the efficacy of lo-chol in hypercholesterolemia
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The Efficacy of Lo-Chol in Hypercholesterolemia. Researcher :Dr. Mujeeb Hoosen Supervisors : Prof. Rashid Bhikha, Dr. Yumna Abrahams Date : 24 September 2011. Abstract. - PowerPoint PPT PresentationTRANSCRIPT
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The Efficacy of Lo-Chol in Hypercholesterolemia
Researcher :Dr. Mujeeb HoosenSupervisors : Prof. Rashid Bhikha, Dr. Yumna AbrahamsDate : 24 September 2011
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Abstract Modern medicine has provided impressive results in the past
century however currently there is an increase in the lack of public confidence, largely due to several factors like the dehumanization of modern medical practice and procedures, modern medicine is becoming economically unsustainable, its inability to effectively treat chronic conditions, rise of iatrogenic diseases and the re-emergence of life threatening infections.
Globally the public are seeking safe, effective holistic healthcare solutions. Unani-Tibb can make a significant contribution due to its legacy of wisdom, knowledge and the prescription of safe and effective remedies. For this to be integrated in public health, Unani medicine has to rise to the many challenges that it face. One of them being to scientifically prove that Unani medicine are safe, effective and sustainable.
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Abstract Coronary artery disease is one of the leading causes of death in
Western countries. The disease occurs most frequently in populations with diets high in cholesterol.
This study looks at the efficacy of Lo-Chol, a cholesterol lowering medicine used for the treatment of hypercholesterolemia at the Tibb Medical Centre.
Dietary and medication compliance were recorded for 20 patients to determine the efficacy of Lo-Chol in patients with hypercholesterolemia.
Results showed that Lo-Chol is effective as a cholesterol lowering medication however further studies are needed to confirm its efficacy
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Research Problem
Coronary artery disease is one of the leading causes of death in Western countries.
The disease occurs most frequently in populations with diets high in cholesterol.
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Research Problem cont. Tibb – “most illness results when incomplete
digestion of food has occurred over a short or long period of time” (Chisti,1991).
NB – effective assimilation and elimination
Allopathic – ‘Statins’ aimed to lower cholesterol levels. NB – Common adverse effects: GIT effects such as abdominal pain, constipation, diarrhea, flatulence, nausea, dyspepsia etc. (SAMF, 2008).
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Definitions: Allopathic vs Tibb
Hypercholesterolemia : the presence of elevated concentrations of cholesterol in the blood which predisposes to atheromatous disease
Tibb – C & D / Melancholic imbalance
Pathway 2 (chronic)
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Aims and Objectives
To establish the effectiveness of Lo-Chol in patients with hypercholesterolemia.
Can Lo-Chol lower blood cholesterol levels in patients with hypercholesterolemia
Is Lo-Chol more effective in patients who are compliant to the prescribed diet and medication.
Does the effect of Lo-Chol vary amongst different temperaments
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Methodology
Sample size - 20 patients Population - Patients attending the Saartjie
Baartman Tibb Medical Centre Inclusion- Both genders, age 25 - 85 years
old, pre- diagnosed patients and newly diagnosed patients. Patients on allopathic medication requesting to change to Tibb medication. All temperament groups.
Exclusion - 24 years old and younger Time period : March – September 2011
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Methodology Equipment- Cholesterol meter,
cholesterol strips, alcohol swabs, needles
Testing total cholesterol levels once weekly for 1 month followed by monthly testing for 5 months. Document dietary and medication compliance.
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Methodology Therapeutic goal (dosage):
Low risk patients - < 5.5 mmol/L
High risk patients - < 4.5 mmol/L
mmol/L 5.5 - 6 6 - 7 7 – 7.5 > 7.5
Lo Chol Diet / 1bd 2bd 2tds 2qid
mmol/L 4.5 - 5.5 5.5 - 6 6 - 7
Lo Chol 2bd 2tds 2qid
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Parameters
Temperamental evaluation Age Gender Co-morbid factors Dietary compliance Medication compliance
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Treatment Plan Diet – cholesterol lowering Herbs – flaxseed, garlic, carrots, mint,
psyllium Purging – Melanpurge / Laxotabs Exercise Cupping – dry and wet Medication – Lo Chol (emphasis on
compliance)
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Results Data presentation: Table and graph format according to
temperament. Table 1-4 : Pts, temperament, age,
gender, co-morbid factors Graph 1-4 : Chol/mmol. (3-8) vs
visits (1-10) indicates diet /meds /both
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Patient Temperament Age Gender Co-morbid factors
