Pregnant women are among those who are exempted from Ramadan fasting. Despite that, many pregnant women had chosen to fast despite understanding the risk of complications especially hypoglycaemia. In Hospital USM (HUSM), an insulin regime for pregnant women who wish to fast was designed based on expert opinion of obstetricians, but its safety and efficacy are yet to be determined. Objective: To determine the safety and efficacy of the formulated insulin regime using subcutaneous Actrapid® and Insulatard® amongst pregnant women with diabetes who fast in Ramadan.Methodology: Pregnant patients with diabetes on insulin who wish to fast during Ramadan were invited to participate in the study. The total daily dose of insulin requirement prior to Ramadan was divided 3 parts; 2/3 foriftar(sunset meal) and 1/3 for sahur(pre-dawn meal). For each timing, 2/3 of the calculated dose was given as short-acting insulin Actrapid® and remaining 1/3 as intermediate-acting insulin Insulatard®. Three patients were monitored in the ward while fasting for two days. Blood glucose checked eight times a day. Following that, eight patients were followed up during Ramadan fasting with this regime. Weekly blood sugar profile (BSP) was taken and glycaemic control evaluated. Results: All patients were able to fast without any hypoglycaemic episode, both during in-patient study and during out-patient Ramadan fasting. Mean daily blood glucose per day for in-patient monitoring was 7.3 mmol/l with the lowest being 4.56 mmol/l in the afternoon. During Ramadan fasting, average glucose level was higher (6.79 mmol/l) compared to prior to Ramadan value (5.67 mmol/l) (p> 0.05). However, improvement of glycaemic control was observed towards end of Ramadan. Conclusion: Pregnant women with diabetes treated with insulin can fast safely during Ramadan using the suggested insulin regime with improvement of glycaemic control observed at the end of Ramadan.
Azoospermia is present in 15% of infertile cases and it is a major concern due to inability to produce sperm. Most of IVF (in-vitro fertilization) clinics abroad has been using sperm donation via sperm bank facilities as a solution for infertile couple to have their own offspring. In Islam, it is forbidden to use sample from male other than their spouse. It is according to maqasid syari’ah to ensure the heredity of the human being. Based on the latest technology, one approach of stem cell differentiation process had been established to produce mature cells from primitive or immature cells (stem cells). This technology is in line with the concept of maqasid syari’ah since we are using the cells from one person. We try to adopt this technology to study the potential of testicular cells from non-obstructive azoospermic (NOA) patient to undergo in vitrospermatogenesis.Samples were cultured in modified human embryonic stem cells (HESC) media with specific growth factors; basic fibroblast growth factor (bFGF) and leukemia inhibitory factor (LIF). Protein expressions were analyzed by immunofluorescent staining on day 49 and 90 of culture. Results show spermatogonial stem cell-like cells (SSC-like cells) colonies formed after 14 to 21 days, the cells were expanding successfully and were stable for 49 days duration. Then SSCs differentiated into later stage of spermatogenesis on day 90. Four specifics SSCs protein markers were identified on day 49; ITGA1, ITGB1, CD9 and GFRA1 whereas SCP3 and TP1 proteins were expressed on day 90. This in vitrospermatogenesis suggests a possible approach for future for Muslim NOA patients in order to have their own children.
Severe early childhood caries (SECC) is a microbialinfection that severely compromises the dentition ofyoung children.The aim of this study is toidentify bacteria associated with SECC and compare bacterial species between SECC and caries-free children. Bacterial samples were isolated from dental plaque samples of 3 to 6-yearold preschool children and the status of dental caries at the surface level was evaluated using World Health Organization (WHO) diagnostic criteria for decayed, missing and filled tooth surfaces (DFMS). 30 samples from the interproximal part were collected and genomic DNA was extracted using MasterPure™ Gram Positive DNA Purification Kit. Polymerase Reaction (PCR) was conducted on the genomic DNA extracted to amplify 16S rRNAgene and successfully amplified 16S rRNAgene from the samples was sent for sequencing.This research was approved by the IIUM Research Ethic Committee (IREC). Using the selected kit, genomic DNA was successfully extracted and PCR amplification of the bacterial 16S rRNAgeneusing universal bacterial primers was achieved giving a product of 1500 bp. Results from sequencing when analysedusing BLAST from the NCBI website, identified bacteria from the genus Vibrio, Haemophilusand Aggregatibacterfrom SECC samples while for caries-free samples Granulicatellawas identified.
