King of the World: Shah Jehan & my video of Shalamar Gardens

Browsing around the internet, as I am wont to do, I came across an image of the tughra, or seal of Shah Jehan, which brought back memories of my visit to Lahore, city of Shah Jehan's birth.  Before I show you some home videos, here is a picture of the tughra from the Met:

Image: Metropolitan Museum of Art

The intricate beauty of the calligraphy, the silver script almost invisible, is only befitting a man whose name means, "King of the World" and who was the ruler of the Mughal Empire at its peak.  Shah Jehan was born in Lahore in 1592, the grandson of Akbar, son of Jehanghir.  He came to power in 1627 and ruled until 1658.

Shah Jehan was a gifted ruler, but he is most remembered for the legendary love he had for his wife, Mumtaz Mahal ("jewel of the palace") for whom he built the Taj Mahal, one of the wonders of the world.  He established his court at Delhi and built many architectural marvels that stand to this day.

I recently visited Lahore and saw the Shalimar Gardens, which were commissioned by Shah Jehan in 1641 and built in just a year.  It is a beautiful network of 410 fountains, with water supplied by a canal that spanned 161 kilometers.

Below is a brief movie I took of Shalimar Gardens, back in November 2010. I think the video is so narrow due to size restrictions on blogger.

This is the upper part of the Gardens and the water was drained because they were cleaning out the fountains in preparation for Eid-ul-Adha, as hundreds, if not thousands, of people were expected to offer Eid prayers.  Also, a slight correction to the commentary, the Gardens are about 369 years old:

Second video, showcasing a different, and I think more beautiful, part of Shalimar:

Badshahi Masjid: then and now

Fascinating picture of Badshahi Masjid in Lahore from somewhere between 1858 to 1861, via the Met, taken during British rule:

Image: The Metropolitan Museum of Art

Compare that image to one that I took in November 2010:

Copyright: Umar Shakur, 2010

The Masjid is next to Shahi Qila, the Lahore Fort, and both pictures are taken from that vantage point. The top picture also shows Ranjit Singh's palace, in white and on the right, built in Hazuri Bagh (a garden) when the Sikh's took over Lahore (1799-1849). 

The beauty of Badshahi Masjid remains, but look how open the grounds around the masjid are in the old picture.  There are large, grassy fields surrounding the complex.  Today, it is full of people, roads, buildings and the bustle of thousands. In fact, essentially across the street, stands the Minar-e-Pakistan.

Another interesting tidbit, Badshahi Masjid was built in about 2 years at the direction of the Mughal ruler Aurangzeb, son of Shah Jehan, and features some of the finest Islamic architecture in the world.  Its minarets are taller than the Taj Mahal's and it remains the 5th largest masjid complex in the world.

Compare that to the 8 years it took to build Minar-e-Pakistan in the 1960s. Amazing to consider how efficiently and masterfully the Mughals did their construction work.

Finally, a brief video I took of the adhan at maghrib time in the Badshahi Masjid.  The spirituality and sense of peace one finds there remain intact, over 300 years later:

Leslie Hazelton: an agnostic Jew's reading of the Qur'an

Leslie Hazelton is a prolific writer, formerly a Middle East reporter, who has taken an interest in religious writing and describes herself as an "agnostic Jew." She is writing a book about the Prophet Muhammad, peace be upon him, and gives an interesting talk at TEDxRainier, about her experience with the Qur'an.

It is an intriguing 9 minutes

Happy Holidays!

Ah, digital media.

So, one post-call day, my very sleep deprived intern decided he wanted to take pictures of the ward team, apparently to help him remember a very memorable call night.  He got his pictures, which were actually quite nice, and later, an intrepid, and digitally savvy, medical student used the pics to create this, um, fascinating video clip:

Personalize funny videos and birthday eCards at JibJab!

Who says medicine isn't fun? Just for the record, I have never participated in any 80s-style rock band groups...

WorldScopes

WorldScopes is a worthwhile charity, sponsored by the American Medical Association, that seeks to provide doctors all over the world with stethoscopes. If you have an extra one lying around, consider making a donation today.

LeBron

Wow, man got Nike to do a commercial in which he tells us, he doesn't care what we think about him. Well, Lebron, so much for fixing your public image problem. Dude, you still have a lot to learn about class. Take notes from D-Wade while down in Miami...

Danny and Annie from StoryCorps

Thanks to Farooq for the link

How to end suicide bombing

Robert Pape is a Professor in Political Science at the University of Chicago and a national expert on suicide terrorism.  He has written several books and heads the world's largest academic research project on the subject.  

Image via University of Chicago

He has co-authored an important new book, "Cutting the Fuse: The Explosion of Global Suicide Terrorism and How to Stop It" in which he argues that suicide terrorism is essentially driven by political considerations rather than religious ones. 

