
Larry King was
also shown to the
audience which
contained interviews
of eminent US cardiologists
about EECP and
of the patients
who benefited from
the procedure.
Others
who spoke on the
occasion were Haroon
Ahmed Malik, Director
and Head of Commercial,
Macter International,
Dr Salman Faridi,
Consultant General
Surgery and former
Medical Director,
Liaquat National
Hospital, and Dr
Zakiuddin Ahmed,
Medical Director,
Macter International.
The next CME session will be held on 26 June 2008 and
will cover issues in General Surgery related to the practice
of family physicians. The speakers and panelists of the
forthcoming CME session include Dr Salman Faridi, Dr
Rufina Soomro, Dr Nadeem Khurshaidi, Dr Irfan Daudi,
Dr Zahid Habib and Dr Turab Pishori.
