Hello Doc,

You are absolutely right. You can add some Ghee or Til oil to the basti kadha. In the near future, a new Anuvasan basti formulation in trial at present, will be launched to handle such Vata vruddhi related low BMI patients.

The new formulation will help the patient to stop weight loss and also help in weight gain also keeping his blood sugar levels in control.

As well this patient you mentioned if has his HbA1C under 6.5, it seem the patient has good control of his blood sugar. In that case, a new oral supplement called PND in trial also can be given to the patient. Contact Dr. Rahul Mandole or your ZMH for the same.

Hello Doc,

Statins have a specific mode of action of inhibiting HMG co A reductase enzyme. This enzyme is known to halt the process of cholesterol biosynthesis in the liver. Thus in simple words, it shuts down the manufacturing factory of Cholesterol. As a result, LDL which transports the Cholesterol molecules from Liver to the target organ also reduces down as there is no cholesterol to be transported.

Inspite of this, many patients do present with elevated LDL and Cholesterol levels because Cholesterol is not only manufactured in the Liver, but it is manufactured in almost all cells of the body, brain and intestine also.

Statins are normally branded by certain pharma companies to halt the progress of Atherosclerosis, but that is not completely true. They change the plaque composition to a certain extent instead of reducing down the plaque size considerably. As per Asteroid trial, Statins could reduce the atheroma by 6.8 cu mm only even after intensive statin therapy for 24 months.

Visit this research paper to know more about it.

Asteroid Trial

https://www.ahajournals.org/doi/full/10.1161/hc2901.093188

Secondly, Statins are marketed to reduce down the mortality rate by reducing down the incidence of heart attack. If possible, click the following link to understand things better.

The above trial says that if 217 patients consume Statins for 5 years, only 1 patient can avoid a Heart attack.

In such a scenario, one should not fear to taper Statins for your patients. Having said this, we need to follow a specific guideline to taper Statins.

Taper statins as per the protocol in a compliant patient under your regular monitoring if,

1. Total Cholesterol is below 200 mg/dl
2. LDL is below 100 mg/dl
3. TG is below 100 mg/ dl

Along with tapering, every clinician has to regularly monitor for lipid profile, Vit D3 and relevant vitals at specific frequency. Guide the patient for the diet restrictions and regular exercises with cessation of smoking and control on alcohol intake.

Few patients who are non compliant to above guidelines, its advisable to refrain from tapering Statins and antioxidant medicines or supplements.

For more details about tapering medications talk to your ZMH for specific protocols.

Yes Doc!

We can use Framingham risk score for initial screening. No doubt.

It is calculated on the basis of whether the patient is Diabetic, HTN, Smoker and his Lipid levels. As an initial screening, we can use this as a home based questionnaire. Infact, the branding and lead generation team in our organization screens the patients on the same criteria before sending the patients to the clinic. Limitations of the score lies in it being a very preliminary screening process, nothing else.

When it comes to screening inside the clinic by a doctor, further investigations like ECG, Stress test and ECHO can be better tools to diagnose the patient better.