2010/07/27
By Syed Nadzri, NSTP
....Correct Me if I Am Wrong.....
YES, get rid of the Manchester United jerseys. But only because there are other better football teams around with even more attractive jerseys, and not because some ulama say so.
Not too long ago the brunt was on Liverpool jerseys, which had a beer brand strung across the chest. Now the prohibition has gone on to the Manchester United attire since the club’s crest carries the image of a red devil, hence wearing the team jersey is akin to worshipping the devil.
A news item late last week quoted Perak Mufti Tan Sri Harussani Zakaria and former Johor mufti Datuk Nooh Gadot as saying that wearing the Manchester United jersey is un-Islamic.
Also off limits, according to the report, are the jerseys of other teams, including Brazil, Portugal, Barcelona, Serbia and Norway, all of which carry images of the cross on their team emblems.
“This is very dangerous,” Nooh said. “As Muslims, we shouldn’t wear such jerseys, either for sport or fashion reasons. Even if it (the jersey) is a gift, we should decline it. It is even more sinful when people realise this is wrong but still buy these jerseys to wear. These Muslims should repent immediately.”
Yesterday, Harussani was quoted in this paper as saying there was no need for a fatwa to ban Muslims from wearing jerseys with images of Satan, alcohol and crests of other religions as it was already clearly stated in Islamic laws that it was haram to do this.
These statements have huge implications not only because there are millions of football fans in Malaysia and all over the world who are Muslims, but they raise the question of where do we stop on the matter of assigning such sins.
Correct me if I’m wrong, but shouldn’t there be a line between the sanctity of matters concerning divine faith and the frivolity of football fashion?
With all due respect to Harussani and Nooh — and this is certainly not an affront or an attempt to engage the ulama in a theological debate over the issue — in my humble opinion, there are some simple questions on straightforward day-to-day matters that need to be answered:
- Of the millions of football fans, many regularly collect their favourite club’s merchandise — shirts, caps, ties, scarves, flags, even fridge magnets. And they have been doing this for ages. So just how much have the “sins” accumulated and do they have to discard these precious items now and repent? It has to be mentioned that some of the country’s top leaders are ardent supporters of clubs such as Manchester United and Barcelona and they have been known to don these jerseys often.
- On the same premise, does this therefore mean that those who attended mission schools all these years fall in the same category since these schools, such as St Michael’s Institution, Convent Green Lane, St John’s Institution, had, or still have, the cross in their emblems and on school badges that every student has had to wear. Have they all sinned as well?
- And how many of us still remember Blue Cross milk? I think I swallowed quite a bit of this in my younger days when condensed milk in the smaller towns inevitably meant either Milkmaid (cap junjung) or Blue Cross (palang biru). Since the blue cross on the label was so prominent, have we terpesong (deviated) by consuming the content?
- How about Muslim players playing for clubs or countries mentioned above? El-Hadji Diouf, the winger from Senegal, used to play for Liverpool, where he donned the Carlsberg label on his shirt week after week; his countryman Mame Biram Diouf is in the current Manchester United squad, which means committing himself to the club with the red devil on its emblem; then there’s Zlatan Ibrahimovic, a Bosnian who has become a Swedish national and plays for the Swedish national team (there’s a cross in the crest) and Barcelona FC at club level (there’s a cross here as well). And what about superstar Zinedine Zidane? He donned the Real Madrid colours for quite some time. The club emblem has a crown with a cross right on top.
- And for music fans among the baby-boomers, do they now have to take down posters of singer Tom Jones (who always wears a big cross on his chest) and Robert Plant of Led Zeppelin (for the same reason). Or stop listening to the Beatles’ Let It Be since it contains a biblical reference to Mother Mary (Virgin Mary, though some would like to think Mother Mary means marijuana)?
- By extension, does it mean that we have to discard those Black Sabbath and Judas Priest records and CDs, and repent? And, for the younger set, the vampire movies such as Twilight?
The implications, as we can see, are too far-reaching because the same principle could apply in so many areas — to Muslims living as minorities in some countries, for instance. Have they sinned as well by subscribing to certain practices? For example, what is the status of those saluting the Union Jack in Britain (which has, not one but three crosses on it) and singing God Save the Queen? There are more than two million Muslims who are British citizens. Even the Japanese flag is not safe since it has the symbol of the sun. Saluting it might be construed as worshipping the sun.
The point I am trying to make is, where do we stop if we start with the jerseys?
Correct me if I’m wrong, but if it can get too complicated to support a certain football team, wouldn’t it be better — and perhaps a lot safer — to just switch allegiance? To Chelsea for instance?
......................
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Dato Syed Nazri,
I think if I am not mistaken we share the same alma mater MCKK. You must be Rehman Rashid's batch? A lot of creative people there... how come? Three years my junior perhaps. I am Hasan Marican's batch..no creative talents my batch, just a lot of dry people:doctors,engineers,lawyers, accountants . The Matron must have served us different diet altogether!
