The family of Ali Zakwan, the little boy who died at IGMH due to negligence of the then head of Childrens' medicine department Dr George John, has been denied justice by the Maldives justice system. Case of medical negligence filed by Zakwans' family has been given the cold shoulder.
We at MMW have been informed of a special investigation report into the incident that was compiled by a team of doctors at IGMH headed by Dr Abdulla Waheed. This investigation was conducted in the immediate aftermath of the death of Zakwan as part of an internal review into the circumstances of the events that lead to the sad outcome.
Although we have not gained access to the report itself, we are made to understand that the 10 plus page document clearly highlights negligence committed by doctors involved in care of Zakwan at IGMH. The report, we are told, names Dr George John, then the incharge of childrens' department as the main culprit in the negligent act. It also highlights that IGMH must take responsibility for the whole affair and pay compensation to the family for their loss.
What has happened to this report? In a private conversation that we had with a senior level medical administrative staff at IGMH, who at that time worked with Dr Mohamed Solih himself at his office, informed us that Dr Abdulla Waheed ordered the report be`shelved as part of a cover-up! Working from within the ministry of Health, Dr Waheed himself, formed a second committee to re-write the report, with the interest of the hospital getting preference over the truth, to draw up a second non-damaging report.
In addition to this, we are aware of a campaign conducted by Dr Abdulla Waheed and Dr Abdulla Afeef to plant the entire blame for the sad outcome on Dr Fathmath Shafga, with whom they apparently had a strained relationship. On the instruction of Dr Waheed, Dr Afeef planted ideas in the head of the family of Zakwan to suggest that the outcome was as a result of negligence from Dr Shafga, a fact that, we are told, was disputed in the first report into the events.
MMW, has also been informed that Mr Husnu Suood, the lawyer for the Zakwan family, was informed of the presence of the first report and the acts of Dr Abdulla Waheed in obstructing justice for the family. He has not been given access to the original report. The case, has been held back from courts for the past 3 years with nothing other than an initial hearing conducted.
MMW asks that justice be done for the family of Zakwan and just compensation be provided. They deserve to know the truth.
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This is a totally misleading article. If aynone wants to know the truth they must read the report submitted by the investigating commitee of which I was the chairman. The report reveals the full findings. If the report was concealed, then that could have been done by IGMH authorities or Ministry (I was not in any of those organbizations). Further, during those days when the matter went to court I had written an article in Miadhu Daily welcoming the first case of medico-legal malpractice in the Maldives and asking for justice.
If the report has been concealed by Ministry of Health (I don't know whether it has been concealed) I condemn that act, and demand immediate revealing of the full report so that the public and the family will know the truth. Waheed
WE?? lol....you mean you and niyaf
I wonder if drwaheed would like to know who you are?...
Evaluation of a dysfunctional voider begins with a detailed elimination history.
It is important to address the topics of specific problems in infancy, age of toilet
training, and family history of urological problems. All voiding symptoms and
the present status of continence should be quantified.
The most frequent complaint is urinary incontinence without any underlying
structural or obvious neurological anomaly. We ascertain if the incontinence
is a new development or has been present ever since toilet training. It is not uncommon
to see new urinary incontinence after a stressful occurrence at home or
school. Subsequently, any new changes or psychological stresses in the child’s life
should be probed [17]. Characterization of the pattern of incontinence is important.
A history of continuous incontinence throughout the day in a girl would
suggest an ectopic ureter, inserting distal to the urethral sphincter or into the
vagina. Organic factors, such as diabetes and epilepsy, that can contribute to urinary
incontinence should be excluded. Other voiding symptoms commonly seen
with dysfunctional voiding include urinary urgency, frequency, or dysuria (Table
2). Voiding symptoms may also be associated with sexual abuse and should be
further explored if suggested during the patient interview [18]. Children often
demonstrate holding maneuvers such as leg crossing, squatting, or “Vincent’s
curtsey.” Although there is some overlap in the features of many voiding disorders,
each has a characteristic pattern that stands out sufficiently from the rest so
as to be appropriately identified.
