“Early diagnosis & good management key factors to stop COPD progress,”
“Cessation of smoking and stepwise treatment of COPD gives best results,”
Dr. Nasir Hussain.
“Good suspicion, investigation and Proper antibiotic will cure Pneumonia,”
Dr. Faisal Zuberi.
KARACHI – Pulmonology Department, Baqai Medical University, and Brookes Pharma held a seminar on COPD and Pneumonia, at local Hotel. Around 70 family Physicians from old city area, and DHA attended the program.
After recitation from holy Quran, Mr. Amir Iqbal gave introduction of the program and speakers. He also highlighted the pharmaceutical activities of his company, especially the social activities such as running a Free School (Brookes Education System), Surgani Town and helping Madadgar centre of police at Brookes Chorangi etc. He also thanked the speakers and participants for attending the seminar and participation in discussion.
Dr. Zafaryab Hussain, HOD Pulmonology, Baqai Medical University, regarding Clinical Presentation of COPD patients said that it should be suspected in individuals above 40 years of age, smokers, with cough most of time and sputum production, with worsening breathlessness on exercise or walking uphill etc. Shortness of Breath is persistent with exertion. About 30% COPD Patients are non-smokers but they have exposure to biomass used for cooking or heating rooms or because of pollution, indoor or outdoor. X-Ray chest is helpful to exclude other pathologies, may show bullae, low flat diaphragm, long tubular heart etc. Other routine investigations are not helpful. Standard test for diagnosis of COPD is Spirometry done after giving inhaled bronchodilator.
Normally 80% air is exhaled in 1 second. But in COPD it is reduced and overall reduction is also seen.
The ratio FVC /FEV1 is also reduced. If COPD is suspected in young patients below 40 yrs serum α1 anti trypsin level should be checked. CAT (COPD assessment Test), and mMRC (modified Medical Research Council) questioner are available to assess the severity of COPD and also available in Urdu language.
Dr. Nasir Hussain, Pulmonologist, National Medical Centre, was talking about management of COPD, as per Gold guidelines. He said patient should be grouped according to Risk factors, frequency of symptoms, and history of exacerbations. As diagnosis is made by Spirometry, severity should be graded 1-4 and matched with spirometry, for treatment of COPD. Lot of Medicines and devices are available for treatment but the best choice is acceptance by patient. Inhalers are the best way to deliver the drugs in respiratory tract either Metered dose or dry powder inhalers. In mild cases only short acting salbutamol is sufficient. In moderate cases long acting β2 agonist with Inhaled corticosteroids or long acting anticholinergics are recommended. In severe cases all the three are used. In very severe cases all above medicines and Nebulize with anticholinergics, systemic steroids, and oxygen are required. Avoidance of risk factors is necessary in management of COPD at all stages. At each visit smoking avoidance must be stressed and enquire whether smoking is quit or still taking some cigarettes. If working in polluted place must be advice to take all preventive measures and may require change of Occupation. Pneumococcal Vaccine 23 antigen is recommended to all severe n very severe cases and given once in life time. If patient is having recurrent flu, should get FLU Vaccine every year in month September.
Dr. Faisal Zubairi from Dow University discussed about CAP (Community Acquired Pneumonia). He said it is inflammation of lungs caused by Bacteria, Fungi, viruses etc. Tb germ also can present like Pneumonia. Usually there is Cough with Rusty Sputum, fever and localized chest pain. CBC, Sputum smears, and C/S and Chest X-Ray are helpful in diagnosis. Treatment is according to causative organism. If not responding to treatment think about other diagnosis, like Tb, or Malignancy etc.