The issue of medicine has recently come to the forefront in our health policy. This is what has been emphasized in the various activities held under the patronage of the Ministry of Health.
Medicine for politicians and educated people is a service, but for businessmen it is a profitable commodity similarly to other goods. However, medicine for specialists means using any simple or compound substance for the treatment of specific diseases or for protection.
In this respect Ismael al-Ghaberi of the Yemen Times interviewed Dr. Ahmed Mohammed al-Khazan, consultant in obstetrics.

Q: How do you assess medical investment in Yemen?
A: Medical investment is of great importance, unless there are laws and restrictions regulating the profession of medicine. It is therefore related to the scrupulous practitioners and doctors who have experience and are highly qualified in their fields. He or she has to adhere to the rules and scientific regulations. This will pave the way for us to avoid mistakes that may lead to inevitable consequences.

Q: How do you view doctors these days?
A: I feel more sorrow than anger when I see that our doctors and those who are in charge of the preventive health care system in Yemen are viewed as a laughingstock. It is by no means considered to be a bad phenomenon spread in our country.
Amid the huge health and clinic establishments scattered in our country, we find that doctors don't adhere to the medical dimensions where a patient can be treated by doctors who are well experienced and well informed of their profession.
In the future there should be sections for tackling mistakes committed by intruders without even being monitored. The profession of the medicine has become a magnet for every Tom, Dick and Harry. Even it has become a profession for the magicians and conjurors.

Q: Medical diagnoses are improper and have become common nowadays, which in turn may lead to inevitable consequences on the part of a patient. Can you comment?
A: A distinguished and skillful doctor is one who knows that diagnosis has to be undertaken before taking medicine. Without diagnosis there is never medicine. This is the ultimate goal of medicine and its central core.
There should be a law or regulation that have to be general for all medicine practitioners.
In order to perform his duty successfully, a doctor has to be supervised by well-experienced experts.
There are two bodies in hospitals administration. The first one is called a medical body. Its duty is restricted to diagnosis and treatment. The second one is related to administration where the first one pokes its nose into the second's affairs and businesses. Then, the profession of medicine turns into chaos.

Q: The profession of medicine has become something related to trade business run by some people who have no familiarity with medicine at all. Can you comment?
A: Preventive medicine is supposed to be more organized and more careful.
If we draw a simple distinction between the medicine and the army, we will find that patients are exposed to death if they are treated badly as a result of, for example, wrong doses they have taken, or as a result of spreading an epidemic.
Whereas in a battlefield the death cases are limited and become restricted to a group of people.
In this case the profession of medicine has to be adhere to the rules and regulations, which determines the high standards of hospitals as well as doctors.
Medicine is a service not a commodity.

