Your source for clinical lab test information.

Shifa International Hospital Islamabad Pakistan Looks Like Police Station

Posted Nov. 7, 2013

I am sorry to say about the Shifa international hospital Islamabad is just like the police station. I never thought that they have so poor standards of patient look after.

My Own story

  • I got the appointment for my wife and I was asked to come at 2.3 p.m.I was told that Dr.Najam Shah will see the patient.
  • On day of appointment I rushed and reached there at 2.00 p.m.I just talked to the receptionist and was advised to get the registration as a new patient.
  • I went to cash counter and there was long queue and only one person was looking after. I was supposed to wait for my turn came. The receptionist asked the previous registration ,when I told I am new patient. Then he asked me to go to other place and get registration form ,fill and again come in the line.
  • So I went , filled the form and again in the line.
  • Anyhow I was successful after paying RS 350 registration and RS 1400 for doctor visit.
  • No again we went in the waiting hall that was stinking and hot without any air-conditioner.I can not imagine how those poor people after paying heavy fees and sitting just like train station. But I will say train stations are better because you can at least get fresh air.
  • After waiting another one hour when I asked why we are not called when we have been given appointment at 2.30.
  • We were told that Dr.Najam shah sahib gone for lunch.
  • Anyhow at 3.40 he started to see patients. Now it was interesting that his assistant nurse was showing her own patient without any appointment or you can say this is our culture to oblige our own people.
  • Now my patience was gone and I asked what is going on. Her assistant said if you can not wait then you can get back your money.
  • I think this was height of the disgrace and went to Doctor office and I asked that we had appointments at 2.30 and now it was 4 p.m.
  • He replied that you do not know you may have to wait for 5 hours and it is written outside.
  • I went and asked the cashier where it is written that we have to wait for 5 hours. He replied sir there is no such order.

The Shifa International hospital Islamabad was given the facility of land by the government of Pakistan to set up state of art facility.

My question is that is this state of art facility

  1. Where there is no better sitting facility for patient.
  2. The space was not enough for the patient.
  3. This room was hot and humid and that is best source of spreading the infection to other people.
  4. Why they do not observe the appointment timings.
  5. Why their staff is just like illiterate people and rude to patients.
  6. Why they can not have courteous staff.

My request is to the administration to improve patient facility and appointment timing should be observed

Swat Valley in 1976 and Now 2013

Posted Oct. 27, 2013

  • This is the sad story of the beautiful valley of Swat which I saw in 1976 and now in 2013.
  • Swat valley is one of the the rich valley due to its aggriculture and more land available for cultivation.
  • Swat mountains are not making narrow valley like Kaghan or Hunza .
  • People of the Swat are educated and soft .They are not aggressive like other mountain areas
  • The first time i visited Swat in 1967 when I was medical students.We lived in the college hostel and paid only few rupees for whole week.We were out late at night without any fear.
  • Then I was regularly visiting Swat after 1976.
  • I was always coming to Swat for relaxtion due to its sceinic beauty, wheather and clean atmosphere.The sky at night looked blue and stars were bright.The fields were full of greenry.The people were smiling and friendly.There was some sort of nice feeling here.I used to spend days here but never got bored.We were going daily for hiking and were enjoying the melody sound of spring water like huming of birds.
  • Now I came in 2013 and was disappointed by the terrorism and seeing the pale faces of those swaties which were always full of joy.Now I am bound to my house and every body discourage me not to go for hiking.
  • When i go out I can see the depressed faces of the people and they do not know what happened to their heaven like Swat valley.I never thought that this will be the hopeless situation of this valley which was my favourit place and i have always tranquizer effect on my mind during my visit to this valley.
  • To my surprise that this valley has no boundry attatched to India or Russia or China or even Afghanistan.Why this valley is selected for such terrorism actvity which answer we may get after 10 to 15 years.
  • I pray for the people of Swat and hope will see again Swat valley as it was before this terrorism.

Dr.Riaz Bhutta

Depression Can Effect Your Health

Posted Oct. 25, 2013

Depression can effect your health in many ways.

