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Papers by Hassan Chamsi-Pasha

Research paper thumbnail of The cardiac patient during Ramadan and Hajj

The holy month of Ramadan is one of the five pillars of Islam. During this month, fasting Muslims... more The holy month of Ramadan is one of the five pillars of Islam. During this month, fasting Muslims refrain from
eating, drinking, smoking, and sex from dawn until sunset. Although the Quran exempts sick people from the duty of fasting, it is not uncommon for many heart disease patients to fast during Ramadan. Despite the fact that more than a billion Muslims worldwide fast during Ramadan, there is no clear consensus on its effects on cardiac disease. Some studies have shown that the effects of fasting on stable patients with cardiac disease are minimal and the majority of patients with stable cardiac illness can endure Ramadan fasting with no clinical deterioration.
Fasting during Ramadan does not seem to increase hospitalizations for congestive heart failure. However, patients with decompensated heart failure or those requiring large doses of diuretics are strongly advised not to fast, particularly when Ramadan falls in summer. Patients with controlled hypertension can safely fast. However,patients with resistant hypertension should be advised not to fast until their BP is reasonably controlled. Patients with recent myocardial infarction, unstable angina, recent cardiac intervention or cardiac surgery should avoid fasting. Physician advice should be individualized and patients are encouraged to seek medical advice before fasting in order to adjust their medications, if required.
The performance of the Hajj pilgrimage is another pillar of Islam and is obligatory once in the lifetime for all
adult Muslims who are in good health and can afford to undertake the journey. Hajj is a physically, mentally, emotionally, and spiritually demanding experience. Medical checkups one or two months before leaving for Hajj is warranted, especially for those with chronic illnesses such as cardiovascular disease. Patients with heart failure,uncontrolled hypertension, serious arrhythmias, unstable angina, recent myocardial infarction, or cardiac surgery should be considered unfit for undertaking the Hajj pilgrimage.

Research paper thumbnail of Warfarin resistance in a patient with mechanical valve prosthesis

Saudi medical journal, 2005

Research paper thumbnail of Heart transplantation for Churg-Strauss syndrome

Heart, 1989

A patient with heart failure caused by Churg-Strauss syndrome was successfully treated with trans... more A patient with heart failure caused by Churg-Strauss syndrome was successfully treated with transplantation. The case was unusual because there was little evidence of Churg-Strauss syndrome in the lung. The patient remains well on standard transplant immunotherapy.

Research paper thumbnail of Kidney transplantation: ethical challenges in the Arab world

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2014

There is a wide gap between organ supply and demand, which results in a very long waiting time fo... more There is a wide gap between organ supply and demand, which results in a very long waiting time for kidney transplantation and an increasing number of deaths of the patients while on the waiting list. These events have raised many ethical, moral and societal issues regarding organ donation, allocation and use of living donors through exploitation of the poor for the benefit of the wealthy. Success in the implementation of kidney transplantation programs in a country depends on various factors including the economic situation, religious approval, public views, medical expertise and existing legislation. The public attitude toward donation is pivotal in all transplantation programs; increasing the awareness of the leaders of religion is vital in this regard.

Research paper thumbnail of Critical congenital heart disease screening

Avicenna Journal of Medicine, 2016

Research paper thumbnail of The cardiac patient in Ramadan

Avicenna Journal of Medicine, 2016

Ramadan is one of the five fundamental pillars of Islam. During this month, the majority of the 1... more Ramadan is one of the five fundamental pillars of Islam. During this month, the majority of the 1.6 billion Muslims worldwide observe an absolute fast from dawn to sunset without any drink or food. Our review shows that the impact of fasting during Ramadan on patients with stable cardiac disease is minimal and does not lead to any increase in acute events. Most patients with the stable cardiac disease can fast safely. Most of the drug doses and their regimen are easily manageable during this month and may need not to be changed. Ramadan fasting is a healthy nonpharmacological means for improving cardiovascular risk factors. Most of the Muslims, who suffer from chronic diseases, insist on fasting Ramadan despite being exempted by religion. The Holy Quran specifically exempts the sick from fasting. This is particularly relevant if fasting worsens one's illness or delays recovery. Patients with unstable angina, recent myocardial infarction, uncontrolled hypertension, decompensated heart failure, recent cardiac intervention or cardiac surgery or any debilitating diseases should avoid fasting.

