IHD-HIGH CHOLESTEROL-OBESITY
DrSaroshKhanMD
CONSULTATION
Dr. Sarosh Ahmed Khan
Hypertension
IHD-Cholesterol-Ramadan
Acid Peptic Disease
Diabetes Mellitus-Obesity
PHOTOS
MODERN HOSPITAL
THE DOCTORS PAGE
ISCHEMIC HEART DISEASE
Ischemic heart disease (IHD) also called coronary artery disease is on the rise. More and more Kashmiris are suffering from this dangerous disorder. Increase in diabetes mellitus, hypertension and obesity has contributed to this rise. High fat diet, sedentary life, lack of exercise, and lack of fiber in the diet are some of the risk factors.
Symptoms and Signs: Chest pain, breathlessness, palpitations, and fatigue on exertion are the main symptoms of this problem. Chest pain may be severe and may be felt as a tightening or constriction by the patient. If patient has a heart attack (myocardial infarction, MI) he may be sick looking, and his blood pressure may be low (hypotension). A fast feeble pulse, a pale, anxious look, sweating, and distress due to chest pain may be the only signs. However the doctor may pick up certain signs on examination of the heart.
Diagnosis: Other than clinical history and examination, ECG is the most important tool. It tells the doctor the type of IHD, type of MI, extent of MI, and complications like arrhythmias. Comparison with previous ECGs if present may be extremely helpful. A chest x-ray may also be needed, as well as blood tests to know about associated risk factors like increased cholesterol, DM, increased uric acid etc. Many will require catheterization and coronary angiography.
Course of the disease: Untreated patients condition will gradually deteriorate and will develop more symptoms with minimum exertion and even at rest. MI may be fatal if patient does not get hospitalization and proper treatment. Many develop heart failure.
Treatment: Low fat diet, more fruits and vegetables, weight reduction, daily isotonic exercise and medicines are recommended.
Advise: If you are more than forty, go for an ECG an year.
HIGH CHOLESTEROL
Increased or high cholesterol is called Hypercholesterolemia in medical terminology. The common man is taught about the good and the bad cholesterol. Cholesterol, Triglyceride, and Low Density Lipoprotein (LDL) are all bad. High density lipoprotein is considered good. Bad means it is harmful to the heart. It leads to clogging of the blood vessels especially of the heart. Thus Ischemic heart disease and myocardial infarction (MI) result.
Symptoms and Signs: As there is no specific symptom or sign of Hypercholesterolemia, laboratory test to detect it is the only way. Patient may suffer from hypertension, diabetes, obesity, or even a stroke with paralysis when his cholesterol is checked and found to be high. Thus all these patients as well as anybody more than forty should get his or cholesterol checked once a year.
Diagnosis: Check the level of cholesterol in a reliable laboratory.
Course of illness: High cholesterol is harmful for the blood vessels of the heart, brain, limbs, etc. It gets deposited in the wall and narrows it down. Thus it decreases the blood flow to the organ which that artery supplies. The result is often devastating in the form of heart attack (MI) or stroke with paralysis. Untreated it continues as a risk factor.
Treatment: Low fat diet, exercise, high fiber diet, and medicines to lower cholesterol are recommended.
Advise: Fat may be fatal.
Medical Benefits of Ramadan
Most Muslims do not fast because of medical benefits but because it has been ordained to them in the Quran. The medical benefits of fasting are as a result of fasting. Fasting in general has been used in medicine for medical reasons including weight management, for rest of the digestive tract and for lowering lipids. There are many adverse effects of total fasting as well as so-called crash diets. Islamic fasting is different from such diet plans because in Ramadan fasting, there is no malnutrition or inadequate calorie intake. The caloric intake of Muslims during Ramadan is at or slightly below the national requirement guidelines. In addition, the fasting in Ramadan is voluntarily taken and is not a prescribed imposition from the physician.
Ramadan is a month of self-regulation and self-training, with the hope that this training will last beyond the end of Ramadan. If the lessons learned during Ramadan, whether in terms of dietary intake or righteousness, are carried on after Ramadan, it is beneficial for one's entire life. Moreover, the type of food taken during Ramadan does not have any selective criteria of crash diets such as those which are protein only or fruit only type diets. Everything that is permissible is taken in moderate quantities.
The only difference between Ramadan and total fasting is the timing of the food; during Ramadan, we basically miss lunch and take an early breakfast and do not eat until dusk. Abstinence from water during this period is not bad at all and in fact, it causes concentration of all fluids within the body, producing slight dehydration. The body has its own water conservation mechanism; in fact, it has been shown that slight dehydration and water conservation, at least in plant life, improve their longevity.
The physiological effect of fasting includes lower of blood sugar, lowering of cholesterol and lowering of the systolic blood pressure. In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension. In 1994 the first International Congress on "Health and Ramadan", held in Casablanca, entered 50 research papers from all over the world, from Muslim and non-Muslim researchers who have done extensive studies on the medical ethics of fasting. While improvement in many medical conditions was noted; however, in no way did fasting worsen any patients' health or baseline medical condition. On the other hand, patients who are suffering from severe diseases, whether diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not try to fast.
There are psychological effects of fasting as well. There is a peace and tranquility for those who fast during the month of Ramadan. Personal hostility is at a minimum, and the crime rate decreases. Muslims take advice from the Prophet who said, "If one slanders you or aggresses against you, say I am fasting.'" This psychological improvement could be related to better stabilization of blood glucose during fasting.
There is a beneficial effect of extra prayer at night. This not only helps with better utilization of food but also helps in caloric output. There are 10 extra calories output for each rakat of the prayer. Again, we do not do prayers for exercise, but a mild movement of the joints with extra calorie utilization is a better form of exercise. Similarly, recitation of the Quran not only produces a tranquility of heart and mind, but improves the memory. Therefore, I encourage my Muslim patients to fast in the month of Ramadan, but they must do it under medical supervision.
