SIMPOSIUM PERUBATAN ISLAM 2016:

KE ARAH PERUBATAN ISLAM YANG PROFESIONAL DAN

KONTEMPORARI

26 -27 April 2016 Universiti Kebangsaan Malaysia Anjuran Kumpulan Penyelidik

LRGS/D/2012/USM-UKM/KT/03

Integration of Islamic Ruqya Practices into Modern Medicine :

Myths and Reality

UKM Bangi

LRGS 26 April 2016

Wan Mohd Azizi Bin Wan Sulaiman MD (USM) MHerbal Medicine (Sydney) PhD (Pharmacology) Complementary Medicine

NATURAL MEDICINAL PRODUCTS CENTRE

After 48 hours treatment

Before treatment

After 3 treatment

• 1st treatment 600 free range

•2nd treatment 600 free range

•3rd treatment 200 free range

Maggot Stage

Medical Fly Life

Cycle

Maggot Debridement Therapy on Diabetic Foot Ulcer: Experience from Maggot Treatment Centers By: Wan Azizi WS, Adham, Yee BL, Nurulaini

Natural Medicinal Product Center, Kulliyah of Pharmacy International Islamic University Malaysia

Kuantan, Pahang

Introduction Maggot debridement therapy (MDT) is a therapeutic use of sterile larvae of Lucilia Cuprina from entomology lab of IMR to treat non healing diabetic foot ulcers. In Malaysia, MDT has been approved by MOH as one of the standard treatment for wound management. It has been used widely in both government and private hospitals.

Data analysis (wound progress) This case studies is based on case controlled where patient serve as control involving pre and posttest. All the patients were taken photograph before starting the MDT and each time of treatment. Wound assessment was done by visual grading based on wound outcome scoring system by Aaron, G. Paul et al.

Objective To assess the benefit of MDT on patient with diabetic foot ulcer (DFU).

Study Design A single subject study design which involves a pre-test followed by an intervention, and a post-test, in order to determine the effect of MDT on patient with DFU, in one particular patient at a time.

Setting Maggot Debridement Therapy Center in Kuala Lumpur and Kuantan, collaboration of International Islamic University Malaysia and Medical BioTherapy Sdn Bhd.

Patient Selection The study was carried out on eleven (11) patients. Inclusion criteria: patient aged 30-70 years. Diabetic foot ulcer with slough , estimated medium wound size of 3cm x 11cm, required re-debridement, indicated of sepsis as antibiotics were given, patients willingness to try natural medicinal products (maggots). Exclusion criteria: wound with profusely bleeding, medium wound size with deep “tracking”, ischemic wound, gangrenous wound, patients who have entomophobia, patients who refused to try natural medicinal products.

Table 1: Outcome Classification for MDT

Discussion The role of MDT in treating diabetic foot ulcers has been demonstrated clearly by the improvement of and speeding up the wound healing process. The debridement and antiseptic properties of MDT helps to clear and clean the debris and necrotic tissues. In addition to that, it also promotes granulation tissues and nerve stimulations. MDT also manage to reduce the cost of wound management by shortens the length of hospitalization stay and avoidance of operation and amputation procedures. Our patient’s entire wound completely healed after average of three times maggot treatment, with average vial of 200. The average time for wound condition free from slough was 30 days. Subsequently, patients will continue the normal dressing and skin graft procedures. These data’s supported our findings of shorter duration of healing and cost saving as they have been followed up as outpatient.

Conclusion This study indicates the beneficial effect of MDT towards diabetic foot ulcer patient in our Maggot Treatment centers. However, we propose a proper and large scale studies to further confirm our findings.

References Sherman RA (2009) Volume 3, Issue 2 Journal of Diabetes Science and Technology Bowling FL VOLUME 30, NUMBER 2 (2007) DIABETES CARE Marta OS (2009) British Medical Journal Aaron GP; Ahmad NW ; Lee HL (2009) Int. Wound Journal.

Grade Sub-grade Outcome

Healed 1A Suitable for SSG, flap coverage or self healing

1B Debridement + SSG/ flap coverage

1C Assisted debridement in between to remove necrotic tendons or exposed bone

Unhealed 2 Surgical debridement (MDT abandoned)

3A Minor amputation (below ankle)

3B Major amputation (above ankle)

Others 4 Others (patient withdrawal, discontinuation, death, etc.)

Patient Wound size (estimate) Amount of maggots per treatment

Duration of treatment (from starting till ending)

Classification for MDT

P1 4cm x 7cm 50, 50, 50, 100 32 days Healed- 1C; assisted debridement + 2 rays amputation

P2 6cm x 9cm 100, 100, 100, 150 20 days Others- 4; discontinuation due to other systemic disorder

P3 5cm x 8cm 50, 50, 100 43 days Healed- 1A; wound clean, for self healing

P4 5cm x 7cm 100, 100 51 days Healed- 1C; assisted debridement in between to remove necrotic tendons or exposed bones

P5 3cm x 6cm 50, 50, 200 28 days Healed- 1A; wound clean, for self healing

P6 3cm x 6cm 300, 300 50 days Healed- 1A; wound clean, for self healing

P7 5cm x 10cm 1000 13 days Healed- 1A; wound clean, for self healing

P8 3cm x 8cm 200 11 days Healed- 1A; wound clean, for self healing

P9 5cm x 10cm 400, 200, 400, 400 22 days Healed- 1A; wound clean, for self healing