Research paper thumbnail of Pragmatic message to junior doctors

Postgraduate Medical Journal, 2016

Although several studies described the experience of doctors in their first postgraduate years, f... more Although several studies described the experience of doctors in their first postgraduate years, few shed the light on the ethical issues encountered by them. These doctors face a broad range of 'everyday' ethical challenges, from breach of confidentiality to truth-telling or improper informed consent. The daily ethical issues faced by junior doctors are not as dramatic as the major issues learned at medical school. Junior doctors have to make the best ethical decisions within the time limits available. Undergraduate medical ethics curricula should give priority to the real-life issues that doctors will face in their first years of practice.

Research paper thumbnail of Doctor-patient relationship. Islamic perspective

Saudi Medical Journal, 2016

The doctor-patient relationship is an intricate concept in which patients voluntarily approach a ... more The doctor-patient relationship is an intricate concept in which patients voluntarily approach a doctor and become part of a contract by which they tend to abide by doctor's instructions. Over recent decades, this relationship has changed dramatically due to privatization and commercialization of the health sector. A review of the relevant literature in the database of MEDLINE published in English between 1966 and August 2015 was performed with the following keywords: doctor-patient relationship, physician-patient relationship, ethics, and Islam. The Muslim doctor should be familiar with the Islamic teachings on the daily issues faced in his/her practice and the relationship with his/her patients.

Research paper thumbnail of Difficulties in apologising for a medical error

Research paper thumbnail of Kidney transplantation: Ethical challenges in the Arab world

Saudi Journal of Kidney Diseases and Transplantation, 2014

Research paper thumbnail of Ethical Issues in Genetics (Premarital Counseling, Genetic Testing, Genetic Engineering, Cloning and Stem Cell Therapy, DNA Fingerprinting)

Contemporary Bioethics, 2015

Research paper thumbnail of Virtue Ethics and Moral Character Related to Medical Profession

Contemporary Bioethics, 2015

Research paper thumbnail of The Sources of Common Principles of Morality and Ethics in Islam

Contemporary Bioethics, 2015

Research paper thumbnail of Assisted Reproductive Technology: Islamic Perspective

Contemporary Bioethics, 2015

Research paper thumbnail of Regulation of Medical Profession and Medical Research

Contemporary Bioethics, 2015

Professional virtues and codes of conduct were historically associated with the philosophy and et... more Professional virtues and codes of conduct were historically associated with the philosophy and ethos of each community. The medical profession, in particular, was esteemed by all nations and cultures. Imam Shafi [1] (767-820 CE) said: "There are two kinds of persons who are indispensable for people. The scholars (of religion and law = ulema) for dealing with their matters of religion, and physicians for dealing with their bodies. Abubaker AlRhazi [2] (864-925 CE) said: "The physicians possess traits that are not found in others, among such is the unanimous view of the followers of religion and authority, of the preference of their occupation, and the acknowledgement of both kings and laymen for the exigent need for their services; for their everlasting strive to discover the unknown in the field of knowledge, of their pursuance to improve their profession, and of their persistent concern of introducing happiness and comfort to others."