It echoes my belief that extremists distort Islamic tenets to achieve political aims among adherents who are largely ignorant of Islam's rich intellectual and spiritual tradition.  

Indeed, traditional Islam has never accepted suicide under any circumstances nor has it ever accepted an "anything goes" approach to achieving political aims.  The Islamic tradition is to first make and spread peace.    

If nothing else, Pape's book argues for a more nuanced approach to dealing with the threat of extremism, one that avoids foreign occupation but still safeguards American interests both domestically and abroad. 

Below is a copy of the press release from the University of Chicago:

How to End Suicide Bombings: New book argues the problem is not Islam, but lengthy military occupations. 

October 4, 2010

The University of Chicago Project on Security & Terrorism and the New America Foundation will hold a major national policy forum in the U.S. Congress titled “Cutting the Fuse, Moving Beyond the War” on Tuesday, Oct. 12. The conference will be streamed live athttp://www.thewashingtonnote.com. For more information and a list of speakers, visithttp://cpost.uchicago.edu.

To put an end to suicide bombings, the United States needs a new strategy that would reposition troops and work with local allies to boost their fighting capacity, contends Robert Pape, a political scientist at the University of Chicago and one of the nation’s leading experts on suicide terrorism.

Despite a popular belief that suicide terrorism is the result of religious fanaticism, such bombings are really a calculated response to occupations by outsiders, according to research in a new book, Cutting the Fuse: The Explosion of Global Suicide Terrorism and How to Stop It. The book examines exhaustive data on suicide attacks since 1980 in the Middle East, Chechnya, Sri Lanka and around the world.

The data show that the best way to reduce suicide bombings in Afghanistan or Iraq is not to condemn Islamic extremism, but to end foreign occupations as quickly as possible, Pape claims.

Pape’s co–author is James Feldman, a former professor of decision analysis and economics at the Air Force Institute of Technology and the School of Advanced Airpower Studies. The book is published by the University of Chicago Press.

Their work shows that the suicide terrorism threat to America is growing, despite military efforts in Iraq and Afghanistan as well as Pakistan’s attempts to fight its own militants.

“Each month there are more suicide terrorists trying to kill Americans and their military allies in Afghanistan, Iraq and other Muslim countries than in all the years before 2001 combined,” Pape said. In addition to nations where the United States is involved in military conflicts, the United States also has stationed troops on the Arabian Peninsula, a situation that al Qaeda claims is the reason for its hostility to the U.S.

The central problem is that leaders in the United States have constructed a narrative that identified the threat as coming from Islamic extremists who hate the United States. That explanation led to the invasions, occupations and eventual efforts to establish democratic regimes, something that requires a heavy military presence, the authors explained.

“But we now have strong evidence that the narrative — that suicide terrorism is prompted by Islamic fundamentalism — is not true,” Pape said. Despite some military success, suicide terrorism has continued, Pape said.

The book’s extensive research points out that after the United States occupied Afghanistan and Iraq, suicide attacks worldwide rose dramatically — from 300 between 1980 and 2003 to 1,800 from 2004 to 2009. More than 90 percent of the attacks were anti–American. Indirect occupations, in which the United States helps lead an occupation without committing troops, such as in Pakistan, have the same impact as direct occupations and explain the rise of suicide terrorism there, Pape said. The research also showed that civilian casualties during occupations increase suicide terrorism by giving terrorist leaders rallying points to turn local residents against the invading force.

Pape oversees the Chicago Project on Security and Terrorism, the world’s largest academic research project on suicide terrorism, and Feldman is the project’s principal advisor. The CPOST team recently completed a study of more than 2,000 suicide attacks. The team also studied tapes left by suicide bombers and collected other key information, such as their religious backgrounds, methods and number of casualties resulting from the attacks.

The research found that in each of the countries where suicide terrorism flourished, it was used to combat an occupying force. While occupation may sometimes be necessary to achieve immediate foreign policy goals, it does so at the risk of stimulating a suicide terrorist campaign against the occupier’s homeland. This is the dilemma an occupier faces, Feldman noted, since when the threat of occupation was removed, suicide terrorism largely stopped. After Israel withdrew from southern Lebanon in 2000, for instance, Lebanese suicide terrorist attacks against Israel ended, Pape pointed out. Since Israel withdrew militarily from Gaza and portions of the West Bank, suicide attacks have been down 90 percent.

In order to end suicide terrorism, or to “cut the fuse,” the United States needs to “reduce the reliance on foreign occupation as a principal strategy for ensuring national interests,” they concluded.

