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.
The management of Valproic Acid (VPA) toxicity is mainly supportive treatment. Invasive management such as hemodialysis (HD) and hemoperfusion were only used in isolated cases where patient is highly VPA toxic, which results in coma. We described a case of mild VPA toxicity (VPA serum concentration 326.42mcg/mL), where the patient was successfully treated with two hours of low-flux HD with no complication. While the guideline of indication of HD in VPA toxicity has yet to be published, low-flux HD can be an effective treatment in cases of mild VPA toxicity, if other supportive measures failed or not available.
The Falsified Medicines Directive (FMD) imposes strict serialisation requirements on pharmaceutical manufacturers, distributors and dispensers. This article outlines everything you need to know and what you need to do for a seamless serialisation process – before regulators remove your right to trade.
Pharmaceutical manufacturers are currently the main actors in a serial drama where getting their lines right is paramount. Well, four lines of data, to be precise; in (and next to) DataMatrix barcodes applied to every pack of prescription medicines. The introduction of serialisation, designed to ensure the authenticity and traceability of individual medicines, promises to improve patient safety and create exciting opportunities for digital health. But there is a twist in the plot. Failure to comply with the EU regulation that mandates it means you cannot legally ship your product. No barcode, no trade. That is when a serial drama turns into a tragedy. And time is running out to be ready.
The unfolding story of the Falsified Medicines Directive (FMD), which was first introduced in 2011, is into its final episodes. The denouement arrives on February 9, 2019, when the Directive is fully enforced and the penalties for non-compliance officially come into play. FMD is an attempt to prevent inauthentic, substandard or harmful medicines entering the supply chain. It imposes strict serialisation, traceability and verification requirements on pharmaceutical manufacturers and their associated wholesalers, distributors and contract manufacturers. In particular, it mandates companies to print a unique identifier on the packaging of prescription medicines. Furthermore, companies are not just responsible for the data that goes on the packaging, they are responsible for submitting it to the central data hub that will enable pharmacists to authenticate products before they dispense them. It is a complex undertaking that could be easily underestimated – but not if you understand some key steps. The implementation of serialisation is not an overnight task – it encompasses processes that have multiple touch-points across global organisations, partner networks and the wider supply chain. Yet despite this – and despite the enormous implications of getting it wrong – many companies are still some distance from being fit for purpose. Indeed, in some organisations, the Directive has not yet hit their radar. It needs to – because the clock is ticking. But all is not lost. Here are seven steps to successful serialisation.
Advances in modern science and technology have not only reduced mortality from communicable diseases but increased physical comfort, life expectancy and quality of life. However its advances have generated changes in the moral values and basic philosophies of mankind, a bi-product being loss of faith in religion as a partner in healing. This has resulted in changes in lifestyle, moral degradation, laxity in sexual behaviours, and disrupting social values. New diseases caused by negative lifestyles such as sexual promiscuity, alcoholism, illicit drug use and smoking, take the greatest toll in terms of deaths and disability among young people. As a consequence, relevant international organizations have supported more novel approaches to health promotion.Good health is the basic requirement of every human being and one of the greatest blessings of ALLAH (SWT)on mankind. The Islamic way of life is a system of divine principles sent by Allah swt through revelation on Prophet Muhammad (saw) which covers physical, intellectual and spiritual needs of human life. It has many constructive ideas to offer in the field of health care and medical practice. It contains many teachings that urge nurturing of one’s health and rejecting any behaviour, which are contradictory to health. Therefore by adopting an “Islamic way of life” we can promote behavioural change. Since Islam encourages adoption of modern technology and science in support of a greater good, we must understand it and adopt all that is good in it and propagate it in the spirit of Tawhid (Unity of God), for the benefit of all humanity. This paper seeks to analyse how medical professionals can promote healthy behaviour to specific target groups and public in general through teachings of Islam.
