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Doctors Caution Diabetic Muslims On Ramadan Fasting

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Doctors Caution Diabetic Muslims On Ramadan Fasting

Doctors Caution Diabetic Muslims On Ramadan Fasting

New Delhi: Muslims around the world fast in this holy month of Ramadan — from pre-dawn hours to dusk. Health experts have a word of caution for those who may be diabetic.

Due to prolonged fasting, diabetics undergo metabolic changes as they don’t eat anything for long, say medical experts.

“Prolonged fasting results in metabolic changes which necessitate adjustment in diabetes management plan, in terms of dietary intake and medication schedule. During Ramadan, most people take two large meals with a gap of 12 to 15 hours,” said Atul Luthra, senior consultant physician, Fortis C-Doc.

He said carbohydrate and fat intake should be kept under control to prevent blood sugar from rising rapidly during the day, or between “sehari”, the early morning meal prior to the beginning of the fast, and the “iftaar”, the ritual breaking of the fast in the evening hours.

“Diabetics should not indulge in high-calorie, high-refined food. Rather, they should take food with high fibre content. All patients must be aware of the warning symptoms of low blood sugar and they should not continue with the fast if the symptoms appear,” he added.

The problems diabetics face while fasting can either cause hypoglycemia (sudden fall in blood sugar levels), which can cause seizures and unconsciousness, or hyperglycemia (increase in blood sugar).

Doctors add that their condition can worsen with a “potentially life-threatening complication” called diabetic ketoacidosis which causes vomiting, dehydration, deep gasping breathing, confusion and even coma.

“They can also develop thrombosis, which leads to formation of a blood clot inside blood vessels,” Luthra warned.

According to Luthra, Type 1 diabetics, or those who have a history of recurrent hypoglycemia, are at a higher risk if they fast.

“Hypoglycemia and hyperglycemia may also occur in patients with Type 2 diabetes but generally less frequently and with less severe consequences as compared to Type 1 diabetics,” he added.

S.C. Juneja, endocrinologist at the Diabetes and Health Care Centre in west Delhi, said only those who take insulin, which helps regulate sugar in the bloodstream, once a day can fast.

“But those who take it twice or more should refrain from fasting as it becomes necessary to eat after taking insulin,” Juneja said.

Agreed Sujeet Jha, diabetologist at Max Hospital (Saket) in south Delhi. He said that even if diabetics wish to fast, they must not skip their medicines.

“Patients on insulin should completely avoid fasting. Having nothing for almost 14-15 hours a day at a stretch can lead to low sugar levels. They should also be well hydrated,” Jha said.

Experts say that patients should regularly consult doctors and follow the suggested medication.

Juneja said there should be frequent monitoring for diabetics to ensure safe fasting, and they should eat more fruits and vegetables along with high fluid during the non-fasting period.

“Carbohydrate and fat intake should be kept under control to check blood sugar. Diabetics should not take high-calorie and high-refined foods. They should instead take food high on fibre content,” Juneja said.

Sweets must be shunned while breaking fast.

“Patients should include fruits, pulses, vegetables and curd in their diet while breaking fast. There should be least sugar in drinks, and fried food should be avoided. Items containing starch like basmati rice and wheat chapati can be taken,” Luthra advised.

Jha added: “Patients should take a walk or exercise in the evenings.”

SOUTH ASIA

Pakistani Anti-graft body wants travel ban on Nawaz Sharif, kin

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Pakistan’s anti-corruption watchdog has asked authorities to place ousted premier Nawaz Sharif, his daughter and son-in-law on the Exit Control List to prevent them from leaving the country.

The National Accountability Bureau (NAB) sent a formal request to the ministry of interior. The interior ministry officials confirmed that the NAB wrote that names of Sharif, his daughter Maryam Nawaz and son-in-law Capt (retd) Muhammad Safdar should be put on the Exit Control List (ECL), which listed individuals not allowed to leave Pakistan.

The NAB argued that as the trial of the three nears its conclusion, it is feared that they would leave the country.