“I’m not saying that we should cut and run, but rather that we have to use our military power differently,” Pape said. Offshore and in–country balancing would contain the threat to American rather than fuel it, he said.

Offshore balancing would involve stationing American forces on ships in the Persian Gulf and and islands in the Indian Ocean, and establishing military bases with non–Western forces on the Arabian Peninsula to support rapid deployment of ground forces, if needed in a future crisis.

In–country balancing involves working more closely with local forces, such was the case in Anbar Province in Iraq, where Americans empowered local Sunni leaders to be responsible for their own defense and accordingly curtailed insurgency.

“Intelligent debate and decision making require putting all the facts before us. For over a decade our enemies have been dying to win. By ending the perception that the United States and its allies are occupiers, we can cut the fuse to the suicide terrorism threat,” Pape said.

A Conversation with President Obama

This is pretty cool, MTV, BET and CMT hosted a "Conversation with President Obama." Below is a link to the show, best parts come later in show:

A Conversation with President Obama on MTV

Musharraf interviewed on This Week

Saw part of this interview of former Pakistani prime minister Pervez Musharraf, by This Week's Christiane Amanpour, in which Musharraf argues that Pakistan plays an important role in the fight against terrorism that is not fully acknowledged by the international community.

Over 2,000 Pakistani soldiers have died, in military actions against extremists, and many Pakistani civilians have lost their lives due to attacks by extremists as well as drone attacks that inadvertently hit civilian populations.  



Musharraf has made quite a career for himself on the lecture circuit since leaving office, and has apparently evinced enough nostalgia for his leadership to form a new political party with the aim of returning to Pakistani politics.  The problem with his tenure as prime minister has mainly to do with his lack of respect for civic institutions.  The end of his term was marked by "emergency rule" and effective dissolution of the judicial branch of government in Pakistan.  

Nevertheless, he does remind viewers in this segment that Pakistan continues to incur a high cost in the war against terrorism.  No one is more interested in stability and an end to terrorism than Pakistanis.

Extremism in Islam is not native to Pakistan nor is it embraced by the majority of the population.  Islam spread in Pakistan mainly by the efforts of Sufi scholars and saints, who still enjoy a special reverence in Pakistan today, both culturally (in terms of music, poetry) and religiously. Only by reconnecting to this spiritual tradition can we hope to battle extremist interpretations of Islam.

In Health Bill, Obama Attacks Wealth Inequality

An interesting argument about the healthcare bill from NY Times columnist Leonhardt:

For all the political and economic uncertainties about health reform, at least one thing seems clear: The bill that President Obama signed on Tuesday is the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.

While I'm sure the assertion will be widely debated, I think it frames an important issue, the stark economic inequalities of our time.  We see an economy in which there is 10% unemployment but the stock market is riding high with the Dow Jones at over 11,000.

This disconnect is not healthy.  America's middle class needs to be revived and it needs leaders who will represent and defend its interests.  Instead, we've had the rise of the Tea Party whose reactionary zeal threatens not only our economic sensibilities but even more fundamental institutions such as religious freedom.

Astonishingly, the Democratic party seems unable to articulate a coherent response.  Yet there could be no simpler strategy than to reaffirm our tradition of civil, religious and economic liberties that made this nation great.

In the interim, it is important for us all to do what we can to be more neighborly, to extend a helping hand to each other to show the kind of individual leadership that builds communities and societies.  

The healthcare bill has important reform that went just short of what it could have been. Nevertheless, if Leonhardt is right, it will probably be the most important thing Obama has done in his presidency to date.

Should we Fear Islam?

Keith Ellison, a Democratic congressman from Minnesota, has written an important opinion piece in the Washington Post's "On Faith" series, in which he offers an important analogy between the way the media is portraying Muslims in America and how that would look if the same portrayal was extended to the African American community.

Keith Ellison is not only an African American, he is also the first Muslim American to be elected to Congress.  He has always taken a practical, inclusive approach to his politics, from which many others in Congress could learn.

Here is an excerpt from the article, which is worth a read:

We are having a national conversation about belonging. The threatened Qur'an burning in Florida and the controversy over the proposed Islamic Center in lower Manhattan are examples of this national conversation about whether America can stretch her arms wide enough to embrace Muslims too. Irresponsible and sensational depictions of Muslims in the popular media are not the cause of Islamophobia, but they certainly can make it worse. Recent news shows and media reports do nothing to shed light or understanding on this national conversation, which is too bad.

The Bears: hold on to the towels

As Bears fans are wont to do, the hand-wringing, second guessing and desire to throw in the towel will begin tonight given the beat down the Bears took from the NY Giants.  But, I say, hold on to your towels...

Despite Cris Collingsworth attempt to paint the Giants as an awesome defensive machine, despite the record-setting sacks in the game, the score was still 3-0 at the end of the first half.

