Salam alaikum,
Thought to revisit here after a sporadic hiatus owing to a bit of
blogathy & more of
blogstipation really.
Its been a while since I've been
pestering insisting my spouse to maintain an online collection of her learning experiences. Not only will it serve as a first hand experience narrative, but may prove to be priceless resource in the long run too (inshAllah).
But, as it turns out.. there are some time issues in way of sitting & organizing thoughts, i suppose - a difficult thing indeed.
Nonetheless, every now & then i'll be posting here whatever bits I receive from her & reproduce them as is (albeit a lil face-lifting though :p) on this blog of mine, till such time i set up a new one for her own personal use.
Title of such entries will remain the same, as in; 'Med Shreds' with a sequel #.
Here goes the first one;
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By: Dr. Naz. S.
I got convinced lately, that there are not many informal cancer resources online. None in Riyadh that I know of.
I've been told that jotting down daily learning in a bullet form, will help boost the response in upcoming challenges.
I've also been told that if I do that, it'll be like an online encyclopedia for people to cross reference on things I've recollected over time.
So, after making a good intention, of sharing knowledge in which ever way possible for the greater benefit of humanity, I will be writing (inshAllah) from now onwards.
He was an
inspirational speaker, a visionary & carried out revolutionary work in health & education sectors.
Its been long since
King Faisal died an
unexpected death.
But his hospital which was inaugurated in 1975, still continues to be (sadqah jariyah) one of he best in whole of the middle east, its research center being the only recognized center of excellence in the whole region (besides israel).
The other day I heard Dr saheb ask tess; "Is the new physician at her seat?.. if yes send her in!"
I kind of felt like being summoned for another viva. But times have changed. Gone are the golden soul crushing days of med school life.
The discussion that day was just about how things were going with me, & if i was finding the patient follow up work interesting at all.
Dr. Saheb, who is an Allama Iqbal med school graduate, a Brooklyn Downstate hospital trained M.D., a Medical Oncologist Consultant, was narrating how the center has achieved yet another prestigious membership of an International Cancer Research body, & the amount of effort placed into it in terms of patient follow up & data collection.
In the course, he asked me to define a one liner difference between a
tumor stage & a
tumor grade, also asked me to describe in a sentence whats a tumour marker, where is it produced, its role?
Then went on to ask for types & phases of clinical trial (of which i was unaware, as i am fairly new to this kind of stuff)
He gently asked me to go grab a gist of what a clinical trial is, its origin prerequisites, & get a grip of its phases etc, & get back to him with whatever i gained..
I started exploring & reading & came to know the basic salient stand points that demarcate Clinical trials on humans from those on animals.
Although it is understandable to focus on goals of contributing to the field of science, keeping in mind our society values & the rights and welfare of individuals, but it is not considered ethical behavior to use humans solely as means to an end.
So, in order to exhibit & lay down the importance of demonstrating respect for research participants, there are certain set of principles used to define ethical research and the regulations, policies, and guidance.
In my self study session for the given assignment, I came to know that the first ever concept of a Clinical Trial (more so an ethical clinical trial) was introduced by Ibn e Seena (Aivcenna) in 1025 A.D in his bool
Al-Qanoon fi al-Tibb (The Canon of Medicine).
It was a time when Muslim world was the pioneer in Research & Development.
He laid down rules for the experimental use and testing of drugs on human subjects, and wrote a precise scientific guide for practical experimentation for discovering and proving the effectiveness of medical drugs.
Ibn Abd Allah ibn Sina simple rules and principles for testing the effectiveness of new medications form the basis of modern clinical trials:
- The drug must be free from any extraneous accidental quality.
- It must be used on a simple, not a composite, disease.
- The drug must be tested with two contrary types of diseases, because sometimes a drug cures one disease by its essential qualities and another by its accidental ones.
- The quality of the drug must correspond to the strength of the disease. For example, there are some drugs whose heat is less than the coldness of certain diseases, so that they would have no effect on them.
- The time of action must be observed, so that essence and accident are not confused.
- The effect of the drug must be seen to occur constantly or in many cases, for if this did not happen, it was an accidental effect.
- The experimentation must be done with the human body, for testing a drug on a lion or a horse might not prove anything about its effect on man.
Qanoon (which means "law" in Arabic), the Canon of Medicine remained a medical authority up until early 19th century. It set the standards for medicine in Europe and the Islamic world, and is Abu Ali ibn AbduLLAh's most renowned written work alongside Kitab al-Shifa (The Book of Healing).
Qanoon was used at many medical schools—at University of Montpellier, France for instance, as late as 1650, to understand the basis & ethics of research. Much of the book was also translated into Chinese as the Huihui Yaofang (Prescriptions of the Hui Nationality). The Canon also formed the basis of Unani medicine, a form of traditional medicine practiced in subcontinent.
The principles of medicine described by the Qanoon ten centuries ago are still taught at UCLA and Yale University, among others, as part of the history of medicine.
Then I came to know that physician Frederick Akbar Mahomed of subcontinent origin, who worked at Guy's Hospital in London made substantial contributions to the study of high blood pressure during his short professional career from 1872 to 1884, when he died at the age of 35.
In the process of clinical trials during his detailed clinical studies, he separated chronic nephritis with secondary hypertension from what we now term in medical as 'essential hypertension'.
He also founded 'the Collective Investigation Record for the British Medical Association'; this organization collected data from physicians practicing outside the hospital setting (extramural) and was the precursor of modern collaborative clinical trials & medical transcription.
Another famous clinical trial was James Lind's demonstration in 1747 that citrus fruits cure scurvy disease. He compared the effects of various different acidic substances, ranging from vinegar to cider, on groups of afflicted sailors, and found that the group who were given oranges and lemons had largely recovered from scurvy after 6 days.
Dr. Saheb asked me to take a 3 hours online certification exam on
'Protecting Human Research Participants in clinical trials.'
It was basically a test of medical ethics, mainly regarding how to be gentle, generous & at the same time meticulous with your patients.
Questions revolved around some basic qualities like
Justice,
Beneficence &
Respect for persons, their medical rights, their
Anonymity & their
Autonomy.
I scored 20 out of 21 (alhamduliLLAh).
Its just the beginning of the journey full of learning & serving & sawab (hopefully)
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