Exploring the Association of Sū’ Mizāj al-Kabid al-Bārid with the Clinical Profile of Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Observational Study
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide and is strongly associated with obesity, insulin resistance, type 2 diabetes mellitus, and metabolic syndrome. Although Tashaḥḥum-i-Kabid Ghayr Khamrī not explicitly described in classical Unani literature, its clinicopathological features closely resemble Sū’-i-Mizāj al-Kabid al-Bārid, involving impaired hepatic temperament, defective metabolism, and fat accumulation. Objectives: To explore the etiopathogenesis of Tashaḥḥum-i-Kabid Ghayr Khamrī (NAFLD)from the Unani perspective, correlate classical concepts with contemporary medical understanding, and assess the role of Sū’-i-Mizāj al-Kabid and associated risk factors. Materials and Methods: An observational cross-sectional study was conducted on 60 ultrasonography-confirmed NAFLD patients attending the OPD/IPD of HAHRDM Hospital, State Unani Medical College, Prayagraj. Demographic characteristics, lifestyle factors, clinical features, laboratory investigations, ultrasonographic findings, Mizāj, and Sū’-i-Mizāj al-Kabid were assessed using a validated questionnaire developed from classical Unani literature. Statistical analysis was performed using Chi-square/Fisher's exact test at a 5% level of significance. Results: Most participants were females (65.0%) aged 41–50 years (43.3%). Balghamī Mizāj (76.7%) and Sū’-i-Mizāj al-Kabid al-Bārid (80.0%) predominated. Frequent consumption of fatty foods, sedentary lifestyle, and non-vegetarian dietary habits were common. Elevated AST (78.3%) and ALT (75.0%), dyslipidaemia, and Grade I fatty liver (71.7%) were the predominant laboratory and ultrasonographic findings.Conclusion: The findings suggest that Sū’-i-Mizāj al-Kabid al-Bārid, impaired Quwwat Ṭabī‘iyya, and unhealthy lifestyle factors contribute to Tashaḥm-ul-Kabid, supporting an integrated Unani and contemporary approach to its prevention and management.
Keywords: Balghamī Mizāj, Non-Alcoholic Fatty Liver Disease, NAFLD, Sū’-i-Mizāj al-Kabid al-Bārid, Tashaḥḥum-i-Kabid Ghayr Khamrī, Unani Medicine
Keywords:
fatty liver disease, Tashaḥḥum-i-Kabid Ghayr Khamrī, Sū’-i-Mizāj al-Kabid al-Bārid, , NAFLDDOI
https://doi.org/10.22270/jddt.v16i9.7993References
1. Duseja A. Non-alcoholic Fatty Liver Disease. In: Munjal YP, et al, editors. API Textbook of Medicine. 10th ed. Mumbai: The Association of Physicians of India; 2015. p. 1199-1203.
2. Longo DL, Kasper DL, Jameson JL, Fauci AS, Hauser SL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 18th ed. United States of America: McGraw-Hill Companies; 2012. Chapter 309, Non-alcoholic Fatty Liver Diseases; p. 2598-2602.
3. Caldwell SH, Argo CK. Non-alcoholic Fatty Liver Disease and Nutrition. In: Dooley JS, Lok ASF, Burroughs AK, Heathcote EJ, editors. Sherlock’s Diseases of the Liver and Biliary System. 12th ed. London: Blackwell Publishing Ltd; 2011. p. 546-567. https://doi.org/10.1002/9781444341294.ch28
4. Walker BR, Colledge NR, Ralston SH, Penman ID. Davidson’s Principles and Practice of Medicine. 22nd ed. China: Elsevier; 2014. p. 969-971.
5. Duseja A. Non-alcoholic fatty liver disease in India: a lot done, yet more required. Indian J Gastroenterol. 2010; 29: 217-225. https://doi.org/10.1007/s12664-010-0069-1 PMid:21191681
6. Dabhi AS, Brahmbhatt KJ, Pandya TP, Thorat PB, Shah MC. Non-Alcoholic Fatty Liver Disease (NAFLD). Journal, Indian Academy of Clinical Medicine. 2008; 9(1): 36-41.
