Friday, February 17, 2006

Wasm !!!

Hey all ..

For more than an hour I was trying to write about anything but my brain ( if I have one which I doubt) was really confused and was unable to translate any of the topics that I thought about into readable words .. I was writing a political entry … and I was in the middle then I got stuck .. and I delete the whole thing .. then I was writing something medical and again I remember that I promise that am not going to medicalize my blog .. and I delete it too .. I know what you are thinking .. amean if I was tooo picky like this then how come I have 50 crappy entry in my blog : ) well believe it or not .. I am picky .. and what I delete is much worse than what I publish or that how I see them ..

Any how I feel that I need to post about Wasm which is somehow medical but again it is more of social topic as it is one of alternative medicine that is widely practiced in our region and in most of the Islamic countries .. it will be a long post am sorry if its boring yet I think you got used to me being boring : )

I wrote this topic one week ago but I couldn’t view the blogger site ..


Definition :
So for you who don’t know what is wasm … wasem is a Burn induced by a metallic tool ( usually iron ) done by a traditional healer and thought to heal different physical diseases
ranging from Jaundice to Cancer .. In wasem they are using a metallic Tool that
they put it in fire till it become red and use it to burn specific places
depend on the disease .. like if it jaundice ( the person became yellow or what disease as locals call it “al safra” the yellowish disease yet we need to make some clarification here as jaundicie is not a disease by it self but it is a sign of other diseases like red eye or rash ) they burn the part behind the ear ... and they repeat with the other ear if the patient didn't achieve a full recovery . in chronic constipation or abdominal pain they would burn just above or below the umbilicus .. while there are different methods ( couldn't really understand the logic behind it ) in
burning to treat tumors ..but usually they burn over the tumor and sometimes in circle around it ..

Epidemiology/ statistic :
Now how common it is used ? well there are not definite statistics illustrate how common is it practiced .. in my point of view it is very common among patients with chronic diseases that medicine fail or recovery need long time to be achieved so patients look for alternative therapy and they usually go for wasm .. where it is common ? as I practice medicine in Oman and I never saw a single Kuwaiti patient I noticed it is more common in patient from al dakhlia region , less common among educated ppl more among elderies than in young ppl .. yet I still see children less than two years old with wasm scar ..
As I said before it is used usually for chronic ( long lasting ) diseases .. but widely used for jaundiced as it is believed ( in some regions ) to be the only curative therapy for such a disease ..


Origin :

From where we developed such a therapy ?well it is old as old as the human being in earth .. and the prophet (PBUH ) mention it in one of his says that al “al kay “ burning could be curative .. ..


جاء في صحيح البخاري: عن سعيد بن جبير ، عن ابن عباس عن النبي [ أنه قال: الشفاء في ثلاث: شربة عسل، وشرطة محجم، وكية نار، وأنا أنهى أمتي عن الكي.

The translations is as following ( sorry for my weak English ) : Cure Could be achieved by three modalities , Honey , Mehjam ( drawing blood from specific places using a blade and cup ) and AL kay ( wasm ) , And I don’t want my ppl to use the “Kay” ( cauterization ) (wasm )

now that will cause a conflict for us “doctors” ( yet am not really one of them yet ) to convince someone that there is no scientific or any medical studies shows any therapeutic importance of wasm.. not that any of them got conducted as far as in know because it is partially un ethical to induce a burn in a patient with out any previous studies that show any therapeutic usage of this burn am not disregarding what the prophet said here .. but for some one who try to explan things sceitifically it just doesn’t fit.. I was like why the prophet used this type of therapy when I search in some of the religion books I found that the prophet had used wasm in some occasion for stopping the bleeding ..

وفي هذا يقول الخطابي : أن النبي [ : »إنما كوى سعداً ليرقأ الدم من جرحه، وقد خاف عليه أن ينزف فيهلك [



Al khotabi said that the prophet cauterize Sa’ad to stop his bleeding , because he was afraid that he will die from bleeding ..


well that make a lot of sense to me as we still use that in surgery to by using cautery ( electrical machine used to cut tissues and stop bleeding by burning the bleeding artery or vein ) and there is nothing about the using of such a treatment for jaundice or any other disease in sunna ..


Now why am bothering you all with this and why am giving you a headache .. since most of you from Muscat and I saw only 1 case or two from Muscat using wasm ( yet my medical experience and my exposure is limited and am not in place to make statistics ) .. well if you are still awake .. wo if you didn’t skip reading the rest o this so called article I need you to see those two cases. ..

