Medical benefits, fasting & Diabetes Mellitus2

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TABLE 1
1500 CALORIE AND DIET MENU FOR RAMADAN
FOOD EXCHANGES
PRE-DAWN BREAKFAST


American Pakistani Middle Eastern
Fruit 1 1/2 c Orange Juice 1/2 Grapefruit 1/2 Grapefruit
Starch 3 1/2 c Oatmeal1
English Muffin
1 Pit Bread
1/2 Potato Bhujia a
1 Pita Bread
1/3 c Fool Midammis
Meat 2 1 Boiled Egg
1/4 c Cottage Cheese
2 egg Omelet
1 oz Feta Cheese
1 Boiled Egg
Fat 1 1 tsp Margarine
1 tsp Olive Oil
1 tsp. Olive Oil
And 2 Black Olives
Skim Milk 1 1c Skim Milk 1 c Skim Milk 1 c Laban
Free Foods 2 tsp Sugar Free Jam
Coffee
Tea Tea

POST-SUNSET ENDING THE FAST

Fruit 1 2 large Dates 2 large Dates 2 large Dates
Starch 1 6 sm Vanilla Wafers 1/3 c Chana Chaat 1/3 c Salatet Hummus
Skim Milk 1 1 c Skim Milk 1 c Lassi 1 c Rabat

DINNER

Meat 3 3 oz Roast Beef 3 oz Bhuna Gosht 3 oz Tikka Kebab
Starch 2 1 sm Baked Potato
1 Dinner Roll
1/3 c Daal
1 Chapati
1/3 c Lentil Soup
1 Pita Bread
Vegetable 2 1 c Tossed Salad
(carrot, cucumber,
tomato, radish) 1/2 c Steamed
1 c Sliced Raw Vegetables
(tomato, cucumber, onion)
1/2 c Bhindi Bhujia
Cauliflower in Tomato
Broccoli Sauce
1/2 c Tomato and Onion
(cooked with Tikka Kebab)
1/2 c Cooked
Fat 1 2 tsp Sour Cream 1 tsp Oil used in cooking 1 tsp Oil (used in cooking)
Fruit 1 1 Fresh Apple 15 sm Grapes 1 Fresh Apple
Free Foods

Lettuce (for salad) -as desired
2 Thl Reduced Calorie Dressing
C coffee
Tea Tea

BEDTIME SNACK

Fruit/Starch 3 Graham Cracker 1/2 Mango 2 Tangerines
Skim Milk 1 1 c Skim Milk 1 c Skim Milk 1 c Laban

Editor's Notes

(1) The age limit of 20 has no Quranic basis. The actual physical development and tolerance which can precede the physiological age is the criteria here, not the age. If a male diabetic has the physical built and ability of fasting, he should be instructed to fast if he can do it without difficulty or compromising his heatlh as explained in the rest of the article.
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(2) Again the age limit of 20 has no Quranic basis. See note (1). Also the ban on fasting of pregnant females or nursing mothers is not Quranic or called for. Pregnant and or nursing mothers have to assess their own tolearance and ability of fasting. Those who are healthy enough, having mild Dibetes should be able to fast.
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(3) Again. These are general suggestions, not Quranic rules. We should not use the scale to decide when to fast or not. A healthy slightly under weight person has no excuse not to fast, if he/she can. He/she can check with his/her physician if he/she is questioning his/her ability to fast.
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(4) Again. these are generalization that is not necessarily correct. Some COPD or emphysema patients, mild infections, mild coronary artery disease....etc. may be able to fast withut diffclulty or compromising their well being. If in any doubt ask your good submitter (Muslim) doctor.
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Notes are sent to us by Mohammed Shafik, M.D., New York, N.Y.

reference :web .submission.org

Medical benefits, fasting & Diabetes Mellitus

22:36 Posted In , Edit This
From an Articles by Shahid Athar, M.D.

Most Muslims do not fast because of medical benefits but because it has been ordained to them in the Quran. The medical benefits of fasting are as a result of fasting. Fasting in general has been used in medicine for medical reasons including weight management, for rest of the digestive tract and for lowering lipids. There are many adverse effects of total fasting as well as so-called crash diets. Islamic fasting is different from such diet plans because in Ramadan fasting, there is no malnutrition or inadequate calorie intake. The caloric intake of Muslims during Ramadan is at or slightly below the national requirement guidelines. In addition, the fasting in Ramadan is voluntarily taken and is not a prescribed imposition from the physician.

Ramadan is a month of self-regulation and self-training, with the hope that this training will last beyond the end of Ramadan. If the lessons learned during Ramadan, whether in terms of dietary intake or righteousness, are carried on after Ramadan, it is beneficial for one's entire life. Moreover, the type of food taken during Ramadan does not have any selective criteria of crash diets such as those which are protein only or fruit only type diets. Everything that is permissible is taken in moderate quantities.

The only difference between Ramadan and total fasting is the timing of the food; during Ramadan, we basically miss lunch and take an early breakfast and do not eat until dusk. Abstinence from water during this period is not bad at all and in fact, it causes concentration of all fluids within the body, producing slight dehydration. The body has its own water conservation mechanism; in fact, it has been shown that slight dehydration and water conservation, at least in plant life, improve their longevity.

The physiological effect of fasting includes lower of blood sugar, lowering of cholesterol and lowering of the systolic blood pressure. In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension. In 1994 the first International Congress on "Health and Ramadan", held in Casablanca, entered 50 research papers from all over the world, from Muslim and non-Muslim researchers who have done extensive studies on the medical ethics of fasting. While improvement in many medical conditions was noted; however, in no way did fasting worsen any patients' health or baseline medical condition. On the other hand, patients who are suffering from severe diseases, whether diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not try to fast.

There are psychological effects of fasting as well. There is a peace and tranquility for those who fast during the month of Ramadan. Personal hostility is at a minimum, and the crime rate decreases. This psychological improvement could be related to better stabilization of blood glucose during fasting as hypoglycemia after eating, aggravates behavior changes.