With respect to your article today..Correct Me if Am Wrong,I beg to differ.
Sorry Dato Syed, with due respect to you and your important position as the substantive chief editor of NST, you are damn wrong.
By your editorial , you are trying to trivialise and put into fore ulama' position in saying what they have to say. I can understand your position, but just use your brain a wee bit. Being an ulama' in Malaysia cannot be an easy task. Even clowns like Samy Velloo can often times be encouraged to take pot shots at you , let alone like minded minded people with little knowledge of Islam like Marina Mahathir, Zainah Annuar of SIS and even Shahrizad et al. Yet the ulama' have the heavy responsibility to interpret Quranic injuctions and the sunnah with respect to the current way of life and thinking and give advice. Their advisory on superficial examination by us may not seem to be in parallel with current fashion and thinking, even yours or mine ...but before one make a polemical issue out of it, one has to think ten times. More so certainly for people in your very high profile position and access to the public domain. To trivialise it from a very secular, superficial perspective, not taking in the wisdom that is inherent in the ulama' view is worse still. Perhaps for people in your position if one day you wakes up and find yourself nothing to write on, then it is better for you to just write about the famous Malaysian weather ...There is so much to write in Malaysia....Corruption self serving public servants, politicians, their meddling and interventionist 'wives' perhaps if one wants to be petty,and etc etc and etc. But understandably your job can be difficult though as there are many 'no go' areas so finally you guys have nothing better to do than to continue this unhealthy national pastime of Ulama' bashing!
The secular lay press, and NST is a secular press I dare say, is not the right forum to discuss fatwas and the Muslim position. I do not give a hoot about MU's jersey or Brazil's, but when people like you who should know better take upon yourselves to trivialise Ulama' you are opening a pandora's box. As a Muslim I do not enjoy matters pertaining to halal-haram be a matter of discussion by the likes of Samy Velloo or Karpal Singhm not even Marina Mahathir or Zainah Anwar or even Shahrizad!. There is already enough ulama' bashing in the lay press by Muslims like you who should know better.
Please refrain from selling your religion for a few ringgits!
Dr Nik
http://drnikisahak.blogspot.com/
......................
an alternative viewpoint from D.K:
Date: Tue, 27 Jul 2010 21:57:23 -0700
From: d. k @yahoo.com
Subject: Fw: ...Correct me if I am wrong.....
To: syedn@nst.com.my
CC: drnikisahak@hotmail.com
Dato Syed..I agree with your editorial..I'm glad that NST occasionally reports & writes in a way that I can agree with. I suppose you can't please all the people all the time; you'll have to be happy with pleasing some of the people some of the time!
I must say this to your credit: I have been reading your pieces for some time now, & I note that you attempt, at the very least, to be objective. Now that in itself, given the environment that our journalists have to live in, is very laudable. I enjoy reading your pieces also because you don't pontificate & talk down to the people you address (unlike some of your colleagues!).
As for Dr. Nik, I'm told he's a damn good doctor, but in all honesty I don't care much for his views..especially on religion. But then my thinking is secular, although I profess to be a Muslim. I suppose in some people's views I'll be consigned to hell when my time comes! But that's something between Allah & I, not some Ullama who thinks Allah has given him a mandate to interpret what Allah's laws are on this earth. I will take my chances: I will follow my conscience & be guided by it. I am resolute in my believe that the Allah I believe in is "All merciful & all forgiving" & when my time comes it is only He that will judge me..not some Ullama.
Keep up the good work Dato Syed!
Regards & best wishes.
D.K
..........................
A short rebuttal:
From: drnikisahak@hotmail.com
To: d.k@yahoo.com; syedn@nst.com.my
CC: jublintan65@yahoogroups.com
Subject: RE: ...Correct me if I am wrong.....
Date: Wed, 28 Jul 2010 18:55:22 +0800
TQ Dato D.K,
I respect your viewpoint. I was looking at things from the perspective of the current sport of 'ulama bashing'.
There must be a proper forum for this. NST, Star, The Chinese vernacular press are not the right forum certainly. Islamic issues on halal/haram/makruh are certainly not open for lay discussion by people who are the least qualified. Certainly not for Samy Velloo et al.
In my opinion, Dato Syed Nadzri has taken an unfair swipe at the institution of the ulama'. Of course cloak under petty examples of petty footballers elsewhere and other unrelated things. But still, reading in between the lines, an unhealthy swipe at the institution of ulama'. Who is the real Syed Nazri anyway?, a liberal Islamist??...Holding to the new concept that all religions are the same....
I know time has changed. There are too many people like you and Syed Nazri now who consider all things are not sacred anymore but in matters of faith and Islam, it is not up for grab yet. Right and wrong from the Islamic perspective is not for the meek in faith to vote and decide.That must be a bitter pill for guys like you to accept and swallow, Dato'!