To quantitate voiding problems, the families fill out a 3-day elimination diary
(Fig. 1). We send them home with a voiding and elimination record sheet, as
well as a measuring “hat” that sits in the toilet to determine voided volumes.
Parents often have very little detailed information regarding their child’s voiding
frequency, volumes, or pattern. It is also imperative to have the families record
the presence of bowel movements and their appearance during the elimination
diary period. In today’s society with both caregivers working, it is impractical for
the child to be held out of school to attain the elimination diary. This information
does not have to be on consecutive days but needs to be reflective of complete
24-h periods. Typically, the weekends are the best opportunities for the caregiver
to document and record the elimination pattern.
The overactive bladder manifests itself mainly by daytime
urgency and incontinence. It may have a nocturnal component, which causes it to
sometimes be confused with the symptoms of nocturnal enuresis. Some nocturnal
enuretics also may have episodes of wetting during the day, and this overlap is
the source of difficulties in diagnosis and management. Nocturnal bladder instability
has been demonstrated in about one third of enuretics [44].
The uninhibited or overactive detrusor contraction that triggers bladder
overactivity occurs early in the filling phase, causing the pelvic floor to respond
by a voluntary contraction, which in turn gives rise to holding maneuvers such
as leg crossing, squatting, or Vincent’s curtsey. The passive external urethral compression
that is achieved in this manner may possibly cause a temporary reflex
relaxation of the detrusor, affording momentary relief from the effects of an uninhibited
detrusor contraction. UTIs are common due to poor emptying secondary
to these holding maneuvers used to combat the bladder instability. Children with
recurrent UTIs are sometimes maintained on antibiotic prophylaxis until bladder
emptying is improved with treatment.
A constant finding on the voiding and elimination diary is a small functional
bladder capacity for the child’s age. This is due to a state of detrusor hypertonicity
resulting from persistent overactivity, which resolves as the condition improves.
It is therefore a good clinical indicator of response to treatment.
Constipation is often present and may contribute significantly to the symptomatology
of the overactive bladder; it must be diligently sought in the course
of the patient/family interview. The association of constipation or various degrees
of fecal retention with the overactive bladder has led to speculation that the frequent
voluntary pelvic floor contractions generated to combat incontinence episodes
end up favoring constipation by simultaneously contracting the external
anal sphincter [45].
The Hinman syndrome represents the extreme of the spectrum of voiding dysfunction.
In this syndrome, bladders behave much like a neuropathic bladder,
although these children do not have any apparent neurological deficit. To emphasize
the absence of neurological disease, the term non-neurogenic neurogenic bladder
was coined. As this term seemed to cause some confusion, the condition became
known as the Hinman syndrome in 1986 [58]. Hinman syndrome is believed to
be an acquired voiding disorder characterized by the inappropriate voluntary
contraction of the striated urinary sphincter during the process of micturition.
This results in a functional urinary obstruction that over time causes UTIs, myogenic
bladder failure, hydronephrosis, and eventually renal insufficiency. The exact
etiology of this disorder is uncertain, but it is considered a behavior that is
acquired during potty training, when children learn to control their urinary tract
by actively contracting the urinary sphincter. It is postulated that this behavior
becomes habitual when the child fails to differentiate between voluntary and involuntary
voiding.
Myogenic detrusor failure occurs as end-stage bladder decompensation. It is frequently
seen in neurogenic bladders. Because this altered detrusor state takes time
to develop, patients have typically reached early adolescence by the time it is
recognized. These patients have a moderate amount of residual urine and thus
are prone to develop recurrent UTIs. Hydronephrosis is the result of the earlier
hyperreflexic state of the detrusor before decompensation and usually tends to
remain stable. These patients may require intermittent catheterization or possibly
α-blocker therapy.
