AN INTERVIEW WITH Dr. ABDUL HAFEEZ CHAUDERY
Emed team was lucky one to make an appointment with Dr. Abdul Hafeez Chaudery. He is the eminent cardiologist of the city. He is working at Punjab Medical College, Faisalabad, Pakistan. He is professor of Medicine. His credentials includes fellowship in Medicine and cardiology (FCPS (Medicine), FCPS (Cardiology) . This reflects his deep interest in the field of Cardiology.
In the subsequent discussion, no wonder, our main focus will be common heart diseases in Pakistan and their prevention.
EMED: Professor Hafeez Sb., what was the source of inspiration for you to become a cardiologist, although you were already an established and known medical specialist.
PROFESSOR: Well! Its a good question, just look around even in your own family you may find some one suffering from heart disease. I will try to make this discussion simple for readers. Heart diseases are taking their toll rapidly and our young people are often victims of heart diseases and other heart disorders. So, still there is a need not only to have more cardiologists but to emphasis more on the subsequent of preventive cardiology. It should be part of care curriculum in Medicine. Doctors studying at fast level care facilities (FLCFs) must know how to interact with the patient and impart heath education tot hem. This is more imperative as our set up where literacy rate is very low ad 68 percent of total population resides in rural areas.
EMED: What are common heart diseases in Pakistan?
Professor: Well! We must clarify what are types of heart diseases. See there are diseases which involve valves of the heart by birth. Still some other involve septum , which people report as "hole in heart". There comes diseases of the muscles of the heart called "Myocarditis". If the arteries of the heart itself are narrowed due to lipids (Cholesterol), there is deduction in pure blood supply to heart and patient complaints of chest pain lasting for a few minutes on exertion, this is called Angina. There are four other types of Angina, resting angina being the dangerous one. Now, if the major artery is occluded there is severe chest pain lasting for 15-20 minutes with sweating, vomiting and there may be or may not be disturbance of rhythm. This is heart attack. Then the membrane covering the heart called pericardius is infected, it leads to what is called pericarditis. Furthermore, there are diseases of of heart in heart rate, rythm is disturbed. This was was very being description of heart diseases. It is worth mentioning here that there are often diseases in which heart is secondarily involved. Lets talk about "Rheumatic Heart Diseases" (RHD). RHD seen on young children with sore throat, joint pains and involvement off valves of heart. Each of the above disease have complications, for example if a valve called Mitral Valve is incompetent, there is a potential danger of bacteria attacking and residing on the valve called infective endo carditis.
E-med: That is a matter of great concern how can we know that so and so is likely to develop heart disease.?
Professor: Well I guess, we being Muslim believe that Allah Almighty is the ultimate healer of man is the source. How ever, there are something called Risk Factors which, if present, increase the chances of heart attacks and angina. These includes:
1-Smoking, 2-Obesity, 3-Lack of exercise, 4-High Cholesterol, 5-High Blood Pressure, 6-Diabetes.
See all these six factors can be controlled if we decide to control. Strict control of diabetes, Blood Pressure, Cholesterol, Exercise, weight reduction, stop smoking. They modify the outcome significantly.
E-med: Do you think, it is an easy job?
Professor: I know it is difficult but there is quote that "if wealth is lost, something is lost, if health is lost, everything is lost". My point is we should make more and use of print and electronic media, arrange health awareness program, encourage common man to ask more question. He must know the warning sign of appropriate action thereafter. Similarly, patient must be educated to not ignore any heart problem, say so as heart diseases do have specific symptoms. RHD must not be ignored. Bottomline is a qualified doctor must be consulted. School heart services must be strengthened.
E-med: You quote quite often most diseases are preventable. What are the tools to make them preventable?
Professor: Well!, some, I have mentioned earlier, modification in life style, control of diabetes, Blood pressure etc. Moreover tests like Echocardiography, Thallium Scan, Angiography are very instrumental in assessing the stage of heart disease depending upon the nature of heart problem.
E-med: Rich people prefer to go abroad for heart surgery. But do you think majority of out patients could afford this?
Professor: There is no doubt that technologically western countries have an edge. But it is does not mean we do not have competent heart surgeons in Pakistan. As I know in Karachi, Lahore and Rawalpindi major heart surgery is being done with good outcome and is cost effective too.
E-med: Thank you very much for your valuable time. Any message?
Professor: I must stress again, heart problems are like epidemics. We must focus on preventive cardiology. We must make a plan of action right now.
E-med: We appreciate your feelings professor.
INTERVIEW NO. 1
Professor Zahid Yasin Hashmi was interviewed last month. His interview shall remain on our web for some times and latter will be transferred to Archive section. EMED
Prof. Zahid Y. Hashmi Speaks in an Exclusive Interview about the Attrition of Research in Medical Field.
Dr. Zahid Y. Hashmi is currently working as Professor of Medicine at Punjab Medical College, Faisalabad. He graduated from KEMC with distinction. In subsequent interview he speaks about the research and its implication in medicine.
(EMED). What are your areas of interest in medicine.
(A). Well! I guess its is a difficult question however I have special interest in diagnosing and treating patients suffering from Hypertension, Diabetes, Mellitus, Hepatitis and other Liver dieceases.
(EMED). It is assumed that these diseases are major cause of morbidity and mortality in Pakistan. Do you confine yourself to just treating these diseases or conduct research work as well?
(A). I guess, research is a part and parcel of our job. But unfortunately due to lack of funds, interest and some other reasons we are far behind from other developing countries like Egypt. I quote one example of WHO, Head office for Middle East in Alexandria, Egypt. Quite understandably that country gets funds and manpower to carry out research. Furthermore, in Pakistan, we are not very clear about prevalence of Hepatitis C where as in Egypt it is widely documented as 17 %. This supports my arguments, that we need funds and resources. We have manpower but need training in the field of medical research.
(EMED). Given an option, would you prefer to be a Researcher or just a Doctor examining patients?
(A). Now, I feel that I may adopt research as a career and I realy mean that. I have done a lot of work on hypertension, Diabetes and Hepatitis. I have presented my papers internationally.
(EMED). Dr. Hashmi, do you think that you can do these things all alone?
(A). Certainly not, we need a team of dedicated researches. Moreover, we need support from NGO's and other research Institutes under working of Government.
(EMED). Professor, We produce a lot of Doctors every year, but how many of them switch to research work?
(A). There is no data available but let us assume that it is just handful of them.
(EMED). Professor Hashmi, how will you address this issue?
(A). Research should be the part of core curriculum of MBBS. In Western countries before appearing in first year MD/MBBS exam, each student has to take a supervised research project. Alternatively you can say they know the basic tools of research when they are done with medical graduation. That is the reason we rarely find any article from this part of earth in a reputed Journal.
(EMED). Any interesting event regarding Research?
(A). As you might be knowing that when the research paper is concluded there is a long list of references. One of my students, asked me, " Sir out of the two referencing systems which was more commonly used in medical research. Ofcourse, answer was "Vancouver System" but I was taken by surprise and was delighted that if we work on our students, they are second to none.
(EMED). Any message?
(A). Any one who is really interested in research work, should read some books on research, see a good biostatistion and try to develop a research proposal. That is how I learned, and learning is an on going process.
(EMED). Thank you Doctor for your time and views.
(A). Thank you very much.