Day 2 :
Keynote Forum
Hwa Mu Lee
University of California,USA
Keynote: Karma of cardiovascular risk factor management for optimizing prevention of Chronic Obstructive Pulmonary Disease(COPD)
Time : 10:00-10:40
Biography:
Dr. Hwa Mu Lee is Clinical Professor of Medicine in the Division of Pulmonary and Critical Care Medicine at the University of California, Irvine College of Medicine, in Irvine, California and Clinical Professor of Medicine at Western University of Health Sciences, in Pomona, California. Dr. Lee is a noted authority on the relation of COPD with cardiovascular disease, including the role of cardiovascular risk assessment in patients with COPD and the role of lung function in the prediction of cardiovascular outcomes. He has published in prestigious journals including CHEST, European Respiratory Journal, and Respiratory Medicine. Dr. Lee regularly presents his work and lectures to trainees, researchers, and practitioners in the field locally and internationally.
Abstract:
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the U.S and affecting approximately 64 million worldwide. According to US age-adjusted death rates from 1965 to 1998, while cardiovascular disease (CVD) mortality decreased by 60%, there was a 160% increase in COPD mortality. Furthermore, COPD is significantly underdiagnosed, and the actual prevalence is uncertain due to misdiagnosis, silent COPD, or accompanying comorbidities. Despite continued declines in CVD mortality, it remains the number one leading cause of mortality in the US. There is a strong association between COPD and CVD that is underappreciated. Patients diagnosed or treated for COPD have at least a two-fold greater risk of developing CVD compared to those without COPD; however, there is limited interaction between pulmonologists and cardiologists and misdiagnosis is frequent. Research on COPD and associated factors that increase CVD risk is crucial because of the substantial CVD risk associated with COPD; moreover, there are no proven methods of prevention of COPD except for the cessation of smoking. COPD and CVD have in common many risk factors such as age, smoking, hypertension, diabetes and systemic inflammation. Thus, a concerted effort to manage these risk factors together could reduce the CVD burden associated with COPD. Recently, we evaluated American Heart Association’s Life’s Simple 7 Cardiovascular Health metrics in relation to COPD and demonstrated a strong association between COPD and Life’s Simple 7 scores, indicating that COPD prevention might be benefitted by improved adherence to Life’s Simple 7 measures. Our findings indicated that those at ideal levels of Life’s Simple 7 metrics had higher levels of lung function and lower COPD prevalence. This supports a call-to-action for health professionals to encourage the public to optimize cardiovascular lifestyle-related risk factors not only to maintain CVD health, but also to maintain pulmonary health.
Keynote Forum
Rakesh Gupta
Department of Health & Family Welfare, India
Keynote: Punjab smokes out E commerce sites for E cigarette sale: A case report from Punjab
Time : 10:40-11:20
Biography:
Rakesh K Gupta is the Deputy Director, Non-Communicable Diseases, Department of Health & Family Welfare, Punjab. He has expertise in managing National Non-Communicable diseases Programs especially Blindness Control/Tobacco Control Programs and has professional experience of 33 years in service. He has represented MOHFW in WHO ENDS Consultation in Panama 2016 and WHO consultation on Plain packaging in Geneva 2017.
Abstract:
Electronic Nicotine Delivery System (ENDS) popularly known as e-cigarettes are highly addicting and potentially lethal products. It is mostly being used by children and youth because these are glamorized by the tobacco industry. Though not generally available in stores, they are widely promoted and sold through E commerce sites with discount offers. Sales are increasing sharply all over the world. Punjab was the first state in India to declare electronic nicotine delivery system (ENDS) as unapproved under Drugs and Cosmetics Act in 2013. A circular was issued by Government of Punjab regarding declaration of manufacture and sale of ENDS as illegal. To counter the sale on the ecommerce site, Punjab Government had issued a demi-official letter to cyber-crime cell regarding the sale of E-cigarettes in 2016. Awareness notices were sent to various E commerce sites regarding the sale of E cigarette. District level Task Force effectively implements the ban through conducting raids at suspected point of sale, which is being monitored monthly by Deputy Commissioners of all Districts. Cyber Crime Cell identified the 26 E commerce sites that were selling the E cigarettes. Letter was sent to these sites regarding the blocking/banning the sale of e cigarettes. After that No E commerce sites are selling E cigarettes in Punjab. The declaration by the Government of Punjab opens the way for other states to follow suit and prevent ENDS becoming an additional marketing strategy for tobacco companies.