Successful treatment of voiding dysfunction requires proper identification and
an understanding of the various subtypes. Treatment plans are tailored to the
individual voiding dysfunction disorders. Many of the mild and moderate forms
of voiding dysfunction can be treated by the primary care provider. However,
those children with more severe voiding dysfunctions that are refractory to initial
management require referral to specialists.
I saw this article and read it today. It is disgusting that the writer has blamed me for something I had not done. I have never blamed Dr Shafga regarding her management of Zakwan. Whoever had spread these lies did it for reasons beyond my comprehension. Or else he/she might have mistakenly thought someone else was me. I am a professional and respect those in my profession.
I saw this article and read it today. It is disgusting that the writer has blamed me for something I had not done. I have never blamed Dr Shafga regarding her management of Zakwan. Whoever had spread these lies did it for reasons beyond my comprehension. Or else he/she might have mistakenly thought someone else was me. I am a professional and respect those in my profession.Dr Afeef
DRUG CZAR AND DOT SECRETARY ISSUE GUIDANCE THAT
MARIJUANA SMOKING PROHIBITED IN SAFETY-SENSITIVE JOBS
DESPITE CALIFORNIA PROPOSITION 215 AND ARIZONA
PROPOSITION 200.
What will you do to ensure that the government takes scientific research into account when making laws? Especially when it comes to questions about the legalization of marijuana and the use of medical marijuana."
Annual US Deaths from causes:
Tobacco 435,000
Alcohol* 110,640
Prescriptions† 32,000
Overdoses‡ 16,926
NSAIDS 7,600
Caffeine 2,000
Marijuana 0
* Does not include alcohol-related crashes or murders.
† Adverse reactions to prescription drugs
‡ Overdoses and poisonings from legal and illegal drugs.
Despite protestations from the government that ‘more research is required’, people have known about the medical properties of Cannabis for thousands of years, and a massive amount of knowledge exists for anyone wishing to find it and use it.
The Chinese, Indian (Ayurvedic) and Tibetan literature on the subject goes back to at least the 10th Century. In China as early as 2737 BC it was used by herbalists in the court of Emperor Shen. The Tibetans call it ‘Sman-mchog rgyal-po’ which translates as ‘King of the best of medicines’. In Ayurveda it is called ‘Harikaki’ and described as being ‘useful to human beings like a mother’; “At times even a mother becomes angry but ‘Haritaki’ never causes any harm to a person who takes it”.
somebody seems very interested in legalizing marijuana.
hakuru boegen meehun dhuvaa varu madhee adhives!
What is it?
Cannabis sativa, also known as the hemp plant, has been cultivated for centuries for industrial and medical use, and for its "psychoactive," or mind-altering, effects. Marijuana, hashish and hashish oil all derive from the cannabis plant.
More than sixty-one chemicals, called cannabinoids, have been identified as specific to the cannabis plant. THC (delta-9-tetrahydrocannabinol) is the main psychoactive cannabinoid, and is most responsible for the "high" associated with marijuana smoke.
Hemp grown for industrial use has very low levels of THC. Hemp fibres are used to make rope, fabric and paper. Hemp seeds are high in protein and yield an oil with nutritional and industrial value.
Many claims about the medical uses of marijuana have not been scientifically proven; however, research has shown that THC and other pure cannabinoids can relieve nausea and vomiting and stimulate appetite. This can help people who have AIDS or who take drugs used to treat cancer. Further research is needed to establish the medical value of marijauna in relieving pain, reducing muscle spasms and controlling some types of epileptic seizure.
(Thanks Dr Abdulla Waheed)
What does marijuana do to the brain?
Some studies show that when people have smoked large amounts of marijuana for years, the drug takes its toll on mental functions.4 Heavy or daily use of marijuana affects the parts of the brain that control memory, attention, and learning. A working short-term memory is needed to learn and perform tasks that call for more than one or two steps.