The expression product of VASA gene is widely conserved germ line marker and participates to regulate the development of reproductive system and spermatogenesis in healthy man. Azoospermic is a condition which the man is unable to produce any sperm cells for reproduction activity. This condition produced has bad impact to the man since the ability to produce their own progeny will be interrupted or blocked forever. Not only the family bloodline of the man would be ended, the psychological issue like shamefulness and low self-esteem occurs. In Islam, seeking knowledge is an obligatory to Muslims in order to solve problems and improve lives. Thus to unveil the problem of azoospermic man we aimed to determine the level of VASA gene expression in samples of testes cells of non-obstructive azoospermic (NOA) and compare it with sperms of healthy man. Samples were taken from three NOA patients by testicular sperm extraction (TESE) to obtain testicular biopsies. Testicular cells were isolated and cultured in supplemented knockout DMEM media. VASAgene expression was determined by reverse transcriptase polymerase chain reaction (RT-PCR). The VASA gene expression from sperm of healthy man was also determined for comparison purpose. It was demonstrated that the addition of growth factor significantly increased SSC-like cells colony formation in tissues obtained from NOA patients. No VASA expression was detected in spermatogonial-like stem cells culture on day 1, 7, 14 and 21 in each of the azoospermic samples. Our findings shown VASA gene was not expressed in spermatogenesis in vitroculture that might be associated with the abnormal differentiation of primordial germ cells that lead to male infertility. Islam also teaches us to not have feelings of despair and for problems that we are facing but to find the solution and consider the problem as a test from the Almighty. All the tests should be handled with strong believe since only Allah (SWT) knows what the best for us and each of the tests will have justified wisdom and benefits which we as human being are unable to realise thoroughly.
Expression of beta-human chorionic gonadotropin (bHCG) mRNA in early cleavage cell stages is important in predicting embryo viability at blastocyst stage of development. Embryo viability is crucial for in vitro fertilization (IVF) treatment to be successful in terms of increment of implantation and pregnancy rate. In order to establish fertilization outside the human body, optimum condition mimicking the natural body environment like hormones and growth factors as well as impeccable timing must be established. ImamMuslim narrated from Hudhayfa ibn Asad that the Prophet Muhammad (SAW) said: “After the sperm-and-ovum drop (nut.fa) has been [in the uterus] forty-two days, Allah sends it an angel that gives it form and fashions its hearing, sight, skin, flesh, and skeleton”. Therefore the aim of this study is to find the significant association of bHCG expression with early cell stage cleavages and its relationship as predictive marker for potential embryo implantation. Our study focuses on leftover frozen embryos from eight patients consists of six pregnant patients and two non-pregnant patients. We assessed the human bHCG mRNA expression at different cell cleavage stages in these frozen embryos using reverse transcriptase-polymerase chain reaction (RT-PCR). Our results have shown three out of eight patients with five to ten cells of blastomeres were expressed with bHCG. This study indicated that bHCG was expressed on froze-thawed late cleavage stage of embryos in IVF patients.
This discussion paper aims to synthesise available literature on hearing sciences from Islamic perspective and to relate this to the current hearing care practices. The paper focuses on several main scopes: i) the importance of sense of hearing from Islamic and scientific perspectives ii) impacts of hearing impairment iii) limitations in understanding and practicing Islamic teaching due to hearing impairment, iv) Islamic responsibility towards people with hearing impairment, v) current available methods to facilitate Islamic practices among hearing impaired people, and vi) incorporating Islamization in hearing care practice. Design:Narrative review and synthesis Method:Related publications and references were identified through several ways: i) by structured searches in PubMed, Google scholar, Web of Knowledge and Science Direct using the combinations of ‘Islam’, ‘hearing impairment’, ‘hearing loss’, ‘hearing’, ‘social’, learning’, ‘memory’, ‘disability’, ‘Islamic responsibility’, and ‘learning for deaf’ as key words, ii) by inspecting the reference lists of relevant articles, and iii) by identification of relevant references from Quran and Hadith by authors who have background in Quranic studies. Results:The number of publications within the audiology field, which address the aforementioned scopes, is rather limited. Additionally, a review and synthesis of literature from other related fields such as medical, health, and education, with references from Quran and Hadith, were also carried out to facilitate the discussion of the above mentioned scopes. Conclusion:This paper concludes that there is an emerging trend for the studies of hearing and Islam in the literature. Facilitating hearing impaired people in understanding and practicing Islam becomes a shared obligation for parents, society, and the patients themselves. This discussion also identifies that there is a need for more contributions from Muslim scholars in integrating and implementing the Islamic principles in current hearing care practices.