Recitation of the Quran not only produces a tranquility of heart and mind, but improves the memory. Therefore, I encourage my Muslim patients to fast in the month of Ramadan, but they must do it under medical supervision. Healthy adult Muslims should not fear becoming weak by fasting, but instead it should improve their health and stamina.

DIABETES MELLITUS AND RAMADAN FASTING

Diabetes mellitus affects people of all faiths. Muslims are no exception. Many diabetic Muslims have a desire to fast during the month of Ramadan, although if they cannot for health reasons, they have a valid exemption. The dilemma for physicians and Muslim scholars is whether or not Muslim diabetic patients (1) should be allowed to fast if they decide to; (2) can fast safely; (3) can be helped to fast if they decide to; (4 ) can have their disease monitored at home; and (5) are going to derive any benefit or harm to their health. Fasting during Ramadan by a Muslim diabetic patient is neither his right nor Islamic obligation, but only a privilege to be allowed by his physician, at the patient's request, knowing all the dangers and assuming full responsibility in dietary compliance and glucose monitoring, with good communication between the physician and the patient .

PSYCHOLOGICAL STATE OF DIABETES DURING RAMADAN

Diabetes mellitus itself adversely affects patients' psychological states by changes in glucose metabolism, blood and CSF osmolality, needs for discipline and compliance, fear of long term complications and threat of hypoglycemic attacks and the possibility of dehydration and coma.

On the other hand, fasting during Ramadan has a tranquilizing effect on the mind, producing inner peace and decrease in anger and hostility. Fasting Muslims realize that manifestations of anger may take away the blessings of fasting or even nullify them.

Diabetics know that stress increases the blood glucose by increasing the catecholamine level and any tool to lower the stress ; ie., biofeedback or relaxation improves diabetic control. Thus, Islamic fasting during Ramadan should have a potentially beneficial effect with regard to diabetic control.

EDUCATIONAL PROGRAM FOR DIABETICS DURING RAMADAN

It should be directed toward (a) diabetic home management; (b) preparing them for Ramadan; (c) recognizing warning symptoms of dehydration, hypoglycemia and other possible complications.

Patients should be taught home glucose monitoring, checking urine for acetone, doing daily weights, calorie-controlled diabetic diet, need for sleep and normal exercise. They should be able to take pulse, temperature, look for skin infection and notice changes in the sensorium ( mental alertness ) . They should be on special alert for any colicky pain, a sign for renal colic, or hyperventilation, a sign of dehydration, and to be able to seek medical help quickly rather than wait for the next day.

CRITERIA ALLOWING DIABETICS TO FAST DURING RAMADAN

  • a. All male diabetics over age 20. Please see editor's note (1).
  • b. All female diabetics over age 20 if not pregnant or nursing. Please see editor's note (2).
  • c. Body weight normal or above ideal body weight. Please see editor's note (3).
  • d . Absence of infection, co-existing unstable medical conditions, ie, coronary artery disease, severe hypertension (B/P 200/120), kidney stones, COPD or emphysema. Please see editor's note (4).
reference :web .submission.org

Manfaat Puasa (sumber : Hembing)

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*Manfaat Puasa Bagi Kesehatan*
Kesehatan merupakan nikmat yang tidak dapat dinilai dengan harta benda.Untuk menjaga kesehatan, tubuh perlu perlu diberikan kesempatan untuk istirahat. Puasa, yang mensyaratkan pelakunya untuk tidak makan, minum, dan melakukan perbuatan-perbuatan lain yang membatalkan puasa dari terbitnya fajar hingga terbenamnya matahari sangat bermanfaat untuk menjaga kesehatan jasmani dan rohani pelakunya.
Puasa dapat mencegah penyakit yang timbul karena pola makan yang berlebihan. Makanan yang berlebihan gizi belum tentu baik untuk kesehatan, karena overnutrisi dapat mengakibatkan kegemukan yang dapat menimbulkan penyakit degeneratif, seperti kolesterol dan trigliserida tinggi, jantung koroner,kencing manis, dan lain-lain.
Pengaruh mekanisme puasa terhadap kesehatan jasmani meliputi berbagai aspek,
diantaranya yaitu :
* Memberikan kesempatan istirahat kepada alat pencernaan
* Pada hari-hari ketika tidak sedang berpuasa, alat pencernaan di dalam
tubuh bekerja keras, oleh karena itu sudah sepantasnya alat pencernaan
diberi istirahat.
* membersihkan tubuh dari racun & kotoran (detoksifikasi) . Puasa merupakan
terapi detoksifikasi yang paling tua. Dengan puasa, berarti membatasi kalori
yang masuk dalam tubuh kita sehingga menghasilkan enzim antioksidan yang
dapat membersihkan zat-zat yang bersifat racun dari dalam tubuh.
* menambah jumlah sel darah putih sehingga dapat meningkatkan daya tahan
tubuh
* menyeimbangkan kadar asam dan basa dalam tubuh
* memblokir makanan untuk bakteri, virus, dan sel kanker,
* mendorong terjadinya pergantian sel-sel tubuh yang rusak dengan yamng baru
(peremajaan)
* meningkatkan daya serap makanan,
* memperbaiki fungsi hormon & meningkatkan fungsi organ tubuh.

Ibadah puasa mengandung banyak hikmah, salah satu hikmah puasa yaitu dapat membantu usaha terhadap pencegahan dan penyembuhan penyakit, antara lain yaitu :
* menurunkan kolesterol dan trigliserida tinggi,
* menurunkan berat badan dan mencegah obesitas (kegemukan),
* mengurangi risiko kencing manis (diabetes mellitus) tipe II
* menurunkan tekanan darah tinggi,
* mencegah pengerasan pembuluh darah,
* mencegah gangguan jantung dan stroke
* pada umumnya maag yang fungsional akan membaik karena puasa
* meningkatkan kuantitas dan kualitas sperma