You'd think, with all the praise being heaped on the Giants, that the Bears were doing nothing.  Yet the Bears defense kept Eli Manning's offense to just a field goal.

Where things went south were with the exit of Cutler and thus any leadership or rhythm to the offense.  The way Cutler played in the first half, though, you'd be right to say there was never any rhythm.  I mean, given all the blitzes the Giants were throwing, you'd think Cutler would figure someone would be free 5 yards from the line, and as the replays demonstrate, there always was.

This is where Mad Scientist Martz messes us up.  When you are in a defensive showdown, you take every 5 yard completion you can get and tell your QB to stop looking downfield.  Instead, Martz got Cutler concussed right out the game.

When your backup quarterback is in his 16th season, and no one has heard of him, you effectively knew the game was over.  Despite our defense, which continued to create amazing turnovers, the offense could do nothing.

At one point, I just wanted Urlacher, Harris and company to line up on the o-line and run routes.  Maybe even have Urlacher as QB.

This was a game where we needed the defense to score and, unfortunately, they were playing against Eli Manning and company, who are not known for allowing the defense to score on them.

This loss demonstrates that we have championship level defense but need an offense.  We have to hope that Cutler is not out and that Martz realizes that short completions are just fine when you don't have a running game.  We can still do this.

Research on coffee, brought to you by Dunkin Donuts

I love this, Dunkin Donuts and CareerBuilder funded a study to look at coffee habits in the workplace.  Interestingly, health professions are at the top with nurses followed by physicians.

The hospital I go to next year actually has a 24-hour Dunkin Donuts in the basement, next to the cafeteria! I can just see a Dunkin Donuts board meeting: Agenda item #14: Hospitals, time to perk up those who are feeling down (or working there).  

Also, not surprisingly, government workers at #12 on the list.  They go on to say that coffee consumption correlates with productivity, so draw your own conclusions... :-)

The List:

1)     Nurses
2)     Physicians
3)     Hotel workers
4)     Designers/Architects
5)     Financial/Insurance sales representatives
6)     Food preparers
7)     Engineers
8)     Teachers
9)     Marketing/Public Relations professionals
10)   Scientists
11)   Machine operators
12)   Government workers

Thoughts on the Bears (so far) undefeated season

People are making excuses for the Bears wins (that they are mainly based on penalties) but a win is a win. And there is a definite momentum and energy to being undefeated in the NFL, no matter how you got there. 

These 3 wins were crucial for the confidence of the team moving forward and the proof is the re-emergence of skills that we used to take for granted (defense and special teams).

We need a better run game, because Cutler is no Vick and him out-running Forte is a sad testimony to Forte's lack of skills. In the mean time, the offensive shoot outs that the passing game offers is fine, if the defense can come up big like it did last night.

Lastly, an opposing team often starts committing penalties when the other team has gotten inside its head or somehow has it off kilter. So I don't buy all those, "Green Bay beat itself arguments"

Having a sure-thing FG knocked down does something to you. Messes you up. You'd rather jump off sides than see that happen to you again.

If we keep winning this way, that's fine with me.

Lobby quite empty at night! 

Pioglitazone (Actos) under FDA review

The FDA is now reviewing pioglitazone (Actos), a popular drug for the treatment of diabetes, for a possible link to bladder cancer.  Pioglitazone has been gaining in popularity after a rival drug, rosiglitazone (Avandia), had been shown to increase cardiovascular risk.  Pioglitazone sales top $3 billion annually, while rosiglitazone has fallen to less than $600 million annually due to the negative data on myocardial ischemia.    

So far, the FDA is not recommending discontinuation of pioglitazone, as the association with bladder cancer comes from an interim analysis of a 10-year study being performed by the drug's manufacturer, Takeda.

The entire drug class of TZDs has come under increasing scrutiny over safety.  I am beginning to think that the entire class of medication should be avoided and other means of controlling hyperglycemia in diabetics should be pursued.

Will be interesting to see what future data will reveal about pioglitazone.

Eid Mubarak!

Muslim Americans Find their Voice Amid the Shouts

Story via NPR:

No one's really sure how many Americans are Muslim. The estimates range anywhere from 1 million to 7 million. But what's clear is that over the past few weeks and months, almost every poll that's been taken on Muslims has pointed to one conclusion: anti-Muslim sentiment is on the rise.

Image on NPR site via myfaithmyvoice.com

Muslim 'Day of Dignity' Observed in Baltimore

Nice story from the Baltimore Sun about Islamic Relief USA's Day of Dignity in Baltimore:

Under a printed head scarf and the warm sun, Candice Abdal-Rahim served hundreds of strangers food and drink that she could not sample until sundown.

