How does loneliness affect your brain?

Spreng et al. The default network of the human brain is associated with perceived social isolation. Nature Communications. December 2020.

A recent study found fundamental structural and functional differences in the brains of lonely people. Researchers examined the magnetic resonance imaging (MRI) data, genetics, and psychological self-assessments of over 40,000 middle-aged and older adults in the UK Biobank medical database. They then compared the MRI data of participants who reported often feeling lonely with those who did not. There were several major differences in the brains of lonely people which were primarily found in what is called the “default brain network,” a group of brain regions that are involved in inner thoughts such as remembering, future planning, imagining, and thinking about others. Detailed analyses of these regions showed that surprisingly, the default networks of lonely people were more strongly wired together and their grey matter volume in regions of the default network was greater. Moreover, bundles of nerve fibers called fornix that connects the hippocampus to the default network were better preserved in the brains of lonely people. These findings suggest that since lonely people are more likely to use imagination, memories of the past, or envisioning the future to overcome their social isolation they strengthen memory-based functions of their default networks through internally-directed thoughts and imagining social experiences. Loneliness has been increasingly turned into a major health problem, as other studies showed that older people who experience loneliness have a higher risk of cognitive decline and dementia. As COVID-19 related social distancing continues, isolation and loneliness could affect our society even more dramatically. Understanding how loneliness manifests itself in the brain at the structural and functional level, and how these paradoxical findings translate into late-onset brain pathologies, would be critical to prevent both neurological diseases and related social problems.

Human-made mass is about to exceed total global living biomass

Elhacham et al. Global human-made mass exceeds all living biomass. Nature. December 2020.

Humanity is rapidly approaching a new milestone in the history of our planet. The amount of manmade objects on Earth will soon outweigh all living biomass. A new study finds that each person alive today produces approximately the amount of manmade mass equivalent to their bodyweight every week. Our daily life objects such as roads, houses, cars, and clothes now weigh in at around 1.1 trillion metric tons, which is equal to the combined dry weight of all plants, animals and microorganisms on the planet. The production and accumulation of manmade objects, also known as anthropogenic mass, has accelerated since the early 1900s. The world’s plastics alone now weigh twice as much as the planet’s marine and terrestrial animals.

About 50% of the current anthropogenic mass is concrete. Bricks, asphalt, metals, plastic, and other materials make up about 19% of the total. Three major problems will arise from the outproduction of antropogenic mass. First, manufacturing consumes resources which will not be available for future generations unless objects are recycled or new raw materials are discovered. Second, even if we can achieve 100% recycling, pollution is generated and energy is used during manufacturing, so resources are still consumed. Third, many of the manufactured items will eventually be discarded which will cause serious disposal issues in the future. This is particularly alarming for the future. Nature is not infinite like so many of us would like to believe. If the current trend continues, anthropogenic mass will grow to three times the world’s biomass by 2040. In the next 20 years, we will generate as much waste as from the last 110 years together. These huge waste flows could lead to massive environmental catastrophes. This study demonstrates the brutal scale and impact of human activities on our planet. Humans are modifying the planet to such an extent that we might have already started a new geologic epoch likely called the Anthropocene.

Drug repurposing by artificial intelligence

Liu et al. A deep learning framework for drug repurposing via emulating clinical trials on real-world patient data, Nature Machine Intelligence. January 2021.

Researchers have developed a machine-learning method that analyzes very large datasets to discover which existing medications could work for diseases for which they were not prescribed. This process is called “drug repurposing,” a popular strategy to find new purposes for existing drugs that offers a rapid transition from research to clinical care. Drug repurposing can lower the risk associated with safety testing of new medications and dramatically reduce the time and money required to get a drug into the marketplace for clinical use. However, discovering new uses for existing medications still requires time-consuming and expensive randomized controlled trials to prove that a drug that is effective for one disorder will also be useful to treat another disorder. To overcome this challenge, a team designed a computational framework that works in two steps. First, it searches enormous patient care-related datasets with high-powered computation to arrive at repurposed drug candidates for a given disease. Second, it calculates and estimates effects of those existing medications on a defined set of clinical outcomes. As a proof-of-principle, researchers decided to focus on repurposing of drugs to prevent heart failure and strokes in patients with coronary artery disease. The edge of the machine learning approach is that it can analyze and compare thousands of human differences within a large population that could influence how a drug will work in the body. These confounding factors such as age, gender, race, and disease severity function as parameters in the deep learning computer algorithm on which the framework is based. This information is streamed from “real-world evidence,” which consists of longitudinal observational data about millions of patients captured by various sorts of electronic medical records. The team used insurance data for more than 1.2 million heart-disease patients. The algorithm analyzed each patient’s drug prescriptions and diagnostic tests for every visit and models input for drugs based on their active ingredients. The model yielded a total of 9 drugs with potential therapeutic benefits, three of which are currently in use and six new candidates for drug repurposing. Interestingly, two diabetes medications, metformin and escitalopram, have been found to lower the risk of heart failure and stroke in the model patient population. This study shows how artificial intelligence can speed up hypothesis generation and clinical trial processes. While this study focused on heart failure and stroke, the framework is flexible and could be applied to most complex diseases.

Question: Oppression is everywhere and exists in almost every form. How should believers respond to oppression when they have to face it?

Oppression, at its most basic form, is a transgression of boundaries and a violation of others’ rights. Killing an ant is oppressive, for nobody is authorized to take an animal’s right to life unjustly. If it is human who is being unjustly treated then it is definitely a form of oppression of a much higher magnitude. As for the oppression committed against a collective group of people, that is an incomparably greater and more horrible misdeed.

Irrespective of its exact nature, believers are seriously warned not to oppress others. Otherwise, it will appear on the Day of Judgment as a manifold darkness that will suffocate and distress the one who oppresses (Bukhari, Mazalim 9; Muslim, Birr 56). Each act of oppression and injustice – be it against animals, people, or even God – will appear before that person as a separate trouble in the Afterlife.

Oppression, according to some insightful scholars, is among one of the obstacles that can prevent a person from embracing faith. While it is an obstruction to having belief in God, it is similarly a significant reason that causes believers to drift out of the realm of faith.

Preventing oppression

Given that oppression is evil to this degree in regard to how other people are treated, it definitely needs to be prevented. According to Prophet Muhammad, peace be upon him, everyone should try to prevent oppression depending upon their capability, power, and position be it by direct intervention or via verbal objection. In the event that a person cannot resist oppression physically or verbally, it is at least necessary to protest the oppressor in one’s heart (Sahih al-Muslim, Iman 78; Tirmidhi, fitan 11; Abu Dawud, salat 239). Likewise, it is a famous old adage that “(the) one who remains silent before oppression is a mute devil.”

Preventing oppression on a smaller scale is within the capability of individuals, but there are some forms of oppression that can only be prevented by the state. In this contemporary world when justice and democracy have wide – though not perfect – prevalence such oppressions are committed at degrees big enough that even states are not able to tackle them. Preventing those oppressions and successions of atrocities, by which people are swept away in floods of blood, families are shattered, children are orphaned, and spouses are widowed, can only be possible through the hands of certain international establishments and organizations. In this respect, those who remain silent before oppression while they have the power to stop it—be they individuals, a state, or an international establishment—in a way have a share in that oppression by turning a blind eye to it and not taking the preventive action that they could have, and they will be treated accordingly on the Day of Judgment.

As it is very important to take a stance against oppression and to prevent it, determining the correct strategy to follow while not making any mistakes with the method is no less important. People must reckon well from the beginning how they can prevent unfairness, be aware of their capabilities, and also must not exacerbate problems while attempting to prevent oppression. They must not commit evil by thinking that they are doing something good.

Nothing good can come from oppression

It is a gross delusion to think that one can reach any positive goal via oppression and injustice. While it is not possible to obtain any favorable outcome with oppression, it is not possible to reclaim one’s violated rights via oppression either. If people try to move themselves or their societies in a new direction, or try to reclaim the rights that they lost by means of oppression, then this will give way to new acts of oppression, violations of rights, and a shattered system of justice. If these demands are for rights to be upheld and for justice to prevail, then strict adherence to a righteous course is needed from beginning to end. Just as the end should be lawful, so should be the means and ways to that end.

We do not know exactly to what degree we can prevent any oppression and injustice in our time. What matters most is being on the path to setting things right and correcting previous misdeeds. The duties that befall the wayfarers of the righteous path are that they must always be representatives of what is right and truthful, open one’s heart to everyone, and also not respond to oppression and injustice committed in the same wrong way. To put this in the words of the Poet Nabi:

“Do not trouble anyone with oppression
Even if they did oppress you, you do not be unjust to them
Do not arrive at God’s door with complaints
As for those who oppressed you, leave them to the Divine.”

Be like Rumi

In many instances, we quote, with a little bit of boastful considerations, the names of masters such as Jalaluddin Rumi, Yunus Emre, Ahmad Yasawi, or Haji Baktash Wali and bring their tolerance to attention. It is easy to make mention of Rumi, but it is difficult to be like him. At a time when you make mention of Rumi, are you really able to open your arms for all people, even for those who insulted you? When they come upon you, do you seek ways to settle issues in a peaceful manner? Are you able to make those who bear hostility against you share the same peaceful considerations after a while? This is how you become a Rumi in the real sense.

Historians mention the following anecdote about the tolerance of Rumi: One day, a rude bigot accosted him and criticized his statements such as, “one of my feet is in the center of Islam, while the other is among all nations of the world.” He accused Rumi of apostasy, misguiding Muslims, and proceeded to let out an invective against him. Without ever interrupting the man, the venerable master listened to him peacefully with God-granted self-restraint. On seeing that the man stopped talking and had no other words to say, he asked if he was done. When the man replied in the affirmative, Rumi spoke with a soft voice and said, “You are most welcome; my heart is open for you too.”

This is the very point at which words cease. In such a situation, all of the negative feelings within the latter melted away. The grudge and hatred suddenly started pouring down in the form of fireworks of love. While it is possible to treat people with showers of light, why should we shower them with meteors instead?

If you are focused on representing the spirit of Rumi, even if those who show hostility towards you commit oppression and injustice against you for one, two, three, or four times, they will give up such acts after some time on account of not having the same kind of response from you. Now, while there is a way to settle issues with mildness and agreement, why should we engage in other behavior that will only spur ill-feelings and hatred?

