Update on the Management of Diabetes during Ramadan Fast for Healthcare Practitioners

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.

Airway Y-stent Insertion in Tracheobronchomalacia: A New Experience

This case report describes a rigid bronchoscopy-assisted placement of a silicone airway Y-stent in a patient who developed tracheobronchomalacia following repeated dilatations for post-tuberculous airway stenosis. This is the first report of an airway Y-stent insertion in Malaysia.

Euthanasia and Physician-Assisted Suicide: A Review from Islamic Point of View

Due to globalizing trend of homogenisation of culture, changes in the health care delivery system and market economics infringing on the practice of medicine, there has been a gradual shift in the attitude of the medical community as well as the lay public towards greater acceptance of euthanasia as an option for terminally ill and dying patients. Physicians in developing countries come across situations where such issues are raised with increasing frequency. As the subject has gained worldwide prominence, we want to review this topic from Islamic perspective due to its significance in medical ethics and clinical practice.

Role of rigid bronchoscopy in massive haemoptysis

Massive haemoptysis can occur in lung abscess. Massive haemoptysis itself may be life threatening due to asphyxiation or respiratory failure secondary to acute large airway obstruction by blood clots. Prompt removal of the obstructing blood clots save life. We describe a case of lung abscess causing massive haemoptysis resulting in acute airway obstruction which required rigid bronchoscopy to remove the huge blood clot. (JUMMEC2010; 13(2): 107-110)

Usefulness of cytological specimens from bronchial brushings and bronchial washings in addition to endobronchial biopsies during bronchoscopy for lung cancer: 3 years data from a chest clinic in a general hospital

A retrospective review of all bronchoscopy cases for investigation of lung cancer between January 1997 and December 1999 was done. The cases were included if endobronchial mass was visible (Group A) or when there was an abnormal mucosa and/or bronchial narrowing in the absence of a mass (Group B). All patients in Group A (n = 177) underwent endobronchial biopsy (EB) bronchial brushings (BB) and bronchial washings (BW). All cases in Group B underwent transbronchial biopsy (TBB), BB and BW. Only a small increase in the positive results for cancer was seen when cytology specimens (BB and BW) were added to EB (85.3% vs 88.1%, McNemar's P = 0.06) in Group A but there was a significant increase in Group B (37.3% vs 54.2%. McNemar's, P = 0.001). Therefore although cytology specimens did not significantly add to overall yield of positive results when endobronchial lesions were visible, when mass lesions were not visible, cytology specimens increased the yield by 16.9%.