|
From Farhan Raza
RAHIM
YAR KHAN: Aspirin is a wonder drug which prevents at least one third of
heart attacks in men and 17% strokes in women; hence Low Dose Aspirin
therapy should be prescribed to all men over the age of thirty five
years and women over the age of forty five years particularly those in
high risk group. This was stated by Prof. M. Akbar Chaudhry a well known
physician and President of Pakistan Aspirin Foundation. He was making a
presentation on Aspirin the Wonder Drug at a seminar organized by
Pakistan Aspirin Foundation here on March 21st 2012.
The meeting was very well attended by family physicians besides faculty
members of Sheikh Zayed Medical College Hospital Rahim Yar Khan. It was
jointly chaired by Prof. M. Saeed Principal of SZMC and Prof. M.Naeem
Aslam Prof. of Cardiology at SZMC Hospital. Members of the Experts
panel included Dr. Faizul Hassan Associate Prof.of Cardiology at SZMC,
Dr. Irfan Ahmad Head of the Dept. of Medicine, and Dr. M. Ali Bukhari
Head of Dept.of Neurology. The meeting was moderated by Dr. Zafar Majeed.
Picture on right shows Prof. M.
Saeed Principal Sheikh Zayed Medical College presenting Bouquet to
Prof. M. Akbar Chaudhry the guest speaker at the seminar on
Aspirin Update organized by Pakistan Aspirin Foundation at Rahim
Yar Khan on March 21st while on right a bouquet is being presented
to Prof. Naeem Aslam Prof. of Cardiology at SZMC.
Continuing Prof. Akbar Chaudhry said that the physicians should also be
careful particularly in elderly patients who are on dual antiplatelet
therapy. These patients should have their haemoglobin and stool checked
for occult blood loss every six months. However, after the age of
eighty years one has to be extremely careful while using Aspirin. Use of
Aspirin is now well established in a wide range of diseases including
Acute Myocardial Infarction, Acute Coronary Syndrome and secondary
prevention of MI, Primary prevention of CAD, TIAs and Stroke,
prophylaxis for thrombo embolism, hypertension and diabetes mellitus.
Despite the fact that there has been lot of data supporting the use of
Aspirin in primary prevention of CAD but the largest trial in primary
prevention (ARRIVE study) which has enrolled twelve thousand patients
in five countries started in 2009 and the results will be available in
2013. This will conclusively prove the benefits of Aspirin therapy in
primary prevention which it is hoped will clear all doubts and
accelerate the use of Aspirin in this era of Evidence Based Medicine. He
discussed the disease burden of IHD in poor developing countries in
detail and suggested how to prevent it. He also talked about the risk
factors and laid stress on prevention the modifiable risk factors in
particular.
Prof. M. Saeed Principal Sheikh
Zayed Medical College presenting bouquet to members of the experts
panel and others at the Aspirin seminar from (L to R) Dr. Faizul
Hassan, Dr. M. A. Bukhari, Dr. Irfan Ahmad, Dr. Idrees and Dr. Zaka
Ashraf.
Prof.
Akbar Chaudhry then quoted numerous studies to prove usefulness of
Aspirin in acute myocardial infarction, acute coronary syndrome,
secondary prevention of MI and Stroke. Speaking about the new and
emerging indications for Aspirin therapy he mentioned colonic cancer,
oesophageal cancer, breast and lung cancer, dementia, eclampsia and
prostatic cancer. He then talked about the recent controversies
regarding the use of Aspirin in primary prevention in diabetics and
peripheral arterial disease. He quoted various guidelines of American
Heart Association and American Task Force for prevention of
cardiovascular diseases and stroke which recommend the use of Aspirin
therapy. He concluded his presentation by stating that Aspirin has
proved to be poor man’s streptokinase and then took out a tablet of
Aspirin from his pocket and said that he always keeps it with him so
that it may be used in emergency by himself, his near or dear ones,
fellow travelers and recommended that all of us should keep Aspirin at
home, in our bags, at clinics and offices.