One thing that needs to be kept in mind is that we can give up on our personal rights and forgive others for their unfair treatment of us. However, we do not have the authority to forgive on behalf of others when there is an offense against values like faith or country. When such an offense happens, we should make plausible explanations to offenders to show them what they are doing is wrong. If they still insist, we deny their claims with denouncements. If they still persist, then we sue them and claim compensation.

We must always act carefully to remain within the confines of laws and ethics, and we must never make concessions on our fairness when responding in these ways. It is paramount that we must always act humanely but assertively. Even while making certain clarifications, corrections, and denouncements, we always try to give positive messages to the other side and never make concessions from our own character. We voice what we are to say not with whisperings of Satan, but with the voice and breath of the Archangel Gabriel. Oppression and assaults only indicate the character of the offender. This situation should not avert people attached to faith and universal human values to act as becomes their own character.

Is it worth it?

This passing worldly life is neither worth committing oppression against others nor responding to their oppression in the same way. After all, each of us is a traveler in this world. After staying in this guesthouse that we call life, we will pass to the Afterlife in order to be brought to account for what we did here. Is it worth it to promote fighting? Is it worth it at all to cause disunity and dissension? Is it worth it at all to commit oppression and injustice?

In an anonymous saying, the simple and transient nature of the world is expressed as follows:

Behold with the eyes of wisdom, this world is but a guesthouse;
Not a single person remains settled, what a strange abode it is.
The share of a king and subject alike, is nothing but a plain shroud.
As for those who fall for it, what else can they be called but mad?

Humankind has oftentimes made use of oppression and hatred in order to solve the problems that we collectively faced. If only we could make use of love and tolerance from now on! If only we were able to open our hearts to everyone so that those who enter therein would never have worries of remaining without a seat. If only we would treat everyone with a deep feeling of respect and reverence, and if only we could read into other’s feelings, their cultural backgrounds, and treat everyone with a serious feeling of empathy! For whatever style of treatment we expect to receive from others, they similarly expect the same from us. If we expect respect, we must show respect. If we expect observance of our rights, we must observe everybody’s rights.

It is necessary to know that the problems in our time have taken a complicated form to such an extent that they cannot be tackled by those with narrow minds and dull thoughts. There is not much that those with radical thoughts, who act out of bigotry in order to pursue arrogant purposes, can do for the sake of conquering people’s hearts and bringing peace to humanity. Particularly with this harsh attitude of theirs, they can never evoke in hearts any love towards their own values. They cannot let others love the Pride of Humanity, peace and blessings be upon him, because they are too captivated by their own worldly, illicit desires.

Therefore, for the sake of solving the problems of humanity, there is a need for people with immense conscience, rich hearts, and profound thought. Just as Rumi brought people together anew with the plausible cures he came up with some 7-8 centuries ago, in the contemporary world when people are so detached from one another, when people cannot agree on anything, and relations are built upon conflict and hostility, the duty that falls to those with faithful hearts is to revive the spirit of Rumi once again. As far as this cannot be done, it will not be possible to put a stop to oppression and hostilities in different parts of the world. This is particularly the case if we consider to what degree world peace is under threat by ambitious tyrants and horrible weapons prepared with vengeful intentions. It will then be best understood how great the responsibility is of the altruistic souls who have dedicated their lives to love and tolerance.

In his Twentieth Word, Bediuzzaman Said Nursi, a 20^th century Islamic scholar and teacher, uses an interesting phrase, where he argues that the miracles of the prophets represent the highest points that scientific developments would ever attain and as such, they are set as goals which humanity should seek to accomplish. In interpreting the verse about the miracles of Jesus, upon whom be peace, in which it is said that Jesus would raise people from the dead by God’s leave, Bediuzzaman Said Nursi indicates that there is a cure to every disease which can be found through research. He also employs an interesting phrase in this section: “It is even possible to give a temporary tinge of life to death” [1]. While some suggest that with this intriguing sentence Nursi points to recent developments in medicine such as those involving organ transplantation or the use of ventilators, it appears that this phrase implies going one stage further.

The Holy Qur’an relates several miraculous events regarding raising the dead in the present, worldly life. In Chapter Baqara (2:67-73), the Holy Qur’an tells us of the incident upon which the chapter was named: Prophet Moses, upon whom be peace, and his people were told by God to slaughter a cow and strike a dead person with part of the slaughtered cow, afterwards the dead man was resurrected and told them who had killed him. Thus, the Qur’an reasserts that God Almighty has the power to resurrect people. Reflecting on this verse, Fethullah Gülen maintains that in addition to the miraculous nature of striking the dead body with a piece of the cow, the mention of this incident may imply that humanity is guided toward a scientific or technological goal [2]. In medicine, biological drugs used to treat certain diseases are produced from certain animals. Also, certain medications, such as insulin, can be produced making use of the ability of bacteria to produce genetically coded proteins. Perhaps, biological drugs to be obtained with the help of other living organisms may contribute to being able to give a temporary tinge of life to death. In this regard, researchers are particularly interested in stem cells and their potentials. In this method, it may be possible to use a person’s stem cells to produce organs, tissues, and replace malfunctioning organs with new ones without the risk of rejection. We have so far heard no positive results in these directions, but it was demonstrated that stem cells taken from a person and transplanted into an embryo of another living being started to grow [3]. God knows best, but this method may be part of the truth behind the act of striking the man’s corpse with a part of a cow in reference to the verse in question.

Chapter Baqarah gives two more examples concerning resurrection in worldly life. A man passed by a town that had fallen into utter ruin and asked himself in bewilderment, “How will God restore life to this town that is now dead?” God made him remain dead for a hundred years and then raised him to life, and asked him, “How long did you remain in this state?” He said: “I remained so for a day or part of a day.” God said, “No, you have rather remained thus for a hundred years. But look at your food and drink: it has not spoiled; and look at your donkey!” The verse tells us that only bones were left of the donkey (2:259).

The next verse is about Prophet Abraham, upon whom be peace, who prayed God to give him certainty in the heart about resurrection. He had to kill four birds and then put them on different hills which resulted in them being restored to life and flying back to him (2:260). While it may not be related to resurrection fully, the story of Ashab al-Kahf (“People of the Cave” or “Seven Sleepers”) is certainly intriguing and carries a similar theme. God made seven men fall sleep in a cave for roughly 300 years and then restored them to life temporarily, however they had believed that they had fallen asleep for only a very brief period. They were probably considerably skilled and well-educated young people with high positions in society, however falling asleep for three centuries caused them to lose their positions and possibly disappoint those who had invested in them at that time. Yet God Almighty’s wise purpose requires otherwise by making those people send a message to future generations, i.e., us, and giving them praiseworthy remembrance after their death. The same sura also describes the travels of Prophet Moses, upon whom be peace, accompanied by Yusha’ ibn Nun, during which the cooked fish they were carrying with them for supper was resurrected and swam into the sea (18:61-64). In a tradition of Prophet Muhammad, peace and blessings be upon him, it is recorded that he talked to a dead girl by God’s leave upon her parent’s request, but the girl refused to come back to this world as she had found something better there [the Hereafter] [4]. 

The prevention of aging, alongside the wish to attain immortality, has long been one of the greatest aspirations of human beings. Several scientists and philosophers of the previous century argued that this might become possible in the 21st century. Chapter Baqarah refers to a prototypical society with greed for life, noting that people of that society wish “if only [they] might be spared for a thousand years” (2:96). Perhaps, the ultimate goal of today’s medical research is to try to ensure human beings live forever in this world. Prophet Muhammad, peace be upon him, warns that this is a vain thought, although we should seek healing by all possible means: “O servants of God, search for remedy for your diseases. Indeed, God has created no incurable disease except one: old age (or, death, in another narration)” [5]. Nobel laureate Alexis Carrel maintained that human cells are immortal under favorable conditions but Leonard Hayflick, later, demonstrated that cell divisions are limited due to DNA damage and shortening of telomeres [6, 7]. According to the Hayflick limit, the maximum lifetime a person can get even if he or she lives under the best conditions is 125 years. Telomeres are the structures located at the end of the chromosomes that protect DNA, and during cell regeneration, the length of telomeres decreases with each cell division and the number of divisions declines after a critical limit. Scientists dream of slowing down the aging process by reactivating these telomeres, but they have not made much progress despite some positive results in experiments with rats.

Big technological corporations have recently been making considerable investments in order to find ways to further increase human lifespan. Venkatraman Ramakrishan, who won the Nobel Prize in chemistry in 2009, said, “Californian billionaires are having such a good time at the party of life that they don’t want it to stop” [8]. The investments and efforts in this field do not seem very promising because the human body is not suitable for immortality. Instead, scientists are pursuing the idea of merging human brains with machines, which would require uploading a human brain to a computer. In today’s world where research on artificial intelligence is rapidly advancing, a human being’s habits and memory are supposed to be transferred to a computer. Elon Musk, the founder of Neurolink, a company that seeks to restore memory using gadgets planted into the human brain, once said that digital intelligence and biological intelligence would converge over time with increased interaction between the two. This sounds promising for the treatment of certain diseases such as Alzheimer’s. There is, however, another lead in this research according to Josh Bocanegra: “When the time comes and all the necessary advancements are in place, we’ll be able to freeze your brain, create a new artificial body, repair any damage to your brain, and transfer it into your new body” [9]. This may be an artificial body developed using stem cells with possible aid from diverse robotic devices. Ray Kurzweil, who works on Google’s machine learning project, argues that the use of tiny robotics that connect a human brain to computers may be possible by 2029, which will in turn extend human lives considerably. Another futurist, Ian Pearson predicts that in 2050, humans will achieve virtual immortality and a person’s personality transferred to a computer will be able to communicate with people in the future [9]. A recent New York Times article suggests that brain implants could change humanity [10].

Ultimately, it is hard to predict the extent of scientific and technological developments. The idea of eliminating death reminds us of Bediuzzaman Said Nursi’s saying that it is impossible for the lake of Barla (the town he lived in at the time) to be destroyed for the time being, but people can imagine such destruction and this imagination does not change the reality. Yet even the very imagination of eliminating death may serve as a false hope for people who rationalize everything and try to forget about the idea of death, and in this way, they stick to worldly pleasures more fervently. At this point, Prophet Muhammad, peace be upon him, shows us the correct manner of thinking: “Remember death frequently as it dulls out pleasures” [11].