P10 4cm x 5cm 300, 200, 200 31 days Healed- 1A; wound clean, for self healing

P11 6cm x 11cm 350, 400, 200, 100 32 days Healed- 1A; wound clean, for self healing

OUTLINE 1

• Modern Psychiatric: Etiology, neurochemical theories, drugs used

• IMP : Etiology, Diagnosis, Treatment used

• Overlap Symptomatology and Diagnosis issues

• The Role of Ruqya Syari’yyah

OUTLINE 2 INTEGRATION

• Why should we integrate Islamic Medicine Practices into Modern Psychiatric Discipline

• Challenges of Integration

• Proposal for Integration

Principle of Etiology in Psychiatry

SIDE EFFECTS

Principle of Etiology in IMP

Surah al-A'raaf ayat 16 dan 17:

(Iblis) berkata, kerana Engkau telah menghukum aku sesat, aku benar-benar akan menghalang mereka dari jalanMU yang lurus. Kemudian aku akan datangi mereka dari muka dan dari belakang, dari kanan dan kiri mereka. Dan Engkau tidak akan mendapati kebanyakan daripada mereka bersyukur.

Can Satanic influence thoughts and behaviour

• Satan is a member of the class of beings called jinn. Like all jinn, he can transform himself into various forms, sometimes appearing as a man, sometimes as an animal.

• infiltrates a person’s thoughts by means of one aspect of the human soul called al-nafs al-ammarah(the lower soul).

• Al Islam

and CONTROL

DO HARM

Satanic Influence • These manifestations take on different forms, yet they all

conform to what the lower soul desires:

• 1. The beautification of ugly deeds • “Satan made their actions seem beautiful to them, and

then diverted them from Allah’s path.”7

• 2. False promises • “Satan promises them and compels them to entertain

farfetched hopes.”8

• 3. Fear • “Satan threatens you with poverty and enjoins you toward

sin.”9

• Al Islam

7 Tipu Daya Syaitan Ke Atas Umat Islam

Hafiz Firdaus Abdullah

Overlap Symptoms and Signs • PSYCHIATRIC • SIHIR

Delusion Hallucination Trance and Possession Disorders Obsessive Compulsive Disorders Depression Stress and stress related disorders

Pain of Unknown Origin Paralysis Psychosomatic Nightmares Malas Beribadat Abnormal symptoms reading Quran Prolong Menstruation Infertility Sukar dapat Jodoh Selalu ditindih ketika tidur. Kuat berangan. Terlalu rasa rendah diri dan tidak berkeyakinan. Nafsu seksual yang melampau. Selalu melihat kelibat dirumah. Sakit mental atau gila.

The role in Diagnosis and Differential Diagnosis: IMP

• Schizophrenic and Psychotic Disorders

• Trance and Possession Disorders

• Obsessive Compulsive Disorders

• Depression

• Stress and stress related disorders

• Psycho social disorders

JINN POSSESSION DISORDERS GANGGUAN SIHIR

Role of Ruqya Therapy

• Definition • Types • Guideline and requirements for Practitioners • Short Term and Long Term effects • Role for Psychotics symptoms • Role for Depression • Role for Stress and Psychological Therapy • Role for Behaviour Therapy

• http://www.pisang.org.uk/index.php?q=node/195

Ruqyah secara biasa adalah jampi-jampi atau

mantera.

Ruqyah secara syar'i ( Ruqyah Syar'iyah )

adalah jampi-jampi atau mantera yang

dibacakan oleh seseorang untuk mengubati

penyakit atau menghilangkan gangguan jin

atau sihir atau untuk perlindungan dan

sebagainya.

Dengan hanya menggunakan ayat-ayat Al-Quran dan

doa-doa yang bersumber dari hadiths-hadiths

Rasulullah SAW yang dapat difahami maknanya

selama tidak mengandungi unsur kesyirikan.

RUQYA- IS THERE EVIDENCE BASED

What we know so far in IMP

What we know so far in IMP • Two different Disciplines

• Should we integrate Islamic Medicine Practices into Modern Psychiatric Discipline

ROLE CONTRIBUTION

IMPORTANT

Preservation of knowledge and practices

LOSS OF TREASURES

Should we integrate Islamic Medicine Practices into Modern Psychiatric

Discipline • 1. The role in Therapeutic

• Ruqya Therapy in various subtypes ailments

• Mental Health Index

Should we integrate Islamic Medicine Practices into Modern Psychiatric

Discipline • 2. The role in Psychotherapy/Behavioural

Therapy

PROPOSAL FOR INTEGRATION

• Where do we start

• 1. JOINT NATIONAL COMMITTEE,PROPER BOARD

• 2. INSTITUTE UNDER JABATAN PERDANA MENTERI, JAKIM

• 3. RESEARCH INSTITUTE, UNIVERSITY

• 4. ACADEMIC COURSES, SEMINAR

• 5. INTERNATIONAL COLLABORATION

LAW FOR SIHIR