Makanan Sehat untuk Berpuasa
Disunahkan agar berbuka puasa diawali dengan makan buah kurma, atau dengan buah-buahan dan minuman yang manis seperti madu. Ajaran ini mengandung makna kesehatan karena buah-buahan dan minuman yang manis merupakan bahan bakar siap pakai yang dapat segera diserap oleh tubuh untuk memulihkan tenaga setelah seharian tubuh tidak disuplai oleh makanan dan minuman.
Glukosa yang terkandung di dalam buah-buahan dan minuman yang manis merupakan sumber energi utama yang dapat menggerakkan susunan saraf pusat.Glukosa efektif dibutuhkan ketika tubuh memerlukan masukan energi yang diperlukannya. Namun pada penderita kencing manis (diabetes mellitus) harus berhati-hati, jangan mengkonsumsi makanan dan minuman manis yang berlebihan. Penderita kencing manis harus menghindarkan kadar glukosa darah terlalu
tinggi (hiperglikemia) atau terlalu rendah.
Seperti halnya sarapan, sahur amat perlu untuk mengimbangi zat gizi yang tak diperoleh tubuh selama sehari berpuasa. Anjuran sahur bukan semata-mata untuk mendapatkan tenaga yang prima selama menunaikan ibadah puasa, melainkan juga mengandung makna bahwa puasa perlu persiapan agar selama berpuasa produktivitas kerja dan aktivitas sehari-hari tidak terganggu.
Sebaiknya makanan untuk sahur dipilih yang mengandung serat dan berkuah seperti sayur dan buah-buahan karena dapat mengurangi rasa lapar dan haus. Pada waktu buka puasa dan sahur suplai gizi perlu diusahakan memenuhi unsur-unsur yang dibutuhkan tubuh, meliputi enam jenis zat gizi yaitu karbohidrat, protein, lemak, vitamin, mineral, dan air. Makan yang seimbang
baik dalam porsi maupun gizi akan mempengaruhi susunan saraf pusat dan kondisi biokimia tubuh.
Pada beberapa orang, pada saat puasa mempunyai keluhan seperti merasa lemas dan lesu atau stamina menurun, juga gangguan pencernaan. Beberapa bahan pangan tertentu dapat digunakan untuk mengantisipasi keluhan pada saat berpuasa. Berikut beberapa bahan atau makanan dan minuman sehat untuk berpuasa agar tetap fit, sehat dan segar.
1.Madu
Khasiat : meningkatkan stamina dan mempertahankan stabilitas tubuh agar tetap segar, mencegah gangguan pencernaan, melancarkan metabolisme.
2.Kurma
Khasiat : meningkatkan stamina dan energi, mencegah dan mengatasi anemia, lelah, melancarkan pembuangan.
3.Akar Alang-Alang (Imperata cyllindrica)
Khasiat: menghilangkan haus, melancarkan kemih, mengatasi radang dan batu ginjal, hipertensi, dan lain-lain
4.Rambut dan Tongkol Jagung (Zea mays)
Khasiat : melancarkan kemih, mencegah dan mengatasi batu ginjal, hipertensi,kolesterol tinggi, kencing manis, dll.
5.Kismis
Khasiat : meningkatkan stamina, mencegah lemas dan kurang darah
6.Semangka dan Kulitnya (Citrullus vulgaris)
Khasiat : menghilangkan haus, melancarkan kemih, radang ginjal, prostat.
7.Ubi Jalar Merah (Ipomoea batatas Poir.)
Khasiat: perut kembung, peluruh kentut, masuk angin, gangguan lambung.
8.Temu Lawak (Curcuma xanthorrhiza)
Khasiat : meningkatkan stamina, perut kembung, peluruh kentut, mengatasi masuk angin, gangguan lambung dan pencernaan.
9.Kencur (Kaempferia galanga)
Khasiat : meningkatkan stamina, mengatasi masuk angin, gangguan lambung dan pencernaan seperti kembung, mual, muntah, dan lain-lain.
10.Kunyit (Curcuma longa)
Khasiat : meningkatkan vital energi, mengatasi radang lambung dan gangguan pencernaan (kembung & begah, mual).
11.Jahe (Zingiber officinale)
Khasiat : meningkatkan stamina, mengatasi kembung, masuk angin, pusing, mual dan mencegah muntah
12.Kapulaga (Amomum cardamomum)
Khasiat : mengatasi perut kembung dan sebah, mual, muntah
13.Cengkeh (Eugenia aromatica)
Khasiat : mengatasi muntah karena lambung dingin, mual, kembung
14.Kayu Manis (Cinnamomum burmanii)
Khasiat : mengatasi radang lambung, mual, muntah, kembung.

*Sumber: hembing*
**Made Teddy Artiana*

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Laughter the worst medicine for asthma sufferers

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LAUGHTER is said to be the best medicine, but new research suggests it may actually be harming people with asthma by triggering attacks.

Just under 40 per cent of Australia's two million asthma sufferers experience attacks after chuckling, according to the National Asthma Council Australia.

It is causing some sufferers to avoid situations where they may not be able to stop themselves letting out a laugh.

"When asthma is managed well, people should be able to enjoy life's everyday pleasures, which most of us take for granted," said Professor Christine Jenkins, a lung expert from Sydney's Concord Hospital.

"Worryingly, these findings show that while many believe they have their asthma under control, asthma is actually controlling them and their lifestyles."

The National Asthma Council Australia research found 74 per cent of asthma sufferers believe their condition is well managed but 85 per cent miss out on socialising, exercising or getting a good night's sleep.

About 30,000 asthma sufferers took time off work in July because of their condition, the council said.

The organisation has launched an assessment tool on its website to help people manage the condition better.

"Taking time to complete this lifestyle assessment and discussing the results with a doctor should be a priority for all people with asthma - particularly those who have lived with the condition for a number of years," National Asthma Council Australia chairman Dr Noela Whitby said.


LAUGHTER is said to be the best medicine, but new research suggests it may actually be harming people with asthma by triggering attacks.

Just under 40 per cent of Australia's two million asthma sufferers experience attacks after chuckling, according to the National Asthma Council Australia.

It is causing some sufferers to avoid situations where they may not be able to stop themselves letting out a laugh.

"When asthma is managed well, people should be able to enjoy life's everyday pleasures, which most of us take for granted," said Professor Christine Jenkins, a lung expert from Sydney's Concord Hospital.

"Worryingly, these findings show that while many believe they have their asthma under control, asthma is actually controlling them and their lifestyles."