A polemical discussion in the lay press on issues of faith and Islam , in a plural society such as ours, even if one seem to enjoy bashing the ulama' is not ON. At the end of the day if there is no one there to defend them, what do we have.
"Clogged souls, my friend, are more deleterious in the long term than clogged up arteries". Believe me.That is something for all of us to think about...and I am not just thinking of the next 10 , 15 years of our life. Just thinking a wee bit further.
Just my 2 cent worth..
Dr Nik
Wednesday, July 28, 2010
Monday, July 26, 2010
The family of Imran , 3 : 34-68.....Biblical Stories in The Noble Qur'an
Lo! Allah preferred Adam and Noah and the Family of Abraham and the Family of 'Imran above (all His) creatures. (33) They were descendants one of another. Allah is Hearer, Knower. (34) (Remember) when the wife of 'Imran said: My Lord! I have vowed unto Thee that which is in my belly as a consecrated (offering). Accept it from me. Lo! Thou, only Thou, art the Hearer, the Knower! (35) And when she was delivered she said: My Lord! Lo! I am delivered of a female - Allah knew best of what she was delivered - the male is not as the female; and lo! I have named her Mary, and lo! I crave Thy protection for her and for her offspring from Satan the outcast. (36) And her Lord accepted her with full acceptance and vouchsafed to her a goodly growth; and made Zachariah her guardian. Whenever Zachariah went into the sanctuary where she was, he found that she had food. He said: O Mary! Whence cometh unto thee this (food)? She answered: It is from Allah. Allah giveth without stint to whom He will. (37) Then Zachariah prayed unto his Lord and said: My Lord! Bestow upon me of Thy bounty goodly offspring. Lo! Thou art the Hearer of Prayer. (38) And the angels called to him as he stood praying in the sanctuary: Allah giveth thee glad tidings of (a son whose name is) John, (who cometh) to confirm a word from Allah lordly, chaste, a prophet of the righteous. (39) He said: My Lord! How can I have a son when age hath overtaken me already and my wife is barren? (The angel) answered: So (it will be). Allah doeth what He will. (40) He said: My Lord! Appoint a token for me. (The angel) said: The token unto thee (shall be) that thou shalt not speak unto mankind three days except by signs. Remember thy Lord much, and praise (Him) in the early hours of night and morning. (41) And when the angels said: O Mary! Lo! Allah hath chosen thee and made thee pure, and hath preferred thee above (all) the women of creation. (42) O Mary! Be obedient to thy Lord, prostrate thyself and bow with those who bow (in worship). (43) This is of the tidings of things hidden. We reveal it unto thee (Muhammad). Thou wast not present with them when they threw their pens (to know) which of them should be the guardian of Mary, nor wast thou present with them when they quarrelled (thereupon). (44) (And remember) when the angels said: O Mary! Lo! Allah giveth thee glad tidings of a word from him, whose name is the Messiah, Jesus, son of Mary, illustrious in the world and the Hereafter, and one of those brought near (unto Allah). (45) He will speak unto mankind in his cradle and in his manhood, and he is of the righteous. (46) She said: My Lord! How can I have a child when no mortal hath touched me? He said: So (it will be). Allah createth what He will. If He decreeth a thing, He saith unto it only: Be! and it is. (47) And He will teach him the Scripture and wisdom, and the Torah and the Gospel, (48) And will make him a messenger unto the Children of Israel, (saying): Lo! I come unto you with a sign from your Lord. Lo! I fashion for you out of clay the likeness of a bird, and I breathe into it and it is a bird, by Allah's leave. I heal him who was born blind, and the leper, and I raise the dead, by Allah's leave. And I announce unto you what ye eat and what ye store up in your houses. Lo! herein verily is a portent for you, if ye are to be believers. (49) And (I come) confirming that which was before me of the Torah, and to make lawful some of that which was forbidden unto you. I come unto you with a sign from your Lord, so keep your duty to Allah and obey me. (50) Lo! Allah is my Lord and your Lord, so worship Him. That is a straight path. (51) But when Jesus became conscious of their disbelief, he cried: Who will be my helpers in the cause of Allah? The disciples said: We will be Allah's helpers. We believe in Allah, and bear thou witness that we have surrendered (unto Him). (52) Our Lord! We believe in that which Thou hast revealed and we follow him whom Thou hast sent. Enrol us among those who witness (to the truth). (53) And they (the disbelievers) schemed, and Allah schemed (against them): and Allah is the best of schemers. (54) (And remember) when Allah said: O Jesus! Lo! I am gathering thee and causing thee to ascend unto Me, and am cleansing thee of those who disbelieve and am setting those who follow thee above those who disbelieve until the Day of Resurrection. Then unto Me ye will (all) return, and I shall judge between you as to that wherein ye used to differ. (55) As for those who disbelieve I shall chastise them with a heavy chastisement in the world and the Hereafter; and they will have no helpers. (56) And as for those who believe and do good works, He will pay them their wages in full. Allah loveth not wrong-doers. (57) This (which) We recite