She was observing the Muslim holy month of Ramadan by fasting and performing an act of charity at the annual Day of Dignity, a national effort organized by Islamic Relief and the church of Jesus Christ of Latter-day Saints.

Serving others "makes the day go quicker," said Abdal-Rahim, a city schools administrator.

Image via Baltimore Sun

American Muslims Ask, Will We Ever Belong?

Interesting piece from the NY Times:

For nine years after the attacks of Sept. 11, many American Muslims made concerted efforts to build relationships with non-Muslims, to make it clear they abhor terrorism, to educate people about Islam and to participate in interfaith service projects. They took satisfaction in the observations by many scholars that Muslims in America were more successful and assimilated than Muslims in Europe.

Via NY Times

Indonesian Fashion scores Ramadan Hit

Via AFP:

JAKARTA — This Eid al-Fitr Muslim holiday, Malaysian Sharifa Ahmad is determined to make heads turn in her "Made in Indonesia" outfit -- a black flowing chiffon robe with embroidered neckline and matching headscarf hand stitched with Swarovski crystals.

"The dress is perfect for the holy day -- modest yet elegant. I'm definitely going to rock my little black Islamic dress," the 35-year-old civil servant told AFP.

Image via AFP

Rosiglitazone

The chairman of the FDA's advisory committee, Dr. Clifford Rosen, finally comes out to say that rosiglitazone (Avandia) should either be restricted to compassionate use or taken off the market. It's about time! Numerous studies have reinforced the risk of myocardial ischemia with Avandia, yet there continues to be robust use of the drug in the United States.

UK regulators have already recommended pulling rosiglitazone off the market as well.  If you are a patient, or know a patient, who takes rosiglitazone (Avandia), you should talk to your physician about switching to another agent.  Pioglitazone (Actos) is a drug that is similar to Avandia but does not have the same cardiovascular risk.  

Of course, everyone's medical situation is different and you should make any decisions about treatment in consultation with a physician who knows you well. You should not discontinue any medications without consulting your physician.  I do not have any conflict of interest or ownership in either company.  

Ramadan 2010

Via Boston Globe's, The Big Picture, wonderful pictorial essay of Ramadan around the world:

Muslim men and women across the world are currently observing Ramadan, a month long celebration of self-purification and restraint. During Ramadan, the Muslim community fast, abstaining from food, drink, smoking and sex between sunrise and sunset. Muslims break their fast after sunset with an evening meal called Iftar, where a date is the first thing eaten followed by a traditional meal. During this time, Muslims are also encouraged to read the entire Quran, to give freely to those in need, and strengthen their ties to God through prayer. The goal of the fast is to teach humility, patience and sacrifice, and to ask forgiveness, practice self-restraint, and pray for guidance in the future. This year, Ramadan will continue until Thursday, September 9th.

Via Boston Globe's The Big Picture

Islam Spiritual Center takes root in downtown Santa Rosa

Nice story of a Muslim community in Santa Rosa, California, via the Press Democrat: 

The call to prayer, “Allahu Akbar” — God is Greatest — is delivered by a gray-robed man in a black skullcap facing northeast into one cinder-block wall of the mosque, toward Mecca.

Outside, traffic moves along Mendocino Avenue a few blocks north of Old Courthouse Square.

Image via Press Democrat

Reignited ire buffets Muslim students

News story from Boston Globe:

WELLESLEY — Laila Alawa fiddled with her cellphone, pretending she hadn’t heard what an apparently intoxicated man near her on the MBTA had said about “her people’’ wanting to build the “ground zero mosque.’’


Growing up in a large Muslim family in upstate New York and New Hampshire, Alawa had often drawn stares because of her headscarf, and sometimes endured harassment from neighborhood children. But this summer, as she shuttled between research jobs at Wellesley College and MIT, the looks and questions from strangers about where she was from seemed to come more often, and with a sharper edge.

Image via Boston Globe

American Muslims Gather to Break Fast

Via VOA:

The holy month of Ramadan is marked by fasting from dawn to dusk. Muslim Americans end each day of fasting with a festive meal known as Iftar. After a long day, they relax and share the rituals of Ramadan from sundown to the predawn hours.

Via VOA

Local Muslim families mix Ramadan's rituals with American culture

Story from Detroit Free Press:

In front of the fireplace in their Canton home, the Ahmed family has four shoeboxes, one for each of their kids, packed with small toys like "Star Wars" figures and Hot Wheels. They call them Ramadan boxes, an idea the parents came up with after noticing Christmas stockings.

