For Muslims with consuming diseases, Ramadan can pose dilemmas | Health and Health

CAIRO (AP) — When the Islamic holy thirty day period of Ramadan begins, a fight rages in Habiba Khanom’s intellect: If she goes without the need of foodstuff or drink, is she doing it for God or since of her anorexia? Deep down she knows the reply, and it saddens her.

“If I did speedy, it would be for my feeding on ailment,” claimed Khanom, a 29-12 months-previous London resident. The religious duty that several Muslims obtain soul-nourishing can, in her case, supply “permission … to slide back into my old behaviors and shed bodyweight and sort of not get judged for it mainly because everybody is doing it.”

A time of worship, contemplation and joyous gatherings with relatives and buddies, Ramadan is also a month when food stuff performs a central role, from the ritual daytime fasting to celebratory iftar meals to crack the rapidly.

For Muslims grappling with feeding on disorders, navigating individuals spiritual and social rituals can pose one of a kind problems. It is a battle that they and the specialists dealing with them say is normally mostly invisible to broader modern society, which at situations can make it all the extra challenging.

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“Understanding of consuming problems in standard is nominal,” reported Ghena Ismail, director of the consuming diseases application at the American College of Beirut Clinical Middle in Lebanon. “People are just beginning to appreciate psychological disease.”

Fasting from dawn to sunset throughout Ramadan, which this year commenced in early April, is a spiritual obligation, one particular of the 5 Pillars or basic beliefs and techniques of Islam. The religion will allow for exceptions, nevertheless, these kinds of as for younger kids and sick grownups.

The assistance Ismail offers to Muslims with consuming conditions is dependent on each individual individual’s stage of cure. For those with critical signs, she suggests not fasting. She retains just one-on-1 discussions about the objective of fasting and alternative strategies to really feel connected to the faith, this sort of as reading through the Quran and concentrating on the charitable offering factor of Ramadan. Self-compassion is critical.

“I reframe that as part of their true obligation towards them selves and towards the connection to the Creator, that you could not interact in any type of ritual at the cost of your individual health,” Ismail said.

“This will become

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As public health workers flee the field, California becomes more vulnerable to mix of diseases

There were days, nights and weekends in the early months of the pandemic when Denise Von Bargen was the only person running coronavirus tests at the public health lab in Ventura County. She once had eight or nine employees to assist her, but, one by one, they had all retired or left for other jobs.

Like other public health laboratories in California charged with broad-scale disease testing and surveillance, the Ventura lab received federal and state money for new equipment and short-term hires to bolster its response to COVID-19. But the funding was temporary, and Von Bargen, the director, could not use it to increase the salaries of her employees, who could earn more money doing less work in the private sector.

Operations deteriorated further last month, after the lab lost its license to run routine tests that check the county’s ocean water for deadly bacteria. It appears to have been a clerical error: The licensing paperwork changed, and the staff typically responsible for submitting the application had quit.

“The biggest threat to [public health labs] right now is not the next emerging pathogen,” said Donna Ferguson, director of the public health lab in Monterey County, “but labs closing due to lack of staffing.”

Across California, public health departments are losing experienced staffers to retirement, exhaustion, partisan politics and higher-paying jobs. Even before the pandemic throttled departments, staffing numbers had shrunk with county budgets. But the decline has accelerated over the past year and a half, even as millions of dollars in federal money has poured in.

Public health nurses, microbiologists, epidemiologists, health officers and other staff members who fend off infectious diseases like tuberculosis and HIV, inspect restaurants and work to keep communities healthy are abandoning the field. It’s a problem that temporary boosts in funding can’t fix.

The brain drain is sapping community health oversight in ways big and small. The people who staff public health labs, for example, run complex tests for deadly diseases that require specialized training most commercial labs lack. While their work is largely unseen by the general public, they touch almost every aspect of society.

Public health labs sample shellfish to make sure it is safe for eating. They monitor drinking water, and develop tests for emerging health threats such as antibiotic-resistant bacteria. They also test for serious diseases, such as measles and COVID-19. And they typically do it at a fraction of

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Health care costs for people with rare diseases have been underestimated, study shows

A new, retrospective study of medical and insurance records indicates health care costs for people with a rare disease have been underestimated and are three to five times greater than the costs for people without a rare disease. The study, led by the National Institutes of Health’s National Center for Advancing Translational Sciences (NCATS), provides new evidence of the potential impact of rare diseases on public health, suggesting that nationwide medical costs for individuals with rare diseases are on par with those for cancer and heart failure. The study’s results were published Oct. 21 in the Orphanet Journal of Rare Diseases.

There needs to be greater public awareness of the large and growing medical footprint of rare diseases in society. Only about 10% of rare diseases have an FDA-approved therapy for their treatment. The findings underscore an urgent need for more research, and earlier and more accurate diagnoses of and interventions for these disorders.”


Anne Pariser, M.D., senior author, director, NCATS Office of Rare Diseases Research

Most of the approximately 7,000 to 10,000 known rare diseases disproportionately affect children, adolescents and young adults. Individually, most rare diseases might affect only a few hundred to a few thousand people worldwide. However, rare diseases are collectively common, affecting an estimated 25 million to 30 million people in the United States. Many of these diseases have a genetic cause, are serious or life-threatening and are hard to diagnose and treat.

The pilot study was a collaborative effort among NCATS; Eversana Life Sciences, Chicago; Oregon Health & Science University, Portland; Sanford Health, Sioux Falls, South Dakota; and a health insurer in Australia. Pariser and colleagues analyzed patients’ diagnosis information in medical records and billing codes. They used International Classification of Diseases (ICD) codes, which designate a disease diagnosis and other methods, to determine those individuals with rare diseases and their direct medical costs for 14 rare diseases in four health care systems compared to non-rare disease patients of a similar age.

The pilot study aimed to test the feasibility of this approach in analyzing data on rare diseases prevalence and costs. The 14 rare diseases represented a diverse set of disorders that differ in prevalence, organ systems affected, age of onset, clinical course, and availability of an approved treatment or specific ICD code. Examples of the selected rare diseases include sickle cell disease, muscular dystrophy and eosinophilic esophagitis.

The

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