  • Even it is beleived that depression can cause cancer and aggravate the symptoms in diagnosed cases of cancer patients.
  • It is found that in cancer patients with depression has decrease in the T- lymphocyters. We know that T- lymphocytes are very impoprtant to control the cancer cells.Following are the common findings in depressed patients.
    1. Sleep disturbance
      1. Depression effect your mind give rise to mental illness.
      2. Sleep disturbance may the first sign of depression.
      3. Trouble falling asleep or staying asleep is common in people who are depressed.
      4. But some people with depression may sleep too much.
    2. Chest Pain or cardiac pain like symptoms
      1. Sometimes chest pains can be a sign of depressio
      2. There’s also a link between depression and heart disease.
      3. Chest pains can be a sign of a heart or lung disease.. Consult your family physian to rule out any real pathology in heart or the lung.
      4. Depression can increase your risk of heart disease.
      5. People with heart attacks are more likely to be depressed.
    3. Fatigue and Exhaustion
      1. If you feel exhausted for day to day work and have no energy, that may be a sign of depression.
      2. After normal sleep and enough rest if still you feel tired, that is sign of depression.
      3. Depression and fatigue are related with each other.
      4. According to one major study, people who are depressed are more than four times as likely to develop unexplained fatigue.
      5. People who suffer from fatigue are nearly three times as likely to become depressed.
      6. Depression and fatigue together tend to make both conditions seem worse.
    4. Muscle Aches and Joint Pain
      1. Pain and depression are closely linked.
      2. Living with chronic pain can increase the risk of depression.
      3. Depression itself may lead to pain because the two conditions share chemical messengers in the brain.
    5. GIT, gastrointestinal symptoms
      1. Our brains and digestive systems are strongly connected,
      2. When we are stressed or worried we may get nausea or vomiting.
      3. Depression can get you in your gut too and causing symptoms of nausea, indigestion, diarrhea, or constipation.
    6. Headaches
      1. Headach is he coomon presentaion in patients with depression.
      2. Depression may lead to chronic headache.
      3. One study showed that people with major depression are three times more likely to have migraines.
      4. While people with migraines are five times more likely to become depressed.
    7. Changes in Appetite or Weight or disorders of eatingt
      1. Some people lose their appetite when they feel depressed.
      2. While some people do overeating and can not stop eating.
      3. By over eating they think that it is helping them in their frustration and misery.
      4. Over eating will lead to weight gain.
      5. Some time they eat less and have lake of energy.
      6. Depression has been linked to eating disorders like bulimia, anorexia.
      7. Disorders of eating or binge eating. In women, is the link between depression and anorexia or bulimia.
    8. Back Pain
      1. Chronic back pain may contribute to depression.
      2. But depression may increase a person’s risk of developing back pain, too.
      3. People who are depressed may be four times more likely to develop intense, disabling neck or back pain.
    9. Agitation and Restlessness
      1. Irritability and restlessness may be related to sleep problems or symptoms of depression.
      2. Depression increases the risk of alcohol or other substance abuse.
      3. Depression also can contribute to irritability and restlessness.
      4. Men are more likely than women to be irritable when they’re depressed.
    10. Sexual Problems and drug use
      1. Depressed people lose ineterest in sex.
      2. Severe depression can have an impact on sex.
      3. Depressed [eople have more tendency to use drugs and alcohol.
      4. Drugs and alcohol may reduse desire for sex.
    11. Therapeutic drugs
      1. Some of the prescription drugs for depression may reduce your desire for sex.
      2. Some other drugs for heart patient may also effect sex.
    12. How to treat depression
      1. Exercise
      2. Regular excercise keep you fit and also produce chemical substances in the brain that make you:
        1. Feel good.
        2. Improve your mood.
        3. Reduce your sensitivity to pain.
        4. Excercise helpto reduce your depression over the long term.
        5. If you do excercise that may also increase your enengy level.
        6. Exercise can improve energy, ease fatigue, and help you sleep better.

Dr.Riaz Bhutta (modified from web MD)

Diabetes And Excercise

Posted Oct. 21, 2013

There is great role of excecise to control the diabetes.