Keynote Forum
David Edwards
Manchester Metropolitan University, United Kingdom
Keynote: An Exploration of Healthcare-Related Locus of Control in COPD Patients Attending Group-Based Pulmonary Rehabilitation
Time : -
Biography:
Mr David Edwards is a Senior Lecturer in Physiotherapy at Manchester Metropolitan University. He completed this project as part of the award of a Masters in Clinical Research (MClin Res) from The University of Manchester in 2014, which he was awarded a Distinction for. The article was published in Physiotherapy Practice and Research in January 2017. His background consists of work with COPD patients in Central Manchester as a specialist physiotherapist, with a specific focus on Pulmonary Rehabilitation. He also has a significant background in critical care physiotherapy with both adults and children.
Abstract:
Aims: Pulmonary rehabilitation is of proven benefit in improving function and health-related quality of life in patients with COPD; however long-term maintenance is poor. Though reasons for this are not fully understood, psychological concepts such as Health Locus of Control (HLOC) may be of interest. This exploratory study aimed to investigate whether HLOC can be altered through pulmonary rehabilitation.
Methods: A non-randomised controlled Before/After design was used. Eligible participants with a diagnosis of COPD and attending their first pulmonary rehabilitation programme were invited to participate. The intervention consisted of standard pulmonary rehabilitation care - a six-week course comprising twice-weekly group-based exercise and education sessions. Participants completed the Multidimensional Health Locus of Control Form-C (MHLC-C) and standard assessments pre (baseline) and post the six-week programme.
Results: 96 patients were invited to participate, 46 consented and 20 completed both pre-and-post study outcomes. Significant improvement between pre-and-post tests were found for two MHLC-C dimensions (Internal: mean increase 5.4, p=0.012 and Doctors: mean increase 2.1, p=0.016).
Conclusions: Though limited by methodological issues, the results tentatively suggest that HLOC can be significantly altered through group-based pulmonary rehabilitation, potentially through enhanced self-management and education strategies empowering patients. Further investigation of these findings and the relationship with long-term maintenance is warranted.
Keynote Forum
Jimenez C Enmanuel
National University, Costa Rica
Keynote: Meta-analysis on the physiological benefits and quality of life of muscle training in patients with chronic obstructive pulmonary disease
Time : -
Biography:
Jimenez C Enmanuel within his academic training, he is a RRT-Respiratory Therapist graduated from Santa Paula University, and holds a master's degree in integral health and human movement / emphasis in graduate health at the National University of Costa Rica, in addition to completing the course of Cardiopulmonary Rehabilitation phase II in The National University of Costa Rica, and performed the certification of pediatric and neonatal critical air transport of the Asturian association of pediatric intensive care.
He works in the Costa Rican social insurance fund from 2000 to the present, in 2005 until 2008 he worked in clinical research at the ICIC, during this same period also work in home care program for patients with COPD from 2013 to 2016 was coordinator of the cardiopulmonary rehabilitation center at the Adolfo Carit Eva Women's Hospital and from 2015 to date The director of the Santa Paula cardiopulmonary rehabilitation center at Santa Paula Clinic.
Abstract:
Justification: the existence of important peripheral muscular dysfunction contribute at very substantial manner to reduce the tolerance to exercise in a patient with chronic obstructive pulmonary disease.
Methods: this was an exhaustive research on benefits of exercise training for a group of patients, thirteen studies were found (n=351), from these four were excluded studies. The analysis was done using the SPSS v 15.0, and Excel 2007, p< .05 was considered the significance value.
