Bila Khalik Mengeluarkan Perintah

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ALLAH SAW telah berfirman:
Dan apabila dikatakan kepada mereka: Janganlah kamu melakukan kerosakan di muka bumi, mereka menjawab, "Sesungguhnya kami orang-orang yang melakukan perbaikan." Ingatlah, sesungguhnya mereka itulah orang-orang yang membuat kerosakan, tetapi mereka tidak sedar. (Al Baqarah - ayat 11 dan 12).

Bayangkanlah, makhluk yang dicipta Oleh Allah SAW khusus untuk menjadi khalifah di bumi tetapi akhirnya makhluk itu memungkiri janji dengan melakukan kerosakan yang tidak terkira besarnya.

Oleh itu umat manusia tidak harus menyalahkan Pencipta apabila hamba-hamba-Nya yang patuh dan taat menurut PerintahNya iaitu awan, angin dan bumi menimpakan musibah ke atas mereka. Ketika itu ada manusia yang sedar betapa rapuhnya nyawa mereka.

Sepanjang tahun 2011, kita dilanda berbagai bencana alam yang maha dahsyat. Bermula awal Januari, banjir kilat menyebabkan bermacam kemusnahan di Brazil, selatan Afrika dan Australia. 

Bencana berikutnya berlaku pada 11 Mac apabila gempa bumi berukuran 9.0 skala Richter melanda Jepun, sekaligus mencetuskan tsunami dan seterusnya krisis nuklear terbesar di negara Matahari Terbit itu. Jepun yang selama ini bangga dengan tahap keselamatan loji nuklearnya di Fukushima terpaksa menundukkan kepala penuh malu.Beribu-ribu rakyatnya kehilangan kediaman dan punca rezeki.    

Negara Uncle Sam juga tidak terkecuali kerana dilanda bencana bertali arus seperti ribut taufan, kemarau dan kebakaran hutan yang membawa kerugian tidak terhingga. Tuntutan insurans berjumlah AS$100bilion bagi bencana alam tahun ini merupakan yang kedua besarnya selepas tuntutan akibat Taufan Katrina.

Pada 25 Julai dan minggu-minggu selepasnya, ibu negeri Gajah Putih pula dilanda banjir terbesar dalam sejarah negara tersebut. 313 orang terkorban dan menyebabkan berbagai industri mengalami kerugian. Di kaca televisyen kita dapat saksikan sendiri bagaimana kereta yang telah siap dipasang dan bakal dieksport terapung bagaikan bunga-bunga kapas. Tidak dikira lagi sawah padi yang tenggelam. 

Kerugian yang dihadapinya turut menjejaskan import beras negara kita sendiri kerana terpaksa beralih ke negara-negara lain untuk mendapatkan bekalan makanan ruji itu. 

Di negara kita pun tidak kurangnya. Pada 21 Mei kita dikejutkan dengan berita rumah anak-anak yatim di Hulu Langat runtuh akibat gelinciran tanah yang menyebabkan beberapa orang penghuninya maut. Ia berlaku kerana manusia gagal mentafsir petanda-petanda yang telah muncul beberapa hari sebelum itu.

Daerah Dungun di Terengganu yang memang sentiasa dibadai ombak dan hujan lebat pada setiap kali musim tengkujuh, kali ini menghadapi kerosakan besar. Ia berlaku pada Hari Krismas lalu dan beberapa hari selepas itu. Saya tidak dapat menyaksikan dengan mata kepala sendiri kerana keluarga saya telah pulang semula ke Kuala Lumpur selepas bercuti di sana.

Ternyata, jalan menyusuri Pantai Teluk Lipat yang selama ini selalu saya guna untuk ke Pasar Besar Dungun dan Pasaraya Mydin dari kediaman kami di Jalan Taman Bersatu kini tinggal selorong sahaja. Ini bererti saya mesti mengubah laluan ke Jalan Yahya Ahmad yang kini sedang dalam pembinaan. 

Usia bumi ini sudah terlalu sangat tua. Ia sudah “letih” menanggung maksiat yang dilakukan oleh penghuninya. Semua musibah itu bagaikan "batu-batu kecil yang dilempar oleh Allah SAW".

Kita redha dengan segala yang berlaku. Itulah cara Allah SAW menginsafkan kita yang selalu lalai mentaati perintah-Nya. Dalam setiap musibah memang ada hikmah. Kita akan mendapatinya jika diri sentiasa bermuhasabah.

Swinging Like A Pendulum

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A FEW nights without sleep can not only make people tired and emotional but may actually put the brain into a primitive “fight or flight” state, researchers say.  

Brain images of otherwise healthy men and women showed two full days without sleep seemed to rewire their brains, redirecting activity from the calming and rational prefrontal cortex to the “fear centre” – the amygdala.  

“It’s almost as though, without sleep, the brain had reverted back to more primitive patterns of activity, in that it was unable to put emotional experiences into context and produce controlled, appropriate responses,” said Matthew Walker of the University of California Berkeley, who led the study.   

That a lack of sleep can make people grumpy is hardly news.  

