Prof (Dr.) K. C. SinghalM.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

Need to Converge Systems of Need to Converge Systems of Medicine Medicine

An approach to health & Diseases

Parameters Gujarat

CapitalGandhinag

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 Worrying ExperiencesExperiences

1946 Streptomycin Deafness, Renal failure

1958 Isoniazid Hepatitis1952 Chloramphenicol Aplastic

anaemia 1961 Thalidomide - Phocomelia (prenatal exposure)

1964 Phenylbutozone - Aplastic Anaemia

1965 Agranulocytosis1966 Aspirin + NSAIDS - GI ulcer

bleeding1966 Oral contraceptive -

Thromboembolic disease 1970 Clioquinol - SMON1974 Practolol -

Oculomucocutaneous Syndrome

1982 Ketaconozole - Hepatitis1984 Valproate sodium – Spina bifida1986 Ofloxacin - Psychosis 1988 Ceftriaxone - Biliary

lithiasis1994 Fluroquinolones - Achilis

Tendinitis & rupture

1997 Indinavir - Haemolytic anaemia

2001 Nemusalide - Hepatitis

CATASTROPHIC THALIDOMIDE

For those babies who survived, birth defects included:

- Deafness- Blindness- Disfigurement- Cleft palate- Internal disabilities- Phocomelia (most

affected)

Birth Defects

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

“ 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)

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?