In the Qur’an, the most important verses concerning raising the dead are about the miracles of Jesus, upon whom be peace. It is emphasized that he would breathe into something fashioned out of clay in the shape of a bird, and it would become a bird by God’s leave, and that he would revive the dead and heal ill people (3:49). As a matter of fact, Mary becoming pregnant with Jesus and Jesus speaking when he was a baby are also medical miracles. It is interesting to note that today, just as in the time Jesus, materialistic thought dominates the scientific and medical research, which are mostly construed solely with a materialist perspective. Almost all discoveries are used as evidence for disbelief, and they reinforce the self-conceit of those who make them. Bediuzzaman predicts that as Christianity will be purified from superstitions in the End Times, and that science will have the upper hand in rule and power. If such a purification will occur, then one tends to think it is not going to be only in political and administrative fields. Possibly, the change of scientific, or more specifically, medical perspective may constitute a major stage in the purification process that could save modern medicine and science from materialism and become instruments of discovering the truth. Who knows? God Almighty may make a vulnerable and weak baby speak to send a message to a purely materialistic community as a manifestation of His divine power.

References

1. Bediuzzaman Said Nursi, 20th Word, First Station, Words.
2. Fethullah Gülen, Kurandan İdrake Yansıyanlar.
3. https://www.nytimes.com/2017/01/26/science/chimera-stemcells-organs.html
4. Bediuzzaman Said Nursi, 19th Letter, Letters.
5. Bukhari, Tib 1; Abu Dawud, Tib 1; Tirmidhi, Tib 2.
6. Carrel A, Ebeling AH. Age and multiplication of fibroblasts. J Exp Med 1921.
7. Hayflick L. The limited in vitro lifetime of human diploid cell strains. Exp Cell Res 1965.
8. https://www.livemint.com
9. https://www.entrepreneur.com/article/307675
10. https://www.nytimes.com/2020/08/28/opinion/sunday/brain-machine-artificial-intelligence.html
11. Tirmidhi Hadith No. 2307.

Tafrid (individuality) means seclusion from society or going into retreat to devote all one’s time to worshipping God. More particularly, it denotes that even when initiates have attained states or stations that others cannot, they never see themselves as such, because of their conviction that whatever attainment they have is, in fact, a gift from the Ultimate Truth, submitting themselves wholly to Him, and always being in His company. The verse (24:25), Surely God is He Who is the manifest Truth, contains an implicit indication of this rank.

Although resembling each other in coloring, individuality and isolation express different ranks and states of pleasure. Isolation is the state of cutting off relations with everything else save the All-Beloved and of always being with Him, while individuality is being favored with total self-negation with the needle of conscience pointing to Him exclusively. Isolation is marked by the zeal and pleasure of devoted servanthood to God, while individuality is the consciousness of being a servant bound to worship Him. The depth of this consciousness is in proportion to one’s capacity and varies in degrees with respect to the things initiates feel during their spiritual journey.

Those in the initial stages of the way to individuality—which is called individuality on the way to the Ultimate Truth— are constantly in quest of Him, trying to feel Him and making strenuous efforts to find and see Him. While doing this, they never consider what being in constant quest of Him denotes nor what kinds of things are used as means to reach this goal. Even if they make use of these means in a natural way, they are concentrated on the goal with the whole of mind and heart, and are always thinking of it. They use all their abilities of thinking and contemplation on the way to making contact with Him, and endeavor to reach Him, thus spending their whole life in the climate of this sweet dream.

Travelers dedicated to reaching the goal to such degree always feel the gifts or radiations of individuality coming from their turning to God, from their love of Him, and from their visions during the journey. They also feel the pleasure of seeking only Him Who is the One and concentrating all their love on Him alone. Being freed from wasting their faculties of loving, feeling, and seeking, they sip the sweet water of unity in multiplicity. They feel a great zeal and thirst when they are journeying through the step of advancing toward Him as their sole goal, find themselves in waves of annihilation while they are burning with His love, and are in privacy with Him freed from all others than Him when they reach the peak of the vision of Him.

When halfway on the road to individuality—summarized as individuality in the company of the Ultimate Truth—they feel that they are being favored with abundant gifts from the All-Holy One. However, they should not feel vain on account of these gifts; rather, they should be ever conscious that it is not themselves who are the origin of such gifts, but they have come purely from the All-Holy One. With this consciousness, they remain full of thanks and praises for Him. Those reaching this rank of being perfected or of becoming universal human beings and the most polished mirrors to the All-Holy, Ultimate Truth, cannot help but express that this is purely His favor. The following couplet of Hassan ibn Thabit, a famous poet during the Prophet’s time, is an excellent example of this:

I have not praised Muhammad with my words;
rather, I have praised my words with Muhammad. [1]

He means that his words are praiseworthy because they are about Prophet Muhammad, upon him be peace and blessings. Such a favor should be proclaimed in attribution to God as declared in the verse (93:11), As for the grace of your Lord, proclaim it. Some sayings of the Prophet, such as, “I am the lord of the children of Adam, and the first to be resurrected on Judgment Day, and I am the one who will first intercede (with God on behalf of human beings) and whose intercession will be accepted; but there is no pride,” [2] and comparable utterances of some of his Companions about themselves belong to this category. They do not express self-pride, but rather proclaim God’s favors and are overflowing with the feelings of thanking and praising Him. Such a favor can be regarded as a threshold to the perfect knowledge of God that is for the heroes of knowledge, love of God, and spiritual pleasures. The (third) rank of individuality beyond this threshold marks a different depth of their knowledge of God and suggests an unimaginable attainment.

This third rank, which is called individuality on the way from the Ultimate Truth, and which is supported by God’s unique and most comprehensive appreciations of those who have attained it, is the rank where travelers are favored with the constant company of God due to their perfect expansion, knowledge of God, and feeling of awe and reverence beyond all measure. The heroes of this rank feel in their inner worlds that the whole universe has been annihilated in God, they feel His constant company even when among people, and convey to the creation what they have received from the Creator, opening the door for people in order that they may be enabled to meet with the Ultimate Truth. The main characteristics of such people are that, because of their modesty, they are like other human beings in appearance, they always pursue God’s good pleasure and approval in all their acts and dealings, they live in this world by concentrating on the next one, they always feel the exhilarating company of God, they convey to others what they hear, see and feel, they take an interest in everything other than Him only because of Him, and they see every other thing as a shadow of the light of His Existence.

Those who are in the first rank of individuality are dedicated to reaching the goal of their journey. Those who have attained the second rank voice, as a proclamation of the Divine favor, the fact that they have been favored with the rays of His “Facial” Light and the lights of His Existence that they feel in the hills of their hearts. They constantly thank and praise God. As for others who have attained the peak of this journey, which is in fact beyond all ranks, and who share the indescribable depth of those of the second rank, we can approach them only with respect to their missions and their consciousness of these missions. They receive messages from the Ultimate Truth and convey these to people, calling them to meet with God, trying to remove the obstacles between people and God. They put up with living only for the life of others, and if they cannot do anything for the life of others, they experience life as an unbearable suffering. These are perfect guides and conveyors of the Divine messages. Their first or greatest rank is composed of the Messengers and the Prophets, and their true successors constitute the second rank.

The initial-rank travelers to individuality are the heroes of belief and knowledge of God who are in constant pursuit and who hasten to sincerity and purity of intention. Those of the second rank are the loyal ones filled with a knowledge and love of God, who have fully displayed their faithfulness and sincerity. As for the others, whom we try to know by their tasks and missions, they are the guides and conveyors of God’s messages, those who try to make the Ultimate Truth known to people and to rouse the spirits to meet with Him. Since the heroes of this final rank also have the attributes that are shared by those of the first two ranks, they can also be called the leaders of the heroes of knowledge of God. As for the first and foremost among them, he is our master Muhammad u Ahmad u Mahmud u Mustafa, who is the master of creation and the unique one of all time and space, upon him be the best and most perfect of blessings and peace. There are many other great persons near to his sacred sphere, especially including the other great Messengers, upon them be peace. Each of them has been honored with special favors according to his rank. However, it is Prophet Muhammad, the leader of the holiest of humankind, who was constantly being honored with such favors. Others have been ready to sacrifice their lives for the sake of one moment of his relation or togetherness with the Light of Lights. All the beauties and lights with which the others have been honored are mere reflections of the Divine manifestations that he received.

In his famous Qasidatu’l-Bur’a (Eulogy of al-Bur’a), [3] Busiri expresses this highest grace as follows:

All the miracles that the other great Messengers worked by God’s leave,
were caused by the light that reached them from the light of Muhammad.
What we all know concerning him is that he is mortal human being;
but he is the best and greatest of all that God has created.
If the miracles he worked had been in proportion to his greatness,
the rotted bones would be revived when one prays, mentioning his holy name.

O God, bestow Your blessings and peace on him whom You sent as a mercy for all the worlds, and on his brothers among the Prophets and Messengers, and on the angels near-stationed to You, and on Your righteous servants among the inhabitants of the heavens and earth, may God be pleased with all of them.

Notes

1. Ibnu’l-Athir, Mathalu’s-Sair, 2: 357; Imam Rabbani, al-Maktubat, 1:58.
2. Muslim, “Fada’il,” 3; Abu Dawud, “Sunna,” 13.
3. The Bur’a by Al-Busiri is arguably the greatest classical poem in the Arabic language in praise of the character and exalted rank of Prophet Muhammad. Composed by Imam Al-Busiri in the 13th century in Mamluke Egypt, it has been recited ever since throughout the Muslim lands. (Tr.)

In 1981, scientists discovered ways to derive embryonic stem cells from early mouse embryos. Since then, they have been the subject of intense scrutiny, controversy, and advocacy.

They are unique cells, which can be derived from human embryos and can be differentiated into virtually any kind of different cells. In humans, there are about 200 different types of cells including bone, muscle, and nerve cells, and within these cells there are about 20 different types of structures or organelles. Essentially, stem cells can be derived from human embryos, and with the right enzymes, can be stimulated. For instance, bone cells can originate from osteocyte cells, or liver tissues can come from hepatocytes.

Stem cell types and research

There are three types of stem cells:

• Embryonic stem cells
• Adult stem cells
• Induced Pluripotent Stem Cells (iPSC)

Embryonic stem cells are derived from human embryos. Adult stem cells are undifferentiated cells (meaning “clean slates” with the potential to change into another cell variant) found throughout the body after development; they multiply via cell division to replenish dying cells and regenerate damaged tissues. Induced Pluripotent Stem Cells (iPSC), which were discovered in 2006, are derived from skin or blood cells that have been reprogrammed back into an embryonic-like pluripotent state that enables the development of an unlimited source of any type of human cell needed for therapeutic purposes. While these types of cells are interesting and certainly worthy of research, this article will focus on embryonic stem cells as they are consistently the most well-known and discussed type by the general public.