Research paper thumbnail of The Origins of Islamic Morality and Ethics

Contemporary Bioethics, 2015

Research paper thumbnail of Nonmaleficence

Contemporary Bioethics, 2015

Research paper thumbnail of Beneficence

Contemporary Bioethics, 2015

Research paper thumbnail of End-of-Life Care

Contemporary Bioethics, 2015

Research paper thumbnail of Autonomy

Contemporary Bioethics, 2015

Research paper thumbnail of The cardiac patient during Ramadan and Hajj

The holy month of Ramadan is one of the five pillars of Islam. During this month, fasting Muslims... more The holy month of Ramadan is one of the five pillars of Islam. During this month, fasting Muslims refrain from
eating, drinking, smoking, and sex from dawn until sunset. Although the Quran exempts sick people from the duty of fasting, it is not uncommon for many heart disease patients to fast during Ramadan. Despite the fact that more than a billion Muslims worldwide fast during Ramadan, there is no clear consensus on its effects on cardiac disease. Some studies have shown that the effects of fasting on stable patients with cardiac disease are minimal and the majority of patients with stable cardiac illness can endure Ramadan fasting with no clinical deterioration.
Fasting during Ramadan does not seem to increase hospitalizations for congestive heart failure. However, patients with decompensated heart failure or those requiring large doses of diuretics are strongly advised not to fast, particularly when Ramadan falls in summer. Patients with controlled hypertension can safely fast. However,patients with resistant hypertension should be advised not to fast until their BP is reasonably controlled. Patients with recent myocardial infarction, unstable angina, recent cardiac intervention or cardiac surgery should avoid fasting. Physician advice should be individualized and patients are encouraged to seek medical advice before fasting in order to adjust their medications, if required.
The performance of the Hajj pilgrimage is another pillar of Islam and is obligatory once in the lifetime for all
adult Muslims who are in good health and can afford to undertake the journey. Hajj is a physically, mentally, emotionally, and spiritually demanding experience. Medical checkups one or two months before leaving for Hajj is warranted, especially for those with chronic illnesses such as cardiovascular disease. Patients with heart failure,uncontrolled hypertension, serious arrhythmias, unstable angina, recent myocardial infarction, or cardiac surgery should be considered unfit for undertaking the Hajj pilgrimage.

Research paper thumbnail of Warfarin resistance in a patient with mechanical valve prosthesis

Saudi medical journal, 2005

Research paper thumbnail of Heart transplantation for Churg-Strauss syndrome

Heart, 1989

A patient with heart failure caused by Churg-Strauss syndrome was successfully treated with trans... more A patient with heart failure caused by Churg-Strauss syndrome was successfully treated with transplantation. The case was unusual because there was little evidence of Churg-Strauss syndrome in the lung. The patient remains well on standard transplant immunotherapy.

Research paper thumbnail of Kidney transplantation: ethical challenges in the Arab world

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2014

There is a wide gap between organ supply and demand, which results in a very long waiting time fo... more There is a wide gap between organ supply and demand, which results in a very long waiting time for kidney transplantation and an increasing number of deaths of the patients while on the waiting list. These events have raised many ethical, moral and societal issues regarding organ donation, allocation and use of living donors through exploitation of the poor for the benefit of the wealthy. Success in the implementation of kidney transplantation programs in a country depends on various factors including the economic situation, religious approval, public views, medical expertise and existing legislation. The public attitude toward donation is pivotal in all transplantation programs; increasing the awareness of the leaders of religion is vital in this regard.

Research paper thumbnail of Critical congenital heart disease screening

Avicenna Journal of Medicine, 2016

Research paper thumbnail of The cardiac patient in Ramadan

Avicenna Journal of Medicine, 2016

Ramadan is one of the five fundamental pillars of Islam. During this month, the majority of the 1... more Ramadan is one of the five fundamental pillars of Islam. During this month, the majority of the 1.6 billion Muslims worldwide observe an absolute fast from dawn to sunset without any drink or food. Our review shows that the impact of fasting during Ramadan on patients with stable cardiac disease is minimal and does not lead to any increase in acute events. Most patients with the stable cardiac disease can fast safely. Most of the drug doses and their regimen are easily manageable during this month and may need not to be changed. Ramadan fasting is a healthy nonpharmacological means for improving cardiovascular risk factors. Most of the Muslims, who suffer from chronic diseases, insist on fasting Ramadan despite being exempted by religion. The Holy Quran specifically exempts the sick from fasting. This is particularly relevant if fasting worsens one's illness or delays recovery. Patients with unstable angina, recent myocardial infarction, uncontrolled hypertension, decompensated heart failure, recent cardiac intervention or cardiac surgery or any debilitating diseases should avoid fasting.