“We all know implicitly the link between bad sleep the night before and bad mood the next day. We are just adding the brain basis to what we knew,” he said.  

Walker and colleagues at Harvard Medical School in the United States used functional magnetic resonance imaging, which can scan brain activity in real time, to see what was going on in the brains of 26 young adult volunteers. Half were kept awake for a day, a night and another full day. The other half slept as normal. 

Writing in the journal Current Biology, Walker’s team said they noticed profound changes in the brain activity of those volunteers who stayed up.  

“We found a strong overreaction from the emotional centres of the brain,” he said. “It was almost as if the brain had been rewired, and connected to the fright, flight or fight area in the brain stem.”  

And lab workers noticed a difference in the behaviour of the sleep-deprived volunteers.  

“They seemed to swing like a pendulum between the broad spectrum of emotions,” he said. “They would go from being remarkably upset at one time, to the point where they found the same thing funny. They were almost giddy – punch drunk.”  

Next, Walker wants to test people who are chronically sleep-deprived, perhaps by letting them have just five hours of sleep over several days. The average adult needs seven to nine hours of sleep a night. 

He said the findings may shed light on psychiatric diseases. “This is the first set of experiments that demonstrate that even healthy people’s brains mimic certain pathological psychiatric patterns when deprived of sleep.  

“Before, it was difficult to separate the effect of sleep and the disease itself. Now we’re closer to being able to look into whether the person has a psychiatric disease or a sleep disorder.”  

A second study in the same journal suggests daylight-saving time regimes may cause similar effects. 

Till Roenneberg of Ludwig-Maximilian University in Munich, Germany, examined the sleep patterns of 55,000 people in Central Europe.  

      

He found people’s internal circadian clocks adjusted well when the clock moved back in the autumn months, but failed to adjust when it moved forward, costing them an hour of sleep, in the spring.  

He said the effects held for weeks, perhaps causing people to feel continually sleep-deprived in the spring and summer. 

(Source: Reuters) 

Hedonisme dan Hiburan

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HEDONISME adalah perkataan Yunani ini bererti “kesenangan” yang muncul sekitar 433 Sebelum Masihi dan memperjuangkan fahaman bahawa matlamat hidup manusia adalah kesenangan dan hiburan. 

Hedonisme mempromosi gaya hidup tanpa batas tata susila budaya dan agama,  memperkenal dan mempopularkan pergaulan bebas, seks luar nikah, hiburan melampau dan banyak lagi.  

Gejala neokolonialisme ini disasarkan kepada generasi muda yang mengagumi budaya popular. Perkara yang melampaui batas susila dan agama mereka anggap “biasa” sahaja. 

Sebahagian besar pengamal hiburan di negara ini tidak dapat membezakan antara seni dan hedonisme. Mereka menganggap semua yang dilakukan dalam dunia hiburan itu sebagai seni, hakikatnya ia lebih menjurus kepada fahaman hedonisme. “Budaya” kehidupan orang seni yang mereka sanjungi itu sebenarnya adalah perosak seni. 

Berbeza dengan hedonisme, seni menyuburkan pemikiran tinggi, hidup penuh dengan tata susila dan agama. Dalam seni tidak ada kelonggaran untuk melanggar batas budaya dan agama. 

Dalam hedonisme, pengarah filem boleh mewajarkan adegan ranjang semata-mata untuk menyampaikan saranan “kebaikan”. Sebab itulah di negara kita pengarah yang gemar membuat adegan ranjang bukan sahaja tidak pernah ditegur malah dipuji kerana tinggi “seni“nya. Pelakon yang sanggup melakukan adegan itu pula disanjung kerana “keberkesanan” lakonannya. Tidak ada yang mempersoalkan pelakon atau pengarah tersebut mengapa mereka mementingkan hedonisme tetapi mengenepikan batas susila dan agama. 

Kerana itu dunia hiburan tempatan mesti dibentuk semula. Istilah “seni” tidak boleh diperalatkan untuk memangkin hedonisme. Bagaimanapun, ada penggiat hiburan tempatan menganggap itu tidak masuk akal, sebab akal mereka telah tepu dengan hedonisme 

Tahukah mereka bahawa Barat telah lama sedar bahawa hedonisme meruntuhkan peradaban manusia? Kini mereka kembali kepada kepada kehidupan berbudaya melalui penghayatan seni. 

Di sebalik kisah gila-gila Lady Gaga, Barat mengungguli sastera, lukisan, teater dan muzik. Namun di sebalik gila-gila dunia hiburan tempatan, suatu apa pun tidak ada. Alhamdulillah dengan kehadiran TV AlHijrah yang memperkenalkan satu kod etika dalam hiburan.  

Sebenarnya ramai tidak sedar bahawa hiburan hedonisme adalah mainan zionis untuk merosakkan akhlak dan pemikiran remaja dunia. Hal ini disebutkan dalam Protokol Ke-13 sebagaimana yang diputuskan dalam Persidangan Zionis Kedua di Basle, Switzerland pada 1897. Hiburan itu termasuk semua jenis permainan, nyanyian, tarian, program realiti TV dan Internet. 