Introduction: Scarcity of fresh water is currently blighting the population of the least developed countries around the world. According to WHO, waterborne diseases accounts for 4.1% of total disability adjusted life years (DALYs) with a mortality rate of 1.8 million per year. Numerous pathogens and chemicals may be the potential sources of water contamination that leads to waterborne diseases in humans. Some pathogens are only active and express disease whilst within the host. The aim of this article is to identify the cause of water-borne diseases and how to control it from the Islamic perspective. Material and Methods: In this review we had compiled the latest scientific findings related to waterborne diseases and integrated them with Islamic approach of cleanliness. There are many Hadithsof the Prophet (peace be upon him) (PBUH) regarding methods of cleanliness with scientific background to control waterborne diseases. Water pollution may be a natural process, men made, intentional or accidental. More often than not, man are infected after accidently consuming or coming in contact with contaminated water Results: Scientific literature search reveals that individual hygiene and sanitation is the most prominent way to prevent waterborne diseases. In Islam, Prophet Muhammad (PBUH) puts a great emphasize on purification in terms of personal cleanliness and made it mandatory to follow rule to remain pure both physically and spiritually. Conclusions: Sunnaticapproaches of cleanliness may hinder waterborne disease.
Introduction: Caregiving for stroke patients is a challenging task both emotionally and physically. Studies have shown that caregiving can affect caregivers’ wellbeing that could lead to depression. Objective: This study was carried out to determine the prevalence and associated risk factors of depression amongst caregivers of stroke patients attending Hospital Universiti Sains Malaysia (HUSM) in Kelantan over a 6 month period. Methodology: This is a cross sectional study at the primary care clinic in HUSM over a period of 6 months. A total of116 caregivers of medically documented stroke patients who fulfilled the inclusion and exclusion criteria were recruited via convenience sampling. The brief patient health questionnaire (PHQ-9) were used to assess their depression. Descriptive statistics and bivariable analysis was used using SPSS version 23.Results: 63.8% of the caregivers of stroke patients are depressed. Caregiver’s burden, ethnicity and patient’s ethnicity were found to be significant associated risk factors for depression.Conclusion: Screening for depression in caregivers especially those with risk factors must be carried out in the clinic in order to detect and intervene early. Coping mechanisms especially in the religious aspect should be elicited in future studies.
This article targets all who are committed to the care of young children. Commencing with the clinical history and physical examination, the fundamentals of preventive child health offered in a well-baby clinic are highlighted. In this important clinic, the monitoring of core health components such as nutrition, growth, development and vaccination as pillars of preventive health services augments the health status of both a community and a nation. It is here that much needed information on infant nutrition in the first eighteen months of life, exclusive breastfeeding and complementary feeding, early growth and development, together with the provision of immunisation, is delivered. Health care provision is further strengthened by integrating knowledge with progressive dynamics of health services in line with the government’s health objectives such that communities are empowered with crucial information on preventive health. Significance to local scenarios, pertinent to parents and of importance to preventive health, with community relevance, is touched upon. In this way, it may be opportune to attempt innovative parental counsel on contextually related issues linked to the everyday care of children, whenever necessary. Of interest and given the focus of this journal, specific health concerns apropos to a military scenario, may well be further deliberated on and developed
Nik Mohamad Lukman Mat Zin, Anis Syazwani Abd Mubin, Mohamed Sufian Mohd Nawi, Abul Bashar Mohammed Helaluddin, Abdul Razak Kasmuri, Uttam Kumar Mandal
Gliclazide (1-(3,3a,4,5,6,6a-hexahydro-1H-cyclopenta[c]pyrrol-2-yl)-3-(4-methylphenyl)sulfonylurea) is a second-generation sulfonylurea which is orally administered in the treatment of non-insulin-dependent diabetes mellitus in adults. Sustain release drugs help to improve drugs bioavailability by controlling the time of drug release or prolonging it. We are reporting the preliminary formulation of sustain release gliclazide tablets with careful choice of all the ingredients and processes related to syariah compliance manufacturing of pharmaceutical products. In this work, xanthan gum, a natural gum was used to achieve the sustain release criteria. The tablets were produced by wet granulation and semi-automatic tableting process. Tablet characterisation was done following the British Pharmacopoeia (BP) criteria. We expect that the outcome of our study will result in a suitable formulation that could be useful for the formulation of such product that will be helpful for the Muslim patient especially during the fasting month.