Embryonic stem cells are potent and often sought after due to their abilities to proliferate without limit and contribute to any cell type. However, with great power comes great responsibility and stem cells are no exception. Poorly processed cells have been documented to mutate into cancerous tumors that can wreak havoc upon people’s bodies. Bearing this in mind, scientists also do not believe that this should derail stem cell therapies considering that there are DNA tests to check if stem cells will turn out to be problematic or not.

The stem cell project is regularly a subject of ethical debate in both the academic and public sectors. Most embryonic stem cells are derived from embryos that develop from eggs that have been fertilized in vitro—in an in vitro fertilization clinic—and then donated for research purposes with the informed consent of the donors. People willingly donate their eggs for this research, and this process does not constitute child-killing since the eggs are near their zygote phase, not a whole mature embryo. Scientists obtain those types of cells from an embryo which has not yet completed its formation to develop into a human being. Researchers then use these cells for various treatment and research purposes. It is important to stress that they are not derived from eggs fertilized in a woman’s body and that they are produced in a plastic laboratory culture via clinics in vitro.

Some examples of embryonic stem cells being used in research include the following:

1. UCLA stem cell gene therapy cures bubble baby disease

Researchers at UCLA (University of California, Los Angeles) have developed a cure for babies born with Bubble Baby Disease, a rare and life-threatening condition that can be fatal within the first year of life, by using stem cells from multiple patients and gene therapy to correct the genetic mutation of these patients.

2. Asterias biotherapeutics restores some independence to those suffering from paralysis caused by spinal cord injuries

Asterias Biotherapeutics spent much of 2016-2017 developing a stem cell therapy to restore upper body motor function to quadriplegic spinal cord injury victims. Through lengthy and rigorous testing in human clinical trials, the therapy was found to be safe for use in people with all patients treated reporting at least some improvements. Asterias is now expanding its clinical trials to include patients with sub-acute injuries.

3. UC Irvine scientists engineer stem cells to destroy cancer

In a study conducted by University of California, Irvine researchers, a stem cell-based technique was devised to find and destroy breast cancer cells that had already metastasized. The cells “feel” the stiffness of the surrounding tissues and destroy the cancer-causing cells.

Embryonic stem cells can remain undifferentiated when they are grown in a well taken care of culture that is under stable conditions. Problems primarily begin to arise if cells are allowed to clump together to form embryoid bodies in which they begin to differentiate, or change into more specific cell variants, spontaneously. Although spontaneous differentiation is a good indication that shows which cultures of embryonic stem cells are healthy, the process is uncontrolled and, therefore, an inefficient strategy to produce cultures of specific cell types.

The ability of stem cells being able to differentiate into hundreds of other types of cells continues to amaze scientists as this is no small discovery. Researchers believe that the possibilities with stem cells are near endless, especially in regard to “regenerative medicine,” the process of “replacing, engineering, or regenerating human cells, tissues, or organs to restore or establish a new function.” It is even believed that even whole organs could be synthetically grown by using them.” Additionally, stem cells have the potential to rebuild healthy tissues, help people with heart disease, diabetes, ALS, Alzheimer’s disease, liver disease, Parkinson’s disease, cancer, and many more illnesses.

In a stem cell transplant, embryonic stem cells are first specialized into the necessary adult cell type. Then, those mature cells replace tissue that is damaged by a disease or injury. This type of treatment could be used to:

• Replace neurons damaged by spinal cord injury, a stroke, Alzheimer’s disease, Parkinson’s disease, or other neurological problems.
• Produce insulin that could treat people with diabetes and heart muscle cells that could repair damage after a heart attack
• Replace virtually any tissue or organ that is injured or diseased.

Sometimes scientists use stem cells as a drug. For example, it is possible to inject a stem cell into joints to reduce swelling and pain, or in order to promote the healing processes of soft tissues. Stem cell therapy is performed by injecting the patient’s own stem cells to stimulate the body to repair and replace damaged tissue in any joint or soft tissue structures – such as knees, shoulders, hips, wrists, ankles, elbows, tendons, ligaments and non-healing bone fractures. Cellular Dynamics, a large biotechnical company, sells human heart cells called cardiomyocytes that are derived from induced pluripotent stem (IPS) cells. Pharmaceutical companies are adapting to this new and innovative trend on a day-to-day basis. Stem cells can also be used to test the quality and safety of investigational drugs by testing them on stem cells that have been transformed into tissue-specific cells. Researchers are able to monitor the side effects before exposing the drug to a patient and thus have a greater expectancy of how their body may respond to the drug. This allows us to test for cures for potentially fatal diseases in ways that would otherwise be risky or unethical.

With all of the aforementioned advantages, stem cells are a fairly new, but exceptionally promising, research area. For some people, it may seem unethical to use stem cells on the grounds that extracting stem cells damages the blastocyst, which is a structure formed in the early development of mammals, more specifically the sixth or the eighth day of the development of an embryo. In 2006, President Bush vetoed the Stem Cell Research Enhancement Act stating that the federal government should not support “the taking of innocent human life.” Although stem cells are very promising for science and can open new doors to many new treatments in the medical field, it looks like there are still differences of opinion on their ethical use. This is perhaps because there is need for more convincing evidence or people are not informed accurately on the details of this research area.

References

• https://stemcells.nih.gov/info/Regenerative_Medicine/2006Chapter1.htm
• https://www.healthline.com/health/stem-cell-research
• https://www.statnews.com/2017/04/26/stem-cells-cancer-mutations/
• https://plato.stanford.edu/entries/stem-cells/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398703/
• https://www.mayoclinic.org/documents/the-amazing-stem-cell/doc-20249792
• https://www.unmc.edu/stemcells/educational-resources/history.html
• https://www.cirm.ca.gov/patients/power-stem-cells
• https://www.nature.com/news/stem-cells-take-root-in-drug-development-1.10713
• https://hsci.harvard.edu/examining-ethics-embryonic-stem-cell-research#:~:text=Opponents%20argue%20that%20the%20research,taking%20of%20innocent%20human%20life.%E2%80%9D

On the back cover of the 2017 May-June edition of this magazine we were reminded of the knot that binds us to the tangle we have made of human existence. Releasing the knot, one would contend, requires first an awareness of the nature of the knot, which means knowing what caused the tangle.

We are horribly aware of what is, but hardly aware of why. Your correspondent rather fears to suggest that in respect of human history, and as far as the current terrorists are   concerned, they are not even par for the course. This not an apology and is by no means a suggestion that they are anything less than undesirable, but they do have a long way to go to equal our collective bloody past. You don’t need a list.

It may be reasonable to suggest that frustration is at the root of most human folly. The terrorists are frustrated by their own need to find release from persecution perceived, but more likely a purpose for their lives. It amounts to the adoption of a system, a philosophy, a reason to be. It is often similar, in albeit psychological content, to what we often undertake in the name of “our interests.” Humans are also frustrated by the need for some of us to be rude, as in the appalling attacks of the good name of the Prophet Muhammad, which were used as an excuse to release ingrained frustrations. Should we really be aghast when we end up with a bloody nose after insulting someone? We do not discuss right or wrong because we are confronted by simply what is. Our lack of comprehension when being hit tells of an equal lack of awareness of human decency and that really means our own lack because, after all, you generally get back what you engender. The Hindus call it karma. All right, let’s tell it how it is. “Keep your dirty mouth off me, buddy, or you’re gonna get a smack in the eye.” Thus, however crass, crude or unsophisticated, that is how things stand. We must possibly consider that the human fuse is longer or shorter according to the individual. Even if so inclined, one would perhaps risk an oblique thrust against an educated, worldly wise person, but I will hesitate to walk into a black neighborhood shouting about white supremacy. This by no means supposes that people in a black neighborhood are unsophisticated, but it does suppose common sense, as opposed to being either cowardly or brave, or downright silly. Quite obviously, speaking one’s mind is often far removed from exercising common sense. To be fair, there would seem to be a need for a study about what to do with thoughts that are less than useful. The “freedom to be me” set would protest, but I am suggesting a universal creed, borrowed again from one of the mystics, of being able to do anything you like in this world, as long as you don’t hurt anybody.

Don’t think about it: only God is good.

The peoples of this world have been insulting each other since the beginning of time. Nevertheless, there must be more to the matter. History shows us that most nations have at one time or another been at the top of the pile politically, culturally, and naturally financially. The top nations were then seen to slide right on down again (Rome is the obvious example.) How come? They had it all! It is a common notion to say that wealth brings responsibility with it. But with tons of money available, decadence is a beguiling and easy option. Above all, we are bound to admit that the exhilarating, albeit disastrous, slide down is likely to be made rapid to the extent of a nation’s financial means.

One could also suggest that as far as the terrorists are concerned, they may well be running on a sort of universal “now is my time” program. The wheel of human endeavor has turned – someone has even suggested that there is a noticeable historic cycle in social change – and we are now faced with another bully thrusting to the fore. Please remember that none of the so-called advanced nations have ever succeeded without bullying, usually some other country’s indigenous peoples. This brings about frustration and an arising group urge. First comes the insult perceived, then comes the instinctive, then the planned, fight back.

Please consider that terrorists have, in one guise or another, littered the lives and existence of humans for thousands of years. The name, the cause, the flag under which they kill may have been superficially varied, but the root cause, the why, has always been the same. Humans have an appetite for anger. To be precise, anger is an appetite!

Has anyone ever investigated appetite? The mystics deal with it. The Islamic mystic, Sheikh Jilani, has pinpointed our lower instincts, for which the Arabic word is nafs. Our nafs are not merely our egos, but are somewhat akin to the appetites we attach to our lower impulses. Am I splitting hairs, here? Nevertheless, whether from the Arabic or otherwise, nafs, our lower impulses, are universal one way or another to all of humanity.