Hal ini disebutkan dalam Protokol Ke-13 dalam Persidangan Zionis Kedua di Basle, Switzerland pada 1897. Ini dihuraikan oleh mereka seperti berikut: 
Kita mesti bekerja keras bagi meruntuhkan akhlak dan moral manusia daripada segala segi dan lapangan supaya dengan itu mudahlah kita menguasai mereka.Sesungguhnya Freud itu orang kita, dan dia akan terus mempromosi teori hubungan seks di bawah cahaya matahari supaya kaum muda menganggapnya sebagai sesuatu yang suci (betul), untuk mengenyangkan naluri seks, dan ketika itu runtuhlah akhlak mereka.

Dibandingkan dengan jumlah penduduk dunia, bilangan mereka memang kecil namun dengan keazaman dan kuasa ekonomi mereka yang besar, perkara yang mereka hajatkan itu mudah dicapai. Kini mereka sedang berusaha mempromosikan keluarga ‘jantan-jantan’ dan ’betina-betina’ (keluarga homoseksual dan lesbian). 

Menurut kajian yang dilakukan oleh seorang pensyarah psikologi, Hanan Dover di Sydney, 30 peratus (82 orang) daripada responden Muslim mengatakan homoseksual tidak haram. Apabila beliau mengkritik budaya songsang ini secara terbuka pada 2001 dengan menyelar rancangan-rancangan TV seperti Big Brother dan Sex and the City, beliau telah digam selepas memberi ucapan tersebut.  

Institusi keluarga penting dalam membina ummah. Umum juga tahu pendidikan akhlak individu bermula dari rumah. Namun apabila ahli keluarga itu sendiri sudah rosak akhlak lantaran hedonisme, perpaduan ummah turut berkecai. 

Pada pandangan zionis, semua bangsa dan agama yang ada di dunia ini adalah musuh. Hanya mereka sahaja kaum yang terpilih untuk memerintah dunia. Kuasa ini mesti diraih dengan apa cara jua. Adakah itu yang penduduk dunia inginkan?    

(Rujukan: Tulisan Ku Seman Ku Hussain dalam Utusan Malaysia; Online Dengan Tuhan oleh Zulkifli Khair)

Apakah Perubatan Islam?

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APA itu ‘perubatan Islam’? Sebenarnya tiada istilah sedemikian. Ia hanya merujuk kepada jampi atau bahan-bahan yang disebutkan oleh Nabi s.a.w semata-mata. Berubat memang disuruh oleh Islam. Apa sahaja ubat yang mengikut kaedah perubatan yang betul memang diizinkan oleh syarak. Ini termasuk perubatan dan ubat yang disebut oleh Nabi s.a.w, atau selainnya yang mengikut disiplin ilmu perubatan.

Perubatan moden, Cina, Ayurveda atau Melayu yang berasaskan kaedah yang benar, bukan haram, khurafat atau syirik adalah perubatan yang diizinkan oleh Islam. Bahkan jika diyakini boleh menyembuhkan seseorang yang sakit, ia memang disuruh oleh Islam tanpa mengira asal-usul perubatan tersebut.

Nabi s.a.w dalam hadis menyebut perubatan dan ubat secara umum, tanpa menghadkannya. Setiap orang hendaklah berusaha mencari ubat yang paling berkesan. Dalam hadis yang sahih Nabi s.a.w bersabda:
Berubatlah wahai hamba-hamba Allah, sesungguhnya Allah tidak meletakkan penyakit, melainkan meletakkan untuknya ubat, kecuali satu penyakit, iaitu tua- Riwayat Ahmad, Abu Daud, al-Tirmizi dan Ibn Majah.
Juga sabda baginda:
Bagi setiap penyakit ada ubatnya. Apabila betul ubatnya, maka sembuhlah dengan izin Allah - Riwayat Muslim.

Kata Al-Imam Nawawi (wafat 676H): Hadis ini memberi isyarat disunatkan mengubat penyakit. Inilah mazhab ashab  kita (aliran mazhab al-Syafi`i), kebanyakan salaf dan keseluruhan khalaf. Kata al-Qadi ‘Iyadh: Dalam hadis-hadis ini terkandung beberapa ilmu-ilmu agama dan dunia, antaranya; benarnya ilmu perubatan, diharuskan berubat secara keseluruhannya –(Al-Nawawi, Syarh Sahih Muslim, 359/14, Beirut: Dar al-Khair).

Satu perkara yang perlu diperingatkan ialah bukan semua hadis tentang perubatan itu sahih, bahkan banyak yang palsu. Al-Imam Ibn Qayyim al-Jauziyyah (wafat 751H) yang menulis kitab al-Tibb al-Nabawi (perubatan kenabian) sendiri mengingatkan dalam kitabnya al-Manar al-Munif  bahawa salah satu ciri hadis palsu itu ialah lebih berunsur ungkapan para pengamal perubatan yang dibuktikan oleh pancaindera atau fakta yang sahih akan kepalsuannya. Dalam ertikata lain, pada zaman sekarang jika fakta sains berjaya membuktikan kesalahan fakta hadis tersebut, maka itu salah satu ciri bahawa ia hadis yang palsu.