The National Asthma Council Australia research found 74 per cent of asthma sufferers believe their condition is well managed but 85 per cent miss out on socialising, exercising or getting a good night's sleep.

About 30,000 asthma sufferers took time off work in July because of their condition, the council said.

The organisation has launched an assessment tool on its website to help people manage the condition better.

"Taking time to complete this lifestyle assessment and discussing the results with a doctor should be a priority for all people with asthma - particularly those who have lived with the condition for a number of years," National Asthma Council Australia chairman Dr Noela Whitby said.

Source :web.news.com.au

pengidap asma di larang tertawa

22:45 Posted In Edit This
24/08/2009 23:41

Liputan6.com, Sydney: Tertawa yang sehat selama ini dianggap sebagai obat yang manjur untuk penyakit apapun. Namun, saat ini pernyataan itu tak berlaku lagi. Penelitian terbaru menemukan bahwa tertawa bisa menyebabkan serangan asma. Penelitian ini membuat tawa menjadi permasalahan serius bagi 40 persen dari dua juta penduduk Australia yang mengidap asma.

Seperti diwartakan situs The Times of India, Senin (24/8), survei di internet dilakukan terhadap 200 orang penderita asma. Survei ini dilakukan oleh sebuah universitas dan didukung oleh perusahaan farmasi AstraZeneca. Hasil yang ditemukan adalah tertawa dapat mencetus kambuhnya penyakit pernapasan kronis hingga asma.

Kekhawatiran lain yang muncul dan lebih serius mengenai penelitian ini adalah tiga dari empat penderita asma yang diteliti meyakini bahwa penyakitnya sudah cukup bisa dikendalikan. Mereka menganggap pemicu kambuhnya penyakit asma adalah gaya hidup. Untuk itu, mereka berusaha membatasi gaya hidup demi mencegah timbulnya penyakit ini.

Hasil jajak pendapat itu menggambarkan penelitian Universitas New South Wales (NSW) pada 2004 yang diterbitkan di Journal of Asthma dan penelitian Universitas New York pada 2005 yang bertajuk Laughter May Trigger Asthma Attacks.

Hampir dua dari tiga penderita asma yang diamati kehabisan napas ketika melakukan pekerjaan rumah atau berbelanja. Sedangkan setengah dari jumlah itu terserang asma saat melakukan aktivitas favorit mereka. Lebih dari satu dari tiga penderita merasa kelelahan lantaran tidurnya terganggu penyakit ini. Kemudian satu dari lima lagi membatalkan kegiatan sosial mereka, masih disebabkan oleh asma.

Dokter dari Rumah Sakit Concord Repatriation General Hospital (CRGH), Profesor Christine Jenkins mengatakan asma yang dikendalikan dengan baik takkan menghalangi kesenangan dari kegiatan yang dilakukan. "Yang mengkhawatirkan, penemuan ini menunjukkan bahwa disaat banyak yang percaya mereka sudah bisa mengendalikan penyakit asmanya, justru penyakit itu yang sebenarnya mengendalikan mereka beserta gaya hidupnya," ujar Jenkins seperti dikutip Daily Telegraph.(AND)

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fasting and acute coronary syndromes2

21:46 Posted In , , , , Edit This
RESULTS
During the 10 year period, a total of 20 856 patients were admitted to the coronary care unit and cardiology wards; 8446 of them were Qataris and 12 410 were non-Qataris. There was no significant difference among the three periods (one month before, during, and after Ramadan) in regards to the incidence of AMI (123, 142, and 150 patients, respectively, p > 0.05). Furthermore, the clinical characteristics of these patients such as age (61 (12) years, 62 (14) years, and 60 (13) years), sex (male 76.5%, 72.5%, and 73%), smoking status (23%, 20%, and 26%), presence of hypertension (33.5%, 39%, and 38%), hypercholesterolaemia (23.5%, 25%, and 25%), diabetes (58%, 51%, and 53%), prior AMI (15%, 19%, and 19%), and prior coronary artery bypass grafting (3.2%, 3.5%, and 3%) were not significantly different. Patients who were admitted after Ramadan were more likely to smoke more packets per day of cigarettes when compared to the other two time periods (0.84, 0.91, and 1.32 packets, respectively, p <>
No significant differences were found among patients admitted with UA in the three periods (160, 146, and 147 patients, respectively, p > 0.05). Clinical characteristics of these patients such as age (60 (12) years, 60 (12) years, and 59 (12) years), sex (male 58.8%, 50.0%, and 60%), smoking (17.8%, 9.6%, and 19.2%), presence of hypertension (49%, 54%, and 48%), hypercholesterolaemia (27%, 27%, and 23%), diabetes (51%, 56%, and 59%), and pre-existing cardiac disease were also not significantly different. Statistical analysis showed no significant differences in thrombolysis administration (27%, 25%, and 27%), death (9%, 10.4%, and 10.7%), bleeding (0.3%, 0%, and 0.3%) or stroke (0.3%, 0.7%, and 1%) among patients in the three periods.
DISCUSSION
In this population based study, we found no significant differences in the incidence of AMI or UA during Ramadan when compared to the rest of the year.
Previous studies documented an association between Ramadan fasting and biochemical and hormonal changes. Several investigators reported changes in lipid profile; however, these results were based on a small number of patients and were contradictory.1 Fasting has been associated with variations in the incidence of some diseases, however, the incidence of stroke in Ramadan was not significantly different from the rest of the year.2
Despite the fact that fasting during Ramadan is practised by more than a billion Muslim people worldwide, data on the incidence of cardiac diseases are sparse. There are only two reported studies on the incidence of ACS during Ramadan.3,4 Gumaa and colleagues,4 reported an increase in complaints of angina during Ramadan. More recently, Temizhan and colleagues3 reported no significant differences in the incidence of ACS during Ramadan when compared to one month before and after Ramadan in 1655 patients. However, this study had many limitations including the fact that it was not population based, only included a small number of patients, and did not define the exact number of patients with ACS who were actually fasting. The last point is particularly important, considering the patients were from a community where more than 35% of the population do not regularly fast during Ramadan.4 The current study extends the findings of Temizhan and colleagues3 in a more defined population where more than 95% of the population regularly fast. Furthermore, it describes for the first time complete clinical characteristics, mode of treatment, and outcome of patients with ACS. In conclusion, we speculate that Ramadan fasting does not increase ACS.
Abbreviations
  • ACS, acute coronary syndromes
  • AMI, acute myocardial infarction
  • UA, unstable angina





