A seminar was organized at Jamshoro by Pakistan Endocrine Society, in collaboration with Liaquat University of Medical & Health Sciences, Jamshoro on 22nd April 2015.

It was attended by 233 Post Graduates, registrars and faculty of LUMHS.

Pro-Vice-Chancellor of LUMHS, Professor Munir Junejo, the chief guest of this event highlighted the role of CME programs and appreciated the role of PES in promoting awareness and education about diabetes and other endocrine disorders amongst the medical profession and masses. He announced 2 CME PMDC credit hours for the participants of this seminar. The chief guest presented traditional Sindhi Ajrak and topi (cap) to all the delegates of PES.

On this occasion, Dr. Saeed A. Mahar, President of PES and Consultant Endocrinologist at Liaquat National Hospital, Karachi, highlighted the objectives and goals of the Society. Talking on the topic of “Endocrinologist’s Approach to Infertile Couple”, he said that endocrine disorders are not uncommon in Pakistan and the same is true for male and female infertility. He mentioned that infertility should be investigated if the couple is unable to conceive in 24 months. He emphasized that obtaining a detailed history, doing a related physical examination and carrying out basic investigations are cornerstone of the initial evaluation. Later on extensive investigations, including detailed hormonal workup and imaging techniques may be done. 10 % of the couple needs Assisted Reproductive Technique assistance.

Coordinator of the program and Vice President of PES, Sindh Chapter, Prof. M. Zaman Shaikh, said that this CME program is first in the series of seminars and Insha Allah many such programs both for doctors, diabetic and endocrine patients and for the general public would be organized. Talking on his topic “New Developments in the Management of Diabetes “, he said that new once-weekly GLP-1 RAs are Inj. Bydureon, Lixisenatide, Albiglutide, and Semaglutide (soon to come). Once-monthly GLP-1 RAs are also in pipeline. Tab Semaglutide, first oral GLP1-RA is a new development, in phase 1 trial (To be marketed in 2007). New DPP-4 inhibitor is Saxagliptin (now available in Pakistan), Alogliptin, and Linagliptin (excretion: 90% through the gut; 10% through kidneys). Tab Omarigliptin (Once a week DPP-4 inhibitor) is in phase 3 trial (From Japan). There are possible novel roles and pleiotropic effects of GLP-1 RA, for example, obesity, pre-diabetes, T1DM, fatty liver, and even in Parkinsonism. New SGLT-2 inhibitors (handling renal glucose) are Dapagliflozin, Canagliflozin, Empagliflozin, all yet to come in Pakistan. Bromocriptine (Cycloset), as the quick-release formulation is already FDA-approved for T2DM. True basal insulin Degludec is FDA and EMA approved. Smart insulins (with glucose sensors) once daily, even once weekly, are not far away. New routes of administration of insulin will be as S/L spray, oral capsule, nasal insulin and as skin patches. New inhaler insulin, Afrezza is recently approved by the FDA. Semi-automatic insulin pumps with CBGM are now available in Pakistan. However, the dream of the fully-automatic closed-loop pump (artificial pancreas) and smart bionic pump (with insulin+ glucagon) will soon be a reality.

Dr. Muhammad Qamar Masood, Assistant Professor & Consultant Endocrinologist of Aga Khan University talked about “Vitamin D, How Much We Need?” He emphasized that vitamin D deficiency has resurfaced as a significant health problem in recent years. In Pakistan and as well in the region, VDD is very prevalent despite adequate sunshine throughout the year. There are a huge number of studies associating Vitamin D with almost any disease. Recently, concerns about the safe upper level of vitamin D have been raised and a reverse J or U shaped relation has been described with 25-OHD level and mortality. An increasing number of patients are being reported with vitamin D toxicity because of excessive intake of vitamin D resulting from misinterpretation of prescription, manufacturing errors, inappropriate prescription of excessive vitamin D doses for vague musculoskeletal complaints without monitoring 25-OHD concentrations.

He further said that “The study conducted at our center has revealed important implications, first a dose of VD3 ranging from 200,000-600,000 IU given orally or IM will correct the deficiency in more than 70% of the individual at 2 months. A dose of vitamin D 600,000 IU given IM will correct the deficiency in more than 90% of individuals and maintained levels > 20ng/ml in 84% of individuals at 6 months. Multiple mega doses may pose the risk of toxicity.”

Title of the speech of Professor Bikha Ram Devrajani, Professor of Medicine and Director Medical Research Centre, LUMHS, was “Update in Hyperthyroidism.” He said that thyroidectomy and cholesterol-lowering medications like statins may decrease the risk of developing thyroid eye disease in patients with Graves’ disease. Patients should be aware of these findings and discuss the treatment options for Graves’ with their physicians. Immune suppression with prednisolone may improve in-vitro fertilization outcomes in patients with autoimmune thyroid disease.

In the end, the question-answer session was held in which post-graduates, family physicians and medical students of the University took an active part. Professor Rafi Ahmed Ghouri, Professor of Medicine, LUMHS, presented the vote of thanks. This was followed by a traditional Sindhi style lunch. This grand event was generously sponsored by PES Corporate Member Ferozsons Pharma.