There are several independent risk factors that should be considered when making decisions regarding delivery mode. Maternal age and episiotomy in non-instrumental delivery are two of these.

Invited Review introduCtionRamadan fasting (RF) is practiced by adult Muslims during the 9 th lunar month every year. It entails that they abstain from eating and drinking between dawn and sunset. Medical and religious scholars got closer in their approach to advice given to patients based on objective risk assessment. [1] Muslim patients with acute or chronic medical conditions may be exempted from fasting; many do still choose to observe the fast sometimes against medical advice. This may adversely affect their health if not addressed properly by evidence-based recommendations. [2] There has been a tremendous recent interest in the health implications of RF. Keeping up with developments in this area may prove difficult, and hence, a narrative overview under a single cover may be particularly useful in presenting a digest of the research and expert opinion in the year. [3] Our previous review of the literature published in 2017 was the most viewed Introduction: There has been an increased interest in health implications of Ramadan fasting (RF). Materials and Methods: This is a narrative, nonsystematic review of the literature including all relevant full articles in English in three electronic databases (Scopus, PubMed, and Google Scholar). The search term "Ramadan fasting" was used to identify the relevant records to provide a readily comprehensible concise account of the contributions made to research and clinical practice in 1 year (2018). Results: The publications spanned basic, clinical, ethical, professional, and cultural and advocacy facets of the subject. The publications crossed the conventional disciplinary lines and geographical locations and appeared in journals with varying systems of access. Only full-text research articles in English were reviewed. Review articles, news, note items, and correspondence were not included. No formal bibliometric analysis is presented. Emerging concepts are presented under the relevant subheading depending on the available literature. Impact of RF on diabetes control, pregnancy outcome and fetal life, and sports and athletes' well-being received somewhat more prominent coverage by research work published in 2018. Renovascular disease, and risk factors, posttransplant care, and some metabolic concerns for patients with hepatic, renal, and metabolic conditions were covered too. Patterns of use of emergency services during Ramadan and features of some specific medical emergencies were examined by some workers. Most interesting perhaps was the greater focus on documenting the perception, attitudes, and practices of both patients and healthcare professions regarding deciding and acting during Ramadan. Isolated research reports addressed subjects of wide nature from body composition and energy metabolism to smoking, law, music, and history. Conclusions: The volume of scholarly work on Ramadan fasting and health remains modest. Greater improvements in both quality and quantity of research on Ramadan are needed. Most studies indicate that Ramadan fasting is safe in mild and st...

Introduction: Literature on the health aspects of Ramadan fasting (RF) is widespread in many journals, making it less readily available to those interested in the subject. Materials and Methods: This is a narrative, nonsystematic review of international literature from two major online databases (viz., Scopus and PubMed) in 1 year (2019). The search term “RF” was used, and relevant literature was narrated in a concise thematic account excluding diabetes. Results: The publications spanned the fundamental, clinical, ethical, professional, cultural, and advocacy facets of the subject. The publications crossed the conventional disciplinary lines and geographical locations and appeared in journals with different access systems. The content is presented under relevant themes depending on the available literature. Basic coverage included changes in physiology, nutrition, and metabolism during Ramadan. Clinical aspects such as the impact of RF on kidney function, pregnancy outcome, fetal life, structure and function of eyes, and athletes' well-being received comparatively prominent coverage by researchers in 2019. Gut, liver, skin, skeleton, and blood were also covered. Other workers focused on documenting the perception, attitudes, and practices of both patients and health-care professionals during Ramadan. Conclusions: The health aspects of RF received sustained academic interest with a wide spectrum in 2019. We provided a scoping overview to help researchers and clinicians catch up quickly with the state-of-the-art today.

Introduction: The literature on the health aspects of Ramadan fasting (RF) is widely spread in many journals. Materials and Methods: This is a narrative review of data obtained from the PubMed database (National Library of Medicine, Bethesda, Maryland, United States). We used the search term “Ramadan fasting,” and relevant records were examined. The publications are narrated thematically. Results: The publications spanned fundamental, clinical, professional, cultural, and advocacy facets. The publications crossed conventional disciplinary lines and geographical locations and appeared in journals with different access systems. The contents are presented under the themes that emerged depending on the retrieved literature. This year basic coverage included changes in physiology and nutrition during Ramadan. However, the clinical issues included a wide range of topics. These included the impact of RF on nonalcoholic fatty liver disease and adjustments needed in endocrine replacement therapy for hypothyroidism and adrenal insufficiency. Coverage also included chronic kidney disease. The impact on maternal health, fetal well-being, and long-term effects of RF exposures were addressed in several studies. Studies in cardiovascular medicine focused on blood pressure and cardiovascular risk factors. Sports medicine and athletes' well-being received somewhat prominent coverage. The impact on renal function, particularly in patients with chronic kidney disease, was investigated by a few authors. Several groups addressed the eyes' structure and function, neurological conditions, especially headache disorders, and hematological and oncological conditions. Finally, the impact of RF on several aspects of mental health and well-being was addressed by various groups. Conclusions: Health aspects of RF received a sustained academic interest with a broad spectrum in 2021. This narration provides an overview of the year's scholarly health-related literature on various aspects of health and disease. It should help researchers and clinicians catch up quickly with the health concerns during Ramadan.

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