The ego is indeed pure until it acquires a less than useful appetite. Our motivating forces (often animal or material in nature) may well be necessary for navigating our daily lives, but there are few among us able to use them under the governance of a human attitude, read God’s guidance. Nevertheless, it may seem to be confusing the issue somewhat to suggest that our lower impulses are also needed to get out of bed in the morning with a purpose. In other words, an ego is little more than a mechanical function that has somehow acquired enormous clout in the minds of humans. The ego is very useful for undertaking work, for getting you to the train on time, for making money, but not for using money for matters of detriment. Such as having a war supported by a war industry. Thus, doing what you truly feel guided to do and nothing else is demonstrably tricky. Your mind will always find a reason for you to indulge in your appetite for sex, drugs and… (ok, let’s keep rock ‘n’ roll), the world, the world. One of the problems arising when discussing ego is that it is loaded with connotation. Everyone will tell you that egoism is bad, but that is not true! It is what you do with your ego that is often out of context. That’s the point, it is the notion of what you do that is of the essence. The big idea, of course, is to keep your self separate from your ego. In other words: my ego, my servant, and not the other way round. Moreover, my mind, my servant, and not the other way round, would suggest relegating the mind to its proper position within the human frame. This perhaps sounds like a good idea, on paper, and one should be able to exercise free will to undertake it. The problem is that not many wills on this earth are actually free. (Ask any parent struggling to put a child through school.) There always appear to be the add-ons, coloration engendered by experience. The Hindu maintains that “…to live life according to experience is the most bitter of ways.” Another mystic has also said that people make most mistakes when feeling happy. That may sound weird, and this writer apologizes for not offering an example. I would need a month on a desert island to figure that one out.

Can we envisage “my mind, my servant”? A mind that serves and does not lead? A humble mind is a rarity, of course. A mind denying its self for most of us would be, well, unthinkable. This writer asks forgiveness for adding sophistry; it is a writer’s test of faith. But it does mean that the true human self should be, but rarely is, separate from a person’s motivating forces. Hence inner conflict.

It has been suggested that to worship God one must make neutral the effects of the heart and the mind. This emptying of worldly influences, which are actually necessary for living in the world, for a period of worship means permitting God to take over. With the heart and mind in neutral, the nafs, our lower motivating forces, are in abeyance. At the finish of worship, the nafs will again thrust to the fore, often with a vengeance. Five times daily in prayer is a constant return to God. Then by the grace of God we may wish to consider the forces within us as they really are. It must be of great value to be able to dissociate ourselves – achieve distance – from our lower forces, get them into focus but not to eradicate them because one may never get off one’s desert island. One may also meditate at lofty Himalayan heights and even “shake” the hand of God, but would be incapable of coming down to the valley where human life goes on.

Our lower motivating forces should be – in fact are – the instruments given at our disposal for work, for undertaking science, for example, for feeding ourselves and our families, thus, for dealing with our worldly responsibilities. Many persons of an ascetic leaning have removed themselves from “the world” in an endeavor to subdue their lower forces. Indeed, Muhammad went to his cave, Jesus went into the desert for forty days and forty nights. Their motivating instinct, however, was submission, for receiving and not conceiving. After all, can we really be wiser than God? These persons then returned to the world to assist the rest of humankind. This writer remembers the story of a Buddhist monk who had received nirvana, after which he returned to the marketplace, the world, to serve humanity. In its simplest form it was all about knowing what makes people suffer, what makes people afraid, what makes people turn to their lower instincts for answers and then makes them fight. The German language offers Existenzangst, which is a good a word as any for describing the root of the human condition.

Jesus returned knowing what makes people be the way they are, Muhammad, too, and he was reported to have cried out in anguish at his knowing. The Buddha came to his realization of what makes people unhappy, which was, of course, desire.

The Islamic tradition leans, quite rightly I believe, on the sciences – the use of the mind to serve for the betterment of human existence. It is not a mystical matter, but it is engendered by a mystical instinct. First the realization, then the serving. Moreover, using the mind to cultivate a garden, harness solar energy, or simply attending to one’s given profession could reasonably be suggested as being God’s preferred way of keeping us out of trouble. Those of theological persuasion may well suggest that one is unable to enter through the gates of heaven through works. This writer would contend, however, that enterprise is not the real meaning of work, or works. It may be reasonable to suggest that anything undertaken through the designs of God has already been blessed, however mundane it may appear. Philosophers, writers in general and those who would delve into higher things are naturally at risk. It is dangerous terrain, often a tightrope walk over a yawning chasm engendered by the heart and the mind, which amounts to the most sophisticated double act to ever enter upon the stage of human endeavor. This writer has also been in the presence of a mystic who once maintained that he had no real knowledge of what he was about to say (lecture notes would be anathema). His inspiration was from above.

Thus, after our daily prayers we return to the world on a hopefully even keel. Our appetites, which, let’s face it, are currently raging around the planet, are for a while governed by a higher force.

It has been suggested – and don’t get me wrong here – that prayer changes nothing. Prayer changes people and people change things. This writer is inclined to equate prayer with a spontaneously arising feeling of hope for betterment in the face of trouble. Thus, to hope for betterment, and not wish to kill, is in itself grace.

The only way to surrender to God, it seems, is to place one’s lower motivating forces in abeyance for a while. But never, ever, try to eradicate them.

This writer finds himself, at long last, reading James Michener’s Iberia. At the beginning of the book Michener tells us about duende (grace recognized) and shibui (aesthetic rightness). Both explanations are approximations. My leaning for such things, my temperament, brought on enthusiasm. The promising beginning was brief, however, and Mr. Michener then takes the reader through 800 pages of small print dealing mostly with the history, art and culture of the Iberian peninsula. Mr. Michener tells us what is or was, but not why.

We all focused on one topic throughout 2020: Covid-19. No single day passed without news on the pandemic as we counted numbers of positive cases and the death toll while anticipating for a vaccine. In the meantime, we got more familiar with some of the medical processes, like phases, clinical trials, mutations, etc. for all this had to deal with the most precious gift we are given: life.

In our last issue, we touched upon the history of pharmacology and how modern-day drugs are made in an article titled “Pharmacology: The Journey of a Chemical Compound into a Drug.” Now, we will explore the multiple, lengthy phases of clinical trials that drugs must undergo and why they are imperative in order for new medicines to get approved for the marketplace.

Clinical trials are a way to test new methods of diagnosing, treating, or preventing health conditions. The goal is to determine whether a substance is both safe and effective. A clinical trial is only done when there is strong reason to believe that a new test or treatment may improve the care of patients.

A variety of treatment methods such as medications, medication combinations, new uses for existing medications, and medical devices are evaluated through clinical trials. In the United States, all new treatments must go through these trials before being approved for public sale by the Food and Drug Administration (FDA).

At the discovery and development stages, thousands of compounds may be potential candidates for development into a “drug”. After early testing, however, only a small number of compounds look promising and call for further study. The entire process of developing a drug from its pre-clinical research stage to its final marketing phase can take approximately 12 to 18 years and often costs well over $1 billion [3, 4].

Clinical trials show us what works and what does not in the realm of healthcare and are designed to answer some important questions such as:

• Does the new treatment work in people? If it does, how effective is it?
• Is it better than currently used treatments?
• If it is not better, is it just as good and cause fewer side effects?
• Does it work in some people who do not benefit from current treatments?
• Is the new treatment relatively safe? There is virtually no treatment or procedure that is without risk, but do the benefits of the new treatment outweigh the risks?

Answering these questions, while giving as few people as possible an unknown treatment, often requires several clinical trials in different phases. Each phase is designed to answer certain questions while keeping trial participants as safe as possible.

Preclinical phase

Before clinical trials can begin in humans, tests and treatments are assessed in pre-clinical research, which can involve extensive laboratory research over several years of testing on animals and human cells. This research may aim to learn the chemical compound of a drug [1]. If the initial laboratory research is successful, researchers send the data to health authorities for approval in order to begin research and testing on humans.

Once pre-clinical research results are approved, human testing of experimental drugs can begin and is typically conducted in four phases that are denoted by Roman numerals (Phase I, II, III and IV). Each phase is considered a separate trial and, after completion of a phase over many years, researchers are required to submit their data to, and then wait for approval from their local health agency (the FDA in the US) before continuing onto the next phase. If the drug successfully passes through Phases I, II, and III then it will usually be approved by the national regulatory authority for use in the general population. Phase IV trials are “post-marketing” or “surveillance” studies that are conducted to monitor how safe the product is over several years [2].

Phase I

This is the first clinical phase that involves humans. Phase I trials most often include healthy volunteers, however there are some circumstances when clinical patients are used, such as patients who have terminal cancer or HIV. These treatments possess a much higher risk for healthy individuals and could cause to become ill and contract serious adverse side effects.

In a Phase I clinical trial, doctors collect information on:

• The dose or treatment
• When it should be taken, and how often
• Any side effects or complications
• How the treatment affects patients and their preexisting conditions

One of the primary goals of Phase I studies is to find the highest dose of a new treatment that can be given safely without causing severe side effects. Although the treatment has been tested in laboratory and most likely been used in animal studies, the side effects in people cannot be known for sure. During Phase I of a clinical trial, researchers spend several months to evaluate safety, side effects, optimal dosage amounts, and formulation method for the drug on about 20 to 80 people who have no underlying health conditions.

In addition to evaluating safety and ideal dosage, specialists also look at the best way to administer the drug such as orally, intravenously, or topically. These trials are often conducted in a clinical trial clinic where the subject can be observed by full-time staff. Safety always remains the foremost concern in Phase I. The research team keeps a close eye on the people and watches for any severe side effects.

Researchers start by giving very low doses of the drug to a few patients while higher doses are given to other patients until side effects become too severe or desired effects are seen. The drug may help patients, but Phase I trials are to test a drug’s safety. If a drug is found to be safe enough, it can be tested in a Phase II clinical trial. According to the FDA, approximately 70 percent of medications move on to Phase II.

Phase 2

Phase II of a clinical trial usually involves anywhere from 50 to several hundred who are living with the condition that the new medication is meant to treat. They are usually given the same dose that was found to be safe in the previous phase. Investigators monitor participants for several months, or years, to see how effective the medication is and to gather more information about any side effects it might cause.

Most phase II studies are randomized trials where one group of patients receives the experimental drug, while a second “control” group receives a standard treatment or placebo. These studies are mostly “blinded” which means that neither the patients nor the researchers know who has received the experimental drug in order to avoid from bias. Doctors use a computer program to randomly sort volunteers into these two separate groups. Each volunteer has an equal chance of ending up in any of the groups and are randomly put in any group.

This allows investigators to provide the pharmaceutical company and the health authority with comparative information about the relative safety and effectiveness of the new drug. When the development process for a new drug fails, this usually occurs during Phase II trials when the drug is discovered to not to work as planned or to have toxic effects. The FDA estimates that roughly one-third of experimental drugs successfully complete both Phase I and Phase II studies.