Satu contoh hadis yang sedemikian ialah: “Terung itu mengikut hajat ia dimakan” dan hadis “Terung itu ubat untuk segala penyakit”. Ini riwayat palsu. Kata al-Imam Ibn al-Qayyim:
Semoga Allah menghodohkan pereka kedua hadis itu. Perkara seperti ini jika disebut oleh orang yang paling pakar dalam perubatan pun, orang ramai akan mentertawakannya. Jika dimakan terung untuk demam panas, kemurungan dan banyak penyakit lain, ia hanya menambahkan keburukan lagi. Jika orang fakir makan agar dia kaya, dia tidak akan kaya. Jika orang jahil makan untuk pandai, dia tidak akan pandai - (Ibn Qayyim al-Jauziyyah, al-Manar al-Munif fi al-Sahih wa al-Da‘if, m.s. 51. Syria: Maktab al-Matbu`at al-Islamiyyat).

Banyak dakwaan yang dikatakan bersumberkan hadis, seperti makan kismis menguatkan ingatan tiada dalil yang sahih daripada Nabi s.a.w mengenainya. Ibn al-Qayyim sendiri menyebut dalam al-Tibb al-Nabawi bahawa ada dua hadis yang disebut tentang kelebihan kismis, tetapi kedua-duanya tidak sahih. Cuma, ada riwayat daripada al-Zuhri yang menyebut kismis bermanfaat untuk ingatan (lihat: Ibn al-Qayyim, Zad al-Ma’ad, 4/318).

Apa yang disebut oleh al-Quran seperti khasiat madu, tiada sebarang syak tentang kewahyuannya (divinity). Cuma proses perubatan yang hendak dikendalikan atau kadar dan caranya memang memerlukan kajian ilmiah perubatan. 

Adapun hadis-hadis sahih yang menyebut tentang ubat-ubat tertentu seperti hadis habbatus sauda’ (jintan hitam), berbekam, air kencing unta, susu unta, oud hindi dan seumpamanya, para ulama berbeza pendapat. Ada yang mengatakan hadis-hadis ini berasaskan wahyu. Ada pula berpendapat bahawa hadis-hadis ini Nabi s.a.w sebut berasaskan pengalaman, persekitaran dan zaman baginda hidup, bukanlah wahyu daripada Allah S.W.T.

Secara umumnya, ulama Hadis cenderung kepada pendapat bahawa hadis-hadis perubatan yang sahih itu berasaskan wahyu. Dalam ertikata lain ia adalah perkhabaran daripada Allah S.W.T kepada nabi-Nya s.a.w. Maka, semua kandungannya benar tepat dan untuk diamalkan, perubatan yang mendapat pengiktirafan daripada Allah S.W.T sendiri. Maka, dalam kitab-kitab hadis dihuraikan perkara ini sehingga dalam Sahih al-Bukhari ada Kitab al-Tibb (Kitab Perubatan). Ibn al-Qayyim dalam al-Tibb al-Nabawi berpegang dengan pendapat ini.

Golongan kedua pula seperti al-Qadi ‘Iyadh, Ibn Khaldun, Muhammad Abu Zahrah berpendapat bahawa hadis-hadis perubatan ini bukan berteraskan wahyu, sebaliknya Nabi s.a.w bercakap berdasarkan pengalaman dan persekitaran baginda ketika itu. Bagi ulama yang berpegang dengan pendapat ini mereka menyatakan bahawa Nabi s.a.w tidak diutuskan sebagai ahli perubatan dan itu bukan tujuan baginda diutuskan. Maka, ucapan atau tindakan baginda dalam perubatan sama seperti ahli masyarakat Arab lain ketika itu dan tidak semestinya tepat dengan realiti perubatan. 

Antara yang berpegang dengan fahaman ini al-Imam Ibn Khaldun (wafat 808H) dalam kitabnya al-Muqaddimah. Kata Ibn Khaldun:
Maka perubatan yang diriwayatkan dalam syarak (hadis) kepada kita dalah dari jenis perubatan Arab, sedikit pun bukan dari wahyu. Ia hanya perkara yang menjadi kebiasaan Arab. Apa yang disebut keadaan Nabi s.a.w dalam hal ini termasuk dalam jenis adat dan jibiliyyah (tabiat kebiasaan) bukan kerana ia disyariatkan amal sedemikian rupa. Ini kerana Nabi s.a.w diutuskan untuk mengajar syariat, bukan untuk memperkenalkan perubatan atau adat kebiasaan yang lain - (Ibn Khaldun, al-Muqaddimah, 493-494. Beirut: Dar al-Fikr).

