Awareness of the patient and proper medication can keep Asthma under control

As an eminent physician, would you please tell us about the common chest diseases in Bangladesh?
In our country, common Chest Diseases are Bronchial Asthma, Chronic Bronchitis, COPD and Emphysema. Due to season or weather change, we also get many types of respiratory tract infections. Most of them are viral, Pneumonia, and Tuberculosis. These are quite common chest diseases in our country.

Tuberculosis (TB) is reappearing. What are the reasons?
Actually, Tuberculosis is an old disease since long. Presently, it is also present. Usually, in most of the cases, rapid urbanization, overcrowding and poor general health condition, lack of pure drinking water etc. are the main reasons. Also, in most of the cases, especially in the villages, people are not aware of the seriousness of the disease. This is one reason why it is reappearing.

As the management of TB has become a little bit complicated due to its being resistant to drugs, what is your advice to address this new phenomenon?
Yes, there is resistance to drugs in Tuberculosis which is called MDR Tuberculosis. The western world is mostly affected with this phenomenon. In our country, three factors are responsible for this: Patients, Doctors and the Govt. are equally responsible for this sort of thing. Mostly, patients do not complete the course as they stop taking medicine in the middle when they feel better. Secondly, there is a lack of counseling by the doctors.
Unfortunately, doctors fail to give proper counseling to TB patients about the doses and the duration of the courses and also about the consequences if the medication is stopped on the half-way. Thirdly, there is not sufficient supply of medicines in Govt. Hospitals compared to number of patients which is really very high. 
Govt. Hospital supply different medicines on different times, which make the patients confused, especially in the rural areas. Again, the number of doctors is much less in comparison to the number of patients, which is really very high. Consequently, the doctors do not get time to give proper counseling to the patients. 

What is your opinion in the management of asthma in Bangladesh? Is it fully curable? If not, how to keep it under control?
Actually, asthma is a chronic disease, so there is recurrence. Many reasons, like air pollution, mainly dust, frequent change of weather, and also some kind of foods which create allergies are responsible for asthma, but, management of asthma is not a tough thing. Awareness of the patient and proper medication can keep asthma under control. Use of inhaler and nebulizer, in case of emergency, can give relief to the patient but proper use of inhaler is very important. And the patient can also keep a nebulizer handy by buying it as it is easily available and also cheaper. In case of emergency, we also use steroid along with other drugs. So, asthma is manageable. In addition to the above, drugs taken regularly by mouth can also give relief. Regarding complete cure one has to know the reason of allergy and avoid things which give rise to allergy. 

Use of steroid drugs is frequent in controlling asthma. What is your view about it?
Actually, steroid is necessary in case of emergency only. We call it acute severe asthma. Other than emergency, steroid is not usually used. It is used when other emergency measures like nebulizer etc. fail.

What are your suggestions to the asthma patients to lead a normal life despite his being asthma?
Yes, most of the patients can lead a normal life if he is aware, educated and remain away from the factors causing asthma. I have already mentioned that air pollution, dust, fume and most importantly, smoking should be avoided. Asthma patient must lead a disciplined life if he wants to avoid serious asthma attack.

In Bangladesh, the issue of fake, substandard and adulterated drugs has become a cause of serious concern for human lives. How can we combat this?
In our country, this is really a difficult task because not only drugs, almost everything is adulterated. So, it is not drug alone. But, drug adulteration is very dangerous as it is related to human lives. For this, peoples’ awareness, media campaign and drastic govt. measures are required to combat this serious menace.

It is alleged that cost of treatment for a common man has become very expensive due to investigation charges. Is there any remedy for this?
Yes, there are a lot of complaints about this. In fact, in the private clinics and hospitals, the investigation charges are very expensive. The reason behind this, as reported, is the cost of import and installation of latest and sophisticated machineries together with govt. duties. Even then, the charges should be reduced so that the common people can have access to it.

Are you satisfied with the quality of drugs manufactured in Bangladesh? Do you have any suggestion in this regard?
There are quite a good number of companies who are producing quality drugs. At the same time, there are complaints against some drug companies. So, there should be regular check and vigilance Are you satisfied with the quality of drugs manufactured in Bangladesh? Do you have any suggestion in this regard? There are quite a good number of companies who are producing quality drugs. At the same time, there are complaints against some drug companies. So, there should be regular check and vigilance by Drug Control Authorities to guard against adulteration and sub-standard drugs.

What is the overall scenario of Healthcare Services and Quality of treatment in Bangladesh?
Recently, you must have read an article in The Lancet regarding overall healthcare scenario in Bangladesh which is much better than ever before. But, there is room for further improvement to reach the international standard. The bottle-neck is that the number of doctors and hospitals in our country is much less compared to our population. Anyway, we should try to improve the situation further.

How do you evaluate THE PHARMA WORLD?
I have gone through THE PHARMA WORLD and find it very informative and useful for all stakeholders. I would urge upon you to keep it up!