Phase II clinical programs historically have experienced the lowest success rate of the four development phases. In 2010, the percentage of Phase II trials that proceeded to Phase III was 18% [5] and only 31% of developmental candidates advanced from Phase II to Phase III in a large study of clinical trials conducted during the period of 2006 – 2015 [6].

Phase III

Phase III of a clinical trial usually involves up to 3,000 participants who have the condition that the new medication is meant to treat. These participants must include men, women, and people of different ages and ethnic groups in many places across the country (or even around the world) at the same time. This helps doctors learn how treatment works in different people with different genetic backgrounds, races, and ethnicity. These studies tend to last longer – up to several years – than Phase I and II studies.

One of the additional purposes of Phase III is to evaluate how the new medication works in comparison to existing medications for the same condition. To move forward with the trial, investigators need to demonstrate that the medication is at least as safe and effective as existing treatment options. Due to the larger number of participants and longer duration of Phase III, rare and long-term side effects are more likely to show up during this phase.

There can be more than two treatment groups in Phase III trials. The control group may receive the current standard-of-care treatment for their illness while other groups receive the new treatment on trial. Phase III trials are usually double blinded to eliminate bias when interpreting results.

Placebos may be used in some Phase III studies, but they are never used alone if there is a treatment available that works. Sometimes, a patient who is randomly assigned to the placebo for part of the study will at some point be offered the standard treatment as well. As with other trials, patients in Phase III clinical trials are watched closely for side effects, and treatment is stopped if they become too hard to manage.

Every patient in a Phase III study is watched closely, and the study will be stopped early if the side effects of the new drug are too severe or if one group has significantly better results. Phase III clinical trials are often needed before the FDA will approve the use of a new drug for the general public. If researchers demonstrate that the medication is at least as safe and effective as others already on the market, then the FDA will usually approve the medication.

In the United States, when Phase III clinical trials (or sometimes Phase II trials) show a new drug is more effective or safer than the current treatment, a new drug application (NDA) is submitted to the FDA for approval. The FDA reviews the results from the clinical trials and other relevant information.

Based upon the review, the FDA then decides whether to approve the treatment for use in patients with the illness the drug was tested on. If approved, the new treatment often becomes a standard of care and newer drugs may be tested against it before they can be approved. If the FDA feels that more evidence is needed to show that the new treatment’s benefits outweigh its risks, it may ask for more information or even require that more studies be done. Once Phase III is complete, a pharmaceutical company can request FDA approval to begin marketing the drug. Roughly 25 to 30 percent of medications move on to Phase IV.

Phase IV

Phase IV trials test new drugs that are approved by health authorities and often are called Post Marketing Surveillance Trials. The drugs are available for doctors to prescribe to patients, but Phase IV studies might still be needed to answer important questions. In previous clinical phases the drug may not have been tested for interactions with other drugs, or on certain population groups, such as pregnant women, who are unlikely to subject themselves to trials. This phase involves thousands of participants and can last for many years. Investigators use this phase to get more information about the medication’s long-term safety, effectiveness, and any other benefits.

This is often the safest type of clinical trial because the treatment has already been studied a lot and has likely been given to many people. Phase IV studies look at safety over time. These studies may also look at other aspects of the treatment, such as quality of life or cost effectiveness.

Phase IV studies can result in a drug or device being taken off the market or restricted depending on the findings in the study. Unless an adverse effect of the approved drug is shown or the drug is accepted as safe, it will stay on the market and also in Phase IV forever.

This clinical trial algorithm has come out after many scientific studies. Every point of the clinical trials, and possible problems, have been clarified by policies which may differ from country to country. At the end, clinical trials are a very safe and cautious method of finding out the safest and most effective treatment, or diagnostic method, for people. During clinical trials, scientists are very careful about ethical issues and try not to harm any living organisms, be them animals or humans. There is an ongoing public debate over pharmaceutical companies. While some think they play a major role in the emergence of many methods and scientific developments to benefit human health, others doubt their motivations and questions their contribution to the public good. This debate will surely continue for a long time, but under the current circumstances, pharmaceutical companies are found in the center of all these clinical trials described in this article. Regardless of the truth behind these doubts, it is important to be always aware of the priceless value of life, that it has been given to us and all living things as an inalienable right and a precious gift, and that it is a major responsibility take care of it well and seek healing when needed.

• https://www.nccn.org/patients/resources/clinical_trials/phases.aspx
• “The drug development process”. US Food and Drug Administration. 4 January 2018. Retrieved 17 August 2020
• Holland J (2013). “Fixing a broken drug development process”. Journal of Commercial Biotechnology. 19. doi:10.5912/jcb588.
• Adams CP, Brantner VV (2006). “Estimating the cost of new drug development: is it really 802 million dollars?”. Health Affairs. 25 (2): 420–8. doi:10.1377/hlthaff.25.2.420. PMID 16522582.
• “New drugs failing Phase II and III clinical trials”. MedCity News. 2011-06-02.
• “Clinical Development Success Rates 2006-2015” (PDF). bio.org. Retrieved 2018-02-11.

Question: While sayings of Prophet Muhammad, peace be upon him, counsel against condemning believers to shame, despising them, and disclosing their faults, they also enjoin not remaining silent and unresponsive before oppression and evil. How is a believer supposed to achieve this balance?

In our previous issue we commented on not subjecting people to shame or scorn, as well as the importance of forgiving their faults. It is important to stress that we do not believe that it is acceptable to remain silent and passive when confronted with mistakes and wrongdoing, and to not take any action against them. “Commending good and preventing evil” is an important responsibility for believers if we take into account the following verse “You are the best community ever brought forth for (the good of) mankind, enjoining and promoting what is right and good and forbidding and trying to prevent evil, and (this you do because) you believe in God” (Al Imran 3/110), it is seen that being a part of the best community, or the one with the most goodness, is dependent upon this fact. Additionally, the noble Prophet ordered a present evil to be eliminated by direct intervention, and if this was not possible then by making verbal warnings, and if this was not possible either then by taking an attitude against it in one’s heart at least (Muslim, Iman 78; Tirmidhi, Fitan 11).

Trying to stop people from committing evil and enjoining them to engage in good behavior is one of the essential attributes of a believer. However, the method, style, and system to be followed in this respect are very important. Such an act cannot be done by embarrassing people and making them turn their faces away in shame. This will make matters worse, particularly so when certain matters rejected in religion such as lying, slander, and libel are also involved in the issue. What really matters here is making hearts genuinely feel the goodness of what is stated as good, and the darkness of what is stated as bad; namely, convincing people that the acts in question are good or bad (respectively), and making them re-orient themselves accordingly. Otherwise, without taking the other person’s condition into consideration, determining the correct manner, or thinking about which method to follow, an unwise approach such as “I say and tell what I believe and do not care about any other factors” has nothing to do with the religious teaching of “commending good and preventing evil.”

If we view the life of the Prophet Muhammad (pbuh), we find many examples of the points mentioned. For example, he counseled repentance to his companion Maiz who had committed fornication when he came to him and confessed his sin, saying that there is no sin God will not forgive. Although he turned Maiz down four times, the noble Prophet had to enforce the legal ruling upon the insistence of Maiz. However, he told people to ask for forgiveness for Maiz and pointed out that he had repented in such a way that if his repentance were to be distributed to the all people throughout the earth then it would suffice to purify everyone (Muslim, Hudud 22; Abu Dawud, Hudud, 24, 25). Thus, the Pride of Humanity prevented his community from continuing to hold a negative opinion about Maiz, for he wished Maiz to be remembered not as a sinner but as a person who was absolved from his sin and who had passed onto God’s divine presence in a purified state.

The noble Prophet neither put anybody to shame nor embarrassed anybody by mentioning their fault to them throughout his exemplary life. It is not possible to find examples in his life where he revealed people’s faults, treating fallen ones with contempt, or responded to evil with evil. On the contrary, he urged believers not to spy into others’ private issues. He always counseled covering faults and his entire life was permeated with forgiveness and tolerance. He made the following address to the people of Mecca, who had inflicted every kind of torment and suffering onto him, after him and his community peacefully took over the city: “No reproach this day shall be on you. Go now, all of you are free.” This mildness and magnanimity of his was one of the most important factors that conquered hearts and got people to enter Islam in droves.

If he had noticed a shortcoming of one of his Companions, he would never reveal it in an embarrassing way. He addressed such shortcomings during his public sermons without pointing the finger at that person, and he ensured that the person concerned also received a share from the teaching. Even in situations of meeting serious opposition where some were in a mood of disobedience, he would gather his Companions to make a general sermon that would not incriminate any one person. Hence, problems were solved without hurting and breaking the heart of anyone, without disgracing them, and without letting any grudge and rage be involved in the issue.

In this regard, it is very important, particularly for people who are at the forefront of dialogue and discourse with others, to undertake certain responsibilities. It is critical to know the people in your company and to not remain indifferent to their mistakes. A teacher must know the general situation of their students; in fact, it is an important aspect of their duty and responsibility. Their goals should be to treat everybody humanely, not to break anyone’s heart, and to try to eliminate evil in the most appropriate way. In other words, while eliminating evils as well, a believer is supposed to act in a way that reflects this character while remaining loyal to the path of the Prophet.

A manner appropriate for each person in question needs to be determined for the sake of not breaking anyone’s heart and not letting any problems escalate further, and each case should be taken into consideration separately as no two people are ever truly identical. Instead of giving an immediate reaction when faced with problems, and talking about them here and there, we must definitely mull over the subject and try to find the most appropriate solution. If you deal with matters in a crude and careless fashion and are as blunt as a kick in the shins, then you may risk hurting people and pushing them away from you. It should not be forgotten that the task of spiritual counsel and guidance requires expertise and sensibility. In a way, we can view it as a task that is best carried out by qualified and learned people.

It should also be known that problems may not always be sorted out by talking. In some situations, speaking over some problems might cause the crisis to get worse. As the saying goes, “a believer’s speaking should be wisdom and their silence should be reflection.” We should speak if we are to say words of wisdom. If this is not the case then we should keep silent and wait for the appropriate time. There are certain conditions where one needs to stop and think, for wisdom develops in the seedbed of deliberation. Otherwise, the blurting out of casual remarks will only produce noise. Just as we know the appropriate time to talk, we similarly need to know when to show patience and wait.

