ABSTRACT
Fasting during the month of Ramadan is one of the five pillars of Islam, a recurring annual ritual, which is passionately practiced by most Muslims across the world. It is obligatory on every healthy Muslim; however, the Qur’an and Islamic teachings specifically exempt people with acute or chronic illnesses from this duty, especially if it might have harmful consequences. Muslims with diabetes are exempted from fasting, but many of them still fast during Ramadan, for their personal convictions as revealed by EPIDIAR study which showed that 43% of patients with type 1 diabetes and 79% with type 2 diabetes fasted during Ramadan. Muslims constitute about a quarter of the world’s population who are spread all over the globe. It is inevitable that health care issues peculiar to them will be encountered worldwide and health care providers will have to counsel them regarding medications and whether it is safe to undertake the fast. This paper is an update on the management of Ramadan fasting based on current evidence from published literature and expert opinions.
ABSTRACT
The aim of this study is to compare the results of excision and plication procedures with that of the internal drainage technique in the treatment of idiopathic hydrocele, with regard to safety and efficacy. A prospective study was conducted between October 1, 2004 and September 30, 2007 at Aden University Teaching Hospitals. A total of 60 patients who had a unilateral idiopathic hydrocele were randomly divided into three groups of 20 hydroceles each. One group undergone excision [Jaboulay's operation] and the second group undergone plication [Lords operation] while the third group undergone internal or closed drainage. Scrotal Ultrasound was done before the treatment then six months after. The complications and recurrence rates of each technique were evaluated. In all, 60 patients were included in the study [mean age 42.8 years, range 16-60] and follow-up examinations were done at 3-month intervals during I to 2 years. The excisional technique group had resulted in a high rate of complications [65%], compared with plication technique group that had lower rate of complication [15%] and lowest rate [5%], regarding internal drainage technique. Infection and haematoma among the three techniques were not statistically significant. The recurrence rate was higher among the internal drainage group [25%], compared with the other groups [10%] for excisional group and [5%] for plication group [P<0.001]. Although it has relatively a high recurrence rate, the internal drainage technique may be the preferable method as it does not necessitate dissection or manipulation of the scrotal contents. Furthermore, infection, oedema, and pain in the postoperative period are minimized. It is essentially indicated in adult patients with idiopathic hydrocele and a healthy tunica vaginalis. Patients with recurrence should be considered for surgical therapy, preferably plication procedure. On the other hand, plication is better than excision as it causes fewer complications