fasting and acute coronary syndromes

21:39 Posted In , , , , Edit This
Heart. 2004 June; 90(6): 695–696.
doi: 10.1136/hrt.2003.012526.
PMCID: PMC1768280
A population based study of Ramadan fasting and acute coronary syndromes
J Al Suwaidi,1 A Bener,2 A Suliman,1 R Hajar,1 A M Salam,1 M T Numan,1 and H A Al Binali1
1Department of Cardiology and Cardiovascular Surgery, Hamad General Hospital and Hamad Medical Corporation, Doha, State of Qatar
2Department of Biostatistics and Epidemiology, Hamad General Hospital and Hamad Medical Corporation
Correspondence to:
J Al Suwaidi
Department of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation and Hamad General Hospital, PO Box 3050, Doha, State of Qatar; jha01@hmc.org.qa
Accepted September 25, 2003.
Keywords: coronary heart disease, myocardial infarction, unstable angina
Sustained fasting over a period is a feature of several of the world’s great religions. One of the five fundamental rituals of Islam is fasting during the month of Ramadan. Muslims neither eat nor drink anything from dawn until sunset. Fasting may have negative effects on cardiac patients because of the limited time allowed for food intake and the heavy physical worship that is performed after a heavy meal, as well as the inability to take any medications during fasting, which may be essential for the patients.1
Despite the fact that most clinicians worldwide treat Muslim patients, data on the incidence of patients presenting with acute coronary syndromes (ACS) in relation to fasting during Ramadan are lacking. Hence, the purpose of this study is to investigate whether Ramadan fasting has a negative effect on the incidence of presentation with ACS such as acute myocardial infarction (AMI) and unstable angina (UA).
METHODS
This study was based at Hamad General Hospital, Doha, Qatar, which is the only tertiary care centre in the country and so all patients with ACS are treated here. The Hamad General Hospital cardiology database was used for this study; this database comprises data collected from all patients admitted to the cardiology department at the hospital since January 1991. Data were collected from the clinical records by the patients’ physicians at the time of the patients’ hospital discharge according to predefined criteria for each data point. We focused our study only on Qatari patients because it is a stable population and avoids the bias in the fluctuation of the expatriate population in the country. Furthermore, more than 95% of Qatari adults regularly practise fasting. The study was approved by the institution review board.
With the described database, all patients presenting with ACS from the year 1991 to 2001 were identified. Age, sex, risk factors including smoking, hypertension, hypercholesterolaemia, diabetes, pre-existing coronary heart disease, in-hospital mortality and morbidity, as well as acute medical care provided were analysed.
Periods corresponding to the month of Ramadan in the Gregorian calendar have been established, since the lunar calendar is 11–12 days shorter than the solar year. To reduce the effects originating from seasonal changes to a minimum and to use the data as a control, we evaluated patients for one month before, during, and one month after Ramadan by going back and forward from the period of Ramadan (29–30 days) in a particular year.
Data are expressed as mean and standard deviation of the mean. One way analysis of variance (ANOVA) t test, χ2 test, and Fisher’s exact test were used for statistical analysis. A probability value of p <>




Berpuasa bagi Penderita Penyakit Akut

23:59 Posted In , , Edit This
Senin, 10 Agustus 2009 pukul 13:13:00




JAKARTA-- Berpuasa merupakan kewajiban setiap muslim. Nyatanya, manfat puasa memiliki keterkaitan erat dengan kesehatan tubuh. Dunia medis sendiri mengakui, puasa merupakan momen yang tepat bagi tubuh mereparasi diri usai menjalani kegiatan berat selama setahun.
Namun, bagaimana dengan pasien penderita penyakit akut seperti jantung, diabetes, hipertensi dan kanker? Bisakah mereka berpuasa layaknya orang sehat?
Seperti diketahui, banyak pasien yang ingin berpuasa namun terbentur dengan pengobatan yang dijalaninya. Akan tetapi, benturan itu bisa teratasi dengan kordinasi dokter dan pasien dalam menganalisis kemungkinan untuk berpuasa. Dengan begitu, dokter bisa menyalurkan aspirasi keinginan berpuasa pasien, dan pasien bisa menerima segala keputusan dokter tentang kemungkinan berpuasa.
Ahli Cerna Rumah sakit Asri, Jakarta , Dr. Agus Sudiro Waspodo menyatakan kegiatan berpuasa bagi pasien penyakit berat sangat mungkin dilakukan dengan catatan harus melalui kontrol ketat minimal dua minggu sebelum puasa. Dengan kontrol ketat itu, pasien dapat mengetahui bisa atau tidak menjalani kegiatan berpuasa.
"Penderita penyakit yang terkontrol akan dimungkinkan menghindari efek perubahan pola saat berpuasa. Sementara bagi penderita yang belum menjalani kontrol diyakini akan mengalami kesulitan beradaptasi bahkan bisa tergolong membahayakan dirinya sendiri," tutur dia kepada Republika Online, akhir pekan lalu.
Kontrol yang dimaksud menyangkut beberapa aspek seperti kandungan gula darah, tekanan darah dan kandungan kolesterol. Bila ketiga aspek tergolong aman maka dokter pun akan mengizinkan pasien berpuasa. Meski terbilang aman,pasien tetap disarankan waspada dan mengkontrol dirinya sendiri walau dokter turut pula memantau.