unto thee is a revelation and a wise reminder. (58) Lo! the likeness of Jesus with Allah is as the likeness of Adam. He created him of dust, then He said unto him: Be! and he is. (59) (This is) the truth from thy Lord (O Muhammad), so be not thou of those who waver. (60) And whoso disputeth with thee concerning him, after the knowledge which hath come unto thee, say (unto him): Come! We will summon our sons and your sons, and our women and your women, and ourselves and yourselves, then we will pray humbly (to our Lord) and (solemnly) invoke the curse of Allah upon those who lie. (61) Lo! This verily is the true narrative. There is no God save Allah, and lo! Allah he verily, is the Mighty, the Wise. (62) And if they turn away, then lo! Allah is Aware of (who are) the corrupters. (63) Say: O People of the Scripture! Come to an agreement between us and you: that we shall worship none but Allah, and that we shall ascribe no partner unto Him, and that none of us shall take others for lords beside Allah. And if they turn away, then say: Bear witness that we are they who have surrendered (unto Him). (64) O People of the Scripture! Why will ye argue about Abraham, when the Torah and the Gospel were not revealed till after him? Have ye then no sense? (65) Lo! ye are those who argue about that whereof ye have some knowledge: Why then argue ye concerning that whereof ye have no knowledge? Allah knoweth. Ye know not. (66) Abraham was not a Jew, nor yet a Christian; but he was an upright man who had surrendered (to Allah), and he was not of the idolaters. (67) Lo! those of mankind who have the best claim to Abraham are those who followed him, and this Prophet and those who believe (with him); and Allah is the Protecting Guardian of the believers. (68)
3 ; 34- 68 , The Noble Qur'an
http://www.quranexplorer.com/
3 ; 34- 68 , The Noble Qur'an
http://www.quranexplorer.com/
Sunday, July 25, 2010
Procedures in Medicine; Stress ECG
Treadmill Stress Test
How does a Regular Stress Test work?
When is a Regular Stress Test ordered?
How is a Treadmill Stress Test performed?
Preparing for the test?
How safe is it?
What is the reliability of the test?
How quickly will I get the results?
How does a Regular Stress Test Work? Patients with coronary artery blockages may have minimal symptoms and an unremarkable or unchanged EKG while at rest. However, symptoms and signs of heart disease may become unmasked by exposing the heart to the stress of exercise. During exercise, healthy coronary arteries dilate (develop a more open channel) than an artery that has a blockage. This unequal dilation causes more blood to be delivered to heart muscle supplied by the normal artery. In contrast, narrowed arteries end up supplying reduced flow to it's area of distribution. This reduced flow causes the involved muscle to "starve" during exercise. The "starvation" may produce symptoms (like chest discomfort or inappropriate shortness of breath), and the EKG may produce characteristic abnormalities. Most commonly, a motorized treadmill is used for exercise, while a stationary bicycle is used in some exercise laboratories.
When is a Regular Stress Test ordered? A regular stress test is considered in the following circumstances:
Patients with symptoms or signs that are suggestive of coronary artery diseases (CAD).
Patients with significant risk factors for CAD.
To evaluate exercise tolerance when patients have unexplained fatigue and shortness of breath.
To evaluate blood pressure response to exercise in patients with borderline hypertension.
To look for exercise-induced serious irregular heart beats.
Please remember that the regular stress test is heavily dependent upon interpretation of EKG changes produced by exercise. Therefore, the reliability drops drastically if there are significant EKG changes at rest (for example in patients with long standing high blood pressure, an artificial cardiac pacemaker, use of medications like digitalis, or presence of a bundle branch block pattern, etc.). In all such cases, the physician will usually order an Echo Stress Test or a Nuclear Stress Test, particularly if he or she is suspecting coronary artery disease. However, a regular stress may be sufficient in stable patients or those with a low suspicion of coronary artery disease who are being assessed for exercise tolerance (for example, prior to undergoing a structured exercise or rehab program).
How is a Regular Treadmill Stress Test Performed? The patient is brought to the exercise laboratory where the heart rate and blood pressure are recorded at rest. Sticky electrodes are attached to the chest, shoulders and hips and connected to the EKG portion of the Stress test machine. A 12-lead EKG is recorded on paper. Each lead of the EKG represents a different portion of the heart, with adjacent leads representing a single wall. For example:
Leads 2, 3, and aVF = bottom or inferior portion of the heart.
Leads V1 and V2 = septum or partition of the heart.
Leads V3, V4, V5 and V6 = anterior or front portion of the heart.
Leads 1 and aVL = superior or top and outer left portion of the heart.
Lead aVR looks at the cavity of the heart and has almost no clinical value in identifying coronary disease.
Three of the EKG leads are also constantly displayed on the treadmill monitor. Each lead representing a different wall. The physician has the option of selecting different combinations of three.