7. Goldman L, Ausiello D. Cecil Medicine. 24th ed. Philadelphia: Saunders Elsevier; 2012. Chapter 152, Alcoholic and Non-alcoholic Steatohepatitis; p. 945-949.
8. Sass DA, Chang P, Chopra KB. Non-alcoholic Fatty Liver Disease: A Clinical Review. Digestive Diseases and Sciences. 2005; 50(1): 171-180. https://doi.org/10.1007/s10620-005-1267-z PMid:15712657
9. Schwenger KJP, Allard JP. Clinical approaches to non-alcoholic fatty liver disease. World J Gastroenterol. 2014; 20(7): 1712-1723. https://doi.org/10.3748/wjg.v20.i7.1712 PMid:24587650 PMCid:PMC3930971
10. Papadakis MA, McPhee SJ, Rabow MW, editors. CURRENT Medical Diagnosis & Treatment. 54th ed. USA: McGraw-Hill; 2015. Chapter 16, Liver, Biliary Tract, & Pancreas; p. 676-678.
11. Ibn Sīnā. Al Qanoon Fit Tib (Urdu translation by Ghulam Husnain Kantoori). New Delhi: Idara Kitabul Shifa; 2010. Vol. 4. p. 353, 433-448, 854-865, 1031-1033, 1445-1447.
12. Jālīnūs. Kitab-Fi-Al-Mizāj (Translated & Edited by Prof. Syed Zillur Rahman). Vol 1. Aligarh: Ibne Sina Academy; 2008. p. 126-141, 137-149.
13. Ibn Rushd AM. Kitab Al-Kulliyyāt. 2nd ed. New Delhi: CCRUM; 1987. p. 26-27, 35, 49, 105, 112.
14. Kirmani BNII. Kulliyyāt-i-Nafisi. New Delhi: Idara Kitab Us-Shifa; 1954. Vol. 1 & 3. p. 19-30, 53, 59-62, 85-86, 132-133.
15. Akbar Arzani HM. Tibb-e-Akbar. Deoband: Faisal Publications / New Delhi: Idara Kitab-us-Shifa; YNM. p. 439-449, 756-758.
16. Kirmani BNII. Mu’ālajāt-e-Nafisi (Urdu translation by Lucknowi SA Hussain). Lucknow: Munshi Nawal Kishore; 1906. p. 538-540.
17. Khan MA. Aksir Azam (Urdu translation by Kabiruddin M). New Delhi: Idara Kitabul Shifa; 2011. p. 481-508.
18. Al-Razi ABMBZ. Kitabul-Hawi fit-Tib. Vol. VII. New Delhi: CCRUM; 2000. p. 75-76.
19. Tabari ABSR. Firdous-Ul-Hikmat. New Delhi: Idara Kitab-US-Shifa / CCRUM; 2010. Vol 1. p. 58-59, 246-248, 452-456. https://doi.org/10.5771/0490-1606-2010-6-246
20. Ali SA. Tarjuma Zakheera Sabit Ibn Qurrah. Aligarh: Litho colour printers; 1987.p. 239-240.
21. Al-Qamarī AMH. Ghina Muna Ma Tarjuma Minhajul Ilaj. 1st ed. New Delhi: CCRUM; 2008.p. 208-212.
22. 2Majūsī ABA. Kamilus sana (Urdu Translation). New Delhi: CCRUM / Idara Kitab-ul-Shifa; 2010. p. 24, 41-45, 130, 525.
23. Tabari AM. Mu’ālajāt-e-Buqrāṭiyya (Urdu translation). Vol 3. New Delhi: CCRUM; 1997. p. 191-210.
24. Jurjānī AH. Zakhira Khwārazm Shahi (Urdu translation). New Delhi: Idara Kitab-Us-Shifa; 2010. Vol. 6 & 8. p. 14, 24-31, 171-174, 377-382, 540-541.