  1. Excercise increase the utilization of glocose by the muscles.Some of the excercises are :
    1. Excercise to strengthen the muscles.
    2. If you have diabetes, excercise control your blood sugar.
    3. You’ll also burn more calories around the clock when you take up strength training.
    4. Excercise improve your mood, lower cholesterol levels, and also lower blood pressure..
  2. How to and when to start excercise
    1. You can start safely the excercise.
    2. You should aim for strength training at least twice a week and regular cardio.
    3. You can do five days a week for 30 minutes,
    4. OR three days for 50 minutes.
    5. Always exercise with caution.
    6. Flexibility work can be helpful,
  3. Training programm of muscle strengthening excercise.
    1. Learn 10 excercises which you can do at home.
    2. These excercises will work your major muscle groups.
    3. For each one, begin with one set of 10-15 reps.
    4. Rest 30-120 seconds before the next move.
    5. Start with resistance bands or light dumbbells.
    6. When you can do two or three sets easily, grab heavier weights.
    7. You should eventually use weights that you can only lift 8-10 times in the first set.
  4. Upper Body: Standing Biceps muscles.
    1. Grab a dumbbell in each hand and stand with your palms facing your thighs.
    2. Squeeze your biceps as you lift the weights.
    3. On the way up, your forearm should rotate so your palms end up facing your shoulders at the top.
    4. Lower the weights slowly to starting position.
    5. Try to avoid using momentum on the way down.Go down slowly.
  5. Excercise of triceps muscles
    1. Stand with one foot slightly in front of the other, and hold a single dumbbell with both hands wrapped around the handle.
    2. Slowly raise the dumbbell overhead.
    3. Straighten your elbows as you raise the weight toward the ceiling.
    4. Slowly bend your elbows and lower the weight behind your head.
    5. Keep your upper arms still and vertical to the floor.
    6. Keep your shoulder blades down and back as you repeat.
  6. Excercise of shoulders
    1. Do the shoulder press while sitting or standing.
    2. Hold a dumbbell in each hand and raise them until they are level with your ears.
    3. Your elbows should be bent at a 90-degree angle.
    4. This is your starting position.
    5. Now push the weights up, until your arms are fully extended.
    6. Now slowly lower to the starting position.

Dr.Riaz Bhutta (Modified from webMD)

Tips For Keeping Cleanliness

Posted Oct. 10, 2013

To keep the house clean and yourself, in Islam is called as half of Islam (Nisf Imman).

  • Clean A Little Every Day
    • Staying neat and organized is an ongoing process. Spend a few minutes every day tidying up the “hot spots” in your home where messes happen often. Wipe up spots around the kitchen sink.
    • Pick up clothes off the bedroom floor and toss them into the hampers or back in the closet.
    • Put away mail, backpacks, and shoes that collect in the front hallway.
    • Separate stacks of papers into smaller “to-do” and “to file away” piles.
  • Regularly clean and wipe down.
    • Make a schedule for bigger tasks. They’re easier to tackle if you do them regularly.
    • Vacuum rugs and under sofa cushions and the kitchen table.
    • Rinse off items that get covered in sticky fingerprints, like booster seats and toys.
    • Throw out any old foods before they turn your fridge into a giant science project.
  • Clean A Little Every Day
    • Staying neat and organized is an ongoing process. Spend a few minutes every day tidying up the “hot spots” in your home where messes happen often.
    • Wipe up spots around the kitchen sink.
    • Pick up clothes off the bedroom floor and toss them into the hampers or back in the closet.
    • Put away mail, backpacks, and shoes that collect in the front hallway.
    • Separate stacks of papers into smaller “to-do” and “to file away” piles.
  • Weekly Wipe-Down
    • Make a schedule for bigger tasks.
    • They’re easier to tackle if you do them regularly.
    • Vacuum rugs and under sofa cushions and the kitchen table.
    • Rinse off items that get covered in sticky fingerprints, like booster seats and toys.
    • Throw out any old foods before they turn your fridge into a giant science project.
  • Find Little Helpers like kids at home
    • Get your children in the habit of being Mom’s — and Dad’s — little helpers early on.
    • At age 3 or 4, they can start matching socks on laundry day or putting toys away.
    • By age 6, kids should be ready for bigger chores — like setting the table or folding laundry.

