At the time of day when most people are relaxing and breaking their fast, doctors at the city's clinics are just getting started.
And while no day is the same in medicine, hospitals are seeing more patients with diabetes or asthma coming to them with fasting related health problems.
Many health related issues during Ramadan are due to medication, with patients unsure of taking their prescribed treatments during periods of fasting, or at the wrong time of day.
The effects can be devastating, with medical staff at the Burjeel Day Surgery Centre on Al Reem Island recording a spike in hospital admissions either first thing in the morning, or later at night.
“We see a lot of problems with the timing of medication taken by our patients that cause problems during fasting hours - because of that, relapses are common,” said Dr Fadi Baladi, medical director of the surgery.
“Because of the nature of the diseases we are treating related to fasting, we do see problems related to gastro intestinal conditions and dehydration in the heat.
“With asthma patients, we have seen some who are worried about breaking their fast by using their inhaler.
“A patient has come into the hospital because her asthma has become a problem.
“When I asked her about the medication, she told me she was taking her daily dose in just four or five hours, rather than the stipulated 24-hour cycle. This was causing a problem.
“Patients with diabetes are also having the same problems by postponing their insulin and this is dangerous.”
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Read more:
What counts as breaking a fast? UAE's religious authority responds
Ramadan 2018: Diabetics urged to fast with care
Ramadan businesses: tent companies busy during the holy month
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Most admissions come from a minority of the hospitals patient community, as 70 per cent are expatriates and non-Muslims, staff have said.
Those with diabetes are most at risk from fasting, and should check with their doctor it is safe to do so.
Insulin injections to control type one diabetes often need to be administered 12 hours apart, but doctors said some who are fasting fail to do this and end up in hospital.
“We wouldn’t usually see these patients during the rest of the year, it is only during Ramadan that they have problems with their medication control,” Dr Baladi said.
“Anyone receiving injections, inhalers or pills should continue – even doing some health tests is difficult during Ramadan.
“Some wait until iftar, and then choose not to come until the day after so it creates a problem.
“We have extra staff in later at night, and transportation for them can be difficult late at night but we try to help as much as possible.”
Patients who continue to take blood glucose lowering medication during the daylight hours of fasting, may increase their risk of hypoglycaemia, or low blood sugar level.
This can result in dizziness, confusion, seizures or even death in extreme cases.
Those with diabetes taking insulin should not stop treatment as it could lead to diabetic ketoacidosis, a dangerous short-term complication which can lead to diabetic coma.
Michael Ghani, director of operations at Burjeel Day Surgery Centre in Abu Dhabi, said all steps are taken to ensure services are available to patients when they’re needed.
“Most of the time, patients are fasting during the day so they so not want to see their doctor,” he said.
“We’ve decided to make our specialists available from 8.30pm-11.30pm. Normally we are working from 9am until 10pm, but it is usually very quiet during the daytime.
“There is a hotline people can use and although we modify the staffing schedule, it is pretty much business as usual.”
Emergency
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Game Changer
Director: Shankar
Stars: Ram Charan, Kiara Advani, Anjali, S J Suryah, Jayaram
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The burning issue
The internal combustion engine is facing a watershed moment – major manufacturer Volvo is to stop producing petroleum-powered vehicles by 2021 and countries in Europe, including the UK, have vowed to ban their sale before 2040. The National takes a look at the story of one of the most successful technologies of the last 100 years and how it has impacted life in the UAE.
Read part four: an affection for classic cars lives on
Read part three: the age of the electric vehicle begins
Read part one: how cars came to the UAE
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Engine: 3.0-litre six-cylinder turbo
Power: 398hp from 5,250rpm
Torque: 580Nm at 1,900-4,800rpm
Transmission: Eight-speed auto
Fuel economy, combined: 6.5L/100km
On sale: December
Price: From Dh330,000 (estimate)
How to protect yourself when air quality drops
Install an air filter in your home.
Close your windows and turn on the AC.
Shower or bath after being outside.
Wear a face mask.
Stay indoors when conditions are particularly poor.
If driving, turn your engine off when stationary.
The specs
AT4 Ultimate, as tested
Engine: 6.2-litre V8
Power: 420hp
Torque: 623Nm
Transmission: 10-speed automatic
Price: From Dh330,800 (Elevation: Dh236,400; AT4: Dh286,800; Denali: Dh345,800)
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The biog
Hometown: Cairo
Age: 37
Favourite TV series: The Handmaid’s Tale, Black Mirror
Favourite anime series: Death Note, One Piece and Hellsing
Favourite book: Designing Brand Identity, Fifth Edition
Dubai Bling season three
Cast: Loujain Adada, Zeina Khoury, Farhana Bodi, Ebraheem Al Samadi, Mona Kattan, and couples Safa & Fahad Siddiqui and DJ Bliss & Danya Mohammed
Rating: 1/5
Cracks in the Wall
Ben White, Pluto Press
Key facilities
- Olympic-size swimming pool with a split bulkhead for multi-use configurations, including water polo and 50m/25m training lanes
- Premier League-standard football pitch
- 400m Olympic running track
- NBA-spec basketball court with auditorium
- 600-seat auditorium
- Spaces for historical and cultural exploration
- An elevated football field that doubles as a helipad
- Specialist robotics and science laboratories
- AR and VR-enabled learning centres
- Disruption Lab and Research Centre for developing entrepreneurial skills
COMPANY PROFILE
Name: Almnssa
Started: August 2020
Founder: Areej Selmi
Based: Gaza
Sectors: Internet, e-commerce
Investments: Grants/private funding
Know before you go
- Jebel Akhdar is a two-hour drive from Muscat airport or a six-hour drive from Dubai. It’s impossible to visit by car unless you have a 4x4. Phone ahead to the hotel to arrange a transfer.
- If you’re driving, make sure your insurance covers Oman.
- By air: Budget airlines Air Arabia, Flydubai and SalamAir offer direct routes to Muscat from the UAE.
- Tourists from the Emirates (UAE nationals not included) must apply for an Omani visa online before arrival at evisa.rop.gov.om. The process typically takes several days.
- Flash floods are probable due to the terrain and a lack of drainage. Always check the weather before venturing into any canyons or other remote areas and identify a plan of escape that includes high ground, shelter and parking where your car won’t be overtaken by sudden downpours.
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
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The specs
Engine: Four electric motors, one at each wheel
Power: 579hp
Torque: 859Nm
Transmission: Single-speed automatic
Price: From Dh825,900
On sale: Now
RESULT
Leeds United 1 Manchester City 1
Leeds: Rodrigo (59')
Man City: Sterling (17')
Man of the Match: Rodrigo Moreno (Leeds)
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Company profile
Name: Oulo.com
Founder: Kamal Nazha
Based: Dubai
Founded: 2020
Number of employees: 5
Sector: Technology
Funding: $450,000
