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In this study, the means utilized by the Qur′ān in actualizing the possibilities of all intellect to face the problem of blind imitation of ancestors were elaborated. Rationality as meant by the Qur′ān and embodied in its unique style is presented. Furthermore, the Qur′ānic documentation of the role of practical demonstration on the individual′s mind as well as the societies′ collective mind is pointed out. In addition, the study shows how the Qur′ān guides people to the proper use of reason within a scientific framework of mind.

This is a study and translation of the section on pericarditis in Al Taisir book written by the Muslim physician Ibn Zuhr Avenzoar who lived and practiced in Eshbeelia nowadays Seville, Andalusia, Spain between 1091-1162 AD. Ibn Zuhr described the serous type of pericarditis as well as the pathological findings in fibrinous pericarditis. His description of the latter may also fit with the picture of chronic fibrous pericarditis. He also described acute purulent pericarditis and involvement of the pericardium in cases of acute carditis with hectic fever. Ibn Zuhr's description of the pericardial effusion in serous pericarditis as looking like urine indicates that he must have seen a sample of the fluid obtained either by pericardiocentesis or during a post-mortem examination. However, his description of solid substances accumulating on the inside of the hearts covering looking like layers upon layers of membranes could not have been made possible without post-mortem dissection.

Knowledge of the chemical composition and structure of urinary stones is of great value in the choice of treatment and prevention of recurrence. This is a brief review and a comparative study of the principles and practical application of various chemical and physical techniques used for urinary stone analysis. The different methods of classifying and grouping urinary stones by results of chemical analytic techniques are, also, compared and evaluated. In addition to reviewing various techniques used for the in-vitro analysis of removed stone samples, the newly emerging physical and radiological techniques for the in-vivo intact-stone analysis are, also, evaluated. These in-vivo techniques, particularly the rapidly advancing unenhanced spiral CT scanning, represent an important step forward towards the notion of non- destructive analysis of urinary stones while still in situ before the choice of treatment modality.

Urolithiasis is a multifactorial recurrent disease of world-wide distribution in rural, urban, industrial and non-industrial regions. Changes in urinary pH is a risk factor especially with hyperuricosuria, hypercalciuria or hyperoxaluria. With recurrence, hypercalcuria and higher urinary oxalate levels are more frequent. Hypercalciuria and hyperuricosuria showed correlation with family history of stones. The ionic relations between various stone forming salts in urine of patients are opposite to that in controls and are well represented in stone composition. Obesity is a risk factor in both genders. Over eating a diet rich in all nutrients was associated with hyperuricosuria while a diet high only in fat was associated with other urinary disturbances. High protein and fat intake are risk factors. High or low calcium diet was associated with urolithiasis and supplemental calcium is not a risk factor. Potassium and magnesium citrate are potent in inhibiting the growth of stone fragments after extracorporeal shock wave lithotripsy. Whether in patients or normal subjects, drinking hard water should be avoided; tap water or low calcium content water is preferable. Seasonal variations in temperature affected urinary volume, pH and relative saturation of uric acid. To prevent recurrence, patients should maintain high fluid intake achieving a urine volume of 2 liters per day.

This is a detailed study of the technique of cystolithotomy as practiced by the Muslim surgeon Alzahrawi (Albucasis) in Cordova more than 1000 years ago. In addition to translating the relevant chapter in his book Al-Tasreef, his technique is critically evaluated comparing it with that of his predecessors and his successors. The study confirmed the originality of Alzahrawi who described operative steps and invented operative instruments not known in the Greco-Roman era. He was also the first to describe, in details, the operative technique in women and to recommend the 2-stage operation in complicated cases. His modifications and innovations greatly influenced surgery in Middle Ages Europe up to the 18th century which witnessed the beginnings of the modern method using the suprapubic, instead of the perineal, approach. Alzahrawi's influence is vividly seen in the practice of the Italian lithotomist "Marianus Sanctus" (16th century), the French "Jack De Beaulieu" (17th century) and the English "Shelsden" (18th century). Alzahrawi is the founder of lithotripsy. He introduced Al-Kalaleeb forceps to crush large bladder stones and Al-Mishaab to drill and fragment an impacted urethral stone. Andreas a Cruce (18th century) only added screw action to Al-Kalaleeb lithotrite but Amussat managed in 1822 to apply it transurethrally. Similarly, by the notion of transurethrally getting at the stone while within the bladder, Alzahrawi's idea of drilling by Al-Mishaab was the foundation of the litholepte of Fournier de Lempdes (1812), the instrument of Gruithusien (1813), Civiale's trilabe (1818) and the brise coque of Rigal De Galliac (1829).

This paper evaluates the progress of anatomy and dissection during the Middle Ages both in Europe and in the Muslim World. For that purpose, the functional anatomy of the ureterovesical junction and the mechanism of micturition were studied both in the works of Galen (130-200 AD) and in the works of 6 Islamic medical scholars who lived in the period from the ninth to the thirteenth centuries AD (Alrazi, Alzahrawi, Ibn Sina, Al-Baghdadi, Ibn El Nefis and Ibn El Quff). The study relied, only, on original sources in the form of authentic editions and manuscripts. In general, the ideas and findings of those 6 Islamic physicians, as regard the anti-reflux and the micturition mechanisms, differed and contradicted with those of Galen but conformed well with our present day concepts.