The treadmill is then started at a relatively slow "warm-up" speed. The treadmill speed and it's slope or inclination are increased every three minutes according to a preprogrammed protocol (Bruce is the commonest protocol in the USA, but several other protocols are perfectly acceptable). The protocol dictates the precise speed and slope. Each three minute interval is known as a Stage (Stage 1, Stage 2, Stage 3, etc. Thus a patient completing Stage 3 has exercised for 3 x 3 = 9 minutes). The patient's blood pressure is usually recorded during the second minute of each Stage. However, it may be recorded more frequently if the readings are too high or too low.
As noted earlier, the EKG is constantly displayed on the monitor. It is also recorded on paper at one minute intervals. The physician pays particular attention to the heart rate, blood pressure, changes in the EKG pattern, irregular heart rhythm, and the patient's appearance and symptoms. The treadmill is stopped when the patient achieves a target heart rate (this is 85% of the maximal heart rate predicted for the patient's age). However, if the patient is doing extremely well at peak exercise, the treadmill test may be continued further. The test may be stopped prior to achievement of the target heart rate if the patient develops significant chest discomfort, shortness of breath, dizziness, unsteady gait, etc., or if the EKG shows alarming changes or serious irregular heart beats. It may also be stopped if the blood pressure (BP) rises or falls beyond acceptable limits. Please note that the systolic BP (upper number) may normally rise to 200 at peak exercise. At the same time, the diastolic BP (lower number) remains unchanged or falls to a slight degree. In contrast, the BP of patients with hypertension or high BP will show a rise of both systolic and diastolic readings. The latter may rise above 90 - 100.
Preparing for the Regular Stress Test:
The following recommendations are "generic" for all types of cardiac stress tests:
Do not eat or drink for three hours prior to the procedure. This reduces the likelihood of nausea that may accompany strenuous exercise after a heavy meal. Diabetics, particularly those who use insulin, will need special instructions from the physician's office.
Specific heart medicines may need to be stopped one or two days prior to the test. Such instructions are generally provided when the test is scheduled.
Wear comfortable clothing and shoes that are suitable for exercise.
An explanation of the test is provided and the patient is asked to sign a consent form.
How long does the entire test take? A patient should allow approximately one hour for the entire test, including the preparation.
How safe is a Regular Treadmill Stress Test? The risk of the stress portion of the test is very small and similar to what you would expect from any strenuous form of exercise (jogging in your neighborhood, running up a flight of stairs, etc.). As noted earlier, experienced medical staff is in attendance to manage the rare complications like sustained irregular heart beats, unrelieved chest pain or even a heart attack.
What is the reliability of a Regular Stress Test? If a patient is able to achieve the target heart rate, a regular treadmill stress test is capable of diagnosing important disease in approximately 67% or 2/3 rd of patients with coronary artery disease. The accuracy is lower (about 50%) when patients have narrowing in a single coronary artery or higher (greater than 80%) when all three major arteries are involved. Approximately 10% of patients may have a "false-positive" test (when the result is falsely abnormal in a patient without coronary artery disease).
How quickly will I get the results and what will it mean? The physician conducting the test will be able to give you the preliminary results before you leave the exercise laboratory. However, the official result may take a few days to complete. The results of the test may help confirm or rule out a diagnosis of heart disease. In patients with known coronary artery disease (prior heart attack, known coronary blockages, previous treatment with angioplasty, stents or bypass surgery, etc.), the study will help confirm that the patient is in a stable state, or that a new blockage is developing. The results may influence your physician's decision to change your treatment or recommend additional testing such as cardiac catheterization, Echo Stress test, or a nuclear stress test.
How does a Regular Stress Test work?
When is a Regular Stress Test ordered?
How is a Treadmill Stress Test performed?
Preparing for the test?
How safe is it?
What is the reliability of the test?
How quickly will I get the results?
How does a Regular Stress Test Work? Patients with coronary artery blockages may have minimal symptoms and an unremarkable or unchanged EKG while at rest. However, symptoms and signs of heart disease may become unmasked by exposing the heart to the stress of exercise. During exercise, healthy coronary arteries dilate (develop a more open channel) than an artery that has a blockage. This unequal dilation causes more blood to be delivered to heart muscle supplied by the normal artery. In contrast, narrowed arteries end up supplying reduced flow to it's area of distribution. This reduced flow causes the involved muscle to "starve" during exercise. The "starvation" may produce symptoms (like chest discomfort or inappropriate shortness of breath), and the EKG may produce characteristic abnormalities. Most commonly, a motorized treadmill is used for exercise, while a stationary bicycle is used in some exercise laboratories.
When is a Regular Stress Test ordered? A regular stress test is considered in the following circumstances:
Patients with symptoms or signs that are suggestive of coronary artery diseases (CAD).
Patients with significant risk factors for CAD.