As age advances most of body system will follow a process of deterioration too and the same goes for reproductive health. There is a gap between the prevalence of reproductive health disorders and rates of treatment. This gap among middle aged and older men is still wide compared to other chronic disease. In Islam, seeking medical treatment for the cure of diseases is part of the Prophet’s tradition and the Prophet (PBUH.) said in the Hadith the following: “For every disease there is a medicine, and if that medicine is applied to the disease, he will recover by Allah’s Leave.” Therefore the aim of this study is to identify a health seeking behaviour among men in for men’s health (MH) disorders in Kuantan. A cross sectional study was conducted among 157 respondents from four governments agencies and the data was collected using self-administered questionnaire modified from a valid and reliable measure. The results showed that 68.2% of the respondents (n=107) have high attitude in seeking for health regarding men’s health while for the rest of the respondents (n=50, 31.8%) have low attitude in seeking for MH. Men from the Service factor are perceived the highest compared the other two factors which are cultural and economic factors. This study showed that MH that includes reproductive disorders has always been taken lightly by the community itself. A Lack of awareness regarding ME issue causes men to ignore the importance of health screening. This should be improved in order to produce a healthy community for better Ummahsince good heredity begins with good ME.
Grief has been defined as the reaction towards loss with typical symptoms including sadness, anger, guilt, yearning, regret, loneliness, numbness and positive feelings related to individual’s personal experience. Grief has been postulated to occur when a safe and secure bond has been threatened. This loss can be an opportunity for personal growth. It is growth that emerges from difficult life events. It may occur during or after the process of grieving. We reviewed three cases related to grief and personal growth. Three cases were described where grief and personal growth were observed. Each case occurred in different situations. These different situations were; an adult child and caregiver of patient with dementia, a widow who loss her husband from drowning, and a cancer survivor who experienced psychological and spiritual growth from the loss and adverse life event. As a comparison three stories taken from the Quran and Hadithwere analyzed to reflect on the three case discussions. The Quran and Hadithhave mentioned stories of personal growth emerging from difficulties. The completeness of Islamic creed has never neglected the spiritual component in treating medical, physical and psychological illnesses. Islamic spirituality facilitates and enhances personal growth in the aftermath of any physical and psychological tribulations. It is important to merge the spiritual aspects of grief from Islamic perspective, as to aid those suffering from grief to attain personal and spiritual growth.
The purpose of this paper is to advocate for a holistic medical philosophy that is capable of accommodating various models of medical explanations. Such a comprehensive and integrated approach of medical philosophy should be capable of addressing, the ethical, epistemological and metaphysical aspects of medical research and practice. The basic presupposition of the paper is that the Islamic principles on health promotion can play an important role in developing such a holistic medical philosophy. Adopting the analytic method, the paper investigates the three major frameworks of explanation that dominated the history of medical philosophy: (a) the humoral model that is based on balance of the humors; (b) the biocentric model which is based on causal explanation and defines disease in descriptive biological terms; and (c) the post-modern or meta-biocentric model that concerned mainly with the medical philosophyand aims at promoting the holistic approach. This paper, also, investigates the three basic forms of medical explanations which are determined by the above domains, i.e. the descriptive, the normative, and the integrated models. The paper traces the impact of explanation methods on good medical practices and explores the Islamic medical philosophy and its potential role in promoting the holistic approach. Along the way, the paper discusses the ideal relationship between physician and patient according to the Islamic perspective.
The obligatory fasting of Ramadan is not only an Islamic ritual to enhance the God-consciousness (called Taqwa), it may also lead to improvement of health status of fasting person(s). In other words, it is a complete overhauling instrument of Muslims soul/body in terms of faith and health. This can be termed as “Islamic fasting: a combination of spiritual elevation and prevention of diseases”. During fasting Muslims try to maintain integrity of the human body both physically and spiritually. It not only keeps us healthy physically/spiritually but also makes us healthy in social obligations. Furthermore,with full devotion it brings long-lasting changes in the individual’s life and relate to the level of righteousness and strength of character to resist desires. In health fasting plays an important role, for example the improvement of hyperlipidemia, obesity (fat loss), diabetes, cognition, cell functions, immunological factors, inflammation, stress and lifespan etc. This article is an effort to review and discuss research carried out on the listed conditions during the holy month of Ramadan on various aspects of human health.
