Professional Ethics and
Pakistan Cardiac Society

I must appreciate your endeavor to highlight the ethical issues in the cardiology conferences held in Pakistan in the last edition of your esteemed publication Pulse International January December 15, 2016 issue. We all talk about lack of attendance in scientific sessions, speakers not adhering to the allotted time, showing brand names of drugs etc. etc. But none of us has the courage to stand up and condemn this practice then and there.

The onus of convening successful conference, in all respects as far as possible, lies on the shoulder of convener and his team. They should be answerable to the executive council of Pakistan Cardiac Society for any mismanagement or irregularities. As a reminder Pakistan Cardiac Society may send a copy of guidelines on the ethical aspects to the convener beforehand. In case of non-compliance the cardiac society should have an option to declare that center ineligible for holding the next conference on its turn at least for once. Your effort to compile and write such a comprehensive article not only pointing out the deficiencies but also providing the solution is really commendable. Keep it up and hope for the best. 

Maj. Gen (Rt.) Ashur Khan,
Consultant Cardiologist,
Hearts International Hospital,
Rawalpindi - Pakistan.

New Year Health Resolutions

New Year is the time to make new resolutions. Pakistan is struck with an epidemic of metabolic syndrome, comprising apple shaped obesity(central), hypertension, glucose intolerance, diabetes-mellitus, hyperlipidemias, leading to heart attacks, strokes, renal failures, fatty liver and other complications. It causes untimely deaths, disabilities, enormous expensive major surgeries-many die due to unaffordable treatment.

The resolution of this menace lies in adopting correct life-styles as done successfully by many Nations. We should promise that this is the year we would be true to ourselves. We should make avid commitment to ourselves of better eating habits. This can be done simply by reducing salt content in our diet(called white poison) drastically reducing the incidence of hypertension including its complications of heart attacks, heart failures, strokes, renal failures etc. We eat too much salt-this should be substituted with other taste enhancing items. The central pillar of the metabolic syndrome is abdominal obesity. By taking a diet consisting of vegetables (raw or steamed) fruits (at least five portions- one cup of leafy vegetables or ½ cup of solid vegetables, a small portion of fruit, whole grains, pulses(lentils, beans, peas) low fat dairy products, mono saturated oils(canola for cooking, olive at table, poly saturated oil, nuts and seeds( inexpensive peanuts, flax, pumpkin seeds and grapes have been found to contain a chemical prolonging life) oily fish, poultry, egg white, red meat, low saturated fats, low cholesterol(depending upon the overall lipid profile and risk factors, avoiding sugars(black chocolate may be taken) having 90% plant based diet, taking at least 6 to 8 hours sleep following circadian rhythm(with short afternoon nap) and a regular schedule of daily exercises, aerobic stretching, muscle strengthening, relaxation exercises(meditation etc.) leading relaxed productive life and avoiding undue stresses.

The important target is to keep abdominal girth i.e. mid-point from the costal margin to upper margin of iliac crest less than 35-1/2 inches in males and 31-1/2 inches in females, overall body weight within limits, overall fat content less than 20% of the weight in males and 30% in females. Early diagnosis of hypertension, even pre- hypertension, glucose intolerance, dyslipidemias etc. and treatment is preventive. Even mild reduction of weight, abdominal obesity brings a lot of improvement.

Good life style living habits should be inculcated from infancy. Mass awareness should be created through media, prayer leaders, NGOs, educational institutions. Prevention is the only effective solution to resolve the problem. It is not only better than cure but is the real cure- the only cure and costs nothing. Making Disease Palaces (huge expensive hospitals) is no answer to the problem. Unfortunately the Governments in Pakistan are making Disease Palaces in the posh urban areas, neglecting the over-whelming majority of the population.

Prof. Emeritus Lt Gen Mahmud Ahmad Akhtar
Former Surgeon General Pak Army

Farewell Reception for
Prof. Khalid Mahmood

Professor Khalid Mahmood has finally retired from service on 11.12.16 after serving for more than 34 years. He has spent most of his time in serving Civil Hospital and Dow Medical College, now under DUHS Karachi.
He has rendered exemplary services to the poor patients of Civil Hospital Karachi and has been a teacher par excellence. His humility, humane nature and emotional attachment with the patients are really unmatchable. We still remember how, at the time of Mohtarma Benazir Bhutto’s death, despite the chaos and panic that had overtaken the city, Dr. Khalid came to the ward with his wife himself upon knowing that the patients were lying without medicines. He took a complete round of the ward, arranging for medicines for the patients and sorting out their problems- it was incredible. And this is just one of the many similar incidents worth mentioning.
In addition to that, he has always been an excellent teacher, equally loved and respected by his students and trainees. His students are serving on distinct posts not only within the country, but abroad as well. They always show him utmost respect and love and give him due credit for reaching where they have today.
Prof. Khalid is a God gifted physician and having been trained by stalwarts in Medicine, he has always depicted exceptional diagnostic skills. The standing ovation he received at his farewell held at Dow Medical College was a memorable event and yet another evidence of the regard that all of us hold him in. Very few people are rewarded this way.
His students, interns and colleagues are equally sad about having to bid him farewell and many even broke into tears at his super annuation. We, his students and trainees strongly believe that he still has a lot to offer and that his services should be utilized to the utmost, as people like him are born rarely. In contrast to western countries where senior doctors and professors are made maximum use of, it is unfortunate how our system does not recognize the importance of and has a fixed age of retirement for everyone, except judges.

Dr. Muhammad Ubaid
(On the behalf of trainees and students)
Dow University of Health Sciences
Karachi - Pakistan.

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