Terstruktur
Pendapat yang sama juga diutarakan Ahli Penyakit dalam Kardiovaskular, Rumah Sakit Asri, Jakarta, Dr. Kasim Rasjidi. Menurut Kasim, semua dokter sebenarnya menganjurkan pasien untuk berpuasa. Pasien yang berpuasa akan merasakan bagiamana membentuk sebuah pola gaya hidup yang baik dan terstruktur. Pola yang harusnya bisa dilakukan tidak hanya saat berpuasa tapi dalam keseharian.
Kasim lantas mencontohkan penderita diabetes tipe 2. Puasa bagi penderita diabetes bukanlah sesuatu yang tidak mungkin. Tetap Dengan catatan, pasien harus melalui kontrol gula darah sebelum menjelang puasa guna menghindari resiko komplikasi macam hipoglokemia (kandungan kadar gula dalam darah rendah) dan hiperglokimia (kandungan kadar gula dalam darah rendah). Selain itu,kadar gula pada penderita diabetes disarankan dalam level tinggi.
Kasim menjelaskan, bila kondisi kadar gula dalam darah berada pada level rendah bisa berpotensi besar mengalami hipoglokemia dan berakibat fatal bila diteruskan berpuasa."Otak kita memerlukan pasokan nutrisi berupa glukosa dalam darah. Bila pasokan berkurang maka berdampak pada kerusakan otak," ungkapnya.
Dia menekankan, penderita diabetes harus memperhatikan dua hal yaitu obat dan pola makan. Pola konsumsi obat disesuaikan dengan kondisi dimana obat berfungsi menjaga kadar gula tetap stabil. Sedangkan pola konsumsi pasien tidak berubah, tetap memperhatikan kandungan kalori dan gula dalam makanan. Pasien juga dianjurkan tidak mengkonsumsi makanan olahan yang mengandung gula langsung.
"kebutuhan makanan disesuaikan dengan tubuh, Dengarkan tubuh kita. Setelah itu ikuti dengan pengobatan dan kebiasaan makan," ujarnya. Kasim mencontohkan,pasien boleh mengkonsumsi nasi putih asalkan tetap memperhatikan kadar kalori dan gulanya.

Dikendalikan
Sama halnya dengan penderita diabetes, bagi penderita penyakit jantung dan kanker juga dimungkinkan berpuasa. Yang paling penting diperhatikan pada penyakit jantung korone yagn tercatat sebagai penyebab kematian nomor satu di dunia yaitu pengendalian faktor pencetus pada saat berpuasa.
Faktor risiko yang bisa dikontrol atau diubah adalah pola makan, kebiasaan bergerak, merokok, kondisi hipertensi, status diabetes, dan kelebihan berat badan dimana faktor pencetusnya adalah stres dan alkohol. ”Dengan berpuasa, segala faktor pencetus dapat dihindari. Makan menjadi lebih teratur, kebiasaan merokok terkurangi, pikiran lebih tenang sehingga jauh dari stres,” tutur Kasim.
Dengan berpuasa, maka kelebihan berat badan sebagai salah satu faktor risiko penyakit jantung koroner dapat dikurangi. Hasil dari berpuasa sehat bisa menyebabkan tekanan darah dan keseimbangan kadar kolesterol ataupun gula darah menjadi terkontrol.
Demikian pula dengan penyakit kanker, khusus diluar penyakit yang menyerang pencernaan semisal kanker serviks dan payudara memang dimungkinkan berpuasa. Akan tetapi penggunaan obat dalam beberapa jenis kanker yang mengakibatkan efek muntah tentu menjadi pertimbangan untuk tidak berpuasa.
Pada akhirnya, baik dari kedua dokter berpendapat apa yang diinginkan pasien untuk berpuasa tergantung dengan kondisi, niat dan kepatuhan pasien terhadap anjuran dokter. Dengan begitu ragam resiko bisa dihindari saat berpuasa. (cr2/rin)
Sumber Republika Newsroom

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Now sperm can have a health check-up.

22:23 Posted In , , Edit This
Childless couples who have filed for years to start a family may benefit from a new test developed by doctors at Baylor College of Medicine Baylor College of Medicine is a private medical school located in Houston, Texas, USA on the grounds of the Texas Medical Center. It has been consistently rated the top medical school in Texas and among the best in the United States. in Houston.

Microsperm penetration assay (micro-SPA) is a modified version of the standard test that measures sperm quality in men with low sperm counts. "The micro-SPA is a valuable diagnostic tool for assessing the sperm's health," says Dr. Larry Lipshultz, a professor of urology at Baylor. "It is a reliable test that may help us better understand the man's role in infertility."

One out of six American couples are infertile in·fer·tile adj.Not capable of initiating, sustaining, or supporting reproduction.


infertile,

adj unable to produce offspring. , many of whom have no history of reproductive disorders. In half of these cases, the problem is attributed to male infertility.

In the micro-SPA, hamster eggs are paired with the patient's sperm in a specially designed test tube. Results are based on the number of sperm that penetrates each egg. Dr. Lipshultz says that, unlike other routine fertility tests, the micro-SPA provides doctors with useful clues on sperm function. "For example, a semen analysis Semen Analysis Definition

Semen analysis evaluates a man's sperm and semen. It is done to discover cause for infertility and to confirm success of vasectomy. will only tell you the number and movement of sperm, but not if the sperm are capable of fertilization," he says.

Surgery or medication is usually the next step in improving sperm quality and its ability to travel from the testes testes
or testicles

Male reproductive organs (see reproductive system). Humans have two oval-shaped testes 1.5–2 in. (4–5 cm) long that produce sperm and androgens (mainly testosterone), contained in a sac (scrotum) behind the penis. to the egg. However, assisted reproductive techniques--such as placing sperm into the uterus-- can be an alternative if medical and surgical treatments are ineffective. Although these new treatments can be beneficial, they can be time-consuming and costly.

"The micro-SPA helps us determine if the sperm is capable of in vitro in vitro /in vi·tro/ (in ve´tro) [L.] within a glass; observable in a test tube; in an artificial environment.

in vi·tro adj.In an artificial environment outside a living organism. (in a test tube) fertilization," says Dr. Lipshultz. "Couples who take the micro-SPA before entering an in vitro fertilizationprogram may save themselves unnecessary anxiety, time and money." The SPA's predictions are fairly accurate, he says, although no fertility test is 100 percent successful. In many cases, it is just a matter of time.

