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·   FH (Familial Hypercholesterolemia) is caused by defects in the LDL receptor. There are two well-described phenocopy syndromes related to defects in other genes along the same pathway; they are non-classical FH (caused by mutations in the ApoB 100 gene)and a more severe autosomal recessive form of familial hypercholesterolemia (caused by changes in the LDLRAP1 gene). In AD (Autosomal dominant) disorders the disease occurs in three successive generations, with both males and females affected and transmitting risk. In recessive disease, both parents are typically either carriers or affected, and so disease tends to occur horizontally (e.g. within a sibship) rather than in successive generations. Diagnosis and Treatment ·   Strong Family History (Early MI, Stroke, Hypertension, Xanthomas, Hyperlipidemia) The lipid profile in classic FH is an elevated LDL (range usually 200–400 mg/dL ), a normal HDL, and normal TG.  HMG Co-enzyme reductase inhibitors are...

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Hypertension in Elderly Management/Treatment Hypertension in the elderly is a common problem. An old patient may come to you with normal appearance and physical signs with slight symptoms of dizziness and the occasional headache. but when you check his blood pressure, you find that it is higher (for example, > 170 mm of Hg). Let’s take the following case as an example. “A 76-year-old man visits his physician with the problem of occasional mild headache with no other noticeable symptom; he came to see the doctor because his wife compelled him to do so. Past Medical History :   No history of heart disease, no stroke, no diabetes, no asthma, no TB. Medications : Not significant Allergies :   No known drug allergies Social History :   Business Man, smoked during his 20’s for 5 years, wine 2-3 times per week Family History :   Father died of MI, Mother died of Stroke, one brother with coronary artery disease and a sister with stroke and hypertensio...

Health System In Pakistan The Delivery of health care is done under four major sectors   1. Public sector   2. Private sector   3. Indigenous health system   4. Voluntary health agencies Public Sector ¨   Starting from lower level these are. •           BHU,RHC,s •           Tehsil headquarter •           District Headquarter •           Tertiary or teaching hospitals •           Some centres functioning are       - leprosy centre       - TB hospital       - maternity homes       - children Hospitals Private Sector: Different private Hospitals like         - RMI in Peshawar      ...

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Primary Health Care ¨   It is the essential health care ¨   Based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and a country can afford to maintain at every stage of their development in the spirit of self-determination. ¨   It is also called Al Mata declaration. Because the declaration came at Al Mata, a city of Kazakhstan,  in 1978  following an international conference. Concepts Of PHC •           PHC is for all, especially for the needy, so regardless of economic status every individuals should have access to good health care •           Service should be acceptable to the community and there must be active enrollment of the community. •        ...

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