Adoption of positive values will be better for all of us-Abdul Rahim Ziaratwal


Public Awareness Session at Preventive Cardiology Conference

Adoption of positive values will be better
for all of us-Abdul Rahim Ziaratwal

Regular use of Low Dose Aspirin can prevent
upto 25,000 deaths daily-Prof. Samad

Diabetics with Triple Vessel Disease should
be referred for CABG - Maj. Gen. Azhar Kiani

From our correspondent

QUETTA: We should adopt positive attitude which will be best for all of us. Healthcare professionals working in public healthcare facilities must protect the hospital equipment, instruments and it they are not in working order, public has a right to ask them for the reasons because they pay taxes and it is their responsibility. The government will not tolerate any corruption, pilferage and things do not improve, we will take action against those found guilty and responsible. This polite warning to all those working in the public healthcare facilities were given by Baluchistan Information Minister Mr.Abdul Rahim Ziaratwal. He was speaking at the Public Awareness Session organized during the just concluded 5th Preventive Cardiology conference held here from August 9-10th 2014.


Prof Munaf Tareen along with Dr. Fawad Farooq and delegate from
Afghanistan chairing one of the scientific sessions during preventive
cardiology conference held at Quetta recently.

He commended the organizers for holding a conference on preventive aspects of diseases and said that we always talk about cure but prevention is the best policy. Our overall planning in health sector, he opined, was not good. We have no parks in the cities for the public to walk and do exercise. The fat consumption has increased manifold. Government property is not protected and it is not owned by the society. The equipment and instruments in the public hospitals are not properly maintained in functioning order or they are not used carefully. Our Government, he said, gives priority to Health and Education but we cannot tolerate pilferage of drugs, medicines and other items from public hospitals. It is high time that those at the helm of affairs, administering these healthcare facilities control this theft and pilferage otherwise we will take action against them and punish those indulging in theft and pilferage. Now we are requesting but we won’t hesitate to take action, he warned.

Continuing Mr. Ziaratwal said that it has come to our notice that the hospitalized patients get the morning dose but they are not given the drugs in the afternoon and at night. These are stolen and sold in the market but the government is charged for all this. He further stated that recently he had a chance to visit the Intensive Care Unit of the Civil Hospital and he was pained to find out that none of the equipment in any room in ICU was functional. Whose responsibility it is to keep them in functional order, he asked? He urged the healthcare professionals that they should shake their conscience and it will tell them what is right and what is wrong. As regards the Government, we will be honest; we are determined to serve the people, control corruption and ensure judicious use of the allocated resources. If we cannot perform, the public will have the right to leave us during the elections, he remarked.


Photographed during the inaugural session of preventive cardiology from (L to R)
are Gen. Azhar Kiani, Dr. Haqdad, Dr. Jalaludidn Achakzai, Governor Baluchistan
Muhammad Khan Achakzai, Prof. Abdus Samad and Prof. Munaf Tareen.

Earlier Prof. Abdus Samad gave highlights from the Million Heart Programme in USA and the Lessons for Pakistan. He pointed out that due to excellence in treatment now heart disease patients in United States are living longer unless the heart is severely diseases during the first attack. Hence, now many sick patients are living and the Government of United States is stuck with resources being provided. They spend lot of money on treatment of hypertension, diabetes mellitus. Preventive measures are important to ensure that heart diseases are decreased. To achieve that the United States has started this Million Heart Programe. At present two million people in US suffer from heart attack every year and during the next five years they wish to reduce these heart attacks by one million by some interventions. There are some lessons for Pakistan and we too can reduce twenty five thousand deaths daily by ensuring that those at high risk get Low Dose Aspirin therapy regularly. He also gave the details of the 11S programme which stands for regular use of Salicylic Acid, use of Statins, Seventeen KMs walk per week, Salad, sweet peanuts, sleep for seven hours. Taking Aspirin, Statins Prof. Samad said, was important while dietary measures are essential though difficult. Sleepless nights and stressful days are prominent cause of heart disease in our population. He advised people to smile when they are upset, the stress will be over. Giving details of the consumption of sugar, milk and red meat in India, Pakistan and Bangladesh, he gave the following figures:

It is the eating habits of our people which are responsible for increased in hart diseases in Pakistan, he added.