DR. Riaz Bhutta (modified from webMD)

Retirement Life

Posted Oct. 5, 2013

This is interesting letter which really give the idea about the retire life and retired people .
Please read and enjoy.

Living Happily After Retirement

Speech by P.P. Ramachandran Veteran of Reserve Bank of India

Post graduate in Economics from the Bombay University. After serving in the Reserve Bank for forty long years, he retired at the age of 60 – a speech given at a Senior Citizen’s Association in Bombay, India.

Thank you Senior Citizen’s Association for having invited me and giving me an opportunity to be with all of you this evening. Now, I will share with you some of my personal beliefs on the subject allotted to me, “Living Happily After Retirement”. Retirement is a problem peculiar to our generation. In the times of our fathers and grandfathers, retirement was not much of a problem.

There are three reasons for this.

First, Life Expectancy.

Fifty years ago, the life expectancy at the age of retirement was fixed at 55 or at most 60. A study of Government records revealed that very few people enjoyed pension for more than five years at that time. Most people died before sixty and consequently spending five years after retirement did not pose any major problem.

Today Life Expectancy after retirement at 58 or 60 – is 75 years which means half of your working life is still left after retirement. To give you an example two Senior Officers of Reserve Bank of India (RBI) died at 93 years—35 years after retirement.

The second reason is the change in the family structure.

Half a century ago, most people were in a joint extended family. The day you laid down office, you still had a large family around you. Surely, in a large family there was always something you could do that was meaningful and made you feel you were contributing to the family. Today the family has become nuclear—husband, wife, children. By the time one retires, the children have gone away. In good old times, daughters used to get married and promptly go away. Nowadays sons get married and very often shift out to stay with their wife from the first night itself! What is left is the old couple — You for Me and Me for you. This is not particularly easy to accept and adjust to after retirement.

The third reason is the problem of “Roots.”

In the old days, people used to have a “native place” and an “ancestral home”. They looked forward to going there and settling down after retirement. Today, there is nothing left in terms of native place. People often are confused as to where to settle.

These three problems make retirement planning a crucial item. If you have planned for retirement you can anticipate and tackle these problems. People are not accustomed to the idea of staying by themselves. If one asks an audience of prospective retirees and their wives, “How many of you expect to stay after retirement with your children, hardly one hand goes up.” If some husband raises his hand, his wife immediately slaps it down saying, “I’ll be damned if I am going to stay with my daughter-in-law!” So it is a tough problem to think about old people staying—just the two of them. This makes planning all the more significant.

The most difficult problem that we face after retirement is the psychological one.

When an executive retires, he is at the peak of his career—his status, prestige and financial status. The moment he lays down his job, all these desert him. He discovers that “Everything becomes Less and Less”. The first thing he notices is the way his status and prestige are affected. Even at home, the retired person is no longer the important person. If he demands of his wife an early breakfast, she will promptly admonish him, “You are retired now. So take it easy. Let those employed go first!” He is no longer “Numero Uno”. A friend of mine who was a Senior Executive in RBI was getting 500 greeting cards and diaries/calendars for the New Year. After one year of retirement it dwindled to fifty and this year he got ten. Greeting cards, calendars and diaries are surely an indicator of the respect you received when you are employed.

The most immediate problem on retirement is time-management.

We all have twenty four hours at our disposal, whether we like it or not. When you are a senior executive you work for ten, twelve or even fifteen hours and you feel “Suppose I had two hours more how nice it would be! I could do more to finish my work and life would be easier the next work day.”

After retirement, we have twenty four hours and nothing to do! Result – misery and this is one thing one likes to spread! No man wants to be miserable alone. He will make as many people miserable as he can. A man who has nothing to do will harass people around him. Turning on head the Benthamite principle of maximization of welfare—maximisation of ' ill-fare ' !

There are two solutions to this problem.

One is to continue to do the same work one was doing at the time of retirement.