Acute glomerulonephritis is inflammation of the kidney mediated by an immunological process. Group A β-haemolytic streptococcal infection is common in children aged 5-12 years old and can lead to acute post-streptococcal glomerulonephritis which may develop after recovery from a streptococcal throat infection or skin infection (impetigo). 97% of cases occur in less developed country. The incidence has decreased in industrialized nations due to improved hygienic condition. A 7-year-old boy, the eldest child of 4 siblings from a divorced parent, was admitted to Hospital Tengku Ampuan Afzan Kuantan in March 2015 due to facial puffiness for 1 day duration. There was also dark colored urine. Patient had history of productive cough for 3 days and fever for 2 days. Father also complained of skin ulcer on patient’s right feet for about 1 month. There was hypertension (198/80 mmHg). Urine examination showed hematuria, proteinuria, and leucocyturia. Anti-streptolysin O titre was high (1:800) and complement C3 level was low (0.29). Patient was treated with antibiotic, diuretic, and anti-hypertension. The child is entrusted to the parents who will be called by the Almighty, who will ask them about this trust. Parents play vital role in maintaining and promoting the good health of the children. Parents should also pay attention to cleanliness, personal hygiene and the prevention of disease, especially infection. Islam paid attention to washing hands and cleansing the air inhaled into the lungs by regular cleaning of the nose as part of ablution before performing prayer. Parents are responsible in preserving life, health and growth of their children. Caring for cleanliness and hygiene is not only deemed a good habit in Islam but also rendered into rituals that constitute part of the faith itself.
Part of the undergraduate training in dental school is treating dental patients under close supervision of trained supervisors. Islam emphasises the highest quality in service rendered. Aim: To evaluate parent’s satisfaction with their children’s dental care provided by undergraduate dental students at the Student Polyclinic, Kulliyyah of Dentistry (KOD), International Islamic University Malaysia (IIUM). Materials and Methodology: This is a cross-sectional descriptive study. A self-administered questionnaire with questions on accessibility and availability, physical environment, service quality, interpersonal communication, cost of treatment, efficacy and treatment outcome was distributed to parents whose children received dental treatment anytime January 2013 to October 2013. Data collected was analysed using the Independent Sample T-Test, and Mann-Whitney Test. Results: 70 questionnaires were completed and analysed. The results showed that the average level of parental satisfaction was high. The parents were most satisfied with students’ interpersonal communication. The level of satisfaction of parents of female children is higher than parents of male children although the difference was not significant. No significant differences were found in relation to which parent accompanied the child for treatment and the parent’s education level. However, the parent’s level of satisfaction is associated with type of occupation, where non-health-related workers expressed higher level of satisfaction (p < 0.05). Conclusion: Parents were generally satisfied with the care that their children received, mainly with the aspect of students’ interpersonal communication and physical environment of the clinic. The results also indicated that level of satisfaction is associated with the nature of the parent’s occupation.
Standard uroflowmetry is performed in a standing position and it is an important investigation for those who are suspected of having lower urinary tract symptoms such as benign prostatic hyperplasia (BPH). Effects of changing positions during uroflowmetry have also been investigated previously but mixed conclusions were made. For Muslims, voiding in squatting position is encouraged as part as daily practice. This is mainly due to cleanliness reason and many Hadiths have emphasised about it. Objective: The aim of this study is to compare uroflowmetry findings between squatting and standing positions amongst BPH patients attending urology clinic Hospital Tengku Ampuan Afzan (HTAA). Methods: This is a cross section observational study carried outfrom March 2015 to December 2015. The maximum flow rate, average flow rate, voiding volume, total voiding time and post-voiding residual volume were measured and recorded. Results:The results were then compared and analysed. 64.2% of patients were non-Muslims. 78.0% of the patients voiding habit were standing and 12.2% squatting position at home. The average International Prostate Symptom Score (IPSS) was 12.07 and 63.4% of them were in moderate group disease. Post void residual (PVR) volume showed a reduction in squatting position (p
The medical profession is amongst the professions that offer tremendous benefit to the entire humanity. Nevertheless, the responsibilities that they have to undertake in their daily practice are constantly increasing as they deal with two most precious commodities of mankind, which is life and health. The demands for accountability when ‘the consequences of an action are considered not to be at par with the expectations’ has become a common trend within the society recently. Law, being an instrument of social regulation, intervenes to establish the rights and responsibilities in medical practice to determine the boundaries of rightful conducts in areas where there exist conflicts of moral, ethical and religious issues. Therefore, it is pertinent for Muslim doctors to keep abreast with the developing law that is governing their practices and at the same time, to ensure that any deliberations flourish within the confines of Islamic law. By employing qualitative research method, namely, doctrinal analysis, this paper seeks to discuss the legal rulings from the Malaysian and Islamic law perspectives relating to significant and current medical issues such as negligence, confidentiality, assisted reproductive technologies, abortion, euthanasia, organ transplantation and sterilisation.