To evaluate exercise tolerance when patients have unexplained fatigue and shortness of breath.
To evaluate blood pressure response to exercise in patients with borderline hypertension.
To look for exercise-induced serious irregular heart beats.
Please remember that the regular stress test is heavily dependent upon interpretation of EKG changes produced by exercise. Therefore, the reliability drops drastically if there are significant EKG changes at rest (for example in patients with long standing high blood pressure, an artificial cardiac pacemaker, use of medications like digitalis, or presence of a bundle branch block pattern, etc.). In all such cases, the physician will usually order an Echo Stress Test or a Nuclear Stress Test, particularly if he or she is suspecting coronary artery disease. However, a regular stress may be sufficient in stable patients or those with a low suspicion of coronary artery disease who are being assessed for exercise tolerance (for example, prior to undergoing a structured exercise or rehab program).
How is a Regular Treadmill Stress Test Performed? The patient is brought to the exercise laboratory where the heart rate and blood pressure are recorded at rest. Sticky electrodes are attached to the chest, shoulders and hips and connected to the EKG portion of the Stress test machine. A 12-lead EKG is recorded on paper. Each lead of the EKG represents a different portion of the heart, with adjacent leads representing a single wall. For example:
Leads 2, 3, and aVF = bottom or inferior portion of the heart.
Leads V1 and V2 = septum or partition of the heart.
Leads V3, V4, V5 and V6 = anterior or front portion of the heart.
Leads 1 and aVL = superior or top and outer left portion of the heart.
Lead aVR looks at the cavity of the heart and has almost no clinical value in identifying coronary disease.
Three of the EKG leads are also constantly displayed on the treadmill monitor. Each lead representing a different wall. The physician has the option of selecting different combinations of three.
The treadmill is then started at a relatively slow "warm-up" speed. The treadmill speed and it's slope or inclination are increased every three minutes according to a preprogrammed protocol (Bruce is the commonest protocol in the USA, but several other protocols are perfectly acceptable). The protocol dictates the precise speed and slope. Each three minute interval is known as a Stage (Stage 1, Stage 2, Stage 3, etc. Thus a patient completing Stage 3 has exercised for 3 x 3 = 9 minutes). The patient's blood pressure is usually recorded during the second minute of each Stage. However, it may be recorded more frequently if the readings are too high or too low.
As noted earlier, the EKG is constantly displayed on the monitor. It is also recorded on paper at one minute intervals. The physician pays particular attention to the heart rate, blood pressure, changes in the EKG pattern, irregular heart rhythm, and the patient's appearance and symptoms. The treadmill is stopped when the patient achieves a target heart rate (this is 85% of the maximal heart rate predicted for the patient's age). However, if the patient is doing extremely well at peak exercise, the treadmill test may be continued further. The test may be stopped prior to achievement of the target heart rate if the patient develops significant chest discomfort, shortness of breath, dizziness, unsteady gait, etc., or if the EKG shows alarming changes or serious irregular heart beats. It may also be stopped if the blood pressure (BP) rises or falls beyond acceptable limits. Please note that the systolic BP (upper number) may normally rise to 200 at peak exercise. At the same time, the diastolic BP (lower number) remains unchanged or falls to a slight degree. In contrast, the BP of patients with hypertension or high BP will show a rise of both systolic and diastolic readings. The latter may rise above 90 - 100.
Preparing for the Regular Stress Test:
The following recommendations are "generic" for all types of cardiac stress tests:
Do not eat or drink for three hours prior to the procedure. This reduces the likelihood of nausea that may accompany strenuous exercise after a heavy meal. Diabetics, particularly those who use insulin, will need special instructions from the physician's office.
Specific heart medicines may need to be stopped one or two days prior to the test. Such instructions are generally provided when the test is scheduled.
Wear comfortable clothing and shoes that are suitable for exercise.
An explanation of the test is provided and the patient is asked to sign a consent form.
How long does the entire test take? A patient should allow approximately one hour for the entire test, including the preparation.
How safe is a Regular Treadmill Stress Test? The risk of the stress portion of the test is very small and similar to what you would expect from any strenuous form of exercise (jogging in your neighborhood, running up a flight of stairs, etc.). As noted earlier, experienced medical staff is in attendance to manage the rare complications like sustained irregular heart beats, unrelieved chest pain or even a heart attack.
What is the reliability of a Regular Stress Test? If a patient is able to achieve the target heart rate, a regular treadmill stress test is capable of diagnosing important disease in approximately 67% or 2/3 rd of patients with coronary artery disease. The accuracy is lower (about 50%) when patients have narrowing in a single coronary artery or higher (greater than 80%) when all three major arteries are involved. Approximately 10% of patients may have a "false-positive" test (when the result is falsely abnormal in a patient without coronary artery disease).