Gen. (Retd) Azhar Kiani Executive Director of Rawalpindi Institute of Cardiology and President of Pakistan Cholesterol Awareness Society in his presentation discussed prevention of heart diseases. He pointed out that we are surprised to see patients nineteen years of age and in their late 20s and early 30s coming with heart attacks which are admitted in the Coronary Care Units. It is because of fast food, smoking, and no physical activity. If we eat carefully, we can prevent many of these heart diseases. Ischaemic Heart Disease is the No.1 Killer and these deaths are preventable with diet and life style modification and reduction in the use of salt. He advised the people to eat less and walk more. We should have cholesterol between 150-200. Diagnosing IHD can cost upto forty fifty thousand rupees and then treatment is much more expensive.

Continuing Gen.Kiani said that at times patients may not have any symptoms. Sometimes the suffer from chest pain, angina and then have myocardial infarction. They can come with vomiting, abdominal pain, palpitation. Abdominal pain after midnight and early in the morning should not be taken lightly. ECG changes take some time to appear. When the patient complains of some discomfort, listen to him/her as patient is always right though there may not be any changes seen in the ECG. Diabetics do not have pain, they develop sudden weakness. Since the heart muscles are dying every minute, it is extremely important that the patient is taken to the nearest healthcare facility as soon as possible after chest pain. Exercise is the best medicine and angiography should be done when indicated, he added.

Prof. Abdul Munaf Tareen discussed the Healthy Life Style while Dr. Haqdad Tareen spoke about behavioural risk factors in prevention of cardiovascular diseases. Dr. Jalaluddin Achakzai gave figures of increase in smoking worldwide and pointed out that smoking is considered as the leading cause of death. Hence it is important that we emphasize on smoking cessation.

Dr. Roohi Ilyas from NICVD Karachi gave a presentation of Basic Life Support. His presentation was supplemented with an interesting informative Video which showed the patient being managed through CPR and defibrillator after suffering from myocardial infarction. She discussed the causes of sudden cardiac death, talked about myopathies and rhythm problems, ventricular tachycardia and highlighted the importance of learning Basic Life Support for healthcare professionals and members of the society. Early access of patients to the healthcare facility, early cardiopulmonary resuscitation (CPR) rapid defibrillation, chest compression, ensuring airway breathing can ensure positive outcome. She also talked about the rationale of early defibrillation besides the use of AED- the automated defibrillator.

During the discussion Dr. Jalaluddin Achakzai stated that they intend to organize a Basic Life Support course in Quetta in the coming months. Tachycardia induced cardiomyopathies also figured in the discussion. Prof.Samad opined that fatty acids are essential and they re present in scaly fish. He also emphasized the importance of making blood chemistry much more favorable. Omega 3 Fatty Acids are useful. Stress is a risk factor for heart diseases hence preventive measures should be taken to reduce and overcome stress. Those people who have negative thinking are prone to developing coronary artery disease.

Gen. Azhar Kiani said that diabetic with triple vessel diseases should be advised CABG. In young patients always put drug eluting stents (DES), diabetics should never have bare metal stents. Young patients who do not wish to get their chest opened should opt for stenting but if it fails and there is restenosis, send them for surgery. Arterial grafts have longer life and re-do cardiac surgery has more morbidity and mortality. If the patient has no complications and there is focal lesion, go for stenting while surgery can be performed any time later. However it must be noted that CABG is quite economical whereas if the patient needs two or three stents, it becomes much more expensive. One should avoid surgery if possible. If patient cannot afford i.e. angioplasty, stenting and CABG, put him/her on optimal medial therapy and make his symptom free. Bad stenting can lead to problems. Even simple problems can have serious complications and one should be ready to face and manage them, Prof. Samad remarked. He suggested that let us start a pilot project of salt reduction in three four cities. Dr. Jalaluddin Achakzai opined that we need to establish Hypertension and Obesity clinics in all the major hospitals.

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