Module 1: Welcome address: Dr Amita Nene from Indian Chest Society welcomed all the delegates, speakers and panelist. First poll was raised
Module 2: Pulmonary Mycoses - A Diagnostic Navigation through Cultures, BioMarkers and Molecular Tests: Dr Samir Garde, discussed about Pulmonary Mycoses. Key points of discussion was
- Candidiasis
- Aspergillosis
- Yeasts to complex highly resistant moulds
- European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG)
- Routine Microscopy
- Culture, Speciation, DST
- Mucor
- Serological tests for endemic Fungi
- Nucleic acid based assays - PCR
- Clinical & Radiological Presentations
Module 3: Invasive pulmonary aspergillosis - An Exciting Run Through: Dr Agam Vora, discussed about IPA. Key points of discussion were:
- Aspergillus is a ubiquitous, filamentous fungus
- Primarily causes infection in immunocompromised hosts and individuals with underlying Pulmonary disease
- The species most involved include A. fumigatus, A. terreus, A. flavus, and A. niger
- Overwhelmingly affects immuno-compromised
- Signs and symptoms
- Management
- Integrated diagnostic measures for aspergillosis, including appropriate imaging, galactomannan, and bronchoscopy in appropriate patients, is critical to expedite the diagnosis.
- When there is clinical suspicion of invasive aspergillosis, the patient must be immediately started on targeted antifungal agents.
Module 4: ABPA and Fungal Ball - An Overview: Dr Priti Meshram discussed about ABPA and fungal ball. Key points of discussion were
- Aspergillus Microbiology
- Case presentation
- BAL cytology
- Dense inflammatory infiltrate composed of numerous intact and degenerating neutrophils with macrophages
- Finger in glove” opacity: suggestive of mucoid impaction in dilated bronchi.
- “Tramline shadows”: suggestive of parallel linear shadows extending from the hilum in bronchial distribution and reflecting longitudinal views of inflamed, edematous bronchi
- “Toothpaste shadows”: representing mucoid impaction of the bronchi
- “Ring shadows”: reflecting dilated bronchi with inflamed bronchial walls
Module 5: Antifungal Agents - All that you need to know: Dr Jairaj Nair discussed about antifungal drugs, key points of discussion were:
- Immunocompromised states ( HIV, Malignancy, those on Chemotherapy, Post Transplant, Those on High steroid doses, Aggressive use of higher antibiotics)
- Better Diagnostic Modalities
- Better isolation, culture techniques
- Availability of anti-fungal drug susceptibility testing
- Availability of less toxic antifungal medications
- Antifungal drug prices coming down
Module 6: Pulmonary Mucormycosis - Review and Update: Dr Pralhad Pranhudesai discussed about pulmonaru mucormycosis. Key point of discussion were:
- Pulmonary mucormycosis
- Mucor sporangia
- Bronchoscopy
- Inflammatory polyp
- BAL Genexpert TB
- BAL Fungal stain
- BAL Fungal C/S
- Case discussions
- Biomarkes - Beta-D- Glucan and Galactomannan comes negative
- For medical management, primarily treat the cause
- The mainstay of antifungal treatment is liposomal Amphotericin B and combinations with Azoles
- Mucormycosis management outcome is good ,when there is a good team
Module 7: Treating Candida in sputum / BAL - when, in whom, with what?: Dr Lancelot Pinto expressed his views on treatment of Candida. Key points of discussion were:
- In most patients, Candida in the sputum/BAL is likely to be a colonizer, do not treat
- Only in severely immunocompromised individuals should treatment be a consideration
- Infection in the lung is likely hematogenous, search for a focus
- Echinocandins are preferred over azoles and amphotericin B
- Targeted step-down therapy based on cultures/DST
- Future research on whether colonization influences outcomes, or is just a marker of outcomes
- When would you treat Candida in sputum or BAL?
- What is your choice of initial therapy for Candida when you decide to treat?
- How long would you treat pulmonary Candida for?
- What are the challenges that one faces during treating such patients?
- What are your thoughts on prophylaxis?
Module 8: Panel discussion on Management of Fungal Infections - Do’s and Dont’s: The panel discussion was moderated by Dr Amita Nene. The panelist for the discussion were Dr PS Tampi, Avya Bansal and Dr Kapil Salgia. The following questions were addressed in the panel discussion:
- In which patient populations should we suspect invasive Fungal Infections especially Invasive aspergillosis and mucormycosis?
- Why are fungal infections on a rise worldwide?
- In which other conditions can Halo sign be seen?
- What are the differential diagnosis and now what next should we do??
- In which conditions would Galactomannan be falsely positive or falsely negative?
- What is the role of PCR based molecular tests?
Module 9: Vote of thanks and felicitation: Dr Amita Nene delivered vote of thanks. All the dignitaries were falicitated. Second poll was raised
We wish you a great learning experience!
We thank Mylan pharmaceuticals Pvt Ltd- A Viatris company for supporting this CME.
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Agenda
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4:30-5:00 PM IST
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Registration and High tea
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Master of Ceremony- Dr Iram Syed
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Time
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Topic
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Faculty
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Chairperson
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5:00-5:10 pm IST
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Welcome address
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Dr Amita Nene
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5:10- 5:40 pm IST
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Pulmonary Mycoses - A Diagnostic Navigation through Cultures, BioMarkers and Molecular Tests
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Dr Samir Garde
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Dr Pralhad Prabhudesai
Dr Lancelot Pinto
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5:40-6:10 pm IST
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Antifungal Agents - All that you need to know
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Dr Jairaj Nair
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(Prof) Dr Agam Vora
Dr Priti Meshram
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6:10-6:40 pm IST
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ABPA and Fungal Ball - An Overview
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Dr Priti Meshram
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Dr P. S Tampi
Dr Kapil Salgia
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6:40-7:10 pm IST
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Invasive pulmonary aspergillosis - An Exciting Run Through
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(Prof) Dr Agam Vora
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Dr Amita Nene
Dr Avya Bansal
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7:10-7:40 pm IST
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Pulmonary Mucormycosis - Review and Update
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Dr Pralhad Pranhudesai
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Dr Samir Garde
Dr Jairaj Nair
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7:40-8:10 pm IST
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Treating Candida in sputum / BAL - when, in whom, with what?
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Dr Lancelot Pinto
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(Prof) Dr Agam Vora
Dr Amita Nene
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8:10-8:40 pm IST
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Panel discussion on Management of Fungal Infections - Do’s and Dont’s
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Moderator: Dr Amita Nene
Panelist:
Dr P. S Tampi
Dr Kapil Salgia
Dr Avya Bansal
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Dr Pralhad Prabhudesai
Dr Priti Meshram
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8:40-8:50 pm IST
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Vote of Thanks
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Dr Amita Nene
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8:50 pm IST onwards
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Dinner
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