How quickly will I get the results and what will it mean? The physician conducting the test will be able to give you the preliminary results before you leave the exercise laboratory. However, the official result may take a few days to complete. The results of the test may help confirm or rule out a diagnosis of heart disease. In patients with known coronary artery disease (prior heart attack, known coronary blockages, previous treatment with angioplasty, stents or bypass surgery, etc.), the study will help confirm that the patient is in a stable state, or that a new blockage is developing. The results may influence your physician's decision to change your treatment or recommend additional testing such as cardiac catheterization, Echo Stress test, or a nuclear stress test.
....No Compulsion in Religion...
This is a free country. One can choose to walk on one's face or walk normally on both feet....but if you choose to walk on your face , do not expect other people to follow you, just do it yourself quietly in the privacy of your homes. Do not 'advertise' your ignorance....
"There is no compulsion in religion. The right direction is henceforth distinct from error. And he who rejecteth false deities and believeth in Allah hath grasped a firm handhold which will never break. Allah is Hearer, Knower."
The Noble Quran , 2 : 256
"There is no compulsion in religion. The right direction is henceforth distinct from error. And he who rejecteth false deities and believeth in Allah hath grasped a firm handhold which will never break. Allah is Hearer, Knower."
The Noble Quran , 2 : 256
Tuesday, July 20, 2010
...Doa and Prayer for all seasons...
Allah! There is no God save Him, the Alive, the Eternal. Neither slumber nor sleep overtaketh Him. Unto Him belongeth whatsoever is in the heavens and whatsoever is in the earth. Who is he that intercedeth with Him save by His leave? He knoweth that which is in front of them and that which is behind them, while they encompass nothing of His knowledge save what He will. His throne includeth the heavens and the earth, and He is never weary of preserving them. He is the Sublime, the Tremendous. (255).....AlBaqarah , chapter 2 ,The Noble Qur'an.
.....These ayats, [2:255], along with Al Fatihah and last three ayat of Surah Al Baqarah, [2:284, 285, and 286] are all 'super heavyweight' in The Noble Qur'an .
A well known hadith narrated by Ibn Abbas as related via Muslim and An Nasa'i ,it was told that Jibril was with Prophet Muhammad when there was a loud reverberating sound up in the heaven.
Jibril lifted his gaze and said: 'This is a door that was opened just now in heaven, and it was never opened before'. An angel came down through the door to the Prophet and said, " Receive the good news of two lights that you have been given and which no prophet before you was given. The opener of the Book [ Al Fatihah ] and the last three ayat in surah Al Baqarah. You will not read a letter from them, but you will be granted its benefit".
Unto Allah (belongeth) whatsoever is in the heavens and whatsoever is in the earth; and whether ye make known what is in your minds or hide it, Allah will bring you to account for it. He will forgive whom He will and He will punish whom He will. Allah is Able to do all things. (284) The messenger believeth in that which hath been revealed unto him from his Lord and (so do) believers. Each one believeth in Allah and His angels and His scriptures and His messengers - We make no distinction between any of His messengers - and they say: We hear, and we obey. (Grant us) Thy forgiveness, our Lord. Unto Thee is the journeying. (285) Allah tasketh not a soul beyond its scope. For it (is only) that which it hath earned, and against it (only) that which it hath deserved. Our Lord! Condemn us not if we forget, or miss the mark! Our Lord! Lay not on us such a burden as thou didst lay on those before us! Our Lord! Impose not on us that which we have not the strength to bear! Pardon us, absolve us and have mercy on us, Thou, our Protector, and give us victory over the disbelieving folk. (2:286)
How succinct!
"Allah, task not my soul beyond my scope. Condemn me not even if I forget or when I missed my mark. Impose not on me that which I have no strength to bear. Lay not a burden on me as YOU did on those before me. Forgive me..... YOU are the journeying".
A prayer and doa for all seasons!
Ayats 284 to 286 of surah Al Baqarah are my favourite ayats and companion, day and night. Along with Ayatul Kursi and Al Fatihah, as a doa ,prayer,constant 'companion', and panacea of all ills, we can never go wrong...
Dr Nik Howk
http://drnikisahak.blogspot.com/
.....These ayats, [2:255], along with Al Fatihah and last three ayat of Surah Al Baqarah, [2:284, 285, and 286] are all 'super heavyweight' in The Noble Qur'an .
A well known hadith narrated by Ibn Abbas as related via Muslim and An Nasa'i ,it was told that Jibril was with Prophet Muhammad when there was a loud reverberating sound up in the heaven.
Jibril lifted his gaze and said: 'This is a door that was opened just now in heaven, and it was never opened before'. An angel came down through the door to the Prophet and said, " Receive the good news of two lights that you have been given and which no prophet before you was given. The opener of the Book [ Al Fatihah ] and the last three ayat in surah Al Baqarah. You will not read a letter from them, but you will be granted its benefit".
