DISEASE: ARTHRITIS

Arthritis is a form of joint disorder that involves inflammation of one or more joints. There ‎are over 100 different forms of arthritis. The most common form, osteoarthritis (degenerative ‎joint disease), is a result of trauma to the joint, infection of the joint, or age. Other arthritis ‎forms are rheumatoid arthritis, psoriatic arthritis, and related autoimmune diseases. Septic ‎arthritis is caused by joint infection. The major complaint by individuals who have arthritis ‎is joint pain. Pain is often a constant and may be localized to the joint affected. The pain from ‎arthritis is due to inflammation that occurs around the joint, damage to the joint from disease, ‎daily wear and tear of joint, muscle strains caused by forceful movements against stiff, ‎painful joints and fatigue.‎

Furthermore, there are many causes of this particular illness. It might be from the genetic ‎where as it was inherited from the parents or grandparents of the patient. Next, it could also ‎because of the age of the patient, where cartilage becomes more brittle with age and has less ‎of a capacity to repair itself. As people grow older they are more likely to develop arthritis. At ‎times like this usually as people grow older the production of their synovial fluid decreases ‎whereas this will let the cartilage rub each other and then eventually it will wear and tear and ‎causes the bones in the particular area to rub each other. Despite from that, it could be also ‎resulted because of the weight of the patient. Because joint damage is partly dependent on ‎the load the joint has to support, excess body weight can lead to arthritis. This is especially ‎true of the hips and knees that can be worn quickly in heavier patients. Then, it might be from ‎the previous injuries had by the patient too. Joint damage can cause irregularities in the normal ‎smooth joint surface. Previous major injuries can be part of the cause of arthritis. An example ‎of an injury leading to arthritis is a tibia, where the broken area of bone enters the cartilage of ‎the knee joint. ‎
Besides that, there are a few types and symptoms of arthritis, osteoarthritis is the most ‎common form of arthritis. It can affect both the larger and the smaller joints of the body, ‎including the hands, feet, back, hip, and knee. The disease is essentially one acquired from ‎daily wear and tear of the joint; however, osteoarthritis can also occur as a result of injury. ‎Osteoarthritis begins in the cartilage and eventually causes the two opposing bones to erode ‎into each other. Initially, the condition starts with minor pain while walking, but soon the pain ‎can be continuous and even occur at night. The pain can be debilitating and prevent one from ‎doing some activities. Osteoarthritis typically affects the weight-bearing joints, such as the ‎back, spine, and pelvis. Unlike rheumatoid arthritis, osteoarthritis is most commonly a disease ‎of the elderly. More than 30 percent of females have some degree of osteoarthritis by age 65. ‎Risk factors for osteoarthritis include prior joint trauma, obesity, and a sedentary lifestyle. ‎Osteoarthritis, like rheumatoid arthritis, cannot be cured, but one can prevent the condition ‎from worsening. Physical therapy to strengthen muscles and joints is very helpful. Pain ‎medications are widely required by individuals with osteoarthritis. For some patients, weight ‎loss can reduce the stress on the joints. When the disease is far advanced and the pain is ‎continuous, surgery may be an option. Unlike rheumatoid arthritis, joint replacement does ‎help many individuals with osteoarthritis. Rheumatoid arthritis is a disorder in which the ‎body's own immune system starts to attack body tissues. The attack is not only directed at the ‎joint but to many other parts of the body. In rheumatoid arthritis, most damage occurs to the ‎

joint lining and cartilage which eventually results in erosion of two opposing bones. ‎Rheumatoid arthritis often affects joints in the fingers, wrists, knees and elbows. The disease ‎is symmetrical (appears on both sides of the body) and can lead to severe deformity in a few ‎years if not treated. Rheumatoid arthritis occurs mostly in people aged 20 and above. In ‎children, the disorder can present with a skin rash, fever, pain, disability, and limitations in ‎daily activities. Often, it is not clear why the rheumatoid arthritis occurred. With earlier ‎diagnosis and aggressive treatment, many individuals can lead a decent quality of life. The ‎drugs to treat rheumatoid arthritis range from corticosteroids to monoclonal antibodies given ‎intravenously. The latest drugs like Remicade can significantly improve quality of life in the ‎short term. In rare cases, surgery may be required to replace joints but there is no cure for the ‎illness. ‎

Symptoms of Arthritis are joint pain and progressive stiffness without noticeable swelling, ‎chills, or fever during normal activities probably indicates the gradual onset of osteoarthritis. ‎Painful swelling, inflammation, and stiffness in the fingers, arms, legs, and wrists occurring in ‎the same joints on both sides of the body, especially upon awakening, may be signs ‎of rheumatoid arthritis. Joint pain and progressive stiffness without noticeable swelling, chills, ‎or fever during normal activities probably indicates the gradual onset of osteoarthritis. Painful ‎swelling, inflammation, and stiffness in the fingers, arms, legs, and wrists occurring in the ‎same joints on both sides of the body, especially upon awakening, may be signs ‎of rheumatoid arthritis.‎
There are several treatments can be done in order to relieve the pain of this illness. There are ‎several classes of arthritis medications that work to control arthritis symptoms, prevent joint ‎damage, and improve mobility and function. Basically, there are 5 categories of arthritis ‎medications: NSAIDs (non steroidal anti-inflammatory drugs), analgesics (painkillers), ‎corticosteroids, DMARDs (disease-modifying anti-rheumatic drugs), and the newer biologics. ‎NSAIDs have been used to treat arthritis for more than thirty years. NSAIDs have anti-‎inflammatory, analgesic (painkilling), and anti-pyretic (fever-reducing) properties. The drugs ‎can cause potentially serious side effects. Patients must weigh benefits and risks of taking ‎NSAIDs.