Research paper thumbnail of Pragmatic message to junior doctors

Postgraduate Medical Journal, 2016

Although several studies described the experience of doctors in their first postgraduate years, f... more Although several studies described the experience of doctors in their first postgraduate years, few shed the light on the ethical issues encountered by them. These doctors face a broad range of 'everyday' ethical challenges, from breach of confidentiality to truth-telling or improper informed consent. The daily ethical issues faced by junior doctors are not as dramatic as the major issues learned at medical school. Junior doctors have to make the best ethical decisions within the time limits available. Undergraduate medical ethics curricula should give priority to the real-life issues that doctors will face in their first years of practice.

Research paper thumbnail of Doctor-patient relationship. Islamic perspective

Saudi Medical Journal, 2016

The doctor-patient relationship is an intricate concept in which patients voluntarily approach a ... more The doctor-patient relationship is an intricate concept in which patients voluntarily approach a doctor and become part of a contract by which they tend to abide by doctor's instructions. Over recent decades, this relationship has changed dramatically due to privatization and commercialization of the health sector. A review of the relevant literature in the database of MEDLINE published in English between 1966 and August 2015 was performed with the following keywords: doctor-patient relationship, physician-patient relationship, ethics, and Islam. The Muslim doctor should be familiar with the Islamic teachings on the daily issues faced in his/her practice and the relationship with his/her patients.

Research paper thumbnail of Difficulties in apologising for a medical error

Research paper thumbnail of Kidney transplantation: Ethical challenges in the Arab world

Saudi Journal of Kidney Diseases and Transplantation, 2014

Research paper thumbnail of Ethical Issues in Genetics (Premarital Counseling, Genetic Testing, Genetic Engineering, Cloning and Stem Cell Therapy, DNA Fingerprinting)

Contemporary Bioethics, 2015

Research paper thumbnail of Virtue Ethics and Moral Character Related to Medical Profession

Contemporary Bioethics, 2015

Research paper thumbnail of The Sources of Common Principles of Morality and Ethics in Islam

Contemporary Bioethics, 2015

Research paper thumbnail of Assisted Reproductive Technology: Islamic Perspective

Contemporary Bioethics, 2015

Research paper thumbnail of Regulation of Medical Profession and Medical Research

Contemporary Bioethics, 2015

Professional virtues and codes of conduct were historically associated with the philosophy and et... more Professional virtues and codes of conduct were historically associated with the philosophy and ethos of each community. The medical profession, in particular, was esteemed by all nations and cultures. Imam Shafi [1] (767-820 CE) said: "There are two kinds of persons who are indispensable for people. The scholars (of religion and law = ulema) for dealing with their matters of religion, and physicians for dealing with their bodies. Abubaker AlRhazi [2] (864-925 CE) said: "The physicians possess traits that are not found in others, among such is the unanimous view of the followers of religion and authority, of the preference of their occupation, and the acknowledgement of both kings and laymen for the exigent need for their services; for their everlasting strive to discover the unknown in the field of knowledge, of their pursuance to improve their profession, and of their persistent concern of introducing happiness and comfort to others."

Research paper thumbnail of The Origins of Islamic Morality and Ethics

Contemporary Bioethics, 2015

Research paper thumbnail of Nonmaleficence

Contemporary Bioethics, 2015

Research paper thumbnail of Beneficence

Contemporary Bioethics, 2015

Research paper thumbnail of End-of-Life Care

Contemporary Bioethics, 2015

Research paper thumbnail of Autonomy

Contemporary Bioethics, 2015