Image: Detroit Free Press

It's the American thing to do

Image via http://www.groundzerodialogue.org/

It is amazing how much emotion and debate has risen up over the proposed Muslim community center at Park 51 in NYC.  I think there are few things more American than community centers and allowing Muslim Americans to build one is the American thing to do.  

I do not have the eloquence of others, so I will simply direct you to Muslims and non-Muslims who have spoken up to defend one of our most cherished freedoms, the freedom of religion.

Here are a sampling:

1. Ground Zero Dialogue, site that explores the American Muslim perspective on the Ground Zero controversy. Several award-winning documentaries screening for free via the site.

2. Keith Olbermann: a scathing criticism of opponents to the community center.

3. Jon Stewart: several funny sketches that deliver important points about religious freedom and the inconsistencies of conservative news media like Fox.

4. Senator Richard Durbin (D-IL). It is nice to see the second-ranking Democrat take a strong position on this issue. President Obama's stance was so wishy washy (they have a right to build the center, but I don't necessarily agree with where they are building it) as to not even be a stance.

5. Qasim Basir, director of the movie, "MOOZ-lum" in his article, "I am a Muslimerican." I enjoy the line, "This is not a plea for sympathy; it is a call to character."

6. Fareed Zakaria, CNN journalist and Newsweek columnist, has come out strongly in favor of the community center. He even returned an award from the ADL, when he learned that they would not be supporting Park 51.

Pakistan: Crisis Continues

The aid so far is just not enough to help Pakistan deal with the devastating flooding of the Indus River.  Please help, it takes a moment and a few dollars can change someone's life across the world.  

Image: Ghazi, Pakistan. Reuters via Boston.com's Big Picture site

The Way Forward

Fantastic article posted by Shaykh Amin, of Darul Qasim, on fasting in Ramadan, and how to find the pleasure in fasting (saum).  More than that, it is a creative reflection on how to lose bad habits and gain good ones, by understanding the wisdom of the Prophetic sunnah in unlocking the gates to Allah's pleasure.

More rain, flood worsens in Pakistan

Image via Reuters; Man saving two boys

Rain continues to contribute to flooding in Pakistan and the military, stretched thin from deployments against al Qaeda, are doing what they can to rescue those stranded or trapped by rising flood waters.

Please consider donating to help relief efforts in Pakistan. Previous post here details ways you can get involved. Perhaps the easiest, and most immediate, is to text SWAT to 50555 on your mobile phone. $10 donation to UNHCR, was announced earlier this week by Secretary of State Hillary Clinton.  Islamic Relief USA is also doing major work there.  Given the degree of damage, a UN official is predicting that rebuilding Pakistan will require billions of dollars.

Image via VOA News; Mother with children

Image via Dawn Newspaper; flood survivor    

Akbar Ahmed on Jon Stewart's Daily Show

Nice interview of Akbar Ahmed by Jon Stewart on the Daily Show. Akbar Ahmed is a former Pakistani Ambassador and has a new book out called, "Journey into America."

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Akbar Ahmed
www.thedailyshow.com
Daily Show Full Episodes Political Humor Tea Party

Pakistan Flooding: Help Needed!

Torrential monsoon rains in Pakistan have led to devastating flooding that began in northern Pakistan and is flowing south along the Indus River.  This is one of the worst natural disasters in Pakistan's history.

Map via BBC

Over 1500 people are confirmed dead, over 650,000 homes were destroyed, over 1 million acres of farmland submerged, ten thousand cattle have perished and millions and millions of people have been displaced. 

The logistical challenges will mount, as crowding and lack of fresh, clean water will add to the spread of disease and the death toll.

Please consider donating today to help relief efforts in this area. Islamic Relief USA is a well-known and respected American charity that has long been in Pakistan and is free of any political agenda.  You can view its Charity Navigator profile here.

There are many, many other ways to donate, as well. UNICEF is collecting money for Pakistani children, Oxfam, Canadian Red Cross, and Doctors without Borders also all have relief efforts underway. 


NPR's The Two-Way Blog has posted a press conference by Secretary of State Hillary Clinton on ways the United States is helping the relief efforts and its enduring commitment to Pakistan.   


Clinton announced that you can donate $10 to the UNHCR by texting SWAT to 50555. You will get a confirmation text, reply with yes and your donation will be made. 


NPR's The Picture Show has an image gallery that captures scenes from the flooding. Truly gives you a sense of how much damage has been done.   


Lastly, a remarkable story of survival, aired on NPR's Morning Edition, about Siraj Begum, a Pashtun matriarch whose faith, wit and resourcefulness got her through tragedy.  


No donation is too small, please donate today!

Qur'an links for Ramadan

From Seeker's Digest, via Creative Muslims, a list of links to the Qur'an online that are worth perusing, especially as the holy month of Ramadan approaches.  I use Quran.com frequently and also enjoy Tanzil.info, which has a nice interface and loads quickly.