"It takes some perfectly healthy young couples under age 30 six months to a year to get pregnant," he says. "If a man or woman has had surgery or injury to the reproductive tract or suspects a problem, they should get an early checkup from their urologist or gynecologist gynecologist /gy·ne·col·o·gist/ (-kol´ah-jist) a person skilled in gynecology.
gy·ne·col·o·gistn.A physician specializing in gynecology. , respectively."

reference :web.thefreelibrary.com

Kapan Harus Periksa Sperma? Taoge Bikin Subur?

21:21 Posted In , Edit This

Minggu, 16 Agustus 2009


Ilustrasi: Aries Tanjung/NOVA

1. Jika istri tidak hamil setahun setelah menikah, meski sudah melakukan hubungan seksual secara teratur (2-3 kali seminggu tanpa KB).

2. Jika saat menikah istri berusia 35 tahun, tapi belum juga hamil 6 bulan setelah menikah, dan melakukan hubungan seksual secara teratur.

3. Jika saat menikah istri berusia 40 tahun, tapi belum juga hamil 3 bulan setelah menikah, dan melakukan hubungan seksual secara teratur.

4. Jika ketiga hal tadi menimpa, ada baiknya segera menemui dokter untuk dilakukan pemeriksaan. Yang paling mudah, memeriksa suami dengan analisis sperma. Namun, yang ideal adalah melakukan pemeriksaan pada kedua pihak, baik istri maupun suami. Analisis sperma pun tak boleh dilakukan sembarangan, karena hasilnya bisa bias. Yang paling tepat adalah melakukan analisis sperma ke klinik kesuburan.

Hasto

Sabtu, 15 Agustus 2009

Benarkah Taoge Bikin Subur?

Ilustrasi: Aries Tanjung

Banyak orang bilang, makan cumi bisa membuat pria subur. Ada juga yang meyakini, taoge akan meningkatkan jumlah dan kualitas sperma. “Banyak mitos yang merugikan pasien. Semua makanan tidak ada yang sangat baik atau sangat buruk, semuanya baik, tapi harus seimbang,” kata Nugroho. (dr. Nugroho Setiawan, MS, Sp.And. )

Alasannya, setiap makanan punya kelebihan dan kekurangan, jadi harus seimbang. “Kalau makan cuminya berlebihan, misalnya, kan, tidak bagus juga.” Lalu, bagaimana dengan taoge? Menurut Nugroho, jika cuma makan taoge saja, ya jelas tidak sehat.

“Ada saatnya kita harus bersikap rasional. Secara teori, taoge memang mengandung vitamin E. Tapi, satu tampah taoge jika diekstraksi hanya akan menjadi sebutir pil vitamin E. Jadi, harus kembali ke penyebabnya. Kalau penyebab kurang suburnya karena kekurangan vitamin E, makan taoge mungkin bisa membantu. Tapi kalau penyebabnya varikokel, taoge setampah setiap hari pun enggak ada gunanya,” lanjut Nugroho.

Hasto Prianggoro

Reference : web Tabloid Nova


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Gaya Hidup Sehat Bikin Sperma Kuat (2)

21:16 Posted In , Edit This

Jumat, 14 Agustus 2009


Ilustrasi: Aries Tanjung/NOVA

Jaga Suhu
Kualitas sperma juga dipengaruhi oleh gaya hidup. Gaya hidup yang baik antara lain dengan istirahat cukup, olahraga secara teratur, berat badan ideal, makan berimbang, serta tidak punya kebiasaan buruk seperti merokok atau minum minuman keras.
“Faktor lain yang juga ikut menentukan kualitas sperma adalah tidak memiliki riwayat penyakit yang mengganggu kesehatan, baik penyakit sistemik seperti hipertensi atau diabetes, maupun penyakit lokal yang mengganggu fungsi produksi sperma,” terang Nugroho.
Gangguan pada testis pun bisa mengganggu kualitas sperma. “Testis akan memproduksi sperma-sperma yang baik bila temperaturnya lebih rendah daripada suhu tubuh, kira-kira 36,7 derajat Celcsius. Makanya, testis diberi kantung yang menggelantung. Kalau kedinginan, kantung akan tertarik ke atas, kalau kepanasan tertarik ke bawah.”
Gangguan pada testis bisa disebabkan oleh banyak faktor, misalnya kebiasaan. “Pakai celana dobel-dobel sehingga buah pelir jadi panas, memakai celana sangat ketat, sehingga kantung buah pelir malah lekat ke tubuh dan menaikkan temperatur. Kalau temperatur pada testis lebih panas, kualitas sperma yang diproduksi akan menurun. Sama seperti kita bekerja dalam ruang kerja yang panas karena AC mati, pasti kualitas kerja akan menurun,” terang Nugroho.
Selain kebiasaan, jenis pekerjaan juga patut diwaspadai sebagai penyebab kualitas sperma menurun. Misalnya, pekerjaan sebagai tukang masak, dimana testis selalu terpapar suhu panas dari kompor atau oven. Atau pekerjaan sebagai supir kendaraan yang membuat testis selalu terpapar oleh panas mesin kendaraan.
“Ada yang bilang, naik sepeda motor bisa membuat laki-laki mandul. Tapi, sebetulnya tidak segampang itu. Kalau mesin motor jauh dari testis, tidak akan berpengaruh, kok,” jelas Nugroho. Sering mandi di bathtub dengan air panas juga bisa membuat suhu testis jadi lebih panas. Akibatnya, kualitas sperma turun.
Gangguan pada testis bisa juga disebabkan penyakit yang menyertai maupun penyakit bawaan. Penyakit yang paling banyak menyertai orang dengan gangguan sperma adalah pelebaran pembuluh darah balik di sekitar testis (plexus spermatikus), yang disebut varikokel atau kantung pelir terlalu tebal akibat peradangan kulit.
“Suhu yang harusnya lebih dingin karena ada ventilasi, jadi lebih panas. Itu sebabnya kantung pelir bentuknya berlekuk-lekuk. Tujuannya untuk membuang panas, seperti radiator mobil.” Jika terjadi kelainan pada sperma, entah karena jumlah, bentuk, maupun geraknya, yang harus dilakukan adalah mencari penyebabnya lebih dulu.
“Ada pria yang mengaku spermanya encer. Padahal, bagaimana ia bisa tahu kalau spermanya encer. Yang paling tepat adalah ke dokter dan melakukan analisis sperma. Kenapa, kok, kualitasnya jelek, jumlahnya kurang, atau bentuknya tidak normal, harus dicari dulu. Setelah penyebabnya ketemu, pengobatan akan bisa sempurna,” katanya.

