Scientific System of Medicine

Scientific System of Medicine The practice of medicine is an art based on science. Today, evidence-based medicine has become the norm in clinical practice. Application of evidence-based medicine in day to day practice means relating individual clinical signs, individual clinical experience with the best scientific evidences obtained by the clinical research. Scientific system of medicine evaluates any health practice, product, based on the scientific evidence available. Scientific system of medicine takes into consideration all of the scientific evidence in their entirety. It also takes into consideration prior scientific plausibility or prior likelihood, whether that treatment is a valid treatment and is effective, when evaluating health or scientific claims or assertions, which evidence-based medicine does not. Any pathy can have treatment at any level of evidence. • Level I: Evidence from a systematic review or meta-analysis of all relevant RCTs (randomized controlled trial) or evidence-based clinical practice guidelines based on systematic reviews of RCTs or three or more RCTs of good quality that have similar results. • Level II: Evidence obtained from at least one well-designed RCT (e.g. large multi-site RCT). • Level III: Evidence obtained from well-designed controlled trials without randomization (i.e. quasi-experimental). • Level IV: Evidence from well-designed case-control or cohort studies. • Level V: Evidence from systematic reviews of descriptive and qualitative studies (meta-synthesis). • Level VI: Evidence from a single descriptive or qualitative study. • Level VII: Evidence from the opinion of authorities and/or reports of expert committees. Randomized controlled trials (RCTs) are regarded as Level 1 evidence and have been ranked highest. Observational studies, generally regarded as Level II or level III evidence, have been shown to be comparable to RCTs. Therefore, observational studies are also important as evidence for a said practice or treatment or product. The word ‘observation’ is defined in the English dictionary as “an act of noting and recording any event”. In terms of science, this can be likened to recording any data generated out of an experiment. Any observation therefore is potential evidence (JAMA. 2000;284(10):1290-1296). There should be only one system of medicine, the scientific system of medicine. And, all pathies must validate their effectiveness through scientific evidence. Disclaimer: The views expressed in this write up are entirely my own.

All systems of medicine should advocate a common lifestyle pattern for lifestyle disorders

All systems of medicine should advocate a common lifestyle pattern for lifestyle disorders Non-communicable diseases (NCDs) such as hypertension, type 2 diabetes, heart diseases, behavioral problems, high cholesterol and obesity are rapidly increasing worldwide, including in India. These diseases are called lifestyle disorders as they have their roots in the lifestyle - habits and behavior - of an individual. An unhealthy lifestyle can contribute to the development of risk factors of NCDs. The epidemic of NCDs in our country is mainly attributed to modernization, urbanization, sedentary lifestyles and longevity (Press Information Bureau, 20.2.17). The WHO’s ‘Global Status Report on NCDs 2014’ has identified four main types of NCDs (cardiovascular diseases, cancer, chronic respiratory diseases and diabetes), four behavioral risk factors responsible for significant proportions of these diseases (tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol) and four major metabolic risk factors (obesity, raised blood pressure, raised blood glucose and raised blood total cholesterol levels). The INTERHEART study published in the September 3, 2004 issue of the Lancet identified nine traditional risk factors for an acute heart attack: Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity. As per the study, more than 90% of the global risk for acute MI is predicted by these nine traditional risk factors. All the major lifestyle disorders or NCDs share common lifestyle-related risk factors like physical inactivity, unhealthy diet, tobacco and excess alcohol intake. These risk factors are modifiable i.e. measures can be taken to prevent them. Non-modifiable risk factors are those which cannot be changed e.g. age, family history and ethnicity. Adopting a healthy lifestyle can either prevent or delay onset and progression of these diseases. Because these lifestyle diseases share modifiable risk factors, patients should be advised a common lifestyle, which will prevent all lifestyle disorders. Instead of advocating a lifestyle for individual disease, these lifestyle modifications should be such that they not only prevent heart diseases but also type 2 diabetes, hypertension, overweight and obesity, depression and cancer. Here is my Formula of 80 to live up to the age of 80. • Keep lower BP, LDL ‘bad’ cholesterol levels, resting heart rate, fasting sugar and abdominal girth levels all less than 80. • Keep kidney and lung functions more than 80%. • Walk 80 minutes a day, brisk walk 80 min a week with a speed of 80 steps (at least) per minute • Eat less and not more than 80 gm or ml of caloric food each meal. Follow a healthy diet (high fiber, low saturated fat, zero trans fat, low refined carbohydrate, low salt, high in fruits). Refined carbohydrates are white rice, white maida and white sugar. • Observe cereal fast 80 days in a year. • Do 80 cycles of pranayama (parasympathetic breathing) in a day with a speed of 4 per minute. • Spend 80 minutes with yourself every day (relaxation, meditation, helping others etc). • Do not smoke or be ready to shell out 80 K Rs. for treatment. • Do not drink alcohol; if you do, do not consume more than 80 ml per day for men (50% for women) or 80 grams per week. Ten grams of alcohol is present in 30 ml or 1 oz of 80 proof liquor. • Avoid exposure to >80 dB of noise. • Avoid exposure to PM 2.5 and PM 10 levels <80 mcg/m3. • Take vitamin D through sunlight 80 days in a year. • If you are a heart patient, consider 80 mg aspirin and 80 mg atorvastatin a day.