I am sure there are many iphone apps, but theonlyword.com is a nice site for ipods. They also give you permission to download an entire mp3 recording of the Qur'an.  I downloaded them a year or two ago, it was virus free at that time, though you always want to double check.

Al-Azhar: Fighting Terrorism through Education

Recent news stories highlighting the efforts of Al-Azhar University, the oldest university in the world, to combat terrorism through education.  Al-Azhar is participating in some innovative programs aimed at promoting mainstream, moderate Islam throughout the world.

The first, is a program that teaches Al-Azhar students English, via a British Council English language training center.  The first class of 68 students, just graduated from a three-year English curriculum that supplemented their Islamic studies.  The hope is that they will be better able to engage the international community by being able to articulate mainstream Islam in English.

Another program involved an exchange program at Georgetown University, when 14 students from Al-Azhar interacted with religious studies students of all faiths at Georgetown.  They studied American democracy and met Congressman Keith Ellison, the first Muslim American elected to Congress.

Defining Prosperity Down

Great Op-Ed piece in the NY Times by Krugman, called, Defining Prosperity Down, some quotes from the article:

The point is that a large part of Congress — large enough to block any action on jobs — cares a lot about taxes on the richest 1 percent of the population, but very little about the plight of Americans who can’t find work.

later on in the editorial: 

What lies down this path? Here’s what I consider all too likely: Two years from now unemployment will still be extremely high, quite possibly higher than it is now. But instead of taking responsibility for fixing the situation, politicians and Fed officials alike will declare that high unemployment is structural, beyond their control. And as I said, over time these excuses may turn into a self-fulfilling prophecy, as the long-term unemployed lose their skills and their connections with the work force, and become unemployable.

I’d like to imagine that public outrage will prevent this outcome. But while Americans are indeed angry, their anger is unfocused. And so I worry that our governing elite, which just isn’t all that into the unemployed, will allow the jobs slump to go on and on and on.

Americans flock to Toronto to buy coveted Pakistani mango

From Seeker's Digest, a great article posted from Canada's Toronto Star about Americans fulfilling their love for Pakistani mangoes...ah chaunsa, how I miss you! Your fragrance, your sweet tenderness, the way you give of yourself...I last had some in London this past June, and have been savoring the memory since...

Americans flock to Toronto to buy coveted Pakistani mango

Preventing Heart Attacks: Is Crestor the answer?

In 2008, Dr. Paul Ridker, a physician-scientist from Harvard, published a study known as JUPITER, which found that Crestor (rosuvastatin) is beneficial in the primary prevention of cardiovascular disease, as it reduced the risk of MI, CVA and death.  

The trial studied males over 50 and women over 60 years of age. Both groups had LDL (bad) cholesterol <130, but they had to have one important risk factor: hs-CRP>2.  

Dr. Ridker believes that there is an important inflammatory component to coronary heart disease and pioneered the development of CRP, an inflammatory marker that is elevated in people at higher risk for cardiovascular disease. His theory was that this inflammation often precedes the hardening of the arteries, which is indirectly measured by cholesterol levels.  

The JUPITER trial was gutsy, because it was going to test whether or not this theory actually holds.  What if you took people with normal cholesterol levels, but elevated inflammatory markers (in the form of CRP) and treated them with a statin?  Would that reduce the development of cardiovascular disease? 

If so, it could be important proof that inflammation is a major driver of cardiovascular disease.  A corollary would be that waiting to treat until the cholesterol levels are high, might be waiting too long and that intervention should take place when the inflammatory process has begun.    

The results of the JUPITER trial seemed to come out strongly in favor of Dr. Ridker's theory.  Earlier this year, the FDA was also convinced and decided to grant permission for Crestor's use in primary prevention of cardiovascular disease. It suggested 3 criteria for use: 

• Age (> 50 years in men; > 60 years in women), and
• An elevated high-sensitivity C-reactive protein level (> 2 mg/L), and
• Presence of at least one additional cardiovascular risk factor (e.g., high blood pressure, low HDL-C, smoking, or a family history of premature heart disease).

 

No other statin, such as Lipitor, has this permission.  Besides low-dose aspirin in men, no other drug is currently approved for primary prevention of cardiovascular disease.  

There have, however, been a lot of criticisms of the study.  Late in June, four papers came out in the Archives of Internal Medicine, all of which criticized the notion that statins are useful in primary prevention.  One of the studies, by Dr. de Lorgeril, targeted the JUPITER trial claiming it was flawed and that, "[t]he results of the trial do not support the use of statin treatment for primary prevention of cardiovascular diseases and raise troubling questions concerning the role of commercial sponsors."  