25. Ibn Zuhr AM. Kitab Al-Taysir fi’l Mudāwā wa’l Tadbīr (Urdu Translation). 1st ed. New Delhi: CCRUM; 1986. p. 114-115.
26. Baghdadi IH. Kitab AL- Mukhtārāt Fit-Tib. New Delhi: CCRUM; 2005. Vol. 1, 2, 3. p. 23, 149, 263, 270-274, 326-328.
27. Angulo P, Lindor KD. Non-alcoholic fatty liver disease. Journal of Gastroenterology and Hepatology. 2002; 17(Suppl.): S186-S190. https://doi.org/10.1046/j.1440-1746.17.s1.10.x
28. Subbarao K, Banerjee S, Aggarwal SK, Bhargava SK. Diagnostic Radiology and Imaging. 2nd ed. New Delhi: Jaypee Brother’s Medical Publisher’s Ltd; 2003.
29. Kumar V, Kumar AK, Fausto N. Robbins and Cotran Pathologic basis of disease. 7th ed. New Delhi: Saunders Elsevier; 2005.p. 902-903.
30. Feldman M, Scharschmidt BF, Slesinger MH. Slesinger and Fordtran’s Gastrointestinal and Liver Disease. 6th ed. New Delhi: WB Saunders Company; 1998. Section on Fatty Liver (Steatosis); p. 1265-1269.
31. Hall JE, Guyton AC. A Text Book of Medical Physiology. 12th ed. United State of America: Elsevier; 2011. p. 837-839.
32. Ahemar SM, Ali F, Jamil AW. Assessment of Metabolic Functions of Liver Through Total Serum Protein in Choleric & Phlegmatic Individuals. Paripex - Indian Journal of Research. 2015; 4(4): 4-7.
33. Kabiruddin M. Ifada-e-Kabir (Mufassal). Hyderabad: Matba-e-Islami (1947) / New Delhi: Idara Kitab-ul-Shifa (2019). p. 33, 119, 143.
34. Thomson ABR, Shaffer EA, Gonska T, editors. First Principles of Gastroenterology and Hepatology in Adults and Children. CAPstone Academic Publishers Ltd; 2014.p. 467-471.
35. Bayard M, Holt J, Boroughs E. Non-alcoholic fatty liver disease. American Family Physician. 2006; 73(11): 1961-8.
36. Mohan H. Text book of Pathology. 4th ed. New Delhi: Jaypee Brothers Medical Publishers P Ltd; 2002.p. 613-615.
37. Rodes J, Benhamou JP, Blei A, Reichen J, Rizzetto M, editors. The Textbook of Hepatology: From Basic Science to Clinical Practice. 3rd ed. USA: Blackwell Publishing Ltd; 2007. p.1323-1332. https://doi.org/10.1002/9780470691861
38. Kabiruddin. Ifadae Kabir Mufassal (Sharah Mojazul Qanoon). 1st ed. New Delhi: Qaumi Council Baraye Farogh Urdu Zaban; 2001. p. 36-37, 96-97, 108, 123-126.
39. Ibn Sina AAH. Al-Qanoon fi Al-Tib (Arabic). New Delhi: Jamia Hamdard; 1411AH.
40. Shah MH. The General Principles of Avicenna’s Canon of Medicine. New Delhi: Idara Kitab-Us-Shifa; 2007.
41. Wang J. Non-Alcoholic Fatty Liver Disease (NAFLD) Pathogenesis and Natural Products for Prevention and Treatment. Int J Mol Sci. 2022; 23: 15489. https://doi.org/10.3390/ijms232415489 PMid:36555127 PMCid:PMC9779435
42. Kumar V, Abbas AK, Aster JC. Robbins & Cotran Pathologic basis of disease. 10th ed. New York: Elsevier; 2020. p. 846-848.
43. Khan HA. Majma-Ul-Bahrain. Lucknow: Matba Munshi Naval Kishore; 1294AH.p. 523-529
44. Leeuwen DJV, Reeders JWAG, Ariyama J. Imaging in Hepatobiliary and Pancreatic diseases: A practical clinical approach. China: WB Saunders; 2000.p. 68-72.
45. Golwala AF, Golwala SA. Medicine for students. 21st ed. Mumbai: Dr. AF Golwala; 2005.p. 51-102.
46. Bessone F, Razori MV, Roma MG. Molecular pathways of non-alcoholic fatty liver disease development and progression. Cell Mol Life Sci. 2019; 76: 99-128. https://doi.org/10.1007/s00018-018-2947-0 PMid:30343320 PMCid:PMC11105781
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