Hasto Prianggoro
reference : web tabloid Nova

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making healthy choices ,Dr. Don Colbert, MD

02:08 Posted In , , , , , , , , , , Edit This
Reclaim your healthy self!
From the truth about tap water to the ultimate insomnia strategies,

the dynamic physician and author of Toxic Relief is back

to reveal the seven core principles of whole-body health—

a fifty-day plan for lifelong rejuvenation.

THE SEVEN PILLARS OF HEALTH

The Natural Way to Better Health for Life

Don Colbert, MD

“These are not the seven ‘fads’ of health or the seven ‘theories’ of health, but the seven pillars of health. Backed up by medical research and my actual experiences with real problems and real people that span more than two decades of practice, these seven pillars have contributed health and freedom to thousands of people. … It won’t take more work on your part. You will simply exchange old habits for new ones.”

—Dr. Don Colbert

Everyone seems to have a special health remedy these days: Pilates specialists, raw-food specialists, sleep-disorder specialists, air-purification specialists, and of course countless “diet” specialists. But Dr. Don Colbert knows first-hand that good health is not the result of trendy “discoveries” by pseudo-scientists or one luminary’s expertise in an isolated field. After more than twenty years as a board-certified family physician, Dr. Colbert realizes that good health is based on synergy—multiple components working together to make you feel great. Now Dr. Colbert brings these essential building blocks together in one powerful resource, THE SEVEN PILLARS OF HEALTH: The Natural Way to Better Health for Life (Publication Date: January 2, 2007; Published by Siloam, an Imprint of Strang Communications; ISBN 1-59185-815-1; 304 Pages; $19.99).

Designed so that readers can incorporate the concepts a day at a time, THE SEVEN PILLARS OF HEALTH takes only fifty days to complete in exchange for a lifetime of wellness. In this primer and its supplemental workbook, Dr. Colbert reveals how changing just a few simple habits can lead to dramatic recoveries, as seven crucial pillars are repaired:

#1 Water: Most of us know the dangers of dehydration, but do you know how to hydrate properly? Dr. Colbert goes beyond explaining how much water we should drink each day and thoroughly assesses the various types of bottled water on the market, provides a website for checking the water quality in your area, and explains the science of filtration systems to ensure that your water isn’t doing more harm than good.

#2 Sleep and Rest: Discover the causes of insomnia, the keys to a perfect night of sleep, and the truth about sleep aids (both herbal and pharmaceutical). Dr. Colbert also reveals why beauty rest is so important; sleep and rest (along with water) are key secrets to looking younger.

#3 Living Food: Give your menu a makeover, eliminating the “dead” foods that are full of chemicals. From choosing the right grains and the right proteins to fighting diabetes and high cholesterol, Dr. Colbert delivers a fact-packed guide to eating well, with eye-opening information on irradiated foods, artificial sweeteners, the canola-oil controversy, going organic, and whether Teflon and plastics cause cancer during food storage and preparation. He also exposes the hidden dangers of MSG (with ways to minimize your intake) and debunks the myth of fat-free “nutrition,” clarifying which fats are good for you and essential.

#4 Exercise: What kind? How often? How long? If exercise always falls to the bottom of your to-do list, Dr. Colbert has a new approach—revealing new benefits and options that include ballroom dancing—to get you moving.

#5 Detoxification: When Dr. Colbert talks about detoxification, he is not prescribing a dubious “cleanser cocktail.” Instead, he addresses the ways you can reduce toxicity in your body and your environment on a continual basis, with solutions for minimizing your risk. His research spans everything from air pollution to mercury dental fillings, from poisonous household products to dust mites and second-hand smoke, with ways to spark the body’s natural detox organs (and a handy chart for balancing acid- and alkaline-forming foods).

#6 Nutritional Supplements: They’re not just for people who eat unbalanced meals. Agribusiness has depleted much of America’s farming soil, growing produce that actually contains fewer nutrients. But the world of supplements is complex (there are eight different forms of Vitamin E alone). Dr. Colbert’s expert guidance includes a complete exploration of antioxidants, current debates regarding specific supplements, and nutrient charts for essential foods. He also tells readers, according to their age, exactly what they need to take daily, walking them through the maze of information now available on this topic.

#7 Freedom from Stress: From the healing powers of abdominal breathing and laughter to reframing your perception of even the most seemingly dire circumstances, Dr. Colbert opens a path to physiological and emotional well-being—culminating in a foundation of spiritual peace.

One of the country’s foremost authorities on the integration of natural and conventional health care, Dr. Colbert brings a twenty-first-century approach to a field popularized by best-selling physicians such as Andrew Weil. He writes in a friendly, non-threatening tone that blends proven science with stress-reducing spirituality. As they master a pillar each week, readers will find daily special “points to ponder” and “action steps,” plus fascinating charts, sidebars, and quizzes to clarify every step of the plan.

In the head-to-toe tradition of Michael Roizen and Mehmet Oz’s #1 New York Times best-seller You: The Owner’s Manual, THE SEVEN PILLARS OF HEALTH is a comprehensive guide to renovating your “primary residence,” the body that will house you for the rest of your life.

ABOUT THE AUTHOR

Don Colbert, M.D., is a board-certified family practice physician, a best-selling author, and a dynamic public speaker. Over the past twenty years, he has treated more than 25,000 patients, always integrating body, mind, and spirit into each of his healthcare strategies. His tremendously popular books, including Stress Less: Breaking the Power of Worry and Other Destructive Habits and the best-seller Toxic Relief, top 4 million copies in print. He and his wife, Mary, live in Orlando, Florida.

THE SEVEN PILLARS OF HEALTH: The Natural Way to Better Health for Life Publication Date: January 2, 2007

reference : web sevenpillarsofhealth.com


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