These papers have sparked a lot of controversy in the cardiovascular community, which is well summarized by this article on theheart.org.  What is interesting about the de Lorgeril paper is that it seems to personally attack Dr. Ridker and another physician, Dr. Rory Collins, which is unusual for someone to do in a scholarly paper. 

I do think these papers make an important point, which is that previous statin trials have not demonstrated benefit in primary prevention of cardiovascular disease.  Also, there was a slight increase in diabetes seen in patients on Crestor.  Lastly, the JUPITER trial was stopped after less than 2 years, so we don't have real long-term data on how these patients will do. It may be that the benefit from Crestor is short-term and not durable.  

It is also possible, however, that Crestor has unique properties that make it different from previous statins (it is far more potent than previous statins, for instance) and why it is able to show some benefit in this area.  In addition, it is important to remember that JUPITER did not take anyone with low cholesterol into the trial, only patients with low cholesterol and high CRP levels.  This kind of stratification hadn't really been done so explicitly in previous trials.  

At the end of the day, everyone agrees that diet, exercise and smoking cessation should be the initial interventions in people hoping to reduce cardiovascular risk.  Add in a baby aspirin if you are a high-risk male between 45 to 79 years old.  

As far as my own practice, I may consider Crestor for primary prevention in patients who meet the FDA prescribing guidelines (age, hs-CRP>2 and one other risk factor), but I may limit treatment to 2 years (as there is no data for treating patients longer).  In addition, I would counsel patients on the cost and side effect profile of Crestor and ensure they have already made therapeutic lifestyle changes.  

Of course, everyone is different and your decision should be made in consultation with a physician who knows your personal and family medical history.  

Pakistan's UN Ambassador speaks on US-Pakistani relations

An interesting interview of Abdullah Hussain Haroon, Pakistan's UN Ambassador, on The Brian Lehrer Show (click on the "Listen" link).  The interview came ahead of the 1st Annual New York Sufi Music Festival hosted by the Ambassador and the Pakistani Peace Builders Initiative.

Ambassador Haroon said some controversial things - like that Pakistan was a democracy before the United States because all Pakistani adults could vote in 1947 whereas blacks and women in America were not given true access to the ballot until the Civil Rights Act of 1964.

Whatever you think of Ambassador Haroon, he is quite confident of his opinions! He also made the case that Pakistan's sacrifice in fighting terrorism is not appreciated given the amount of Pakistani soldiers that have died helping US operations in Afghanistan.  But, overall, he was quite positive about Secretary of State Hillary Clinton and her approach to US-Pakistani relations.

The Cordoba House: A Community Center Maligned

A lot has been written about the Cordoba House, a plan to build a Muslim community center in Manhattan. Many excellent editorials have been written by open-minded Americans on why the House should be built and the importance of religious freedom in America (Washington Post, Sojourners, USA Today, Downtown Express, Jewish Daily Forward).

Another editorial worthy of attention, is the one written by NY Times editorialist Robert Wright, entitled, "A Mosque Maligned."  In his editorial, Wright actually shows how many of the attempts to malign Imam Feisul Abdul Rauf and his wife, Daisy Khan, actually have no connection to their own activities or viewpoints.

Imam Feisul subscribes to Sufism, a more spiritual approach to Islam.  You can see a talk he gave on how to live a spiritual life at beliefnet.  Both Imam Feisul and Daisy Khan have worked hard to show that terrorism has no place in Islam.  We should promote such efforts, both to defeat the evils of terrorist ideology and to honor the great American tradition of religious freedom.

You can keep up with media coverage of the Cordoba House via the newly launched Cordoba Initiative blog.

Enrollment in TIDE trial halted by FDA

The FDA has decided to halt further enrollment in the TIDE trial, a clinical trial sponsored by GlaxoSmithKline (GSK) to compare Avandia (rosiglitazone) to Actos (pioglitazone).  Avandia has come under a lot of fire recently, due to safety concerns, including increasing Congressional scrutiny.


The FDA released the following statement, which reads, in part:

The FDA has instructed GSK to update investigators, institutional review boards (IRBs) and ethics committees involved in the TIDE trial regarding new safety information presented at the joint FDA Advisory Committee meeting held on July 13 and 14, 2010, along with information regarding the deliberations and votes of that meeting.


The decision by the FDA is somewhat surprising given that the same FDA Advisory Committee meeting suggested keeping Avandia on the market, despite uncertainty over its safety profile.  


All in all, I think this is a smart, and surprisingly bold, move by the FDA. It is really advocating for patient safety, though a lot of this may be directly related to bi-partisan pressure from Congress and public perception that the FDA is too closely aligned with the pharmaceutical and medical device industries.