1. Metabolic changes associated with Ramadan fasting were studied in eleven Asian pregnant mothers. This was compared with a group of control mothers undergoing a normal physiological fast.2. At the end of the Ramadan fast day there was a significant fall in glucose, insulin, lactate and carnitine, and a rise in triglyceride, non-esterified fatty acid and 3-hydroxybutyrate. When compared with the control group, none of the Ramadan mothers had a completely normal set of biochemical values at the end of the fast day.3. Pregnancy outcome in the two groups was comparable. 4. We are wary of the metabolic departures from normal observed in the Ramadan fasting mothers. If asked we advise mothers to take up the dispensation from fasting during pregnancy which is allowed.An important aspect of the Muslim religion is the fast of Rosa during Ramadan. During Ramadan all healthy adults are obliged to fast from sunrise to sunset. The length of the fast therefore depends on the exact time of sunrise and sunset in the country where the person lives. The duration of the fast in temperate climates such as Britain averages about 18 h/d when Ramadan occurs during the spring and summer. This is dependent on the exact time of sunrise and sunset, but is approximately observed between 02.30 and 19.30 hours here. Pregnant women are allowed to postpone their fast until after delivery, but about three quarters of mothers attending this hospital continue to observe it for various reasons (Eaton & Wharton, 1982), for example, convenience when eating as a family, and social pressures. However, they often ask about the possible harmful effects of fasting both to themselves and their babies.Although there is some evidence of metabolic stress in Ramadan (Prentice et al. 1983), the work was carried out in the deprived conditions of the tropics where the prevalence of endemic malnutrition, tropical infection and drought may have compounded the effect of fasting during pregnancy. The better environmental conditions of the Muslim population in Britain provides an opportunity to study the metabolic effect of Ramadan fasting without these complicating factors. Moreover, a previous study in Birmingham of nonpregnant Muslim diabetics (Barber et al. 1979) concluded that fasting was safe. This study was designed to determine the metabolic effects of Ramadan fasting during pregnancy in healthy mothers living in Britain. M E T H 0 D S PatientsAs part of a larger study of glucose metabolism in pregnancy all mothers booking at this hospital in time were invited to attend a clinic at 17 weeks and again at 28 weeks for a more detailed assessment than is usually possible in a routine antenatal clinic. Some of these mothers were selected to take part in this Ramadan study as follows.

We evaluated a monoclonal antibody-based enzyme immunoassay for detecting soluble parasite antigen in sera collected in an area in South India endemic for Wuchereria bancrofti. Filarial antigen was detected in sera from 56 of 57 microfilaremic patients, 9 of 64 aminofilaremic patients with clinical filariasis, and 11 of 70 endemic controls. Antigen was not detected in sera from patients from nonendemic areas who had a variety of other filarial and nonfilarial helminth infections. Parasite antigen titers were significantly correlated with microfilarial counts in night blood smears (r = .64, P less than .01). Negative antigen tests in patients with clinical filariasis may be explained in part by antibody-mediated clearance of circulating antigen. Antibodies to circulating W. bancrofti antigen were detected in 41 of 55 antigen-negative sera from patients with clinical filariasis. Despite this limitation, detecting parasite antigen by enzyme immunoassay provides significant advantages over previously available methods for diagnosing active W. bancrofti infection.

Objective: To describe incidence of Down syndrome in Dubai, United Arab Emirates (UAE). Subjects and Methods: A total of 63,398 newborn babies in Dubai (24,250 UAE nationals and 39,148 non-UAE) during a 5-year period of 1999–2003 were routinely examined by experienced nurses, neonatologists, pediatricians and/or general practitioners for symptoms of Down syndrome. Those suspected with Down syndrome were referred to the cytogenetic laboratory for karyotyping. Results: A total of 141 cases were confirmed cytogenetically as Down syndrome. Of these, 139 were trisomy 21 and of the remaining 2, 1 was a translocation and the other a mosaic. Theoverall incidence of Down syndrome in Dubai was 1/449 live births (2.2 per 1,000); 1/319 live births (3.13 per 1,000) among UAE nationals and 1/602 live births (1.66 per 1,000) among non-UAE nationals. The mean maternal age of UAE national mothers was 33.48 ± 8.08, with 41.66% of the mothers being in the advanced maternal age group (>35 years). The higher incidence of Down syndrome among UAE nationals is comparable to incidences reported for other Arab populations in the Middle Eastern region. Advanced maternal age, with mothers bearing children until their 50s and higher parity, appear to be the major contributing factors for the increased incidence. Conclusion: The study indicates the need to provide efficient genetic counseling and to introduce an effective antenatal screening program and prenatal diagnostic services to reduce the psychological and genetic burden on the families and community.

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