Unto Allah (belongeth) whatsoever is in the heavens and whatsoever is in the earth; and whether ye make known what is in your minds or hide it, Allah will bring you to account for it. He will forgive whom He will and He will punish whom He will. Allah is Able to do all things. (284) The messenger believeth in that which hath been revealed unto him from his Lord and (so do) believers. Each one believeth in Allah and His angels and His scriptures and His messengers - We make no distinction between any of His messengers - and they say: We hear, and we obey. (Grant us) Thy forgiveness, our Lord. Unto Thee is the journeying. (285) Allah tasketh not a soul beyond its scope. For it (is only) that which it hath earned, and against it (only) that which it hath deserved. Our Lord! Condemn us not if we forget, or miss the mark! Our Lord! Lay not on us such a burden as thou didst lay on those before us! Our Lord! Impose not on us that which we have not the strength to bear! Pardon us, absolve us and have mercy on us, Thou, our Protector, and give us victory over the disbelieving folk. (2:286)
How succinct!
"Allah, task not my soul beyond my scope. Condemn me not even if I forget or when I missed my mark. Impose not on me that which I have no strength to bear. Lay not a burden on me as YOU did on those before me. Forgive me..... YOU are the journeying".
A prayer and doa for all seasons!
Ayats 284 to 286 of surah Al Baqarah are my favourite ayats and companion, day and night. Along with Ayatul Kursi and Al Fatihah, as a doa ,prayer,constant 'companion', and panacea of all ills, we can never go wrong...
Dr Nik Howk
http://drnikisahak.blogspot.com/
Sunday, July 18, 2010
Al Baqarah [ the Cow ] , 2 : 1-18 , The Noble Qur'an
Al-Baqara
In the name of Allah, the Beneficent, the Merciful
Alif. Lam. Mim.
This is the Scripture whereof there is no doubt,
a guidance unto those who ward off (evil).
Who believe in the Unseen, and establish worship,
and spend of that We have bestowed upon them;
And who believe in that which is revealed unto thee (Muhammad) and that which was revealed before thee, and are certain of the Hereafter.
These depend on guidance from their Lord. These are the successful.
As for the Disbelievers, Whether thou warn them or thou warn them not it is all one for them; they believe not.
Allah hath sealed their hearing and their hearts, and on their eyes there is a covering. Theirs will be an awful doom.
And of mankind are some who say: We believe in Allah and the Last Day, when they believe not.
They think to beguile Allah and those who believe, and they beguile none save themselves; but they perceive not.
In their hearts is a disease, and Allah increaseth their disease. A painful doom is theirs because they lie.
And when it is said unto them: Make not mischief in the earth, they say: We are peacemakers only.
Beware ! They indeed are the mischief-makers. But they perceive not.
And when it is said unto them: believe as the people believe, they say: shall we believe as the foolish believe? Beware ! They indeed are the foolish. But they know not.
And when they fall in with those who believe, they say: We believe; but when they go apart to their devils they declare: Lo! we are with you; verily we did but mock. Allah (Himself) doth mock them, leaving them to wander blindly on in their contumacy.
These are they who purchase error at the price of guidance, so their commerce doth not prosper, neither are they guided.
Their likeness is as the likeness of one who kindleth fire, and when it sheddeth its light around him Allah taketh away their light and leaveth them in darkness, where they cannot see,
Deaf, dumb and blind; and they return not.....
In the name of Allah, the Beneficent, the Merciful
Alif. Lam. Mim.
This is the Scripture whereof there is no doubt,
a guidance unto those who ward off (evil).
Who believe in the Unseen, and establish worship,
and spend of that We have bestowed upon them;
And who believe in that which is revealed unto thee (Muhammad) and that which was revealed before thee, and are certain of the Hereafter.
These depend on guidance from their Lord. These are the successful.
As for the Disbelievers, Whether thou warn them or thou warn them not it is all one for them; they believe not.
Allah hath sealed their hearing and their hearts, and on their eyes there is a covering. Theirs will be an awful doom.
And of mankind are some who say: We believe in Allah and the Last Day, when they believe not.
They think to beguile Allah and those who believe, and they beguile none save themselves; but they perceive not.
In their hearts is a disease, and Allah increaseth their disease. A painful doom is theirs because they lie.
And when it is said unto them: Make not mischief in the earth, they say: We are peacemakers only.
Beware ! They indeed are the mischief-makers. But they perceive not.
And when it is said unto them: believe as the people believe, they say: shall we believe as the foolish believe? Beware ! They indeed are the foolish. But they know not.
And when they fall in with those who believe, they say: We believe; but when they go apart to their devils they declare: Lo! we are with you; verily we did but mock. Allah (Himself) doth mock them, leaving them to wander blindly on in their contumacy.
These are they who purchase error at the price of guidance, so their commerce doth not prosper, neither are they guided.
Their likeness is as the likeness of one who kindleth fire, and when it sheddeth its light around him Allah taketh away their light and leaveth them in darkness, where they cannot see,
Deaf, dumb and blind; and they return not.....
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