Analgesics are a class of drugs used to relieve pain. The pain relief induced by ‎analgesics occurs either by blocking pain signals going to the brain or by interfering with the ‎brain's interpretation of the signals, without producing anesthesia or loss of consciousness. ‎There are basically two kinds of analgesics: non-narcotics and narcotics. Corticosteroids are ‎drugs closely related to cortisol, a hormone which is naturally produced in the adrenal cortex ‎‎(the outer layer of the adrenal gland). In 1948, at the Mayo Clinic in Rochester, Minnesota, a ‎group of arthritis patients were given daily injections of a corticosteroid. The results were so ‎striking and the improvement so dramatic that it was thought that the "cure" for arthritis had ‎been discovered. However, as the use of corticosteroids expanded over the years, significant ‎side effects emerged. They are still used (orally and by injection) to knock down ‎inflammation. DMARDs (disease-modifying anti-rheumatic drugs) appear to decrease ‎inflammation, though they are not categorized as anti-inflammatory drugs. They are unlike ‎NSAIDs in that they do not decrease prostaglandin production, do not directly relieve pain, ‎nor reduce fever. In effect, DMARDs slow the disease process by modifying the immune ‎system. Biologic response modifiers (biologics) stimulate or restore the ability of the immune ‎system to fight disease and/or infection. For example, TNF-alpha is one of the most important ‎cytokines involved in rheumatoid arthritis through its entanglement in the cascade of ‎inflammatory reactions. Anti-TNF drugs bind to ‎

TNF-alpha, rendering it inactive and interfering with inflammatory activity ultimately ‎decreasing joint damage. Anti-TNF drugs are just one type of biologic drug developed for the ‎treatment of rheumatoid arthritis. ‎
From the Islamic perspective, at the time where there is a need to exercise power to ensure ‎the health of populations and at the same time to avoid potential abuses. How are we to ‎ensure that all populations benefit from recent advances in treatments, therapies, and ‎technologies? First, Islam has its roots in seventh century Arabia; however, it is not an "Arab" ‎religion. In fact, out of the 1.5 billion Muslims in the world, <10 50="50" a="a" abhadi="abhadi" actively="actively" african.="african." aim="aim" among="among" an="an" and="and" arabs.="arabs." are="are" as="as" asian="asian" attributable="attributable" based="based" beliefs="beliefs" black="black" by="by" caucasians="caucasians" civil="civil" code="code" converts="converts" create="create" creates="creates" culture="culture" cultures="cultures" differences="differences" econd="econd" ethical="ethical" family="family" fari="fari" foundation="foundation" framework.="framework." further="further" god.="god." hanbali="hanbali" hanefi="hanefi" has="has" i="i" implementing="implementing" in="in" inclinations="inclinations" increasing="increasing" indigenous="indigenous" is="is" islam="islam" ja="ja" jurisprudence="jurisprudence" latino="latino" law="law" major="major" majority="majority" maleki="maleki" man="man" merican="merican" monotheistic="monotheistic" moral="moral" more="more" muslims="muslims" nbsp="nbsp" north="north" number="number" of="of" on="on" one="one" ones:="ones:" opinion="opinion" or="or" p="p" peace="peace" practices="practices" refined="refined" s="s" schools="schools" self="self" sensitivities.="sensitivities." shafe="shafe" society="society" some="some" submitting="submitting" than="than" the="the" their="their" there="there" third="third" this="this" to="to" unifying="unifying" universal="universal" usually="usually" various="various" well.="well." well="well" which="which" will="will" with="with" worldwide="worldwide" yemen="yemen" zaidi="zaidi">
Others are not Islamic but ethnic, and may even violate Islamic norms.3 Between the ‎‎6th and 10th days of Rabi 1401 Hijra (January 1981), an international conference on Islamic ‎Medicine was held in Kuwait, to mark the advent of the 15th century of Hegira. One fruitful ‎outcome of this meeting was the Declaration of Kuwait, which deals with the ethics of ‎medicine in the light of Islamic law. ‎ Indeed  at a time of unprecedented increase in ‎knowledge of rapidly changing technology. Such biotechnology especially when it involves ‎human subjects raises complex ethical, legal, social and religious issues. A World Health ‎Organization expert consultation concluded that "genetics advances will only be acceptable if ‎their application is carried out ethically, with due regard to autonomy, justice, education and ‎the beliefs and resources of each nation and community." Public health authorities are ‎increasingly concerned by the high rate of births with genetic disorders especially in ‎developing countries where Muslims are a majority. Therefore, it is imperative to scrutinize ‎the available methods of prevention and management of genetic disorders. A minimum level ‎of cultural awareness is a necessary prerequisite for the delivery of care that is culturally ‎sensitive, especially in Islamic countries. Islam presents a complete moral, ethical, and medical ‎framework, it is a religion which encompasses the secular with the spiritual, the mundane with ‎the celestial and hence forms the basis of the ethical, moral and even juridical attitudes and ‎laws towards any problem or situation. Islamic teachings carry a great deal of instructions for ‎health promotion and disease prevention including hereditary and genetic disorders, ‎therefore, we will discuss how these teachings play an important role in the diagnostic, ‎management and preventive measures including: genomic research; population genetic ‎screening (pre-marital screening, pre-implantation genetic diagnosis; assisted reproduction ‎technology); stem cell therapy; genetic counselling and others.‎