Objectives. Transurethral vaporization resection of the prostate (TUVRP) is a recent modification of the standard transurethral prostatectomy (TURP). The procedure uses one of the novel, thick resection loops coupled to augmented electrocutting energy. We evaluated the safety and efficacy of TUVRP in comparison with TURP. Methods. Sixty-eight patients with prostatic outflow obstruction were prospectively randomized between equal TUVRP and TURP treatment groups. Safety parameters evaluated included changes in serum hemoglobin, hematocrit, and sodium 1 and 24 hours after resection. Operative time, catheterization time, and incidence of complications were noted. Efficacy parameters included evaluation by the International Prostate Symptom Score and maximum flow rate. Results. Patients of both groups were balanced for the different baseline variables. One hour after TURP, patients had significantly lower levels of hemoglobin, hematocrit, and sodium (P = 0.03, 0.03, and 0.01, respectively). The prostate resection weight was similar in both groups; however, the difference in the mean operative time was significant (TUVRP group 42.4 minutes and TURP group 35.9 minutes, P = 0.02). The postoperative catheterization time was significantly shorter for the TUVRP group (23.1 ± 10.3 versus 36 ± 17.3 hours, P

Schistosomiasis affecting the ureter is commonly accompanied by ureteric dilatation with or without ureteric stricture and altered ureteric wall motility that can influence extracorporeal shockwave lithotripsy (ESWL) results. This study attempts to identify variables that may influence the outcome of ESWL in the treatment of ureterolithiasis in patients with urinary bilharziasis.Forty-three patients with urinary schistosomiasis and ureterolithiasis treated with ESWL were reviewed. The study data include characteristics of patients, stones, urinary tract treated and details of ESWL treatment.Thirty-five patients (81.3%) were stone-free at 3 months. Multivariate analysis with logistic regression identified two significant variables that influenced treatment outcome, namely the presence of ureteric stricture (p = 0.004) and the ESWL voltage (p = 0.003). Ten ureteric strictures were encountered in 9 patients (21%), the majority of these were diagnosed post-ESWL when patients failed to pass well-fragmented stones in spite of pre-ESWL evaluation.In situ ESWL is a safe and effective first line of treatment for urinary stones in bilharzial ureters. The presence of concomitant bilharzial stricture is a significant variable which affects the treatment outcome. Every effort should be made to rule out and deal with possible complicating factors such as ureteric strictures in the pretreatment period.

In a marked shift from the modern positivist materialist philosophy that influenced medical education for more than a century, Western medical educators are now beginning to realize the significance of the spiritual element of human nature. Consensus is currently building up in Europe and North America on the need to give more emphasis to the study of humanities disciplines such as history of medicine, ethics, religion, philosophy, medically related poetry, literature, arts and medical sociology in medical colleges with the aim of allowing graduates to reach to the heart of human learning about meaning of life and death and to become kinder, more reflective practitioners. The medicine taught and practiced during the Islamic civilization era was a vivid example of the unity of the two components of medical knowledge: natural sciences and humanities. It was also a brilliant illustration of medical ethics driven by a divine moral code. This historical fact formed the foundation for the three medical humanities courses presented in this article reporting a pedagogical experiment in preparation for starting a humanities program in Alfaisal University Medical College in Riyadh. In a series of lectures alternating with interactive sessions, active learning strategies were employed in teaching a course on history of medicine during the Islamic era and another on Islamic medical ethics. Furthermore, a third course on medically relevant Arabic poetry was designed and prepared in a similar way. The end-of-the-course feedback comments reflected effectiveness of the courses and highlighted the importance of employing student-centered learning techniques in order to motivate medical students to become critical thinkers, problem solvers, life-long learners and self-learners.

With few exceptions, most of the current publications on history of urology still ignore the scientific and technological events of the more than a thousand years between the Greco-Roman times and the modern era. This has broken an important link in the globally continuous line of progress and evolution of world civilizations. Another aggravation of that missing-link problem in the history of urology, and history of medicine, in general, is the large number of articles based, only, on copying from secondary sources without checking the primary sources (the edited and published original manuscripts). Such articles easily propagate omissions, deficiencies, misunderstandings, distortions, and unfounded claims. On the other hand, in the Arabic and Islamic world, though many original authentic medical manuscripts written by famous scholars of the Islamic era were authoritatively edited and published during the twentieth century, the number of primary source studies based on them by historians or medical researchers remained few and were limited to individual efforts. Therefore, we focused on this missing-link era and performed several primary source studies of the published medical works of ten scholars who lived and practiced between the ninth and the thirteenth centuries and whose Latinized books were available in Europe as early as the twelfth century with their influence lasting until the eighteenth century. Our results confirm that those scholars of the Islamic era were not mere compilers or sheer transmitters of Greco-Roman medical literature. On the contrary, they critically reviewed the translated heritage of previous civilizations rejecting what is superfluous and accepting only what proves to be true. They added original contributions to the progress of urology and pioneered new fields of medical knowledge and practice such as medical ethics, medical education, medical certification, health education, preventive medicine, hospitals and hospital training, medical-practice quality control, clinical medicine, differential diagnosis, experimental medicine, experimental surgery, beginnings of specialization, pharmacology, use of anesthetics, and many other new discoveries in anatomy, physiology, pathology, therapeutics, surgical instruments, and surgical techniques.

Summary— Fifty patients suffering from the late effects of urinary bilharziasis were studied. A preliminary idea about the incidence of bilharzial cancer in the endemic area of Jeezan is presented. The role of ileal loop ureteric replacement in extensive ureteropathy is emphasised. A scheme is proposed for the categorisation of bilharzial patients on the basis of their symptoms in order to detect complicated cases at the primary medical care level.

This paper reports a fluoroscopic study of ureteric peristalsis during intravenous pyelography in 32 patients with urinary bilharziasis and 13 non-bilharzial controls with normal intravenous pyelograms. Ureteric peristalsis is reduced in parallel with urographic signs of involvement. The role of fluoroscopic examination of the ureters in staging bilharzial ureteropathy is discussed.