Earlier
he talked about the aims and objectives of Pakistan Aspirin Foundation
and referred to its achievements so far. The main objective of the
foundation, he said, is to create awareness about the use of Aspirin
among public as well as healthcare professionals and promote the use of
Low Dose Aspirin therapy in its well established indications. He further
stated that they have been holding such seminars in different cities of
Pakistan for the last many years as a part of our CME programme. Rahim
Yar Khan is an important city having a medical college and well equipped
hospital and it had been their desire to organize this meeting here
since long. He was happy that at last they have been successful to have
this meeting here and thanked Prof. Naeem Aslam, Prof. M. Saeed
Principal of SZMC, its faculty members for the warm welcome and kind
hospitality. He particularly thanked Prof. Saeed Principal of SZMC and
said that they will be too glad to organize academic activities at SZMC
Hospital in future as well.
Pakistan Aspirin Foundation organized a
seminar on Medical Uses of Aspirin at Rahim Yar Khan on March 21st
2012 which was largely attended by family physicians and faculty
members of SZMC. Picture shows Prof. M. Akbar Chaudhry President of
the Foundation speaking on the occasion. On extreme left is Dr. Zafar
Majeed who moderated the session while on extreme right Dr. Abdul
Karim is participating in the discussion.
The
presentation was followed by lively discussion. Prof. Akbar Chaudhry
responded to various question from the audience regarding Aspirin
resistance, contra indications and when not to use it besides its side
effects. For ACS the recommended dosage for long term use, he said, was
75mg though 81mg and 100mg are also used but it has the same effect. For
type 2 diabetics the dose recommended is 150mg but in case of emergency
i.e. AMI, Stroke one tablet of 325mg should be used immediately. One
can safely use Aspirin in severe ischaemic stroke before a CT Scan. In
case of resistance or contra indications one can use other antiplatelet
agents like Dipyridamol, Ticlodipine, Clopidogrel, GPIIb IIIa and
Abciximab. Before prescribing aspirin therapy to hypertensive patients
make sure to control the blood pressure first, he remarked.
Dr.
Faizul Hassan speaking
at the occasion referred to the study being conducted by Dr. Zafar
Majeed in rural areas to assess the risk factors i.e. gender, smoking,
family history, inactive life style etc. which was just nearing
completion. Results of this study will soon be published. He also
commented on the results of Aspirin Awareness and Usage Study (AAUS) and
said they were prescribing Aspirin to all the patients suffering from
cardiovascular diseases except those where it is contra indicated. Dr.
Irfan Ahmadopined that one should keenly observe all the side
effects of Aspirin therapy particular the risk of GI bleeding which
could be very serious. Dr.
M. Ali Bukhari said that
they usually receive haemorrhagic stroke patients. At present they are
also conducting a study on these patients and once it is completed he
will be in a better position to comment on the use of Aspirin therapy.
Group photograph taken after
the seminar on Aspirin Update organized by Pakistan Aspirin
Foundation at Rahim Yar Khan on March 21st shows Prof. M.
Akbar Chaduhry (guest speaker) along with Prof. M. Saeed
Principal SZMC, Prof. Naeem Aslam, Dr. Faizul Hassan, Dr. M.
A. Bukhari, Dr. Idrees and others.
Dr.
Idrees from
the department of surgery SZM Hospital Complex pointed out that Aspirin
is a very useful drug as prophylaxis in thrombo embolism but he did not
find any strong recommendation regarding its use in deep vein thrombosis
prevention in high risk surgical patients.
Prof.
M. Saeed Principal
SZMC in his concluding remarks stressed the importance of life style
modification. We as healthcare professionals should discourage the use
of un-necessary drugs but advocate use of healthy diet. He thanked Prof.
Akbar Chaudhry for his visit to Rahim Yar Khan and enlightening them on
the use of Aspirin therapy.
Cardiology Dept. at SZMCH
Earlier Prof.
Naeem Aslam in his
welcome address also gave a brief introduction of the department of
cardiology at SZMCH Complex which organizes such CME programmes
regularly. So far, he said, we have conducted five workshops, four ECG
workshops besides one survey. The department has a well equipped 76-bed
CCU which has almost 100% occupancy. Last year we performed four
thousand two hundred echocardiograms and thirty angioplasties. The
department has also started a unique cardiac clinic for pregnant and
Gynae patients. He also talked about the history of Aspirin and said
that after the incidence at PIC Lahore, many people have asked him about
the use of Aspirin. I have assured them that Aspirin is a very safe and
effective anti platelet agent and was really a wonder drug.
As usual the meeting was sponsored by M/s Atco Laboratories who are
sponsoring the CME programme of Pakistan Aspirin Foundation for the last
many years.
|