Smoking marijuana causes some changes in the brain that are like those caused by cocaine, heroin, and alcohol. Scientists are still learning about the many ways that marijuana can affect the brain.
« Researchers Explain Effect of Broccoli, Soy On Cancer Cells | Main | Indian Herbal Remedy Offers Hope In Pancreatic Cancer »
April 17, 2007
New Study Shows Marijuana Cuts Lung Cancer Tumor Growth In Half
Topics: Medical Science News
Researchers at Harvard University report that in-vivo and in-vitro studies show that Delta-tetrahydrocannabinol (THC), the active ingredient in marijuana, cuts tumor growth in common lung cancer in half and significantly reduces the ability of the cancer to spread:
Science Daily - ... this is the first set of experiments to show that the compound, Delta-tetrahydrocannabinol (THC), inhibits EGF-induced growth and migration in epidermal growth factor receptor (EGFR) expressing non-small cell lung cancer cell lines. Lung cancers that over-express EGFR are usually highly aggressive and resistant to chemotherapy.
THC that targets cannabinoid receptors CB1 and CB2 is similar in function to endocannabinoids, which are cannabinoids that are naturally produced in the body and activate these receptors. The researchers suggest that THC or other designer agents that activate these receptors might be used in a targeted fashion to treat lung cancer.
... Acting through cannabinoid receptors CB1 and CB2, endocannabinoids (as well as THC) are thought to play a role in variety of biological functions, including pain and anxiety control, and inflammation. Although a medical derivative of THC, known as Marinol, has been approved for use as an appetite stimulant for cancer patients, and a small number of U.S. states allow use of medical marijuana to treat the same side effect, few studies have shown that THC might have anti-tumor activity, Preet says. The only clinical trial testing THC as a treatment against cancer growth was a recently completed British pilot study in human glioblastoma.
... researchers first demonstrated that two different lung cancer cell lines as well as patient lung tumor samples express CB1 and CB2, and that non-toxic doses of THC inhibited growth and spread in the cell lines. "When the cells are pretreated with THC, they have less EGFR stimulated invasion as measured by various in-vitro assays,"...
Then, for three weeks, researchers injected standard doses of THC into mice that had been implanted with human lung cancer cells, and found that tumors were reduced in size and weight by about 50 percent in treated animals compared to a control group. There was also about a 60 percent reduction in cancer lesions on the lungs in these mice as well as a significant reduction in protein markers associated with cancer progression ...
and what does all these have to do with waheed concealing the true reports of Zakwan?
O man! She was like an angel when she called. I should have listened. I’m sorry I treated you that way. I just stepped into Sweet Hell.
Frequent or long-term marijuana use may raise a man's risk of testicular cancer, American research suggests. The study of 369 men, published in the journal Cancer, found being a regular marijuana user doubled the risk compared to those who never smoked it. The results suggest that it may be linked to the most aggressive form of the cancer.
After the presidential campaign and inauguration took place, many and plenty of people were happy with the results, then again vice-versa. But see, the thing that people Need to understand is that Barack Obama is not only the President, but he is also an exceptionally amazingly well skilled speaker. You have to take into consideration every word he says to the Neuro Linguistic Programming he uses in his speech performance. Making a ten billion dollar federal loss seem like we just lost a grain of rice from our dinner plate is something that I give kudos to Barack Obama for easing our worries. But then again, does our country need someone who is all talk or someone who can also walk the talk?
The article is entirely based on hearsay and rumors. Until concrete evidence is procured (i.e. the original report) any assumptions should not be made on the circumstances under which the report went missing nor on its content.
These findings are clearly biased, Dr Mohamed Solih may have claimed ‘Dr Abdulla Waheed ordered the report be shelved as part of a cover-up’ to benefit his own ends.
If the article was founded on the claims of multiple witnesses or concrete reports it would make the information substantial; this is simply the rule of good journalism.
-Dan
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