Care for People with Diabetes during The Moslem Pilgrimage (Haj) An Overview

Haj is one of the five cardinal components of Islam commonly known as the five pillars of Islam. Approximately two million Muslims perform it each year. Haj involves travel to the holy sites in and around Mecca and Medina during a specified short period of time in a limited space, not usually inhabited by such a large number of people. This article deals with the effects of this event on diabetes and its management. The importance of this arises from the fact during Haj, the person's life routine changes as he travels to a different place of his own for a period of 4–6 weeks where geography, weather, diet, and habits are different. During Haj most people live what is effectively a very basic life in very crowded places. Therefore, medical conditions, such as diabetes, whose management depends on a stable routine, would predictably be affected significantly. People with diabetes should have enough time to consider a management plan for their diabetes. The objectives are to achieve a good control and avoid any complications that may be particularly associated with the conditions faced during Haj

Practical Management of Diabetes during Ramadan Fast

Fasting in Ramadan is obligatory for all healthy Muslim adults. No food or drink may be consumed between dawn and sunset [1]. Strictly speaking, the fast of Ramadan is a period of “intermittent fasting” or daily cycles of “alternating” fasting and feeding periods. The periods of the fasting and feeding vary by the geographical locations and by time of the year. During the month of Ramadan, there are two main meals in most Moslem communities. These are commonly referred to by their Arabic origin, namely the “Iftar” (i.e. break of fast immediately after sunset) and “Sohur or Suhoor” (i.e. pre-dawn meal). As the Islamic calendar year is lunar, Ramadan (the ninth month) therefore starts approximately 10 days earlier each year on the Gregorian calendar. This year, 2007, Ramadan is likely to start between 12th and 14th September

A Social Identity Approach to Sport Psychology: Principles, Practice, and Prospects.

Drawing on social identity theory and self-categorization theory, we outline an approach to sport psychology that understands groups not simply as features of sporting contexts but rather as elements that can be, and often are, incorporated into a person's sense of self and, through this, become powerful determinants of their sport-related behavior. The underpinnings of this social identity approach are outlined, and four key lessons for sport that are indicative of the analytical and practical power of the approach are presented. These suggest that social identity is the basis for sports group (1) behavior, (2) formation and development, (3) support and stress appraisal, and (4) leadership. Building on recent developments within sport science, we outline an agenda for future research by identifying a range of topics to which the social identity approach could fruitfully contribute

Risk of hyperkalemia in patients with moderate chronic kidney disease initiating angiotensin converting enzyme inhibitors or angiotensin receptor blockers : a randomized study

Background: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are renoprotective but both may increase serum potassium concentrations in patients with chronic kidney disease (CKD). The proportion of affected patients, the optimum follow-up period and whether there are differences between drugs in the development of this complication remain to be scertained. Methods: In a randomized, double-blind, phase IV, controlled, crossover study we recruited 30 patients with stage 3 CKD under restrictive eligibility criteria and strict dietary control. With the exception of withdrawals, each patient was treated with olmesartan and enalapril separately for 3 months each, with a 1-week wash-out period between treatments. Patients were clinically assessed on 10 occasions via measurements of serum and urine samples. We used the Cochran-Mantel-Haenszel statistics for comparison of categorical data between groups. Comparisons were also made using independent two-sample t-tests and Welch's t-test. Analysis of variance (ANOVA) was performed when necessary. We used either a Mann-Whitney or Kruskal-Wallis test if the distribution was not normal or the variance not homogeneous. Results: Enalapril and olmesartan increased serum potassium levels similarly (0.3 mmol/L and 0.24 mmol/L respectively). The percentage of patients presenting hyperkalemia higher than 5 mmol/L did not differ between treatments: 37% for olmesartan and 40% for enalapril. The mean e-GFR ranged 46.3 to 48.59 ml/mint/1.73 m2 in those treated with olmesartan and 46.8 to 48.3 ml/mint/1.73 m2 in those with enalapril and remained unchanged at the end of the study. The decreases in microalbuminuria were also similar (23% in olmesartan and 29% in enalapril patients) in the 4 weeks time point. The percentage of patients presenting hyperkalemia, even after a two month period, did not differ between treatments. There were no appreciable changes in sodium and potassium urinary excretion. Conclusions: Disturbances in potassium balance upon treatment with either olmesartan or enalapril are frequent and without differences between groups. The follow-up of these patients should include control of potassium levels, at least after the first week and the first and second month after initiating treatment

Whole organisms or pure compounds? entourage effect versus drug specificity

As the therapeutic use of sacred plants and fungi becomes increasingly accepted by Western medicine, a tug of war has been taking place between those who advocate the traditional consumption of whole organisms and those who defend exclusively the utilization of purified compounds. The attempt to reduce organisms to single active principles is challenged by the sheer complexity of traditional medicine. Ayahuasca, for example, is a concoction of at least two plant species containing multiple psychoactive substances with complex interactions. Similarly, cannabis contains dozens of psychoactive substances whose specific combinations in different strains correspond to different types of therapeutic and cognitive effects. The “entourage effect” refers to the synergistic effects of the multiple compounds present in whole organisms, which may potentiate clinical efficacy while attenuating side effects. In opposition to this view, mainstream pharmacology is adamant about the need to use purified substances, presumably more specific and safe. In this chapter, I will review the evidence on both sides to discuss the scientific, economic, and political implications of this controversy. The evidence indicates that it is time to embrace the therapeutic complexity of psychedelics.2019-07-3

Corrosion Protection Effect of Chitosan on the Performance Characteristics of A6063 Alloy

This article outlines the behaviour of water-soluble chitosan as an effective inhibitor on aluminium alloy in 3.65% NaCl at room temperature. The inhibitive ability of water-soluble chitosan was examined using electrochemical potentiodynamic polarization techniques, mass loss measurements and computational studies. The outcome of the experiment reveals that chitosan inhibited aluminium alloy in sodium chloride solution exhibits better corrosion protection than the uninhibited because chitosan nanoparticles minimize the ingression of chloride ion into the active sites of aluminium alloy by forming thin film on its surface. The losses in mass by the inhibited aluminium alloy were found to reduce as the concentration of chitosan increases. Results obtained showed that chitosan could offer inhibition efficiency above 70%. Polarization curve demonstrated that chitosan in 3.65% NaCl at room temperature acted as a mixed-type inhibitor. Adsorption of chitosan nanoparticles on the aluminium alloy was found to follow Langmuir adsorption isotherm with correlation regression coefficient (R2 ) value of 0.9961