Educational experts affirm that students prefer various type of learning preference. It is known that the learning style preferences vary among medical students worldwide. Knowing the types will help medical educators to improve their way of conveying lectures and teaching in a more effective learning environment. This study aims to describe the learning style preferences of pre-clinical medical students and the association with their socio-demography. This is a cross sectional study done among Year 1 and Year 2 pre-clinical year medical students in a public university in Kuantan Pahang. Medical students who fulfilled the inclusion and exclusion criteria were recruited using systematic random sampling. A validated learning style questionnaire (VARK) was used to assess their learning style. Descriptive statistics and bivariable analysis was used using SPSS version 23. A total of 166 pre-clinical year medical students participated in this study. The mean age was 21.3 (0.84). Majority of them were Malays (98.2%) and females (69.9%). Most of the students preferred unimodal learning style (80.0%) with the most preferred learning style preferences being kinaesthetic (39.1%). Bivariable analysis showed female students preferred kinesthetic learning style compared to male students (p=0.03).In this study, majority of the pre-clinical year medical students preferred ‘life-like’ learning experience in their study. Hence, we recommend that medical educators to be more aware of the varieties of learning style preferences in order to improve the quality of teaching and learning experiences.
Research into dental treatment via statistical perspective was unraveled through a relation between theoretical and experimental probability. This assessment of association was examined using statistical test over Confirmatory Factor Analysis (CFA) and Latent Class Analysis (LCA). Theoretical results of the prevailing difference between the direct and indirect upshot was verified through a technique known as integrated model by using Mplus® software package. The results expressively show that the dental treatment from the indirect effect has better performance than the direct effect. Besides that, there is a dramatic improvement of dental treatment from different type of malocclusion analysis. Three classes of different type of malocclusion analysis play an important role as mediator for demographic variable and type of dental treatment.
The Islamic perspective slot (IPS) is a strategy to enhance the agenda of Islamisation of Knowledge in the curriculum of the Department of Biomedical Science (DBMS) at the Kulliyyah of Allied Health Sciences (KAHS), International Islamic University Malaysia (IIUM). Here, the outcome of a 4-year implementation of the IPS is assessed by determining the knowledge, attitude and practices on the IPS in the Biomedical Science curriculum among IIUM Biomedical Science students. A cross-sectional study was performed using convenience sampling on 205 students administered with a self-guided questionnaire. The total score for each knowledge, attitude and practice were computed to find the association using SPSS. The total mean and standard deviation of knowledge, attitude and practice score were found to be 20.18±3.60, 89.47±12.99 and 38.22±6.94 respectively. There was weak positive correlation between knowledge and attitude (r=+0.286; p
One of the challenges in the Islamization of knowledge project is the absence of a ready approach for integrating the existing disciplines within the Islamic knowledge paradigm. Among the constituents of such an approach is an epistemological framework that defines a discipline to serve as reference for further efforts on the operational level. This study intends to fill this gap with a perspective on Islamic epistemological framework in the field of medicine during the Islamic medieval era. The focus of analysis is on the topic of the origin of medicine and the views of ancient Greek physicians in the compilation entitled ‘Uyūn al-anbā’ fī ṭabaqāt al-aṭibba’ or History of Physicians authored by Ibn ’Abī ’Uṣaibia‘. The study used interpretive textual analysis method to arrive at certain constructs for an Islamic medical epistemological framework from the point of view of the author. The analysis concludes that the perspective of the author on the selected topics was suggestive of possible constructs for an Islamic epistemological framework that can serve as a point of reference for further development of an approach for integrating medical disciplines in the Islamization context.
Breast milk contains all basic nutrition needed by a child. Exclusive breastfeeding is recommended to all infants in their first 6 months of life. Infants who had been exclusively breastfed have a better health status compared to infants who were introduced with mixed feeding in their early life. Exclusive breastfeeding not only gives benefits to the child, but also to the mother. In infants it offers protective mechanism in lowering risk of gastrointestinal infection and promotes bonding between the mother and the child. The first case was a 2 years and 7 months old girl who was admitted to Hospital Tengku Ampuan Afzan Kuantan due to acute gastroenteritis with some dehydration. She had been admitted a month earlier due to pneumonia. She was breast fed exclusively for 3 months after she was born. Formula feeding was started after she turned 4 months old.. The second case was a 1 year and 4 months old boy who was hospitalized due to acute bronchiolitis. He was not breast fed due to no milk production. Islam views childhood as a critical phase in molding an individual. Parents have been entrusted by Allah to observe and fulfill the rights of the children in providing a conducive environment for them to develop and grow. A good healthcare and proper nutrition are among the child’s rights that need to be filled by the parents. Islam emphasizes the importance of breastfeeding up to 2 years old as a way in providing good nutrition. Islam also provides solution for mothers who are unable to breastfed their child by adopting wet mother. Parents are responsible in providing good health and nutrition for their children. Breastfeeding is also highly encouraged by Islam because it provides medical benefits for both mother and children.