Seeking treatment is a vital when an individual falls sick. However, some may not do so perhaps they are ashamed to admitting having shameful diseases or unable to seek and reach help. Negative perception of the community on sensitive diseases like AIDS or sexual transmitted disease (STD) may drive the patients away from seeking treatment and suffer alone. In Islam we are thought to always have positive perceptions (husnu dzan) towards any issues in daily life especially when dealing with human interaction by avoiding bad perceptions (su’u dzan). Thus, this study aims to identify the factors affecting treatment seeking patterns among public in three selected areas in Kuantan, and to explore factors affecting people not able or avoid seeking treatment, also to determine the relationship between treatment seeking patterns and the influential factors ie distance, accessibility and behaviour; attitude to health, healthcare and self-perception. A cross sectional survey was carried out at Taman Gelora, Teluk Cempedak and Terminal Makmur, Kuantan, Pahang. Convenient sampling method was used in this study. 201 respondents participated and answered a semi-structured questionnaire modified from Adamson. Results showed that the data was normally distributed, 50.2% respondents were male and 58.7% the total respondents were between 16-26 years old. Majority of the respondents had neutral attitude to health and healthcare, and to self-perception; 94.03% and 73.63% respectively. From the results, there were significant association between distance and accessibility, and monthly income, plus between self-perception and demographic data (p
With the modern advances and technological breakthroughs in biomedicine, scientific experiments involving human subjects had increased. Since the American gynecologist Marion Sims (d.1883), who conducted a scientific research on some selected African women suffering from prolapsed uterus disease, or American physician Walter Reed’s (d.1902) team who gave germs of yellow fever to 22 human subjects to test if fever is transmitted by particularly mosquito species, as well as the Tuskegee Syphilis Study that was conductedfrom 1932 until 1972, or the scientific experiments conducted by Nazis of Germany on large numbers of prisoners, clinical trials on human subjects have become part of the scientific activities. These and many other scientific experiments conducted on human subjects had shown the extent of potential threats of unregulated scientific experiments on human life. Serious moral and legal concerns are then raised towards the morality of these activities. These concerns covered four major areas; safety, sanctity of the human body, consent and validity of experiment. This paper uses textual and analytical methods and aims to review Muslim jurists’ opinions on the permissibility of conducting clinical researches that uses human subjects. The opinions of the Muslim jurists are then compared to that of bioethical codes and declarations such as the Nuremberg Code, coined in (1947) and the Helsinki Declaration that was formulated by World Medical Organizationin 1964. Fiqhand legal literature on this subject is exposed, and the moral contents of such writings are analyzed. The study is expected to come up with a comparative account of conventional and Islamic responses to modern clinical trials on human subjects.
Life and death of men is in the discretion of Allah, SWT. No one can decide how long they should live, but Allah, SWT. However, in our society today, life is being terminated by someone such as doctor or family of terminally ill patients when their recovery is absolutely irretrievable according to medical expert opinions. In medical science, ending life for such a situation is called euthanasia i.e. an act or practice of painlessly putting to death persons suffering from painful and incurable disease or incapacitating physical disorder or allowing them to die by withholding treatment or withdrawing artificial life-support measures. Justification given by pro-euthanasia is that it is the right of the patient who should not suffer unbearablepain physically and who does want to be a burden to their family. They insisted mercy killing is absolutely appropriate if the patient’s body is in gradual decline, their organs are in continuous failure, their agonizing pain is unbearable, and the cost of their artificial support system is beyond their limit. This issue has been controversial to many Islamic as well as social organizations as it is against their doctrine and norms. Since life and death is in Allah’s hand, who is to decide that a life has to be ended at a specific time? Is it against predestination and fixation of life by Allah that when the time come no one can stop its arrival? This undesirable situation is confronted by many Muslims in our world too, hence is there any room in Shari’ah law that allows a physician to end the life of a patient? The objective of this paper is to explore any possibility in Shari’ah law that authenticates ending of a life.
Increasing utilization of living animals in ecological and biomedical research has drawn serious concerns in terms of animal welfare and ethical practices in animal handling. Significant attention has been given to animals of higher taxonomical hierarchy especially vertebrates such as fishes, rodents, reptiles and mammals, while ethical framework on invertebrate handling and welfare is less addressed (except for cephalopods). The definition of ‘Animal’ itself by any international consortia or Animal Research Act (ARA) does not include invertebrates as an animal entity. This is due to the lack of standard ethical framework to understand the pain and other physiological stress experienced by the invertebrate test animal. One such example would be the living fossil ‘horseshoe crab’ which is extensively bled to obtain its blue blood that is used for endotoxin quantification in biological samples. The biomedical bleeding itself leads to 15-30% post bleeding mortality of crabs, while pain and stress caused by the bleeding practice is not studied. Hence, this paper discusses the technicality of establishing standard framework for invertebrate handling. The paper also highlights the shari’ah (Islamic law) principles on scientific experimentations on animal subjects, particularly the norms related to the adoption of invertebrates in environmental and biomedical practice. Comprehensive review of ethical regulations in animal experiments, especially invertebrates, would be beneficial for revising and improving existing animal ethical practices.