The first option is very convenient but where is such an opportunity for the majority? There is the temptation to wangle out an extension but this does lead to compromising principles which many succumb to regrettably. I have seen Senior Officers accepting jobs as liaison officers and standing outside the office cubicle of their subordinates and seek favours from them. But how long-lasting is this solution?Extension merely postpones the problem. It crops up again quite swiftly.

The second option is to do something different, i.e. option to get another job.

An executive can get another job provided he is willing to sacrifice self-respect. Generally jobs are given by the previous employer’s suppliers or may be found in other organizations. In commercial organizations, officers are employed to get orders and collect bills speedily from their previous employers. So you will agree that this is no solution.

All of you are aware that the book Bard of Avon – William Shakespeare wrote of the “Seven Stages of Man”. Modern psychologists have abridged it to four and these are thus.

Before finding a girl — Spiderman
After engagement ——— Superman
10 years after marriage – Watchman
20 years after marriage – Doberman

After this lighter side I revert to post-retired life. The retired official is likely to fall into four dysfunctional time options.

The first is “Withdrawal”

Many retired people, the day they retire from their job, withdraw from Life and within a few months they just pass away. When you ask a doctor he will tell you I can give a medical term but this is a case of “simple lack of will to live”.

The second time management option is “Ritual”

A person can create a ritual for himself. He gets up at a specific time, does different activities at a specific time and this invariably results in misery for others if that specific time frame is not adhered to. While he has in essence nothing to do, he is trying to make his activities meaningful. This leads to a meaningless ritual.

The third option is “Pastime”

Many people get together and embark on a combined ritual which is called pastime. This too does not add to the meaningfulness of life.

The last option turns out to be even mischievous – “Playing Games”

It is playing games — not physical ones like badminton, tennis but psychological ones where you try to manipulate people, get into their problems, complicate them and generally enlarge the tension around you. Many a respectable person indulges in this and creates problems where none existed.

The alternative to these are Functional options

The first is become a Consultant.
Lurking inside every executive is a Consultant. But for this, considerable expertise is require. Not everyone can be successful as a consultant.

The second option is to start your own Business or Industry.
But this calls for entrepreneurial qualities which an executive may lack. Many are also faced with the finances to start and sustain a business and stay profitable.

The third option is to involve oneself in professional activities.
For this, one must build up one’s position even before retirement. Many cliques operate to prevent outsiders from encroachment.

The fourth is to get into spiritual activities.
While nobody is required between you and God, nowadays, we find more and more Godmen, Swamiji, pseudo Gurus some even US returned. There is a temptation to follow some Swamiji or even become one yourself. This is a very slippery slope. Beware – there are more hoaxes in the religious field than anywhere else!

The last and most meaningful option is to cultivate a Hobby.
Use your creative abilities and do something that you enjoy doing. You should start this even while in service.

We live in three Boxes.

First is the Box of Learning, which starts from birth and goes on till 20 plus.

Second is the Box of Work which commences at 20 plus and goes on up to 58 or 60—the age of retirement.

Third is the Box of Leisure.
When we are in the Box of Work what is significant is Status, Prestige, Power—all these we aspire for and it is what we get from working life. The more we get, the happier we are. The day we retire, we move into Box 3 —the one of Leisure. If we have to enjoy this we have to change our psychological position and appreciate creativity, autonomy and integrity. When you were a small child of two or three, did status, prestige or money mean anything? What you wanted was autonomy, creativity. A child is always creative. It enjoys creativity. One example. When visitors come you ask your child, “Pushpa, sing ' Twinkle Twinkle Little Star '.” She will not sing. You shout at her. You tell your visitors proudly she is three only and knows twelve nursery songs. The moment the guests are gone and your maid comes for cleaning, your daughter will sing to her all the twelve songs. The child has its own values!

By the time we enter the Box of Work, values change. We are not taught to respect our autonomy but fall in line—conformity is the rule. If the son plays the violin, his mother will come and tell him, “Playing the Violin now? Study now. Your exam is coming and you must do well. Getting into university and getting a good education is so very important. Life is competitive, dear son.”

When we enter the Box of Leisure, values change. Your psychological position has to change too. New values of creativity, integrity and autonomy emerge. Hobbies are an excellent way of getting Leisure Value. Everybody must identify his hobby that he can enjoy. Don’t bother about Power, Prestige and Status.