Self-interrogation

In one of his sayings, the noble Prophet stated that every child of Adam errs but the best of those who err are those who repent (Tirmidhi, Qiyamah, 49; Ibn Majah, Zuhd 30) and thus pointed out that human nature is prone to mistakes and sins. Accordingly, some give their willpower its due and narrow down this gap or totally eliminate it, whereas some do not succeed sufficiently in this respect. What matters here is that after experiencing a spiritual stumble, or perhaps even a fall, we work to straighten ourselves up right away and be purified in the washbasin of repentance.

Yes, everyone can fall. However, immediately walking out on, speaking negatively about, and putting to shame a person who is undergoing a spiritual relapse never comply with the virtuous conduct expected in religion nor with the path of the noble Prophet. Instead of busying ourselves with others’ faults we should be concerned with noticing our own faults and busying ourselves with setting those aright because those who cannot see their own mistakes keep looking for faults in others. A person who is fully concentrated on perfecting themself will be much less focused with the faults of others.

Before throwing a stone at someone, we need to take a look at ourselves first. And if we also have similar faults, then we should fear that such a stone may recoil and hit our own head. It is narrated that our master Messiah said the following in an address to a crowd preparing to stone someone to death for punishment: “Let one who is without sin among you throw the first stone…” Naturally, everybody gently lowered the stones in their hands to the ground.

The fact that people do not care about such matters at all and speak about others’ faults and sins in public does not serve as an excuse for us to behave in a similar manner. Even if the entire world engages in such sinful behavior it still does not justify joining them. As it is expressed in a Turkish proverb, “every sheep is hung from its own leg.” Asserting excuses such as “everybody was talking in this manner and I just followed their way” has no validity whatsoever on the Day of Judgment. As it is stated in the verse meaning, “And no soul, as bearer of burden, bears (and is made to bear) the burden of another” (Fatir 35:18) everybody remains alone with the burden of his or her own sins. And if someone defame others with spoken or written statements, that person will also be burdened with the sins caused by those statements, along with other personal sins.

Rather than being crushed under the weight of such sins in the Afterlife, taking our tongue under control while we can in this world and thus not giving way to such very hard to repair problems from the beginning is the wisest way. A person needs to also be careful about the feelings and thoughts that they may hold about other believers in the first place and should work to keep them pure, for what pours from the tongue are simply our thoughts. A person who is focused on the mistakes of others and continually mulls over them in their mind will firstly speak within about these with the inner voice, and then spill them out to others.

A person who is continually busy with others’ faults and speaks about these will definitely deserve punishment in the Hereafter on account of sins such as spying into others’ private affairs, holding negative assumptions, backbiting, and lashing out with insults. It is not possible for such a person to find comfort in this world as well. For a person who pollutes his or her brain neurons with what others did and who keeps talking about these filthy issues all the time, all of those things will turn into a torment.

It has been over half a year since Covid-19 swept across the world and forced many countries into quarantine. Hopes of a quick resolution of the disease in many countries have since been, unfortunately, proven to be wrong, and it is evident that the virus is here to stay for a while [1]. The virus is so difficult to deal with considering it can be transferred from person to person even if the carrier does not outwardly display symptoms. Even animals, ranging from mice to tigers, can contract and transmit it to humans [2, 3], and we cannot quarantine or force them to wear facemasks. The virus will eventually hit each person; it is just a matter of time. The virus may additionally arrive in multiple waves, as it is possible to be reinfected [4]. COVID-19 will most likely have a lifespan of a few years, much like other major virus outbreaks of the past such as the swine flu in Hong Kong or Spanish flu. It will probably come and go like a common flu in never ending waves. So, each of us need to be ready until a successful vaccine is developed, and the wisest action for each person to be ready would be to boost our immune systems and practice effective social distancing and sanitation measures, while we deal with this virus for however long it may last.

Vaccines are critical for stunting the development and spread of viruses; however, they can be costly, time-intensive to develop, and not always perfect. It is worth exploring alternative methods to help protect our bodies from these pathological invaders while vaccines are being researched. As it so happens, the best method of prevention to date for HIV infections is not a vaccine, but is instead a tradition that is as old as thousands of years: male circumcision [5]. To give a comparison, the current widely popular and heavily promoted influenza vaccine is considered “50% effective against influenza B/Victoria viruses and 37% effective against influenza A(H1N1)” [6]. On the other hand, according to an article published in the prestigious medical journal, The Lancet, circumcision is up to 88% effective in preventing heterosexual transmission of HIV [7]. Male circumcision does not have any medicinal side effects, and the only risks that are involved are those related to any minor surgery – bleeding and infection.

In the 1980s, when I first heard of HIV, I remember reading articles which claimed, quite arrogantly, that vaccines and cures for the condition would be found within two or three years [8]. Forty years later, and after spending many billions of dollars on research, we are still nowhere near an HIV vaccine. At best, we found treatments which helped keep the HIV virus at bay [9]. To date, only two people have been fully cured with a method far too expensive to be applied to the general public [10]. In the meantime, at least 30 million people have died with more than half a million in the year 2019 alone [11]. While vaccines are critical for helping to eradicate viruses, putting all of our eggs into that basket alone can be a risky public health strategy due to how difficult and time consuming they are to discover, verify, and distribute. It is impossible to know for sure how long it will take to develop a vaccine for the coronavirus. In the meantime, communities should heavily consider following the instructions of their local health officials which often include social distancing, limited size gatherings, and frequent hand washing as these methods are already proven to help reduce the spread of the virus.

Development, and even the rushed development of a vaccine, is always a very tedious and dangerous process. The science behind them is exceptionally complex, and imperfect results can have disastrous consequences upon thousands of people. This is further complicated by the fact that phase 2 and phase 3 trials can have quite diverging results [12]. In the USA, AstraZeneca’s COVID-19 vaccine trials were stopped after trial participants fell ill [13]. Third phase trials, which encompass thousands of people [14], still can give little indication of the long-term side effects to any vaccine. Besides, even though there is human life at risk, the vaccine has already become an instrument for many political and economic disputes and conspiracy theories. Some governments claim they have already developed a vaccine, while others find them unreliable, or try to lure a foreign company to work for themselves [15]. In August of this year Russia rushed registration of an unproven Coronavirus vaccine and named it, in Cold-War-like fashion, the “Sputnik V” [16]. The announcement was made by none other than Vladimir Putin himself. It was offered to the USA, but was rejected due to safety concerns stemming from a belief that the drug was not adequately researched and developed [17]. In the meantime, Russia announced the development of a second vaccine [18]. Surely enough, it was dismissed and downplayed by the West as unproven and unreliable. On the other hand, a vaccine developed by a Chinese company Sinovac proved to be the most successful in its phase 3 trials in Brazil [19]. Sao Paulo Governor João Doria purchased 47 million shots of the vaccine. However, the transaction was stopped, arguably for political reasons, by the Brazilian President Jair Bolsonaro [20]. Bolsonaro’s comments when rejecting the purchase of the Sinovac vaccine on the basis that “the Brazilian people will not be anyone’s guinea pig” are not totally without merit. Recalls of “proven and tested” vaccines have happened in the past [21].

It is important for all people to continue exploring methods to develop their immune systems and prevent the spread of the virus while we wait for a vaccine. In an article I had previously published, I discussed the benefits of fasting, vitamin C, and Wim Hof breathing methods to help protect the body from disease [22]. All of these methods are well known and quite benign with respect to side effects, however they are unable to cure Covid-19 or prevent its spread. Additionally, the Center for Disease Control (CDC) has heavily stressed practices included social distancing and the wearing of non-ventilated face masks. Our hope is that going above and beyond to protect ourselves and our neighbors will give scientists the time that they need.

One way of giving that time to scientists is fasting. Fasting, like circumcision, is a tradition that is thousands of years old. In recent studies, a three-day water fast has been shown to reset the immune system of elderly people to the level of a twenty-year old’s [23]. At this current level of emergency in the world it would be very easy to find thousands of willing volunteers to trial monthly three-day water fasts and/or to take extra doses of vitamin C, not as a cure, but as a shield against COVID-19. This kind of study would not pose much risk and would definitely be very cost-effective. We could dive straight into the third phase of trials, for any side effects of fasting are already well known. And finally, if proven effective, its uptake by the population at large would be basically cost free and readily available across the whole world.

Our world has been enduring a difficult and challenging period for the better half of a year now. Time has given us the ability to learn more about the virus, how it disrupts our bodies, and how it spreads. This knowledge has, in turn, allowed us to research it and develop effective social guidelines for limiting its spread. Still, there is much work to be done. Hysteria and haste are not conducive to producing a vaccine that is thorough, effective, and efficient. It should be the responsibility of every able-bodied citizen to do what they can to learn more about how they can protect themselves from the virus and thus prevent it from spreading even more while we wait for a vaccine.

1. https://www.wuky.org/post/beshear-next-few-weeks-will-be-critical#stream/0
2. https://www.washingtonpost.com/science/2020/09/03/coronavirus-deer-mice-spread/
3. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/animals.html
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326402/
5. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)03421-2/fulltext?_eventId=login
6. https://www.aafp.org/news/health-of-the-public/20200226interimfluve.html
7. Halperin, D. T., & Bailey, R. C. (1999). Male circumcision and HIV infection: 10 years and counting. The Lancet, 354(9192), 1813-5. doi:http://dx.doi.org/10.1016/S0140-6736(99)03421-2
8. https://www.immunology.org/publications/bsi-reports/60-years-immunology-past-present-and-future/the-hunt-for-hiv-vaccine
9. https://www.cdc.gov/hiv/basics/livingwithhiv/treatment.html
10. https://www.medicalnewstoday.com/articles/2nd-person-cured-of-hiv-thanks-to-stem-cell-transplant
11. https://www.unaids.org/en/resources/fact-sheet
12. https://www.fda.gov/media/102332/download
13. https://www.usatoday.com/story/news/health/2020/09/09/covid-vaccine-astrazeneca-trial-hold-what-does-mean/5757590002/
14. cancer.org/treatment/treatments-and-side-effects/clinical-trials/what-you-need-to-know/phases-of-clinical-trials.html
15. 15 https://www.nytimes.com/2020/03/15/world/europe/cornonavirus-vaccine-us-germany.html
16. https://www.theverge.com/2020/8/11/21363135/russia-coronavirus-vaccine-unproven-registration
17. https://www.techtimes.com/articles/251792/20200814/covid-19-us-says-no-to-russias-vaccine-sputnik-v-saying-theyll-never-use-it-on-monkeys-let-alone-people-vietnam-and-philippines-say-otherwise.htm
18. https://abcnews.go.com/Health/wireStory/russia-approves-2nd-virus-vaccine-early-trials-73614460
19. https://fortune.com/2020/10/20/covid-vaccine-china-brazil-testing-ground-safest-most-promising-sinovac/
20. https://apnews.com/article/virus-outbreak-brazil-state-governments-health-sao-paulo-b7b5b620ba54f402dbf803e26fe6b842
21. https://www.cdc.gov/vaccinesafety/concerns/recalls.html
22. https://medium.com/@arasweb/surviving-the-pandemic-370b47120d8d
23. https://news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system/

Most of us have taken, or at least interacted with, medicine at some point or another in our lives. This can range from more “simple” over-the-counter drugs to more complex medicines specifically designed for exact illnesses. Considering the Covid-19 era we are going through and as search for a vaccine is at the highest possible speed, it is important to have at least a general idea on how medicines are developed for our use. This article aims to explore how a complicated mix of chemical compounds in a laboratory end up as pills on a shelf in your local pharmacy. We will also explore a brief history of pharmacology, where drugs get their names, how drugs come into fruition, the various affects that drugs can have on our bodies, along with the discrepancies that exist between them in regard to when, how, and why they should be taken.