Results: the moderating variables that were meta-analysis were present in more than two experimental investigations. In total eight variables were found from which six variables showed significant effects (oxygen consumption, volume minute, heart rate, breathing rate, fatigue, dyspnea, emotional condition, six walking test).
Two control groups were compared, heart rate and breathing rate had a significant effect in the group that did exercise.
Another analysis assessed the type of training: muscle streng, aerobic resistance, or combination of both, including body part involved, no significant difference was found.
In both comparisons the training type and the body part involved gives a significant effect.
Conclusion: the types of training should be combined for upper and low limbs.
- Cardiovascular Risk and Chronic Obstructive Pulmonary Disease | Environmental and Occupational lung Disease | Lung Diseases
Location: Meeting Room 2
Chair
Hwa Mu Lee
Western University Health Science, USA
Co-Chair
Rakesh Gupta
Department of Health & Family Welfare, India
Session Introduction
Hwa Mu Lee
Western University Health Science, USA
Title: Karma of Cardiovascular Risk Factor Management for Optimizing Prevention of Chronic Obstructive Pulmonary Disease
Biography:
Dr. Hwa Mu Lee is Clinical Professor of Medicine in the Division of Pulmonary and Critical Care Medicine at the University of California, Irvine College of Medicine, in Irvine, California and Clinical Professor of Medicine at Western University of Health Sciences, in Pomona, California. Dr. Lee is a noted authority on the relation of COPD with cardiovascular disease, including the role of cardiovascular risk assessment in patients with COPD and the role of lung function in the prediction of cardiovascular outcomes. He has published in prestigious journals including CHEST, European Respiratory Journal, and Respiratory Medicine. Dr. Lee regularly presents his work and lectures to trainees, researchers, and practitioners in the field locally and internationally
Abstract:
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the U.S and affecting approximately 64 million worldwide. According to US age-adjusted death rates from 1965 to 1998, while cardiovascular disease (CVD) mortality decreased by 60%, there was a 160% increase in COPD mortality. Furthermore, COPD is significantly underdiagnosed, and the actual prevalence is uncertain due to misdiagnosis, silent COPD, or accompanying comorbidities. Despite continued declines in CVD mortality, it remains the number one leading cause of mortality in the US. There is a strong association between COPD and CVD that is underappreciated. Patients diagnosed or treated for COPD have at least a two-fold greater risk of developing CVD compared to those without COPD; however, there is limited interaction between pulmonologists and cardiologists and misdiagnosis is frequent. Research on COPD and associated factors that increase CVD risk is crucial because of the substantial CVD risk associated with COPD; moreover, there are no proven methods of prevention of COPD except for the cessation of smoking. COPD and CVD have in common many risk factors such as age, smoking, hypertension, diabetes and systemic inflammation. Thus, a concerted effort to manage these risk factors together could reduce the CVD burden associated with COPD. Recently, we evaluated American Heart Association’s Life’s Simple 7 Cardiovascular Health metrics in relation to COPD and demonstrated a strong association between COPD and Life’s Simple 7 scores, indicating that COPD prevention might be benefitted by improved adherence to Life’s Simple 7 measures. Our findings indicated that those at ideal levels of Life’s Simple 7 metrics had higher levels of lung function and lower COPD prevalence. This supports a call-to-action for health professionals to encourage the public to optimize cardiovascular lifestyle-related risk factors not only to maintain CVD health, but also to maintain pulmonary health.