Case one :

One of my friends had an uncle who was sick .. he didn’t mention any thing about him in front of me before .. one day he told me about him and that he is really sick and they diagnose him with liver cancer ( hepatocellular carcinoma ) the tumor was something like 10 cm x 8 cm ( that is pretty big one ) and he was diagnosed in royal hospital .. I asked him if his uncle appeared to be yellow for the last few months or did he lost any weight recently ( jaundice is a sign that can present in the liver cancer as well as other diseases affecting the liver like hepatitis , cirrhosis and other organs like gall bladder and even some blood diseases ) he said he was jaundiced for something like 2 years .. I asked him didn’t he visit any doctor for those two years ? he said No he didn’t he applied wasm so many times as it is the traditional most known therapeutic technique to treat jaundice .. until he got fluid collection ( ascites ) in his abdomen and he thought maybe it is the time to visit a doctor .. he was referred to Royal hospital where a diagnosis of end stage liver cancer with metastasis ( spreading to some where else ) at this stage there is no curative therapy for such a disease .. he went to Thailand for second opinion and they confirm the size of the tumor and the un availability of the treatment .. now am not against God well but let get that straight if this guy went to doctor two years ago where the tumor is so small and didn’t spread yet it could be excised since human being could live with only one third of normal functioning liver ..here I accuse the wasm and lack of education as reason of this guy situation right now …

Case two :
During my surgery rotation last year I was placed in Breast Clinic in SQUH .. I saw this case .. She is 54 years women who had a history of a lump in the breast for the past 5 months .. I was wondering before I counties taking history and do physical examination why this lady waited for 5 month to go to a doctor knowing that referral to breast surgeon is an urgent and it take no less than 2 weeks from health center for as its early detection make big difference in the prognosis ( the outcome of the treatment ) when the surgeon asked her that he want to examine her .. she hesitated then she said that she tried some of traditional medicine .. the doctor ( he was Omani ) was accustomed that most of the patient woulddo that so he said it is ok let me see .. when she exposed the affected breast I was shocked .. most of the flesh was burned except for the areola with deep fresh burn and some of the wounds are infected and need treatment … it was extremely difficult to feel the margin of the lump as manipulating the breast at this situation is really difficult and painful .. the doctor asked for especial type of x ray and asked for biopsy ( cut through the skin into the tumor to take piece of it and send for evaluation which give as semi definite result if it is cancer or benign tumor ) when the doctor tried to explain to the women that he gonna ned the biopsy she start screaming that she wouldn’t accept putting a needle inside her breast and that would be really painful .. now I start talking .. I said , hey you accepted to be burned without complaining and he didn’t with out any pain killer we would do this procedure under anesthesia and you wont really feel the whole thing .. any how she didn’t accept and her son ( who happen to be a student in religious college or something like this ) was supporting her .. and he said it before she leave that western medicine is just fake his mother would be better doing wasm and they shouldn’t come in the first place .. the surgeon and I tried to get the x ray done at least .. because it could give you an idea about tumor .. she accepted .. and the x ray showed a suspicious tumor that most likely to be cancerous .. but thank god it is not spread to the nearby organs .. so it is nicely treatable .. we break out the bad news to them .. they didn’t believe and the son said that they would go to Thailand for second opinion or they would try another traditional healer .. we tried and tried to convince them .. but we couldn’t … I felt really bad I felt we are so limited .. powerless and it was my mistake that I couldn’t convince the women .... and I was thinking about the women for the whole week ..cause I know if our suspicion was true .. then the caner will spread .. and it will be more difficult to treat it .. and sometimes the relapses incidence is so high in late stages .. I conviced them to do all the investigation here in SQUH since that would really decrease the cost of their travel to Thailand and after hesitation they accept ..
Three weeks later I was placed again in the breast clinic and the same patient came she was hesitated little bit .. and son was not there .. we asked her what she had done in those three weeks she said we went to Thailand where the same diagnosis had been made and she refuse to do the biopsy ( the gold standard diagnostic tool for such disease and for most of tumor ) so we asked what we can do for you .. wishing that she had changed her mind … and fortunately she did ..we examined the breast for the second time .. the patient had more wasm scars and now cover the whole breast and some of the wounds radiate to her neck the women hesitated then said .. I thought the first one was not enough to cure me so I went for another and more aggressive traditional healer.. we didn’t say anything .. we did all the investigation she needed and our fears came to be true the disease start to spread and surgery alone wont be enough .. she need a longer course of chemotherapy which is as you know have many side effects .. the women ( thanks God ) was scheduled for surgery week after and I follow up the case and thanks god again she achieve a full recovery … but think about it ( again am not against god well ) if she was properly treated she wouldn’t go through this hassle … God well you will say .. I say ignorance and lack of education …

Disclaimer :
1- do not try to make a diagnoses based on information posted in this blog a proper examination by specialized doctor is needed ..
2- I am not against alternative medicine yet I believe more in western or modern medicine .