A fasting diet reduces risk of chronic diseases

A fasting diet reduces risk of chronic diseases A randomized phase II clinical trial published in the journal Science Translational Medicine February 15, 2017 has highlighted the safety, feasibility and benefits of a ‘fasting’ diet on health by reducing the risk of cancer, heart disease, diabetes and other age-related diseases. The study conducted by researchers at the University of Southern California Leonard Davis School of Gerontology in the US evaluated the effects of a ‘fasting-mimicking’ diet (FMD) - low in calories, sugars and protein but high in unsaturated fats - on markers/risk factors associated with aging and age-related diseases such as diabetes, cancer, and cardiovascular disease in 100 generally healthy participants. The study group consumed a FMD for 5 consecutive days every month for 3 months. The control subjects were then crossed over to the FMD Group for 3 months. Body weight, BMI, total body fat, trunk fat, waist circumference, systolic and diastolic blood pressure, cholesterol, insulin‐like growth factor 1 (IGF‐1), and C-reactive protein (a marker of inflammation) were significantly reduced, particularly in individuals at risk for diseases, while relative lean body mass (muscle and bone mass) was increased. Fasting is not just abstaining from intake of food and water. Fasting also means avoiding negative thoughts. A ‘fast’ or ‘vrata’ purifies the mind, body and soul. It facilitates restraining of the senses and advocates a satvik lifestyle i.e. living a life full of satwa with devotion and discipline and avoiding rajsik and tamsik lifestyle. Our ancestors made it a compulsory practice to observe fasts, which primarily meant abstaining from eating carbohydrates once a week, and during season's change i.e. during the time of Navratras thereby preventing lifestyle diseases. Fasting helps deplete the stores of sugar in your liver. Fasting once a day in a week gives the body a much-needed rest and time to catch up on the process of repair and/or cleaning. There is nothing better than fasting once a week to keep your heart healthy…

Identify fake medicine - Health care professions tell consumers

Identify fake medicine - Health care professions tell consumers Would you be able to tell a real medicine from a fake one? This important question is being posed to the public, health care professionals and policymakers by the World Health Professions Alliance (WHPA) in a video, launched on Thursday that exploits an interactive function of YouTube. Viewers are asked to choose between two products and then shown the consequence of their decision: the person either recovers or ends up in hospital. The project was led by the International Pharmaceutical Federation (FIP). “We're seeing an increase in fake medicines around the world and they're becoming harder to identify thanks to technological advances. We wanted, through this video, to confront people with a situation to which little thought is often given. We wanted to give viewers the responsibility for what happens and, in doing so, to send home the message that there is a need to think twice about the choices they make. The aim was to enable informed decisions,” said Mr Luc Besançon, Chief Executive Officer of FIP. “The consequences of counterfeit medicines include no cure, resistance to treatment, spread of disease, permanent injury and even death,” said Dr Frances Hughes, Chief Executive Officer of the International Council of Nurses (ICN). “We need to empower the public through general health literacy and ensure there is more nursing involvement in strategies.” The video is part of a new WHPA project, “Counter the counterfeits”, which is the latest work in the alliance's long-running campaign to protect people from substandard or falsified medicines and medical devices. It is accompanied by three sets of animated measures that consumers, health professionals and policymakers around the world can take to get rid of fake medicines and the harm that they do. Consumers, for instance, are given advice on how to make sure that medicines bought online are real, and health care professionals are reminded which features of medicines to inspect. Through the third set of measures, the WHPA calls on policymakers to strengthen laws against counterfeiting and to involve health care professionals in policy decisions so that these are appropriate to real-life and more likely to be put into practice. “Patients expect support from health care professionals regarding counterfeit medicines. The project offers six simple measures to health care professionals for reducing the harm these products can cause,” said Mr Jonathon Kruger, Chief Executive Officer of the World Confederation for Physical Therapy (WCPT). “When counterfeit medicines are found in the legal supply chain, public trust in health systems is damaged. Working together through the WHPA we can give the problem of counterfeits an amplified voice and ensure necessary action is taken at both the policy and population level”, said Mr Enzo Bondioni, Executive Director of FDI World Dental Federation. “This project sends a clear message that the problem of fake medicines has not gone away and that doctors, nurses, pharmacists, dentists and physical therapists continue to be concerned. We hope that the video and the measures to take are spread far and wide, particularly through social media sharing,” said Professor Sir Michael Marmot, President of the World Medical Association (WMA). (World Medical Association, 29.09.2016)