Antara alasan golongan yang berpendapat bahawa perubatan Nabi s.a.w berasaskan kebiasaan dan pengalaman bukannya wahyu ialah hadis sahih yang mana Nabi s.a.w pernah melihat sahabat mengahwinkan pokok tamar, lalu baginda bersabda:
Apa yang sedang kamu lakukan? Jawab mereka: Kami telah lakukannya sebelum ini. Jawab baginda: Barangkali jika kamu tidak buat ia lebih baik. Maka mereka pun tidak melakukannya, lalu pokok tidak berbuah. Mereka menyebut hal tersebut kepada Nabi s.a.w, lalu baginda bersabda: Aku ini manusia. Apabila aku menyuruh kamu dari perkara agama, maka ambillah (patuhlah). Jika aku menyuruh kamu sesuatu dari pendapatku, maka aku hanyalah seorang manusia - Riwayat Muslim.


Dalam riwayat yang lain, baginda menjawab:
Jika itu memanfaatkan mereka maka lakukanlah. Aku hanya menyangka satu sangkaan, maka jangan salahkan aku atas sangkaan. Namun, jika aku memberitahu sesuatu daripada Allah maka ambillah, kerana sesungguhnya aku sama sekali tidak akan berdusta atas nama Allah- Riwayat Muslim.

Dalil-dalil lain juga menunjukkan bahawa adanya tindakan dan perkataan Nabi s.a.w itu berasaskan kebiasaan, atau pengalaman atau pandangan baginda dan bukan wahyu. Ini termasuk pemilihan tempat yang baginda buat dalam Perang Badar yang kemudian dicadangkan tempat yang lain oleh Hubbab bin Munzir dan baginda mengubah pandangannya dan bersetuju dengan cadangan tersebut. Perkara ini menjadi perbahasan panjang dalam kalangan ulama dalam membezakan sunnah Nabi yang disyariatkan untuk diamalkan dan yang tidak disyariatkan untuk diamalkan.

Secara umumnya tujuan hadis-hadis perubatan ini ialah memberitahu bahawa kita disuruh  berubat berasaskan bahan-bahan yang diguna dalam perubatan yang diyakini boleh memberikan kesan. Nabi s.a.w menyebut bahan-bahan yang ada dalam masyarakat baginda dan digunakan serta memberi kesan pada zaman dan iklim baginda. Bahan-bahan itu boleh diambil iktibar, namun bukanlah pilihan yang terbaik bagi setiap masa dan keadaan. Bergantung kepada sejauh manakah ia berkesan untuk sesuatu tempat dan masa. Apa yang penting kita disuruh mencari yang berkesan tanpa mengira jenisnya.

Al-Hafiz Ibn Hajar al-Asqalani (wafat 852H) ketika mensyarahkan hadis al-Bukhari:
“Habbatus sauda penyembuh bagi segala penyakit”, menyebut: Ia bermanfaat untuk penyakit yang sejuk, adapun penyakit yang panas tidak! (Fath al-Bari, 11/290. Beirut: Dar al-Fikr).

Kesimpulannya setiap ubat yang bermanfaat adalah diiktiraf oleh Islam, tidak terbatas kepada apa yang disebutkan dalam hadis sahaja. Berdasarkan pendapat sebahagian ulama tadi, apa yang disebut dalam hadis juga perlu untuk diteliti dan dikaji semula kesesuaiannya kerana mungkin ada keadaan yang berbeza, atau di sana ada ubat yang lebih berkesan.

(Tulisan oleh Prof Madya Dr Mohd Asri Zainul Abidin dan dipetik dari www.jomrileks.com)

Immunisation For The Elderly

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WE tend to identify immunisation with infants and young children, but in recent years, there has been public interest in immunisation of adults and the elderly against certain infections.   

Immunisation can protect people against harmful infections, which can lead to serious complications, including death. Immunisation uses the body’s natural defence mechanism to build resistance to specific infections.  

Immunisation and vaccination  

Many laypeople use these terms interchangeably and it may be helpful to clear some misconceptions. 

Vaccination means having a vaccine – that is actually getting the injection.   

Immunisation means both receiving a vaccine and becoming immune to a disease, as a result of being vaccinated against that disease.   

How does immunisation work?  

All forms of immunisation work in the same way. When a person is vaccinated, his body produces an immune response in the same way the body would after exposure to a disease, but without the person suffering any symptoms of the disease.   

When a person comes in contact with that disease in the future, his immune system will respond promptly to prevent the person developing the full blown disease.  

What are in vaccines?  

Vaccines contain either a very small dose of a live, but weakened form of a virus; a very small dose of killed bacteria or virus or small parts of bacteria; or a small dose of a modified toxin produced by bacteria.   

Vaccines may also contain either a small amount of preservative or a small amount of an antibiotic to preserve the vaccine. Traces of egg protein may be present in some vaccines, so please check with your doctor if you have any known allergies.  

Immunisation for the elderly  

Every year thousands of seniors suffer from influenza or pneumonia, sometimes with fatal outcomes. The combined cause-of-death category of “pneumonia and influenza” ranks as the fifth leading cause of death in the United States for people age 65 or older.   

Who should have immunisation?  

In recent years, there has been considerable evidence to suggest that immunisations against the influenza virus and the pneumococcus germ are beneficial to the elderly, especially for those with chronic lung, heart and kidney problems, diabetes mellitus, those in institutions such as nursing homes, and those who travel overseas.   

Immunisations are available for the prevention of both influenza and pneumococcal pneumonia, but very few high-risk seniors receive both vaccines.  