01 P/S 68 M Hypertension (HPT) ,Diabetes (DM)02 S/P 33 M Obesity03 S/P 55 M HPT04 P/S 64 M HPT05 S/P 53 F HPT06 P/S 64 M Congestive Heart Failure (CHF)07 P/S 42 M HPT08 S/P 37 M HPT
1 2 3 4 5 6 73
4
5
6
7
8Pt 1Pt 2Pt 3Pt 4Pt 5Pt 6Pt 7Pt 8
VISITS
Cho
l. m
mol
/LTable 1 : Sanguinous / Phlegmatic
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Patient Temperament Age Gender Co-morbid factors01 P/S 68 M Hypertension (HPT) ,Diabetes (DM)02 S/P 33 M Obesity03 S/P 55 M HPT04 P/S 64 M HPT05 S/P 53 F HPT06 P/S 64 M Congestive Heart Failure (CHF)07 P/S 42 M HPT08 S/P 37 M HPT
VISITS
Cho
l. m
mol
/LTable 1 : Sanguinous / Phlegmatic
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Table 2: Phlegmatic / Melancholic Patient Temperament Age Gender Co-morbid factors
09 P/M 65 M DM10 M/P 57 M Hypercholesterolemia11 P/M 49 F Anxiety /Stress12 P/M 65 F HPT , DM13 P/M 58 F HPT14 P/M 85 M HPT , CVD15 P/M 52 M HPT
1 2 3 4 5 6 73
4
5
6
7
8
Pt09Pt10Pt11Pt12Pt13Pt14Pt15
VISITS
Cho
l. m
mol
/L
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Patient Temperament Age Gender Co-morbid factors09 P/M 65 M DM
10 M/P 57 M Hypercholesterolemia
11 P/M 49 F Anxiety /Stress12 P/M 65 F HPT , DM
13 P/M 58 F HPT
14 P/M 85 M HPT , CVD15 P/M 52 M HPT
VISITS
Cho
l. m
mol
/LTable 2: Phlegmatic /Melancholic
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Patient Temperament Age Gender Co-morbid factors
16 B/S 53 M HPT, GORD
17 B/S 48 F HPT
1 2 3 4 5 6 7 8 9 103
4
5
6
7
8
Pt 16Pt 17
VISITS
Cho
l. m
mol
/L
* Arrows indicates non–compliance to meds/diet/both
Table 3: Bilious / Sanguinous
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Patient Temperament Age Gender Co-morbid factors
16 B/S 53 M HPT ,GORD
17 B/S 48 F HPT
VISITS
Cho
l. m
mol
/LTable 3: Bilious / Sanguinous
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Patient Temperament Age Gender Co-morbid factors
18 M/B 70 F HPT19 M/B 30 M Hypercholesterolemia20 B/M 58 M MI
VISITS
Cho
l. m
mol
/LTable 4: Melancholic / Bilious
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Patient Temperament Age Gender Co-morbid factors
18 M/B 70 F HPT
19 M/B 30 M Hypercholesterolemia
20 B/M 58 M MI
VISITS
Cho
l. m
mol
/LTable 4: Melancholic / Bilious
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Data analysis
60% of patients experienced decreased cholesterol levels on the 1st visit
60% of patients reported that increased cholesterol levels after treatment were due to non-compliance to the prescribed diet / medication / both
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Data analysis
35% of patients experienced decreased cholesterol levels despite non-compliance to diet / medication / both
50% of patients experienced lower cholesterol levels on the final visit
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Discussion
S/P displayed the best (consistent) results – compliance / moistness
B/M dom/subdominent displayed varying (inconsistent) results – non-compliance / dryness
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Discussion
Statistics – women (esp. menopausal) are high risk pts. – dryness?
Age – increase dryness Patients displayed higher cholesterol
levels towards winter – cold ? / diet ?
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Conclusion
Lo-Chol is effective in hypercholesterolemia
Lo-Chol does lower cholesterol levels in patients with hypercholesterolemia
Lo-Chol’s effectiveness is dependant on dietary and medication compliance
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Conclusion
NB – considerations when prescribing Lo-Chol : temperament, age , gender, co-morbid factors, season, dietary / medication compliance.
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Recommendations
Lipogram – asses HDL:LDL (every 3 months)
Comparative study – Intergrative (Tibb) vs Allopathic
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References Beers, M. H et al (2006). The Merck Manual. 18th Edition New
Jersey: Merck research laboratories
Bhikha, R and Abdul Haq, M (2001). Tibb– Traditional roots of medicine in modern routes to health. Gauteng: Mountain of Light South Africa
Bhikha, R. (2006). Four Temperaments six lifestyle factors. Roddepoort: Ibn Sina Institute of Tibb
Chisti G,M (1991). The Traditional Healer’s Handbook. Rochester: Healing Arts Press
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References cont. Gibbons, C J, et al (2008). The South African Medicines
Formulary 8th edition Cape Town: F.A Print
Ibn Sina, (1999). The Canon of Medicine (Al-Qanun fil-tibb) Great books of the Islamic world.
Longmore M, et al (2007).Oxford Handbook of Clinical Medicine 7th edition New York: Oxford University Press Inc.
Mahan, L.K & Escott-Stump, S (2008). Krause’s Food & Nutrition Therapy. 12th ed.Canada.Sanders Elsevier.
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References Siddiqui, S et al (2010). Efficacy of selected Herbal Medicines
for Hyperlipidemia. (Abstract) Souvenir Unicon 2010
Salim, M. (2010). Globalization of Unani Medicine (Tibb) : Opportunities and Challenges. (Abstract) Souvenir Unicon 2010
The British Association Illustrated Medical Dictionary (2006). London: D K
Tibb Practitioner Monograph – June 2011: Ibn Sina Institute of Tibb
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Thank You