Earlier, a similar request to place name of finance minister Ishaq Dar on ECL was not accepted, allowing him to go to London and never return.

Sharif, 68, and his family this week filed an application with the accountability court seeking a fortnight’s exemption from personal appearance from February 19 onwards to let them go to London to see Sharif’s ailing wife. Three cases were filed against Sharif and his family last year, including Avenfield properties, Azizia & Hill Metal Establishment, and Flagship Investments.

Maryam and Safdar are accused only in Avenfield properties case. The NAB had filed two supplementary references against Sharif, his sons Hasan and Hussain regarding Al-Azizia Steel Mills & Hill Metal Establishment and Flagship Investment cases.

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Pakistan “breaches obligations’ on nuclear arms reduction, UN court told

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The Hague: Pakistan is violating its “obligations” to the international community by failing to reduce its nuclear arsenal, the Marshall Islands told the UN’s highest court on Tuesday.

The small Pacific Island nation is this week launching three unusual cases against India, Pakistan and Britain before the International Court of Justice.

Majuro wants to put a new spotlight on the global nuclear threat, its lawyers said yesterday, by using its own experience with massive US-led nuclear tests in the 1940s and 1950s.

“Pakistan is in breach of its obligations owed to the international community as a whole,” when it comes to reducing its nuclear stockpile, said Nicholas Grief, one of the island nation’s lawyers.

Islamabad and its nuclear-armed neighbour India “continue to engage in a quantitative build-up and a qualitative improvement” of their atomic stockpiles, added Tony deBrum, a Marshallese government minister.

DeBrum warned that even a “limited nuclear war” involving the two countries would “threaten the existence” of his island nation people.

Pakistan and India have fought three wars since independence from Britain in 1947, two of them over the disputed Himalayan territory of Kashmir.

In 1998, the rival neighbours both demonstrated nuclear weapons capability.

The ICJ’s judges are holding hearings for the next week and a half to decide whether it is competent to hear the lawsuits brought against India and Pakistan — neither of which have signed the 1968 nuclear Non-Proliferation Treaty (NPT).

A third hearing against Britain — which has signed the NPT — scheduled to start on Wednesday will be devoted to “preliminary objections” raised by London.

The Marshalls initially sought to bring a case against nine countries it said possessed nuclear arms: Britain, China, France, India, Israel, North Korea, Pakistan, Russia and the United States.
Israel has never admitted to having nuclear weapons.

But the Hague-based ICJ, set up in 1945 to rule in disputes between states, has only admitted three cases against Britain, India and Pakistan, because they have accepted the ICJ’s compulsory jurisdiction.

Pakistan’s lawyers did not attend Tuesday’s hearings.

It did however file a counter-claim against Majuro’s allegations saying “the court has no jurisdiction to deal with the application” and insisting that the case is “not admissible”, said ICJ President Ronny Abraham.

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Bangladesh to drop Islam as official religion following attacks on Hindus

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Bangladesh to drop Islam as official religion following attacks on Hindus

New Delhi: Bangladesh is likely to drop Islam as its official religion following a series of attacks on people from other faiths in the country. The country’s Supreme Court is hearing a plea challenging the status of the official religion of the country to Islam.

Bangladesh, which was declared a secular country after its formation in 1971, was declared an Islamic country following a constitutional amendment in 1988.

According to a report in the Daily Mail, the plea has challenged the declaration of Islam as the national religion of the country.

The move is being supported by leaders from the minority communities like Hindus, Christians and Muslim minority Shiites.

Bangladesh has 90 per cent of Muslims, 8 per cent Hindus and remaining constitutes Christians and Muslim minority Shiites.

In last month, a Hindu priest was hacked to death following an attack on a temple in Panchgarh district. Two others were seriously injured in the attack. There have been several lethal attacks on writers and bloggers.

According to a report in the Independent, Islamist groups Jumatul Mujahedeen Bangladesh and Ansarullah Bangla Team are believed to have carried out at least seven attacks on foreign and minority people in Bangladesh in the past year.

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