Ischemic heart disease (IHD) also called coronary artery disease is on the rise. More and more Kashmiris are suffering from this dangerous disorder. Increase in diabetes mellitus, hypertension and obesity has contributed to this rise. High fat diet, sedentary life, lack of exercise, and lack of fiber in the diet are some of the risk factors.
Symptoms and Signs: Chest pain, breathlessness, palpitations, and fatigue on exertion are the main symptoms of this problem. Chest pain may be severe and may be felt as a tightening or constriction by the patient. If patient has a heart attack (myocardial infarction, MI) he may be sick looking, and his blood pressure may be low (hypotension). A fast feeble pulse, a pale, anxious look, sweating, and distress due to chest pain may be the only signs. However the doctor may pick up certain signs on examination of the heart.
Diagnosis: Other than clinical history and examination, ECG is the most important tool. It tells the doctor the type of IHD, type of MI, extent of MI, and complications like arrhythmias. Comparison with previous ECGs if present may be extremely helpful. A chest x-ray may also be needed, as well as blood tests to know about associated risk factors like increased cholesterol, DM, increased uric acid etc. Many will require catheterization and coronary angiography.
Course of the disease: Untreated patients condition will gradually deteriorate and will develop more symptoms with minimum exertion and even at rest. MI may be fatal if patient does not get hospitalization and proper treatment. Many develop heart failure.
Treatment: Low fat diet, more fruits and vegetables, weight reduction, daily isotonic exercise and medicines are recommended.
Advise: If you are more than forty, go for an ECG an year.
HIGH CHOLESTEROL
Increased or high cholesterol is called Hypercholesterolemia in medical terminology. The common man is taught about the good and the bad cholesterol. Cholesterol, Triglyceride, and Low Density Lipoprotein (LDL) are all bad. High density lipoprotein is considered good. Bad means it is harmful to the heart. It leads to clogging of the blood vessels especially of the heart. Thus Ischemic heart disease and myocardial infarction (MI) result.
Symptoms and Signs: As there is no specific symptom or sign of Hypercholesterolemia, laboratory test to detect it is the only way. Patient may suffer from hypertension, diabetes, obesity, or even a stroke with paralysis when his cholesterol is checked and found to be high. Thus all these patients as well as anybody more than forty should get his or cholesterol checked once a year.
Diagnosis: Check the level of cholesterol in a reliable laboratory.
Course of illness: High cholesterol is harmful for the blood vessels of the heart, brain, limbs, etc. It gets deposited in the wall and narrows it down. Thus it decreases the blood flow to the organ which that artery supplies. The result is often devastating in the form of heart attack (MI) or stroke with paralysis. Untreated it continues as a risk factor.
Treatment: Low fat diet, exercise, high fiber diet, and medicines to lower cholesterol are recommended.
Advise: Fat may be fatal.
Medical Benefits of Ramadan
Most Muslims do not fast because of medical benefits but because it has been ordained to them in the Quran. The medical benefits of fasting are as a result of fasting. Fasting in general has been used in medicine for medical reasons including weight management, for rest of the digestive tract and for lowering lipids. There are many adverse effects of total fasting as well as so-called crash diets. Islamic fasting is different from such diet plans because in Ramadan fasting, there is no malnutrition or inadequate calorie intake. The caloric intake of Muslims during Ramadan is at or slightly below the national requirement guidelines. In addition, the fasting in Ramadan is voluntarily taken and is not a prescribed imposition from the physician.
Ramadan is a month of self-regulation and self-training, with the hope that this training will last beyond the end of Ramadan. If the lessons learned during Ramadan, whether in terms of dietary intake or righteousness, are carried on after Ramadan, it is beneficial for one's entire life. Moreover, the type of food taken during Ramadan does not have any selective criteria of crash diets such as those which are protein only or fruit only type diets. Everything that is permissible is taken in moderate quantities.
The only difference between Ramadan and total fasting is the timing of the food; during Ramadan, we basically miss lunch and take an early breakfast and do not eat until dusk. Abstinence from water during this period is not bad at all and in fact, it causes concentration of all fluids within the body, producing slight dehydration. The body has its own water conservation mechanism; in fact, it has been shown that slight dehydration and water conservation, at least in plant life, improve their longevity.
The physiological effect of fasting includes lower of blood sugar, lowering of cholesterol and lowering of the systolic blood pressure. In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension. In 1994 the first International Congress on "Health and Ramadan", held in Casablanca, entered 50 research papers from all over the world, from Muslim and non-Muslim researchers who have done extensive studies on the medical ethics of fasting. While improvement in many medical conditions was noted; however, in no way did fasting worsen any patients' health or baseline medical condition. On the other hand, patients who are suffering from severe diseases, whether diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not try to fast.
There are psychological effects of fasting as well. There is a peace and tranquility for those who fast during the month of Ramadan. Personal hostility is at a minimum, and the crime rate decreases. Muslims take advice from the Prophet who said, "If one slanders you or aggresses against you, say I am fasting.'" This psychological improvement could be related to better stabilization of blood glucose during fasting.
There is a beneficial effect of extra prayer at night. This not only helps with better utilization of food but also helps in caloric output. There are 10 extra calories output for each rakat of the prayer. Again, we do not do prayers for exercise, but a mild movement of the joints with extra calorie utilization is a better form of exercise. Similarly, recitation of the Quran not only produces a tranquility of heart and mind, but improves the memory. Therefore, I encourage my Muslim patients to fast in the month of Ramadan, but they must do it under medical supervision.