Seniors in the above category are at an increased risk of infection and, with few exceptions, should consider receiving an annual influenza immunisation and a one-time pneumococcal vaccine.   

In Malaysia, a recent study has shown a protective effect of the pneumococcal vaccine for those seniors performing the Haj.   

In a study conducted by Prof Ilina Isahak at five old folks homes in West Malaysia, the influenza vaccine has also been effective in reducing the flu-like symptoms amongst resident seniors.  

There are also suggestions to provide vaccinations for those who work in healthcare facilities such as nursing homes and hospitals to reduce the likelihood of health workers spreading infection amongst the old and infirm.  

Such immunisation programmes will improve the quality of resident care in the facility by preventing serious influenza outbreaks and potentially avoiding deadly pneumococcal infections for some residents. The major benefit expected from vaccination in the elderly population is a reduction of severe cases.  

Should all seniors be immunised?  

Although some experts feel that all elderly should be immunised, most studies on the influenza vaccine were conducted in the Northern Hemisphere, in temperate countries where influenza peaks of incidence occur during the winter (influenza season). In these studies, influenza is recognised as an important cause of severe disease among elderly.   

In tropical and subtropical areas, influenza viruses occur throughout the year. Small seasonal peaks may occur coinciding with the winter seasons in the northern and southern hemispheres – spread from travellers from these regions. The importance of influenza infection in tropical areas is not clearly understood, and hence few seniors consider immunisation necessary.  

The association of influenza infection and severe illness amongst seniors is inferred from the link between seasonal increase in morbidity and mortality rates of respiratory disease and detection of influenza virus. This evidence supports vaccination against influenza targeting the senior population and carried out two to four weeks before seasonal peaks.   

Seniors travelling abroad are advised to inform their doctors well in advance as to where they intend to travel as there may be a choice of two influenza vaccines (for the northern and southern hemispheres). Unfortunately, due to the “antigenic drift” of the influenza virus, annual jabs are required to confer some degree of protection.  

Seniors should appreciate that influenza infection is not the only risk factor related to outbreaks of severe respiratory disease in the elderly population. For the Haj pilgrims, it is now mandatory to receive vaccinations for influenza and meningococcus (that can cause meningitis – an inflammation of the lining of the central nervous system) germs.  

How effective is the vaccination?  

To address the issue of vaccine protection, the concepts of efficacy and effectiveness must be clarified.  

Vaccine efficacy is the percentage reduction in the incidence of a disease among vaccinated compared to unvaccinated individuals under controlled conditions, and this is often based on laboratory confirmed cases. At least three clinical trials conducted amongst elderly people found vaccine efficacy between 60% and 67% in laboratory confirmed influenza-like illness.  

Vaccine effectiveness is the percent reduction in the incidence of a disease among vaccinated compared to unvaccinated individuals under routine conditions, and may include non-influenza cases.   

An analysis of 20 studies showed that the vaccine reduced the incidence of pneumonia by 50% and death by 67%. A study conducted in the United Kingdom among seniors showed a 21% vaccine effectiveness against hospitalisations for acute respiratory disease (with no reduction in hospital admissions outside influenza seasons).   

Conclusion  

In all societies, there are usually several health issues contending for limited resources, which direct policymakers to set priorities in allocation of funds.  

Essentially there are different viewpoints (be it society, government or individuals) regarding immunisation in the elderly. Nevertheless, it would seem reasonable and judicious to suggest that “high risk” seniors (those with chronic lung, heart and kidney problems, diabetics, those in nursing homes, and those who plan to travel overseas) should consider immunisation as an insurance to maintain their health.  

(Written by Dr Philip Poi Jun Hua)  

Membina Sifat Mahmudah

serenemaklong.blogspot.com

KITA semua tahu yang amalan agama seperti solat, membaca Quran, bersedekah, berakhlak baik, dan lain-lain lagi suruhan agama adalah perkara yang sangat penting untuk kejayaan dalam kehidupan di dunia dan juga di akhirat. Cuma kita selalu tiada kekuatan untuk melakukan amalan sunnah yang penuh berkat ini. Kita tahu Nabi saw dan para sahabatnya tidak pernah culas ke masjid setiap solat 5 waktu, tetapi mengapa kita tidak mampu menjadi seperti itu?

Cuba lihat carta aliran formula kejayaan seperti di bawah:

Kejayaan
↓
Beramal dengan amalan positif secara istiqamah (Disiplin)
↓
Sedar akan kesan beramal dengan amalan positif
↓
Menyedarkan diri tentang kesan baik amalan positif secara istiqamah

Kejayaan tidak akan terhasil sebelum beramal dengan amalan positif secara istiqamah. Ia harus menjadi tabiat kita. Kita mesti sedar akan kesan baik apabila beramal dengannya.  Dengan berakhlak mulia kita mampu menolak rasuah, kita sedar tentang hilangnya keberkatan dari rezeki akibat rasuah. Kita tidak akan memberi rasuah kerana ada rasa hormat pada Allah yang tersemat di dalam hati.