Human show cruelty to fish during exploiting, culturing, killing, experimentation and amusement. Presently, overexploitation of marine fishes is a serious problem worldwide. More than 50% of total fish production is now raised in aquafarms where many fish suffer from parasitic infections, diseases, and debilitating injuries in culture systems. Every year, millions of fish are caught in nets and on hooks. Many of them are tortured just for sports. Fishes are also regularly used for scientific experiments. Many of them are killed by unethical ways. Among all animals, human is the main culprits in causing harms to animals including fishes by damaging their ecosystems. To secure animal rights, modern bio-ethics started to be developed in the last century. The principle of modern bio-ethics is very similar to the principle of Islamic bio-ethics. Therefore, modern bio-ethics might be guided by Islamic bio-ethics, which was well established in the 7thcentury. According to Islam, God gave the human being responsibility to look after animals, to protect them, and not to abuse or threaten them. Human is not permitted to kill animals just for sports or amusements. God created the universe in a perfect balance and human should not disturb this. Therefore, human may exploit and culture food (fish and other organisms) and ornaments without destroying aquatic ecosystems. Islam prescribes a set of rules to treat animals with the utmost kindness and compassion. However, Islamic direction can be integrated with science to ensure minimum stress, pain and suffering when killing animals including fishes.
To investigate the depression, anxiety and stress, stressors and relieving factors among dental students at Kulliyyah of Dentistry (KOD). Materials and methods:A cross-sectional study was conducted among 222 dental students. Their socio-demographic data, self-reported depression, anxiety and stress (DASS-21) scores, causes and relieving factors were collected using validated semi-structured pre-tested questionnaires. The data was analysed using percentages, chi-square test and Binary logistic regression tests with SPSS version 24. Results:The prevalence of depression, anxiety and stress was 41%, 68.9% and 34.2% respectively.Cross analysis showed that academic-related and laboratory or clinical related reasons were significantly associated with the depressive symptoms [(X2= 15.86, p
Islam provides a comprehensive way of life where the revelations bestowed by Allah from the Quran and Hadithcover all aspects that leads to a well-balanced life. This study compiles all the Quranic verses related to visual functions which may serve as a reference for Muslims as well as non-Muslim primary eye care practitioners during their patients’ treatment and consultation. A website named “Search Truth” on http://www.searchtruth.com/was used as a tool to identify the Quranic verses related to visual function by typing in the keywords “eye/eyes”, “see”, “light”, “sight” and “vision” in the search boxes provided in the website. The program embedded in the website then listed the Quranic verses based on their English translation containing the respective keywords. The listed Quranic verses and their translations were verified manually using the Holy Quran Tafseer. The frequency of Quranic verses for each chosen keyword was determined. There were 34 Quranic verses related to visual function and could be explained scientifically. The frequency of Quranic verses related to visual function under the classification of “eye/eyes”, “light”, “see”, “sight” and “vision” were 15, 8, 3, 7 and 1 respectively. The fundamentals of visual functions may be explained scientifically based on the Quranic verses.
Comparative leaf anatomy study were conducted in three taxa of Acanthaceae from peninsular Malaysia. Three chosen taxa were Acanthus ebracreatus(Vahl), Andrographis paniculata (Burm.f.) Wall. exNees and Chroesthes longifolia(Wight) B. Hansen which is commonly used as traditional medicine especially in peninsular Malaysia. The main objective is to identify the leaf anatomical characteristics that can be used in plant identification and also for supportive data in plant classification. The procedures involved such as cross section using sliding microtome on the petiole, lamina, midribs and marginal, leaf clearing and observation under light microscope. Results have shown the similarities and variations in leaf anatomical characteristics. The anatomical characteristics observed include petiole and midrib outlines, patterns of petiole and midrib vascular bundles, presence of cystolith cells, presence of hypodermis layers in lamina and presence and types of trichomes. In conclusion, results showed that anatomical characteristics have taxonomic significance that can be used in classification especially at species level.