Transcript Slide 1
Need to Converge Systems of Medicine An approach to health & Diseases Prof (Dr.) K. C. Singhal M.D., Ph.D. (Medicine), D.Sc., F.I.A.N., F.I.P.S.,F.I.A.M.S. Former Consultant WHO Center for International Drug Monitoring, Uppsala, Sweden Vice - Chancellor, NIMS University, Rajasthan Jaipur, India Parameters Gujarat Capital Gandhinag ar Geographical area (sq km) 196,024 Administrative districts (No) 26 Population density (persons per sq km)* 308 Total population (million)* 60.3 Male population (million)* 31.4 Female population (million)* 28.9 Sex ratio (females per 1,000 males)* 918 Literacy rate (%)* 79.3 Why converge systems of medicine Worrying Experiences 1946 Streptomycin Deafness, Renal failure 1958 Isoniazid Hepatitis 1952 Chloramphenicol Aplastic anaemia 1961 Thalidomide - Phocomelia (prenatal exposure) 1964 1965 1966 1966 1970 1974 Phenylbutozone Aspirin + NSAIDS Oral contraceptive Clioquinol Practolol - Aplastic Anaemia Agranulocytosis GI ulcer bleeding Thromboembolic disease SMON Oculomucocutaneous Syndrome 1982 1984 1986 1988 1994 Ketaconozole Valproate sodium – Ofloxacin Ceftriaxone Fluroquinolones - Hepatitis Spina bifida Psychosis Biliary lithiasis Achilis Tendinitis & rupture 1997 Indinavir Haemolytic anaemia 2001 Nemusalide - Hepatitis CATASTROPHIC THALIDOMIDE Birth Defects For those babies who survived, birth defects included: - Deafness - Blindness - Disfigurement - Cleft palate - Internal disabilities - Phocomelia (most affected) How would you advise? • More than 95 % of the population in the least developing countries use herbs for health and other purposes. • More than one third of Americans and Europeans use herbs for health purposes, spending over 7.0 billion annually. • More than 25 % of modern pharmaceutical drugs have botanical origins. Sources of information and acknowledgments • This lecture draws extensively from material presented on the European Journal of Herbal Medicine , the British journal of phytotherapy and the America’s guide to natural Health. • In particular, the summaries of information on materia medica is gratefully acknowledged. • Students are encouraged to explore the Supercourse site (I.prevention). ccessible ffordable ssured safety About 70% Indian population (60-70 crore) depends on alternative system of medicine. WHO Herbal drugs are cheaper than generic drugs !!?? Herbal drugs have been used in India for more than 4000 years. • Glamorized discipline • Pursued by most (influenced and so called ‘Literate’) in India and, in western countries • Backed by technological advances -investigations • Based on sound scientific reasoning – experimental evidence; not anecdotal • Thus, Modern Medicine is an evidence-based, techno-savvy science that seems to provide ultimate care to sick patients • The treatment often symptomatic, costly. • Except for infective pathologies, we do not have much to offer except palliation • Lifestyle Disorders like neurodegenerative disorders treatment is often very disappointing and limited by adverse events • treats the Disease (symptomatic) and not the patient ‘as a whole’ (Holistic approach) Therapeutic Objective • The ultimate goal of every physician is to “CURE” the disease. • Has Allopathy achieved this goal for all ailments? No; Except for infective pathologies, we do not achieve CURE • Most often the treatment is Symptomatic and Palliative. • Effective & Safe Medicine Traditional medicines • Middle of 19th century, 80% of all medicines were herbal • Even today 25% of drugs are derived from plant source • Most of these drugs came from traditional lead, folk knowledge etc. • Some of these still could not substituted despite the enormous advancement in synthetic chemistry eg. Reserpine, taxol, vincristine etc. Reverse pharmacology • What is required is “Scientific evidence” • Answer lies in providing scientific validation for efficacy and safety • Screening based on ethnomedical and ethnobotanical lead as chances of hitting the target is more. Where we can introduce Asu drugs - now • • • • • • Hepatitis Childhood cirrtosis of liver Common cold and cough Memory enhancement Neurodegenerative disorders Health care supplements Pharmacovigilance • • • • • • Any thing herbal is safe!!????? Adverse drug reactions (ADR) Drug-drug interactions Herb-Drug interactions Toxicity of the isolated ingredients Traditional process (Shodhana) Traditional Medicine: Threats • Poor positioning on a global level • Ignored by the global scientific community • Very little scientific research validations • Very little publications in peer-reviewed science Journals • Deliberate negative propagandas Health care system in India • • • • • • Allopathy – Disease oriented Ayurveda - (Holistic system) Unani - (Holistic system) Siddha - (Holistic system) Homeopathy Symptom based Conference Principals of Treatment are different • Ayurveda • • - VATA Pitta Kafa • • • • • • Unani - Mijaz ( temperament) Hot, Cold, Dry, Moist Hot + Dry Hot + Moist Cold + Dry Cold + Moist Ayurveda - Ancient Indian System Sidha Unani - Introduced with Mughals Allopathy - Introduction by British “ 10 of top 20 selling medicines in 1998 were derived from natural products” ACE inhibitors Diclofenac Clarithromucin Conjugated Oestrogens Insulin Epoetin * Bacteria – Aminoglycosides * Fungi – Penicillins - Cephalosporins * Plants - Digoxin - Opioids - Steroids (Ref.: DDT Vol. 4,10, Oct. 1999) * Traditional Medical Systems use mainly plants * Greater mass acceptability * Rich flora approx 20,000 species a renewable resource * Source for cheaper and safer medicaments * Valuable resource for attaining the goal of “Health for All” Drugs of ISM – Need of the day • • • • Clinical Trails – Compared with drugs of Allopathy. Analyze Risk – Benefit Ratio Assess Drug on the basis Ayurveda - Vata, Pitta, Kapha Unani - Mijaz ( Temperament) Drug Efficacy and ADR. It is related to patients Prakriti/ Mijaz?