Satu cara terbaik ialah dengan mengadakan sesi taklim di rumah sendiri. Tetapkan satu waktu dalam setiap hari untuk kita membaca fadhilat amalan agama bersama seisi keluarga. Luangkan lebih kurang 30 minit setiap hari untuk perkara ini.

Setiap hari kita jiwa kita diserang dengan berbagai-bagai dakwah negatif dari pelbagai media yang ada di dalam hidup zaman moden ini. Sekiranya kita tidak secara proaktif membina kekuatan iman, necsaya kita akan hanyut dengan segala macam kelalaian dunia.

Semoga kita semua akan berjaya menghidupkan amalan taklim di rumah masing-masing. Doakanlah supaya saya juga mampu beramal dengan apa yang saya tuliskan. Ya Allah, tolonglah kami semua. Aamiin.

(Sumber: Schanizan.blogspot.com)

Doctor's Information

serenemaklong.blogspot.com

Information is power, but when it comes to illness and disease, is too much information beneficial, or detrimental?  

THE patient-doctor relationship has, since time immemorial, contributed significantly to the therapeutic process. This personal relationship, which is based on trust and confidence, has always involved communication.   

However the communication of clinical information was not central to this relationship until recent times. Our parents and even many of us have lived in awe of the health care system. The doctor’s advice and instructions about health, illness, outcome and the different interventions available were often unquestioned.   

However, it is not uncommon today for doctors to be consulted by patients who have already done a literature search in the electronic media and made a provisional diagnosis. The doctor may even be told by the patient what the diagnosis is, or what he or she wants done.  

The public is becoming better informed about health because of the explosion of health information in the print and electronic mass media coupled with the active pursuit of such information. 

 

Quality of information  

With this paradigm shift, the provision of clinical information is now an essential component in the development of the trust and confidence in a patient-doctor relationship. Consumer bodies advocate better information so that patients and their families can make better-informed decisions.   

Yet much of the information available to patients is misleading and inaccurate. The need to improve the quality of the information and to consider the individual’s information needs have been the focus of attention of health educators and planners worldwide.  

The definition of quality information varies with different individuals, and even in the same individual, at different phases of his or her life. The core requirements would include unbiased, current information about the individual’s illness, the possible and likely outcomes, the risks and benefits of different interventions and assistance in decisions about his or her treatment preference(s). There should be discussion whenever there is uncertainty.   

Individuals vary in their requirements for knowledge about their medical condition and what they want to be informed. Some cope better with uncertainty than others. Many in our society still prefer their doctors to make the decisions. The challenge is to assess and decide what the patient wants and needs.   

The desirability of providing patients with up-to-date information and the amount of such information have been questioned by both patients and doctors. Whether such information will promote or alleviate a patient’s anxiety is a pertinent question.   

Would such information increase demands for services by the small, vocal, privileged minority at the expense of the collective good in the public sector? The costs of providing quality information in the form of leaflets, videos and other audio-visuals have to be considered.   

The uncertainties and risks of medical treatment would be exposed even more by better quality information. Uncertainties and risks are certainly abundant in healthcare!  

The advocates for quality patient information, however, argue that it will enhance patient compliance and satisfaction, thereby reducing the likelihood of patient dissatisfaction. The position taken is that patients would be better equipped when forming their views about the services they need and receive. They can make informed decisions about their own healthcare and treatment. They will be more able to identify the services most suited to their needs and are more likely to be capable of accessing care and the services themselves.   

The pressures on the health system may be eased through patients’ improved understanding. The acknowledgement of the unscientific basis of many aspects of medical practice may persuade greater societal involvement in clinical trials designed to provide answers to reduce uncertainties in medical practice.  

The Internet  

An ever-increasing number of Malaysians are subscribing to the Internet, However, there is no accountability for the quality and safety of the information on the Worldwide Web. Anyone with a computer and a modem can be an author, publisher and editor simultaneously, and worse still, can do so anonymously.   

A search on the Internet for any medical condition will reveal information of variable quality. This is not surprising when scientists have the same access to the Web as those with commercial or other agendas. While there are calls for regulation of health sites on the Web, it will be quite some time before this can be implemented.   

Clinical situations  

Society expects and permits an ill person to adopt a certain role that is not expected of someone who is healthy. An ill person is vulnerable and dependent on others – these may be doctors, nurses, other healthcare professionals, family members and/or friends.   

Individual autonomy can be a heavy load for many to bear. Making a decision on treatment may already be sufficiently difficult.   

There has been much emphasis on choice in medical care. Many people have the perception that there is a large menu akin to consumer goods and services like food and clothing. The reality is that the choices in medical treatment are limited. For example, cancers can be treated with surgery, radiotherapy, chemotherapy or a combination of these treatment methods.  

In the typical clinical situation, diagnosis is followed by information about the prospects of what may occur and the treatment available. The treatment choice for patients is a very small menu. It is not uncommon to find only one item on the menu, for example, a certain antibiotic for a particular bacterial infection.   

Sometimes, the patient may also find himself or herself in a worse situation. There is nothing on the menu – for example, untreatable conditions like Alzheimer’s disease, inoperable cancer.   