Biography:
Vinod Musale (Masters in Pharmacy), He has his expertise in development of pharmaceutical inhalation products. Vinod has good number of years of experience in the field of quality to ensure the delivery of quality Pressurized Metered Dose Inhalers (pMDI) and Dry Powder Inhalers (DPI) to the end users for improving the healthcare. He has taken the specialization in Quality Assurance Techniques at post-graduation level and pursuing PhD in specialization of Pharmaceutical Inhalations, from UTU, University - Gujarat (India). Currently heading the Position of Manager Quality Assurance at Vamsi Pharma Private Limited
Abstract:
The purpose and interest of this research on the In-Vitro study of Pharmaceutical Inhalation/Aerosols, is to highlight the critical aspects of Fine Particle Dose (Respirable Fractions) to justify the efficacy of Pressurised Metered Dose Inhalers (pMDI). pMDI is the most common dosage form for inhalation by which the micronized drug is delivered from a pressurized container suspended in a liquefied gas (Propellant- HFA134a/HFA 227ea). Inhalation is the convenient way to deliver drugs to respiratory tract in treatment of respiratory disease like Asthma & Chronic Obstructive Pulmonary Diseases (COPD). Respirable Fraction is defined as the mass of active pharmaceutical ingredient per actuation of the inhaler contained in particles finer than 5.0 μm aerodynamic diameters. Pressurised Metered dose aerosols with particles in the aerodynamic particle size range of 1 to 5μm can penetrate deep into the lungs, permitting ready absorption of the drug into the blood.
The suspension HFA MDI tested in this study contained Salbutamol sulphate and Ipratropium bromide are as active drug substances, and HFA-227ea and 134a are as propellants. The particle size distribution profiles of developed Ipratropium and salbutamol Inhaler MDI product were evaluated with an eight-stage Anderson cascade impactor Copley (ACI, Copley) at flow rate of 28.3 l/min to determine the fine respirable fraction.
The percentage respirable fractions and particle distribution profiles are determined by using Copley Data Analysis Software (CITIDAS).
|
Description |
Salbutamol |
Ipratropium |
|
Respirable Fraction (%) |
41.902 |
31.545 |
|
Fine Particle Dose (μg) |
38.650 |
5.880 |
|
Mass Balance (μg) |
92.24 |
18.64 |
|
MMAD (μm) |
2.5 |
3.5 |
|
GSD |
1.9 |
1.5 |
Table. 01 Shows that the total mass of active ingredients is well within limit 75-125% of the average delivered dose and Fig. 01 Shows Drug Distribution per Discharge.
Hence, the developed formulation was concluded that efficient with achieved respirable fractions by ACI, Copley.
Rakesh Gupta
Department of Health & Family Welfare, India
Title: Prevalence of tobacco use among adults in Punjab, India: Evidence from National Family Health Survey 4
Biography:
Rakesh K Gupta is the Deputy Director, Non-Communicable Diseases, Department of Health & Family Welfare, Punjab. He has expertise in managing National Non-Communicable diseases Programs especially Blindness Control/Tobacco Control Programs and has professional experience of 33 years in service. He has represented MOHFW in WHO ENDS Consultation in Panama 2016 and WHO consultation on Plain packaging in Geneva 2017.
Abstract:
Background and challenges to implementation: Electronic Nicotine Delivery System (ENDS) popularly known as e-cigarettes are highly addicting and potentially lethal products. It is mostly being used by children and youth because these are glamorised by the tobacco industry. Though not generally available in stores, they are widely promoted and sold through E commerce sites with discount offers. Sales are increasing sharply all over the world. Punjab was the first state in India to declare Electronic Nicotine Delivery System (ENDS) as unapproved under Drugs and Cosmetics Act in 2013. Intervention or response: A circular was issued by Government of Punjab regarding declaration of manufacture and sale of ENDS as illegal. To counter the sale on the Ecommerce site, Punjab Government had issued a Demi-Official letter to Cyber Crime cell regarding the sale of E-cigarettes in 2016. Awareness notices were sent to various E commerce sites regarding the sale of E cigarette. District level Task Force effectively implements the ban through conducting raids at suspected point of sale, which is being monitored monthly by Deputy Commissioners of all Districts. Results and lessons learnt: Cyber Crime Cell identified the 26 E commerce sites that were selling the E cigarettes. Letter was sent to these sites regarding the Blocking/banning the sale of e cigarettes. After that No E commerce sites are selling e cigarettes in Punjab Conclusions and key recommendations: The declaration by the Government of Punjab opens the way for other states to follow suit, and prevent ENDS becoming an additional marketing strategy for tobacco companies.