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BackgroundApproximately one-fourth of all the inhabitants on earth are Muslims. Due to unprecedented migration, physicians are often confronted with cultures other than their own that adhere to different pdigms.DiscussionIn Islam, and most religions, abortion is forbidden. Islam is considerably liberal concerning abortion, which is dependent on (i) the threat of harm to mothers, (ii) the status of the pregnancy before or after ensoulment (on the 120th day of gestation), and (iii) the presence of foetal anomalies that are incompatible with life. Considerable variation in religious edicts exists, but most Islamic scholars agree that the termination of a pregnancy for foetal anomalies is allowed before ensoulment, after which abortion becomes totally forbidden, even in the presence of foetal abnormalities; the exception being a risk to the mother’s life or confirmed intrauterine death.SummaryThe authors urge Muslim law makers to also consider abortion post ensoulment if it is certain that the malformed foetus will decease soon after birth or will be severely malformed and physically and mentally incapacitated after birth to avoid substantial hardship that may continue for years for mothers and family members. The authors recommend that an institutional committee governed and monitored by a national committee make decisions pertaining to abortion to ensure that ethics are preserved and mistakes are prevented. Anomalous foetuses must be detected at the earliest possible time to enable an appropriate medical intervention prior to the 120th day.

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Background To this end, the influence of COVID-19 on pregnant women and their neonates is not completely clear. Therefore, the main aim of this study is to investigate maternal and neonatal clinical outcomes with confirmed COVID-19 infection. Besides, it investigates the likelihood of vertical transmission of COVID-19 infection from pregnant women to their neonates. Methods A retrospective descriptive study was conducted in three medical centers during the period from March to November 2020. Data were collected from the available medical records in the respective hospitals using a standardized questionnaire on maternal and neonatal clinical outcomes. All pregnant women with confirmed COVID-19 infection across the three hospitals and their neonates were eligible to participate in this study. Descriptive statistics were presented as a median and interquartile range (IQR) or frequencies and percentages as appropriate using SPSS 24.0 software. Results This study has identified a total of 288 pregnant women with confirmed COVID-19 infection over the study period of a median age of 30 years and median GA at diagnosis 38 weeks (IQR: 39 -33) as well as 27% of them were obese (n = 78). The majority of pregnant women were symptomatic with cough (n = 92, 31.9%) being the most frequent COVID-19 symptom followed by fever and dyspnea (n = 36, 12.5%). Two-hundred and four pregnant delivered (70.84%) and caesarean sections were prevalent among 35.8% of them. The most common adverse pregnancy outcome was premature (n = 31, 15.5%), followed by fetal distress (n = 13, 6.5%), preeclampsia (n = 4, 2.0%), and one pregnant woman died. The laboratory results exhibit that temperature higher than 38 (n = 27), leukopenia (n = 19), neutropenia (n = 54), ALT (n = 12), AST (n = 31), and thrombocytopenia (n = 35) were less frequent among pregnant women while lymphopenia (n = 126), hemoglobin levels lower than 13.0 (n = 218), deceased albumin levels (n = 195) were most frequent among them. However, a small proportion of pregnant women were admitted to the ICU (3.8%). The most frequent maternal treatments were antibiotics (n = 81), antiviral (n = 49), and corticosteroid (n = 24). Of 204 neonates, four had died and all the remaining neonates were alive. The median gestational age at delivery was 39 weeks (IQR: 35–40). Most neonates had normal laboratory results. However, 14 had lymphopenia (7.0%), 22 had neutropenia (11.0%), and 11 had thrombocytopenia (5.5%). Four infants had low hemoglobin levels of less than 13.0 (2.0%) and 81 had hyperbilirubinemia (e.g., total bilirubin of higher than 23; 40.5%). Approximately less than one-half of neonates required admission to the NICU (n = 86, 43%), 7% of them required respiratory support of mechanical ventilation, and none of them get infected with COVID-19 disease. Conclusion This multicenter study suggests that the majority of pregnant women had mild or moderate disease symptoms. Nevertheless, this ...

Introduction Neonatal Acute kidney injury (AKI) is an underestimated morbidity in the neonatal intensive care unit (ICU). However, there is a paucity of information about risk factors, outcomes, and possible preventive measures to limit its occurrence. Aim This study aimed to determine the prevalence of neonatal AKI in a neonatal ICU. Data obtained from this study will help to better understand current local practices and investigate possible preventive strategies. Materials and methods Charts from January 2011 to December 2018 were reviewed. Neonates less than 2 weeks old who depended on intravenous fluid as a nutrition source for at least two days were included. Results Overall, the eight-year prevalence of neonatal AKI in the neonatal ICU was 19.6%, and severity was distributed as follows: stage 1 (46.2%), stage 2 (26.5%), and stage 3 (27.3%). Caffeine administration before 29 weeks’ gestational age significantly decreased the incidence of neonatal AKI. The incidence of neonatal AKI was independently associated with death (odds ratios (OR) = 7.11, P < 0.001) and extended length of hospital stay (OR = 2.47, P < 0.001). In the multivariate regression model, vancomycin (AOR = 1.637, P < 0.004), loop diuretics (AOR = 2.203, P < 0.001), intraventricular hemorrhage (AOR = 2.605, P < 0.001), surgical intervention (AOR = 1.566, P < 0.008), mechanical ventilation (AOR = 1.463, P < 0.015), and dopamine administration (AOR = 2.399, P < 0.001) were independently associated with neonatal AKI. Conclusion Neonatal AKI occurred in one-fifth of the study population in a neonatal ICU. Outcomes can be improved by identifying high-risk infants and cautiously monitoring kidney function.

Background. Thalassemia has a burden on the healthcare systems of many countries. About 56000 conceptions result in thalassemia, globally. Objective. To assess the epidemiological profile of thalassemia in the Gulf Cooperation Council (GCC) countries. Methods. A systematic search was conducted in MEDLINE/PubMed (National Library of Medicine), CINAHL, and Embase. Relevant observational studies reporting the epidemiology of thalassemia among the GCC population were selected. Data on the prevalence, frequency, and complications of thalassemia were extracted. The quality of the retrieved studies was assessed according to the Newcastle–Ottawa Quality Assessment Scale. Results. Eighteen studies (14 cross-sectional studies, two retrospective observational studies, and two retrospective analysis) with a total of 3343042 participants were included in this systematic review. Of the 18 studies, 11 studies were conducted in Saudi Arabia, two in the Kingdom of Bahrain, one in Kuwait, three in the United Arab Emirates (UAE), and one in Qatar. The prevalence of thalassemia among children below five years of age ranged from 0.25% to 33%, while it was 0.9% in children above five years and from 0.035% to 43.3% among adult thalassemia patients. The most-reported risk factors were consanguineous marriage and high-risk marriage. There was a lack of data regarding mortality rates in thalassemia. Conclusions. Despite the premarital screening and genetic counseling (PMSGC) program for thalassemia, the incidence of high-risk couple marriages in GCC countries cannot be effectively diminished. This study suggested that the PMSGC program should adopt more attention for the high-risk areas, to enhance the level of consciousness about the hemoglobinopathy diseases and the consequences of consanguinity among the at-risk couple.

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