Pharmacology is the study of the interactions that occur between a living organism and the chemicals that affect normal or abnormal biochemical functions. It includes the study of how a drugs can affect our biological systems, such as individual organs or an entire part of the body, and how the body overall responds to the drug. The discipline encompasses the sources, chemical properties, biological effects and, therapeutic uses of drugs. Substances with medicinal properties are considered pharmaceuticals, whereas drugs given for therapeutic purposes are usually called medications. Drug therapy, which is also called pharmacotherapy, is the use of drugs to prevent, diagnose, and treat signs, symptoms, and disease processes. When prevention or cure is not a reasonable goal, relief of symptoms can greatly improve quality of life and the ability to function properly on a day-to-day basis. Developing an understanding of this craft can allow us to better appreciate how molecules interact to form the drugs and medicines that can change our lives, and perhaps even allow us to contemplate their complex creation and existence.

In its most simplistic definition, a medication is a substance that is ingested or placed onto the body in order to cure a disease or condition (antibiotics are given to cure an infection), treat a medical condition (anti-depressants are given to treat depression), relieve symptoms of an illness (pain relievers are given to reduce pain), given to prevent diseases (flu vaccine helps to prevent the person from complications of having the flu).

Source of drugs

Historically, drugs were mainly derived from plants, animals, and minerals. Morphine, insulin, and iron are all commonly used examples of their respective sources. Belief in the curative powers of plants and certain substances rested exclusively upon traditional knowledge. But empirical information was not subjected to critical examination. Until the end of the 19th century, medicines were made by natural organic or inorganic products including mostly dried or fresh plants and their parts. These compounds might contain substances that possess healing properties or reactions that exert a toxic effect. It is important to remember that many fruits, vegetables, and plants still possess great power despite not having a “modern” origin.

Most drugs used nowadays are synthetic chemical compounds manufactured in laboratories which are synthesized by altering the chemical structure of an existing drug. The first drug of a particular group of drugs are called prototypes. For example, morphine is the prototype of opioid analgesics, and penicillin is the prototype of antibacterial drugs. Drug classifications and prototypes are defined and most new drugs can be assigned to a group. We must be hopeful and continue to search far and wide for cures for all  diseases, whether they be organic or synthetic, since our world is full of an infinite amount of possibilities and discoveries.

Drug names

The systematic naming of pharmaceutical drugs is called “drug nomenclature.” Drugs primarily have three types of names: chemical names, generic names, and trade names. The chemical names are the scientific names that often sound complex and are based upon the molecular structure of a drug. During development, the company will apply for regulatory approval of the drug by the relevant national regulatory agency, such as the U.S. Food and Drug Administration (FDA), and will be granted a generic name for it. Generic names usually indicate, via their stems, what drug class the drug belongs to. For example, oseltamivir is an antiviral drug because its name ends in the -vir suffix.

After development, testing, and regulatory acceptance of a drug, the pharmaceutical company gives the drug a trade name, which is a standard term in the pharmaceutical industry for a brand name or trademark name. Many drugs have multiple trade names which can reflect separate marketing strategies in different countries, manufactured by different companies, or both.

Drug investigation

A new drug investigation is the beginning of the journey of a chemical compound to a drug that will be used in clinics. The testing process of a chemical compound begins with animal studies to determine potential beneficial uses and also potential toxic side effects of the candidate compound.  The results from these animal studies are reviewed, and if the results are satisfactory, the compound then undergoes clinical trials in humans that people can voluntarily sign up for. Most clinical trials use a randomized, controlled experimental design that involves selection of subjects according to established criteria, random assignment of subjects to experimental groups, and administration of the test drug to one group and a control substance to another group.

Patent protection

New drugs that are developed by pharmaceutical companies will be covered under patent protection. This means that only the pharmaceutical company that holds the patent is allowed to manufacture, market, and eventually profit from the drug. This is seen as a return on the company’s investment that it took to develop the drug, which may require years of work and millions of dollars, along with an incentive for developing other drugs. Other pharmaceutical companies cannot manufacture and market the drug during the patent period.

Usually, the drug patent is awarded for around twenty years in the United States, however the number of years varies across countries and drugs. Pharmaceutical companies apply for a patent long before the clinical trial period even begins. The effective patent period after the drug has finally received approval is often around seven to twelve years. After the patented period expires the drug can be manufactured and sold by other companies. The drug is referred to as a generic drug at this point, and they are required to be therapeutically equivalent and much less expensive than trade name drugs.

Pharmacoeconomics

Pharmacoeconomics involves all of the costs that are accrued due to drug therapy and experimentation including those related to purchasing supplies, dispensing the drug, storing it, administrative fees, laboratory and other tests that are used to monitor patient responses, and losses from expiration. The length of a patient’s illness or hospitalization is also considered. While the most important factor is the health of the patient the costs for treatment are increasingly being considered as a major factor when choosing medications, and research projects that compare costs have greatly increased in recent years. The goal is to make it easier for patients to choose the most cost-effective drugs that combine high quality treatment at an affordable price. For drugs or regimens of similar efficacy and toxicity, there is considerable pressure upon doctors and pharmacies to prescribe less costly drugs for shorter duration.

Prescription and non-prescription drugs

In many countries, consumers have two legal routes of access to therapeutic drugs. One route involves a prescription or order from a licensed health care provider, such as a physician, dentist, or nurse practitioner. The other route is by over-the-counter (OTC) purchase of drugs that do not require a prescription. Both of these routes are regulated by various drug laws that change from country to country. Acquiring and using prescription drugs for non-therapeutic purposes, by persons who are not authorized to have the drugs or for whom they are not prescribed, is illegal.

The rejection of drugs in modern society

Nowadays, there are some people who deny various kinds of treatments because of their religious beliefs. This category of people is only a minority, as the majority of religions advocate for people to be healthy and to take care of their health as much as they can. In almost all belief traditions, the human body is believed to be a trust, and in case of any disease, the most appropriate and fastest treatment methods should be used. Even substances that are not normally permitted are allowed by scholars to be used if the person’s safety is concerned. For believers, the most important goal in life is to worship God, and for this to be possible the body must be healthy.

One day, people asked Prophet Muhammad, peace be upon him:

“Should we make use of medical treatment?”

He replied: “Make use of medical treatment, for God has not made a disease without appointing a remedy for it, with the exception of one disease, namely old age.”

People are encouraged to seek out those remedies and to use them with skill and kindness. Let us also remember that Jesus, peace be upon him, too, was very active in his ministry of healing. He showed by God’s permission miracles like curing the blind and the deaf, and bringing the dead back to life. Thus, religions do not refuse treatment with any available methods, and they even strongly encourage treatment and prevention of diseases.

Religions are also well known to treat stress, which wreaks havoc on the mind and body. It is still not known exactly how stress harms our health, but researchers have found that chronic psychological stress is associated with body’s losing its ability to regulate the inflammatory response. It has been shown that the effects of psychological stress on the body’s ability to regulate inflammation can promote the development and progression of disease. We know that religions and beliefs give people hope and significantly decrease the stress.

Human beings are the most precious creation, and health is necessary for us to achieve the purpose of our existence. Using scientific medicine together with faith and religion can help people to protect their health. Being the science of drugs and by investigating new drug therapies, pharmacology helps us exactly with that.

History of Pharmacology

Claudius Galen (129–200 A.D.) was the first person who attempted to consider the theoretical background of pharmacology.

Ali al-Tabari (838 A.D.) Medieval Islamic physicians used natural substances such as Papaver somniferum Linnaeus, poppy, and Cannabis sativa Linnaeus, hemp as a source of medicinal drugs. Although poppy had medicinal benefits, Ali al-Tabari explained that the extract of poppy leaves was lethal, and the extracts and opium should be considered poisons (4).

Theophrastus von Hohenheim (1493–1541), also known as “Paracelsus”, began to question doctrines from antiquity. He prescribed chemically defined substances with such success that professional enemies had him prosecuted as a poisoner. Against such accusations, he defended himself with the thesis that has become an axiom of pharmacology:

“If you want to explain any poison properly, what then isn‘t a poison? All things are poison, nothing is without poison; the dose alone causes a thing not to be poison.”

Johann Jakob Wepfer (1620–1695) was the first to use animal experimentation for pharmacological or toxicological actions.

Rudolf Buchheim (1820–1879) founded the first institute of pharmacology at the University of Dorpat (Tartu, Estonia) in 1847, which firstly made pharmacology as an independent scientific discipline. In addition to a description of effects, he strove to explain the chemical properties of drugs.

Oswald Schmiedeberg (1838–1921), together with his many disciples, helped to establish the high  reputation of pharmacology. He partnered with pathologist Bernhard Naunyn (1839–1925) to found the first journal of pharmacology, which has since been published without interruption.

After 1920, the pharmacological industry had their own pharmacology laboratories outside established university institutes. After 1960, departments of clinical pharmacology were set up at many universities and in industry.

References

1. Clinical Drug Therapy: Rationales for Nursing Practice – Seventh 7th Edition, Lippincott Williams &Wilkins.
2. Basic&Clinical Pharmacology, 12^th Edition, McGrawHill Lange.
3. Modern Pharmacology with Clinical Applications, Sixth Edition, Charles R. Craig and Robert E. Stitzel, Lippincott Williams &Wilkins.