Article Text

Download PDFPDF
History conflict and non-formulary medicine: a threat for anaesthesiologist in low and middle-income countries
  1. Muhammad Faisal Khan,
  2. Areeba Muzaffar,
  3. Faisal Shamim
  1. Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
  1. Correspondence to Dr Faisal Shamim, faisal.shamim{at}


The practice of complementary and non-formulary medicine has gained tremendous popularity due to their claimed beneficial effects in cardiac, respiratory and chronic diseases, as also other disorders. The most threatening aspect related to these practices pertains to the non-disclosure of its use by patients at the time of their preoperative assessment in elective or emergency setting. We report a case of profound, long-lasting unexplained hypotension during and after anaesthesia in a patient presented for emergency vocal cord surgery (cordectomy). He was taking complementary medicine for last 2 years. Serum cortisol level was sent postoperatively in intensive care unit that was found extremely low.

  • anaesthesia
  • safety
  • adult intensive care
  • public health
View Full Text

Statistics from


  • Contributors MFK and FS were involved in the planning, analysis and/or interpretation of data and revising the manuscript critically for important intellectual content. AM was responsible for the acquisition of data. AM and FS contributed to the drafting of the manuscript. All authors contributed to the approval of the version of the manuscript to be published.

  • Funding The authors have not declared a s pecific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer We certify that we have participated sufficiently in the intellectual content, conception and design of this work or the analysis and interpretation of the data (when applicable), as well as the writing of the manuscript, to take public responsibility for it and have agreed to have our name listed as a contributor. We believe the manuscript represents valid work. Neither this manuscript nor one with substantially similar content under our authorship has been published or is being considered for publication elsewhere, except as described in the covering letter. We certify that all the data collected during the study is presented in this manuscript and no data from the study has been or will be published separately. We attest that, if requested by the editors, we will provide the data/information or will cooperate fully in obtaining and providing the data/information on which the manuscript is based, for examination by the editors or their assignees.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.