18. Al-Kahf/The Cavern
I/We begin by the Blessed Name of Allah
The Immensely Merciful to all, The Infinitely Compassionate to everyone.
18:01.
All Praise and Gratitude is to Allah - The One and Only God of everyone,
WHO has sent down The Divine Book to HIS Servant Muhammad.
And HE has not made any deviousness in it - straight and upright in terms of the perfection of its words, text, and meanings.
18:02
HE has made it a straightforward Book -
meant to warn people of severe punishment from HIM in case of their continued disbelief,
and to give the good news to the believers who practice righteousness -
that for them will be a beautiful reward – Paradise,
18:03
a. Paradise - wherein they will live forever – never to leave, never to die.
18:04
Furthermore, it is meant to warn those who allege:
‘Allah has taken to HIMSELF a son.’
18:05
They have no knowledge about it, nor had their forefathers.
It is really a monstrous assertion of blasphemy that is coming out of their mouths!
They utter nothing but an absolute falsehood against Allah.
18:06
O The Prophet!
You are aggrieved by the hostility aroused by the Divine Message among the polytheists.
Then perhaps you are going to destroy yourself with grief and anguish for their sake
if they are not believing in this Proclamation - The Qur’an.
18:07
This is a reality that WE have made all that is in the terrestrial world,
- a splendor and beauty for it so that WE may test people to see which of them is better in terms of...
Background: Hypertension is a growing medical and public health issue. The United States and European treatment guidelines have been issued to attain smooth control of hypertension in various categories of patients. It is a need of time to unveil safe combination therapies in various populations. Objectives: (i) To determine the efficacy of valsartan and hydrochlorothiazide versus valsartan and amlodipine (ii) To determine the safety and tolerability of both combinations. Materials & Methods: This experimental study was conducted at Shalamar Hospital Lahore. 126 patients with stage 2 hypertension were recruited from the medical outdoor of Shalamar Hospital Lahore after getting informed consent. In group A, 63 patients were given valsartan and hydrochlorothiazide. In group B, 63 patients were given valsartan and amlodipine. Blood pressure (BP) of both study groups was recorded on day zero, 2nd, 4th, and 8th weeks and the readings were entered on a Proforma. The efficacy of drug combinations was accessed in both groups by recording the change in mean systolic blood pressure (MSBP) and mean diastolic blood pressure (MDBP). The safety and tolerability of the drug combinations were assessed in terms of side effects and laboratory findings. Results: In group A, there was a 39±7mmzHg and 18±1mmHg decrease in MSBP and MDBP, respectively, from baseline BP. In group B, there was a 26.7±4mmHg and 14±2 mmHg decrease in MSBP and MDBP, respectively, from baseline BP. Both combinations were safe, and no significant difference in the efficacy of both combinations was observed after 8-week of treatment. Conclusion: Both combinations are effective for control of BP, but the valsartan and hydrochlorothiazide combination (group A) appears to have better tolerability and greater effect in decreasing BP as compared to the combination of valsartan and amlodipine (group B), although this difference is not statistically significant.
Objective: To characterize the immunophenotypic features of CLL/SLL among patients diagnosed at Aga Khan University Hospital, Nairobi.
Background: Cancer is a growing health burden worldwide. Rising to this challenge will require improved diagnostic services. Chronic lymphocytic leukaemia is common in elderly patients. Early laboratory criteria for diagnosis only required demonstration of persistent lymphocytosis and morphological evaluation. The current international standard in diagnosis however, incorporates findings of immunophenotyping. Facilities for immunophenotyping have generally been unavailable in Kenya. The Royal Marsden Hospital criteria (RMH) provide a scoring system that enables CLL/SLL to be distinguished from other mature B cell disorders.
Method: A laboratory based cross sectional survey conducted from August 2011 to April 2012. A census of eligible cases was conducted. Potential cases were identified based on the French-American-British (FAB) morphologic criteria for CLL. Consecutive samples were obtained and subjected to 3 colour immunophenotyping on a Beckman Coulter Cytomics FC 500 cytometer. A limited panel of antibodies was used. These included CD5, CD19, CD22, CD23, FMC7, kappa and lambda. CLL/SLL was defined using the RMH scoring system. The baseline clinical and diagnostic data were also obtained.
Results: Forty nine cases met the eligibility criteria. Thirty one were known CLL cases and 18 were newly diagnosed. Median age at diagnosis was 62 years (range 45-95 years). Male: Female ratio was 1.3:1. Black patients were more likely to present with high risk disease (Rai stages III-IV) and with higher lymphocyte counts than non-blacks at diagnosis. 26.5% presented in Rai stage 0. The prevalence of CD5/CD23 co-expression in cases defined as CLL was found to be 95.9%. CD5 was universally expressed whereas CD23 was present in all but 2 cases. Both were associated with atypical morphology. Complete absence of light chain expression using a monoclonal antibody was found in 12.2% of cases. Five patients had their diagnosis revised. Of 30 patients on follow-up for CLL, only 1 in 6 had had any form of immunophenotyping done.
Conclusion: Immunophenotyping is diagnostically productive and should be part of the diagnostic workup when a chronic lymphoproliferative disorder is suspected.