During the month of Ramadan, observant Muslims typically change their eating habits from three meals a day to two. A small study compared 28 men with high lipid concentrations who “fasted” during Ramadan and 10 men with normal lipid concentrations who did not fast, and found that a low fat, low calorie diet made no difference to the non-fasters. It produced a significant reduction in cholesterol concentrations and energy intake, however, for those who fasted (Saudi Medical Journal 2003;24:184-8).

The internet is increasingly becoming an alternative source of information for patients. A 22 year old man wishing to have a circumcision decided to perform the procedure himself. He acquired a self circumcision kit and instructions from a Korean company via the internet. The constriction device was due to stay on for 10 days. On day 6 it had fallen off, giving the above result.
He presented to casualty with bleeding from the distal prepuce. He was still able to pass urine and there was no evidence of infection. He subsequently underwent completion of circumcision as an elective case.
Andreas Fox, senior house officer, Sunjay Jain, specialist registrar, Tim R Terry, consultant, department …
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