Hassan S. Alorainy

Bio: Hassan S. Alorainy is an academic researcher. The author has contributed to research in topics: Guideline & COPD. The author has an hindex of 6, co-authored 6 publications receiving 206 citations.

The Saudi initiative for asthma - 2012 update: Guidelines for the diagnosis and management of asthma in adults and children

Abstract: This is an updated guideline for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have guidelines that are up to date, simple to understand and easy to use by nonasthma specialists, including primary care and general practice physicians. SINA approach is mainly based on symptom control and assessment of risk as it is the ultimate goal of treatment. The new SINA guidelines include updates of acute and chronic asthma management, with more emphasis on the use of asthma control in the management of asthma in adults and children, inclusion of a new medication appendix, and keeping consistency on the management at different age groups. The section on asthma in children is rewritten and expanded where the approach is stratified based on the age. The guidelines are constructed based on the available evidence, local literature, and the current situation in Saudi Arabia. There is also an emphasis on patient-doctor partnership in the management that also includes a self-management plan.

The Saudi Thoracic Society guidelines for diagnosis and management of noncystic fibrosis bronchiectasis.

Abstract: This is the first guideline developed by the Saudi Thoracic Society for the diagnosis and management of noncystic fibrosis bronchiectasis. Local experts including pulmonologists, infectious disease specialists, thoracic surgeons, respiratory therapists, and others from adult and pediatric departments provided the best practice evidence recommendations based on the available international and local literature. The main objective of this guideline is to utilize the current published evidence to develop recommendations about management of bronchiectasis suitable to our local health-care system and available resources. We aim to provide clinicians with tools to standardize the diagnosis and management of bronchiectasis. This guideline targets primary care physicians, family medicine practitioners, practicing internists and respiratory physicians, and all other health-care providers involved in the care of the patients with bronchiectasis.

The Saudi guidelines for the diagnosis and management of COPD

Abstract: The Saudi Thoracic Society (STS) launched the Saudi Initiative for Chronic Airway Diseases (SICAD) to develop a guideline for the diagnosis and management of chronic obstructive pulmonary disease (COPD). This guideline is primarily aimed for internists and general practitioners. Though there is scanty epidemiological data related to COPD, the SICAD panel believes that COPD prevalence is increasing in Saudi Arabia due to increasing prevalence of tobacco smoking among men and women. To overcome the issue of underutilization of spirometry for diagnosing COPD, handheld spirometry is recommended to screen individuals at risk for COPD. A unique feature about this guideline is the simplified practical approach to classify COPD into three classes based on the symptoms as per COPD Assessment Test (CAT) and the risk of exacerbations and hospitalization. Those patients with low risk of exacerbation (<2 in the past year) can be classified as either Class I when they have less symptoms (CAT < 10) or Class II when they have more symptoms (CAT ≥ 10). High-risk COPD patients, as manifested with ≥2 exacerbation or hospitalization in the past year irrespective of the baseline symptoms, are classified as Class III. Class I and II patients require bronchodilators for symptom relief, while Class III patients are recommended to use medications that reduce the risks of exacerbations. The guideline recommends screening for co-morbidities and suggests a comprehensive management approach including pulmonary rehabilitation for those with a CAT score ≥10. The article also discusses the diagnosis and management of acute exacerbations in COPD.

The prevalence of chronic obstructive pulmonary disease in Riyadh, Saudi Arabia: a BOLD study

Abstract: OBJECTIVE To estimate the prevalence and associated risk factors of chronic obstructive pulmonary disease (COPD) in Saudi adults aged ⩾40 years using standardised post-bronchodilator spirometry according to the Burden of Obstructive Lung Disease (BOLD) protocol. METHODS Saudi men and women aged ⩾40 years were recruited by stratified multistage random sampling in Riyadh, Saudi Arabia. Participants completed questionnaires on respiratory symptoms and exposure to risk factors for COPD. Spirometry was performed according to standard methods. COPD was defined as post-bronchodilator FEV1/FVC (forced expiratory volume in 1 s/forced vital capacity) ratio <70% (Global Initiative for Obstructive Lung Disease [GOLD]) or less than the lower limit of normal (LLN) (95(th) percentile) of the population distribution for FEV1/FVC. RESULTS Seven hundred subjects underwent acceptable post-bronchodilator spirometry. The overall prevalence of GOLD COPD was 4.2% (men 5.7%, women 2.5%). The overall prevalence of COPD stage 1 or higher using the LLN was lower than estimates using the GOLD criteria (3.2%). The overall prevalence of GOLD stage 2 or higher COPD was 3.7%. Male sex, increasing age and smoking were significantly associated with COPD diagnosis. CONCLUSION The overall prevalence of COPD in Saudi Arabia is 4.2%. Male, increasing age and smoking were the main risk factors for COPD.

Spirometric reference values for healthy nonsmoking Saudi adults.

Abstract: Objectives: To derive prediction equations of spirometric values of healthy Saudi adults and to compare the derived equations with equations reported in selected population. Methods: Cross-sectional study of healthy nonsmoking men and women Saudi adults. The measured spirometric values were the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF) and forced mid-expiratory flow (FEF 25%‐75%). Results: A total of 621 spirometric tests were done. The prediction equations were derived using the following formula: Predicted spirometric value = constant + (b1 × age) + (b2 × height (cm)), where b1 and b2 represent the regression coefficients for age and height, respectively.

The asthma–chronic obstructive pulmonary disease overlap syndrome: pharmacotherapeutic considerations

Abstract: Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is a commonly encountered yet loosely defined clinical entity. ACOS accounts for approximately 15-25% of the obstructive airway diseases and patients experience worse outcomes compared with asthma or COPD alone. Patients with ACOS have the combined risk factors of smoking and atopy, are generally younger than patients with COPD and experience acute exacerbations with higher frequency and greater severity than lone COPD. Pharmacotherapeutic considerations require an integrated approach, first to identify the relevant clinical phenotype(s), then to determine the best available therapy. The authors discuss the array of existing and emerging classes of drugs that could benefit those with ACOS and share their therapeutic approach. A consensus international definition of ACOS is needed to design prospective, randomized clinical trials to evaluate specific drug interventions on important outcomes such as lung function, acute exacerbations, quality of life and mortality.