‎80% of investments in genomics in 2000 were made in the United States, and 80% of DNA ‎patents in Genomics in the period 1980 through 1993 were held by US companies.Medical ‎genetics involves the application of genetic knowledge and technology to specific clinical and ‎epidemiologic concerns. Certain ethical and legal responsibilities accompany the flood of ‎genetic knowledge into the current practice of medicine. This is due to its 3 general ‎characteristics of genetic information: the implications of genetic information are ‎simultaneously individual and familial; genetic information is often relevant to future disease; ‎and genetic testing often identifies disorders for which there are no effective treatments or ‎preventive measures. Although there is no single ethical issue that unifies the field of genetics, ‎informed consent, confidentiality and the potential for social harm and psychological distress ‎are issues that physicians involved with testing should understand. Essentially, the principles ‎and components of consent that are generally acceptable in Western countries are also ‎applicable to Muslims, although Muslims (depending on their level of education, background ‎and culture) will often want to consult with family members before consenting to major ‎procedures. Particular care should be exercised when the consent involves abortion, end-of ‎life issues or sexual and gynecological issues.

The 1989 Children’s Act states that age of ‎consent is when a child reaches their sixteenth birthday, or younger, if a doctor deems a child ‎capable of understanding and making decisions.‎ ‎ In Islamic law, the age of majority (and ‎hence full autonomy) taken by Shafi School and Hanbali School of jurisprudence is 15 years ‎while Abu Hanaifa and Malik take the age of 18 years. There is a difference between the age ‎of puberty and the age of taking decisions. The Holy Quran stipulates that orphan children ‎should not receive their inheritance except after being tested for their competence in dealing ‎with monetary problems (The Holy Quran 4:6). Hence the age of majority and decision taking ‎could be postponed to 21 years, if the person concerned is still incapable of giving proper ‎decision before that age. In Islamic countries, Genomics research need to be regulated within ‎the context of culture and religion. The Islamic Jurisprudence Council of the Islamic World ‎League in Makkah Al-Mukarama, Saudi Arabia regularly hold conferences in situations ‎requiring specialist knowledge (for example, decisions concerning medical practice, or ‎research), the somewhat novel concept of a "consensus edict" (fatwa): an authoritative ruling ‎on a point of Islamic law is preferable.

For rulings pertaining to medicine these consensus ‎groups will typically include a broad and diverse representation of Ulema (Islamic Jurists) and ‎specialist, clinicians and scientists from relevant disciplines, the latter responsible for ‎providing the necessary background information. The decision making process is typically ‎transparent with members of the wider community able to scrutinize the arguments.‎
While as for my own perspective of  this illness is that it is indeed an incurable disease but it ‎can still be overcome by many ways such as in reducing the pain using several types of way to ‎relieve the pain or if it has reached the point where it’s unbearable, a surgery can be  done to ‎place an artificial one to the affected joint area. As for the genetically type of arthritis which ‎is rheumatoid arthritis, there are still ways to reduce the pain although it seems like it cant be ‎cured since the genes or the hormones are attacking the immune system itself. So literally it’s ‎more dangerous than the osteoarthritis. So in order to get yourself back to the normal type is ‎quite hard or might be impossible too so as for me, if there’s a will theres’s a way.‎

In conclusion, Arthritis in one of the most chronic diseases and the number one disabler of ‎the elderly. Even though arthritis is a major cause of morbidity and a contributor to early ‎mortality, relatively few studies have been undertaken to examine effects of arthritis patient ‎education. This review was undertaken to provide a summary of arthritis patient education ‎studies, summarize the effectiveness of arthritis patient education in changing knowledge, ‎behavior, psychological status, and health status, address critical issues/problems in arthritis ‎patient education study methodology, and suggest guidelines for future design, ‎implementation, and evaluation of arthritis patient education programs. Some treat all types of ‎pain while others specialize in treating just certain types of pain, and you have yet those ‎clinics that specialize only in certain types of treatments. Pain clinics can’t cure your problems ‎but they might be able to help you learn a better pain management skill. It is very important to ‎ask your doctor if there are any pain clinics in your area. Pain can be the hardest part of ‎having arthritis, but there are many things can be done to help to control the pain. Don’t give ‎up if the first methods doesn’t work, keep trying other methods until you do find one that ‎works. ‎