Persistent vegetative state (PVS) is a clinical condition of unawareness of self and environment with preserved sleep-wake cycles. Its clinical diagnosis can be a difficult unless a physician has adequate experience and expertise in evaluating neurological syndromes. Outcome is based on aetiology and age. Decisions on limiting life-sustaining treatment (LST) for these patients are emotionally and morally challenging. We present a case of a young boy who went into PVS following traumatic brain injury (TBI) with the aim to review some of the ethical issues regarding its management from Islamic perspective
The primary goals of resuscitation are to preserve life, restore health, relieve suffering and limit disability. As nurses, executing the cardiopulmonary resuscitation (CPR) to a patient experiencing cardio-pulmonary arrest is essential in preserving life. However nurses face a dilemma in the decision making to either preserve the patient’s life or let the patient die naturally, if the patient’s autonomy as well as his family’s wish for a “do not resuscitate (DNR)” order. In this dilemma, the sanctity of life and the right to die is the main concern of this discussion. Islamic moral judgment, as the major concern here, should be studied as an alternative to analyse and provide a guideline that is in accordance with the Islamic teaching. Thus, this research is to provide the Islamic moral judgment on the resuscitation issue and its implication in nursing practices. The western ethics that represent the current practices on resuscitation is not included. The comparison was then made with the ultimate origin of Islamic teaching iethe Qur’an and Sunnah, as well as the notions of Muslim scholars on the subject. As the physician opines that CPR is to be beneficial to rescue a life, therefore refusing it may be considered as immoral. However, the DNR order is entirely acceptable if the doctor believes that CPR is futile and gives no benefit to the patient. The doctor has the authority to issue a DNR order if he is certain that the patient would not benefit from CPR without getting consent from the patient or his relative. Nursing implications: As nurses facilitate patients and family members in forming a decision about end of life hence engaging a comprehensive view of DNR based on Islamic teaching would provide an informed choice when advising a Muslim patient and family. The area to investigate would be on the degree of knowledge among nurses regarding the Islamic moral judgement on this matter is highly recommended for future management.
Childhood asthma is known to cause heavy economic burden due to increased hospital visits and prolonged hospital care due to its exacerbations. Despite the advancement of in-hospital management to control asthma, poor compliance has been an astounding problem in the management of the acute asthma attack. An8-year-old boy, who was known as persistent bronchial asthma since 5 year of age, have had frequent visits to the clinics and hospital due to poorly controlled asthma symptoms. During this episode, he presented with worsening shortness of breath. He often misses his daily medication due to parental assumption that the patient is able to manage asthma by himself. His non-compliance towards medications has led to patient’s absenteeism from school and deterioration in his academic performance. Islam is a religion that emphasizes on provision of individual’s and community’s health. This is achieved through taking an optimal care of one’s health and aimed at maintaining disease control state. Parents have the duty to provide their children with good and healthy living throughout the childhood period, and not to neglect them in any way.Islam stresses the importance not only self-care in the societybut also preservation of others’ health especially by the Muslim doctors. Conservation and protection of individual’s right to health especially children require group effort of both parents and medical personnel.
The objective of this study is to look into the stability of Chloral Hydrate 40 mg per ml formulated as oral solution in X-temp Oral Suspension System in order to select proper storage conditions and establish beyond-use date. X-temp is a novel oral, flavoured sugar-free extemporaneous compounding vehicle to assist in the preparation of extemporaneous dosage forms.
The compounded solution of 40 mg/ml was prepared by dissolving chloral hydrate powder in X-temp vehicle. The solution was then packed in amber HDPE containers, and were stored at refrigeration 5 ± 3°C and room temperature 30°C. Physical, chemical and microbiological parameters were evaluated at predetermined time-points up to 180 days. Samples were tested using a validated stability–indicating assay. Chloral hydrate concentration was assayed by high-performance liquid chromatography (HPLC).
The stability results indicated that the solution remained unchanged in visual appearance or pH at both refrigeration and room temperature for up to 180 days. The HPLC results showed that all the stability studies maintained 90 – 100% of initial drug concentration. There was no substantial changes in the microbiological stability.
Chloral hydrate solution prepared in X-temp Oral Suspension System was stable for up to 180 days when stored at room temperature and refrigeration conditions. These results demonstrated that X-temp is a suitable vehicle for extemporaneous compounding for chloral hydrate.