An individual can live in one box only or interchange or combine the boxes. You can have learning, work and leisure together. One can even take up a hobby that is financially productive. As time passes one learns.

The real problem of retirement is that people refuse to face the problem. The mantra is “Let us cross the bridge when we come to it.” This is not correct and is not encouraged. Since we live in three Boxes we must prepare ourselves for crossing from one to the other. Structuring our time is the prime requirement. In the beginning, you are contributing to Value. Think of Transfer Value. After retirement you can think of Leisure Value. Develop good hobbies which incorporates your creativity, autonomy and integrity. I have taken to writing. (Rajaji, Kalam and H R F Keating.)

You will lead a happy life.
Retirement is not adding “Years to your Life but adding Life to your Years”. Retirement is not a calamity but an opportunity.

I would like to advocate some basic qualities one must cultivate.

There are two ways to look at every situation in life. Is the cup half empty or is the cup half full. One man was not worried about him becoming bald. He declared “I have less hair to comb!” Another man in an identical situation moaned, “I have more face to wash!”

Always remember that you are loved, even when it does not seem like it.

Believe in yourself and your values.
Don’t sell out when things go wrong.
Don’t let anything get you down. Always bounce back.
Set goals for your future and never settle for anything less.
Realise that there are others in this world with bigger problems than you.
Appreciate the good things of life – Sunrise , Sunset, Flowers, Birds, Good Healthy Food, Exercise, Travel etc.
Be thankful for the good times you have with your loved ones.
Spend more time with your family and friends. Make new friends with younger people.
Appreciate the simple things of Life and don’t get caught up in the material things of life.
Be an optimist and see the Cup as being Half Full.
Before long, your attitude will rub off on others.
You can make the world a better place to live by simply making yourself a happier person.

Let me conclude with an allegorical story.

First God created the Cow and said, “You must go with farmer daily to the field all day long and suffer under the Sun, have calves, give milk and help the farmer. I give you a span of sixty years.” The Cow said, “That’s surely tough. Give me only twenty years. I give back forty years.”

On Day Two God created the Dog and told him, “Sit all day by the door of your house and bark at strangers. I give you a span of twenty years.” The Dog said, “Too long time for barking. I give up ten years.”

On the third day God created the Monkey and said to him, “Entertain people. Make them laugh. I give you Twenty years.” The Monkey said to God, “How boring, Monkey tricks for twenty years. Give me only Ten years”. Lord agreed.

On the fourth day God created Man. He told him, “Eat, sleep, play, enjoy and do nothing. I will give you twenty years.”
Man said, “Only twenty years. No way. I will take my Twenty and give me the Forty the cow gave back, the Ten that the Monkey returned, and the Ten the Dog surrendered. That makes eighty. OK?” OK said God.

That is why for the first twenty years we sleep, play, enjoy and do nothing.
For the next forty years we slave in the sun and at work to support our family.
For the next ten years we do monkey tricks to entertain our grandchildren.
And for the last ten years we sit in front of the house and bark at everybody.

Thank you all, may you all live to a 100. God Bless .
We never think about our retirement when we are young. But I will suggest to all my young friends to think about the retirement . If possible make planning when you are young. Otherwise it will be too late.
Dr Riaz Bhutta

Diabetes and few Important Remedies

Posted Sept. 25, 2013

In the the diabetes meilitus , latest articles by Web MD and other resources gave few remedies for the diabetic patient..
1. For to prevent hypoglycemia keep Emergency Snack Packs.This consists of a few glucose tablets or gels, or five or six pieces of hard candy, into baggies.

  • Always carry a few with you when you go out in case of hypoglycemia ( low blood sugar)) attacks
  • Sign and symptoms of hypoglycemia are :
    • when blood sugar drops below 70 milligrams mg/dL.
    • You feel, dizzy.
    • Hungry.
    • Shaky.
  • This hypoglycemic attack can trigger by :
    • Skipping a meal.
    • Taking too much diabetes medication.
    • Exercising harder than usual without eating.

DR Riaz Bhutta (will continue)