Tip of the Day : to convince some one .. you need facts .. to convince your self .. you need to believe ..

Sunday, February 05, 2006

Kuwait VS Oman Part II

Hey all ,

My sleeping habit is so messed up .. returning back to be the batman again .. yet no body is sending me the sign ..

Returning back to my topic .. Kuwait VS Oman .. a lot of mental censorship then rewriting happen to this topic .. yet finally I decided to blog it as I think it should be right …

We stopped in the first half time ( that really becoming a football match ) and the result was 1-1 … last goal was scored by Oman so here it goes .. Kuwait re attack …

Restaurants …

Am sure all Omanies got a bad experience about that .. lack of good restaurants ,, sometimes overpriced .. if we count the good-resutrants here in Muscat they will not be more than 20 or maybe less .. as for some one living alone ( like me ) and not much of a cook ( like me also ) that will be really a nightmare .. So restaurants on Oman .. from where should I starts .. well from the beginning I guess …

Small sandwich joints in Muscat .. which is run by Indians have no variety in food yet if you compare to Kuwait they are more expensive .. and less clean .. there still one hundrend fills ( around 130 Bizza ) sandwiches in Kuwait that a three of them will stuff any young adult man ..

CoffeShops .. well wont talk too much about it .. but there are only 4 branches for starbucks , another 4 or 5 for costa and few scattered other brands names .. Muscat could do with more coffeshops .. oh yes and we shouldn’t forget Kargeen which is apart from the not-very-good-service .. a nice place to spend time .. especially in days other than the weekend where it get crowded ..

Fast food .. well after the closure of Burger King , and closure of hardeez ( airport round ) I am left with Macdonald .. Oman is the only country as far I know where fast food chains close because they of bankrupt .. ..

Elegant , international restaurants .. only few .. most of them are in the hotels .. two or three Mexican food restaurants , two Italian ( three if you count Santinos ) few Lebanese restaurants ( Automatic , Beirut ) three or four Chinese food .. and one Japanese restaurant in Sheraton .. yet I never tried it .. but I will give it a visit soon .. the lack of good restaurants some times put us in stressful situation looking for a good restaurant if you want to invite some one either Omani or from Kuwait .. More restaurants with sea-view are needed ..





Clean, neat Country ..

Oman is back to match in no time !!! .. clean country oh yes that what I call Muscat , Oman , I always say to Kuwaitis that in Oman you can sit down with your white dishdasha on the road and your disdasha wont get dirty !! maybe am exaggerating but Oman so far is the most clean country I have ever visit .. when I first came to Oman and been in the university I was shocked to see that they wash the walls of the university with water and soap every week .. but it explain why Muscat is sooo clean .. you can hardly see any tissue in the road .. very clean beaches some of the beaches as a matter fact you feel that you are the first person ever step there yet some of them are heavily used like Qantab and shatti al qurum and that could be explained by two reasons as far as I know .. awareness of the ppl .. the picture of citizen grapping tissue or empty bag and dropping it in dust bin is not strange to see here in Muscat .. the second reason is Muscat municipality is doing great job mashala .. a road like Sultan Qaboos road is planted with roses all along the road .. we are talking here about a 40-50 km road in not very nice weather and in GULF !!! .. and that brings us to talk about the roads again .. there are no gaps in the roads , no cracks ( as far as I know ) and when ever there is something wrong with the asphalt they fix it as soon as possible sometimes in the same day ..


So again the score is 2-2 the referee ( me ) think its s fair result to end the match .. ( yes I end it when ever I want …didn’t you check the new FIFA rules :P )

If they went for penalties they would also score the same …

As Oman got a lot of natural wonderful places to visit ( 3-2 Oman )

Kuwait uses the small natural resources very well ( 3-3 )

Oman weather is much better in the summer than Kuwait … ( 4-3 )

Kuwait winter is much more better ( colder ) than Oman ( I love winter ) ( 4-4 )

Oman is real .. ( 5-4 )

Kuwait is fancy ( 5-5 )

Well for those who asked me what I think about the two countries .. that what I think I don’t think I gave you clear idea about which country I love to settle in .. couse I love them both ..

Tip of the day : Life is chaotic sometimes .. yet if it was simpler .. It will be boring..