By Dr Muhammad Karim Beebani
For The Yemen Times
I feel pity for the stomach. I really feel pity for the stomach, intestines and in fact the whole gastrointestinal system. This is because the whole year we never let this system take a rest.
Apart from the three main daily meals, every few minutes we pour something in the stomach, be it snacks, drinks, fruits or other eatables.
None of us thinks that the food which we had already sent in before is being digested by the stomach and right when it has reached halfway, we dump some more boluses only to disrupt the digestive work up previously completed. This of course makes the food stay longer time in the stomach, which may result in dyspepsia, gastritis, and irritable bowel syndrome.
In contrast, Ramadhan is the only period in which our gastrointestinal system takes good rest as the Muslims observe fasting for the month. Digestion is not just the name of churning movements of the stomach and absorption by the intestines, but it is a huge integrated system involving the nervous system (e.g. vagus nerve) as well as hormone secreting glands.
System rest
So the whole gastrointestinal system gets rest for the first time in the whole year. As digestion begins in the mouth where the salivary glands secrete excessive saliva, which carries hormones to act upon the food, the burden on the salivary glands and the teeth is reduced. The esophagus takes rest during fasting, as there is no food to require it's propelling movements, which push the food to the stomach.
Similarly the stomach and the intestines also get good rest, as after completing the digestion and absorption of the food consumed in the morning, they have nothing to do until Iftar time.
Not only the stomach and intestines take rest, but along with them the glands like pancreas and gall bladder which secrete hormones also reduce their secretions as their is no food to demand their hormones.
Hence, there is substantial reduction in the gastrointestinal hormones like gastric juice, gastrin, CCK-PZ, gastric inhibitory peptide (GIP), motilin, vasoactive intestinal peptide (VIP), neurotensin, enteroglucagon, neuropeptide Y, and gallium.
Lastly the colon and the liver are also at ease during fasting. In short Ramadan lifts the heavy burden which we have put on our gastrointestinal system, and gives it what can be said to be a refreshing annual vacation for 30 days.
Diagnosing problems
Now come to the diagnostic possibilities of Ramadan fasting. A good number of patients, who consult physicians with abdominal pain, suffer from peptic ulcers. The peptic ulcer can be gastric or duodenal in type.
The presentation of abdominal pain in both gastric and duodenal ulcers is different in relation to food intake. Duodenal ulcer pain, though variable, usually occurs when the stomach is empty and the gastric ulcer presents pain after the food intake.
In normal days the differentiation of the two entities is difficult to make as people eat frequently, but in Ramadan an individual undergoes two stages. One, during the fasting when his stomach is empty and the other after evening breakfast when the stomach is full.
If the patient complains of abdominal pain while fasting, it will point to the possibility of duodenal ulcer and if the pain occurs after Iftar the gastric ulcer will be the suspected diagnosis.
It is worth mentioning that the peptic ulcer pain is variable and it may not occur in some patients. Similarly in most of the duodenal ulcer cases, as soon as mild pain starts, the patient eats something, at which time the pain disappears and the disease remains undiagnosed.
This undiagnosed ulcer may later on present itself with perforation of the ulcer, haematemesis (vomiting of blood), that has a high rate of mortality.
In the Ramadan type of severe fasting, the duodenal ulcer is more likely to surface and as there is no provision to relieve the pain with food, the patient may be forced to consult a physician who, with the help of endoscopy, can easily clinch the diagnosis.
While examining the abdomen of a patient who is already fasting, a physician can easily palpate the tenderness as well as feel the edema around the peptic ulcer region. A generalized mild tenderness in the abdomen of a patient who is fasting can be due to irritable bowel syndrome, inflammatory bowel disease or colitis etc.
Healing effect
Ramadhan fasting has a healing effect on peptic ulcers as it curbs smoking and alcohol intake, which are two recognized precipitating factors for the peptic ulcer. It also has beneficial effects on inflammatory bowel disease, irritable bowel syndrome, dyspepsia, gastritis etc.
Last but not the least, imagine a person who has fasted for 14-15 hours and is now ready to break his fast. His taste buds have taken good rest, so at Iftar the food is going to taste more pleasant than ever before.
This is yet another bounty of Ramadan.
Allah's apostle (pbuh) says :" There are two pleasures for the fasting person, one at the time of breaking his fast and the other at the time when he will meet his Lord, then he will be pleased because of his fasting."

Old cars are killing us

BY YASSER AL MAYASSI
YEMEN TIMES STAFF
Old cars which pollute the air with emissions are causing growing environmental and health problems in Yemen.
Since 1990, Yemen has been focusing more on its environment administration. An official institution has been charged with environmental affairs and protection for which it provides a number of environmental laws and programs nationwide.
As a result, an environmental protection law was issued in 1995, determining the standards of air quantity to insure environmental and public health protection as well as the cultural and urban heritage of historical cities. But it was never activated.
Now the government has started to feel the seriousness of the problem, so a special committee was formulated from the Shoura Council in order to study the project adding tax to the fuel price to put an end to damage from old cars.
These procedures come after the negative effects of the secondhand cars and the pollutions it cause for environment specially these shifted to Diesel. Such negative affects became a disturbing problem threatening the people directly.
The effects of diesel remains a danger that threatens the respiratory system, cancer, and suffering of people living among pollution.
The last traffic statistics indicate that the cars in Yemeni cities exceed one million. It is expected that the number will be 1.25 million in the coming ten years.
What adds to the pollution problem is that Sana'a is 2,223 meters high and surrounded by mountains which hinder the air stream of city.