Due to cultural practices and beliefs their
satisfaction level is 71.9% – Dr. Nadir Ali Syed
KARACHI: Almost 50% of population in industrialized world, 80% people in the developing world use Complimentary Alternative Medicine (CAM) and due to cultural practices and beliefs their satisfaction level is 71.9%. This was stated by Dr. Nadir Ali Syed a noted neurologist while speaking at the fourth scientific session during the 23rd Neurology Update and 6th Headache Conference organized by Pakistan Society of Neurology and Pakistan Headache Society here from December 15th to December 17th 2023. This is all scientific based evaluation of complementary medicine and it is quite commonly used.
Dr. Nadir Ali Syed
Dr. Nadir Ali Syed said that generally the conception is that it is the poor people who use complimentary or alternate medicine. However, published studies show that almost 50% of patients who suffer from multiple sclerosis are using it. They are sick but smarter people are using complimentary or alternate medicine and they are from affluent section of the society as well. Studies also show that 53.5% of patients suffering from diabetes also use complimentary medicine. About 10% of the population suffer from migraine. Beta blockers are commonly used but they are effective only in about 50% of the patients. About 84% of patients suffering from migraine use alternate medicine and the use of acupuncture for treatment of migraine is about 69%.
Cochrane review involving 4985 patients showed that these complimentary and alternate medicines were as effective as allopathic drugs. Studies have also showed that acupuncture treatment was as effective as prophylactic drugs. They have few side effects as compared to drugs and this is also one of the reasons why people use complimentary and alternate medicines. Speaking about the usefulness of Cognitive Behavior Therapy (CBT) Dr. Nadir Ali Syed said that elven Randomized Clinical Trials(RCTs) showed that it improves headache frequency. Yoga and Meditation are also used in migraine. Certain herbal drugs are also known to decrease frequency and severity of migraine. Melatonin RCT showed that it also decreased headache intensity.
Electric Nerve Stimulation (ENS) has been approved by the FDA for the treatment of migraine. It results in 50% pain reduction and there is 59% transition from severe to moderate pain. Now more and more patients are using complimentary and alternate medicine. Dr. Nadir Ali Syed was of the view that integrative medicine is the future as according to medical care it is the combination of body and soul.
Dr. Nadir Zafar alongwith Dr. Qasim Bashir, Dr. Abdul Ghafoor Magsi and
Dr. Ra-jesh Kumar Khatri, chairing the Scientific Session-IV on Day-I of
Neurology Update organized by Pakistan Neurology Society held at Karachi recently. On extreme right is Dr. Sidra Jazil Faruqi Moderator of the session.
Prof. Raza Ur Rehman discussed the Gut and Brain Axis: A pathway to Neurodegeneration. Brain, he said, is connected to the Gut and this connection goes both ways. The Gut brain connection stimulates the local brain system. Gut hormones have their effect on brain. It is the brain which controls the microbiota. There is loss of appetite, unusual hunger. This leads to Alzheimer’s disease, migraine, schizophrenia and Autism Spectrum Disorders. GI symptoms, he said, are common in autism. He then also talked about the gut related factors in migraine, gut health and gut microbial biodiversity in Alzheimer Disease.
Dr. Aisha Zafar and other chairpersons presiding the Third session on Day-I
of the International Neurology Update held at Karachi recently.
Normally no importance is given to blood brain barriers and diet. There are good microbes and bad microbes. Probiotics, he pointed out, are the food supplements. These food supplements and diet has an influence on how to improve gut health. Exercise reduces stress and improves physical health. His advice was to drink plenty of water to ensure good health. Dr. Syed Ahmad Asif from Liaquat National Hospital was the next speaker who read his slides related to “Reasons for failure to develop Disease Modifying Treatment for Neurodegernative Dementia”. He discussed in detail the pre occupation of mind and gradual decrease in memory. More than six million people he said, are suffering from Alzheimer’s’ Disease. Studies have also showed that only four out of ten Americans talk to their doctors about loss of memory. He also referred to 3226 studies related to Alzheimer’s Disease and pointed out that AD trials are different from others. He laid emphasis on targeting correct population and creating awareness among the GPs, Family Physicians. Our knowledge about these diseases is still deficiency, he remarked.
Dr. Raza Ur Rehman, Dr. Maria Junadi, Dr. Syed Ahmed Asif, Dr. M. Wasay,
Dr. Shahid Mustafa and Dr. Saleem Barech speaking at the International Neurology Update held at Karachi recently.
Dr. Maria Khan from Dubai was the next speaker who talked about “A Day after Stroke and its Management”. She described in detail as to what one should expect from these stroke patients, prevention and early identification of stroke. All efforts should be made to prevent complications. Work for secondary prevention of stroke. These patients should be admitted in Stroke Unites where they are looked after by multidisciplinary teams. The team members include physiains, nursing staff, occupational therapists, physiotherapists, speech and language therapists. Management of stroke varies in different countries. She laid emphasis on early identification of complications and appropriate management.
Rehabilitation should aim that they live in their homes and are able to do their daily activities independently. In Stroke Units multidisciplinary teams monitor vital signs, prevent hypoglycaemia. Cardiac monitoring is recommended for stroke patients during first twenty-four hours. One should control blood pressure early. Blood glucose monitoring is important because hypoglycaemia and hypoglycaemia both are dangerous. Very tight control, she opined, is not important because it results in worst outcome. She also talked about dysphagia screening and use of nasogastric tube for nutrition should be considered. Nutritional supplements, she said, has no role in stroke management. These patients can have congestive heart failure, brain edema, recurrent ischemia and seizures. She then discussed work up of a stroke patient and referred to the WHO check list for ischemic discharge. It is freely available on the Net. How to set up a Stroke unit, early rehabilitation and reintegration of these patients in the society were also discussed in detail.