The relationship between patients and doctor, in earlier times, was a direct one-to-one relationship.  

However, the situation today is different in many instances, particularly in healthcare institutions like hospitals, in which, the relationships are between patients and complex organisations staffed by many professionals.   

The traditional patient-doctor relationship is being replaced by multiple relationships between the patient and doctors, nurses and other healthcare professionals, all with different perspectives of the patient’s problem(s). It is no wonder then that some sociologists are coming to the view that the patient-doctor relationship is becoming obsolete, particularly in healthcare institutions like hospitals.   

When the well meaning family member(s) and friend(s) is added to the equation, the situation can become more complicated. Sometimes, even community leaders and politicians get involved.   

Most doctors who have been in practice for some time have encountered situations when they had difficulty working out who is the real decision maker – the patient, family member(s), friend(s), local community leader(s) or politician(s)!   

Basing a decision on ...  

The basis on which clinical decisions are made is usually not discernible to the layperson who has no formal training in Medicine. Studies have been carried out on patients’ understanding of the information provided to them by doctors and other healthcare professionals. The results of these studies reveal a stark fact – that although society has unprecedented access to health information, it lacked the skills to interpret them.   

The situation is compounded further, in our country, by a multi-racial and multi-religious population that has different perspectives on health and illness. There are differences in beliefs, knowledge, costs, resources and capabilities.   

The situation is also not helped by the numerous patients that doctors in a busy practice have to manage. Many doctors, in a 5 to 10 minute consultation, have to take a history, perform a physical examination, make a diagnosis and provide information – a truly challenging task indeed, especially when it has to be repeated umpteen times in a day!  

The law  

Court decisions have also impacted on clinical situations. For example, in Burke vs General Medical Council, the English High Court’s ruling in 2004 enabled a patient to insist on treatment, in certain circumstances, although it was against the doctor’s judgement.   

However, balance was restored when the Court of Appeal overturned the judgement in 2005. It ruled that if a doctor decided that a certain treatment is not clinically indicated, he or she is under no legal obligation to provide it, although the doctor should offer a second opinion.   

Similarly, Malaysian court decisions have impacted upon and continue to impact upon medical practice, as do the various regulations.  

The medical profession’s role 

The medical profession recognises its responsibility to provide quality information and the need to work with patients to use the information to the patients’ best advantage. After all, no one disputes that better patient-doctor relationships will enhance the image of the healthcare professions and the healthcare system itself. 

No doctor would want anything to happen that could lead to an erosion in the public’s trust and confidence in the health system, in general, and the patient-doctor relationship, in particular, irrespective of who is responsible.   

Although many patients prefer a passive role, it is important to promote a positive attitude towards their involvement in the decisions made, particularly in primary care, in which the patients could involve themselves to a greater extent than they currently are.  

There has been much emphasis on communication skills in medical schools worldwide. This will go some way towards addressing the need for better communication between patients and doctors. But more needs to be done for information provision. This requires an expenditure of time and effort; communication is never one-way traffic.  

The patient’s role  

The patient has a crucial role to play in making full use of the information available about the medical condition that he or she has.   

One should ensure that the doctor provides information about some or all of the following, where applicable: 

·        What is the diagnosis and the possible complications of the condition? 

·         What treatment is recommended and why? 

·         Details about the proposed treatment, its potential side effects or complications. 

·         What is the success rate of the proposed treatment? 

·         What alternative treatments are available, their potential side effects or complications and success rates? 

·         What could happen if one chooses not to have any treatment? 

·         If surgery is proposed, who is going to perform it and what is the extent of the experience of the surgeon?  

·         If anaesthesia is to be administered, who is the anaesthetist and his/her experience? 

·         If admission to a healthcare institution, for example, hospital, day surgery centre, hospice is recommended, then you need information about the institution, its facilities and equipment, its nursing and other staffing, its risk management procedures and the charges in the case of private institution.   

Any doubt should be clarified with the doctor. In addition, one should always inform the doctor of one’s preferences, fears and anxieties.   

This is often easier said than done, particularly for the large segment of the population who do not have a regular doctor.   

This is why the medical profession has always recommended that every one should have a regular doctor.  

Relationships require time and effort for its development. The patient-doctor relationship is no different. If one has a regular doctor, then he or she can assist in the communication of fears and anxieties to the specialist. Remember, doctors cannot read minds.  

In considering the statistics provided, one should always remember that they are like swimwear. What is revealed is suggestive, but what is concealed is just as important, if not, vital.  

If the doctor does not provide the information sought, one should consider seeking opinion(s) from another doctor(s) or changing one’s doctor.  

Conclusions  

Good communication between patients and doctors will always have a positive impact on a therapeutic relationship.  

Not only the medical profession and patients have important respective roles to play. Society also has a crucial responsibility to ensure that heavy burdens are not placed on the patient-doctor relationship.  

Well-intended regulations or rulings may be impractical because of the various considerations discussed above. This can lead to a negative impact on the provision of healthcare, which is not in anyone’s interest at all.  

(Written by Dr Milton Lum)