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This study was conducted on 429 blood samples collected from Saudi males and females from Al-Ula in the north-western province of Saudi Arabia in order to determine the frequency of the sickle cell gene, glucose-6-phosphate dehydrogenase (G6PD) deficiency gene, and alpha- and beta-thalassaemia genes, and to investigate the pattern of their interactions. The frequency of the sickle cell gene was 0.0785, while that of the beta-thalassaemia gene was 0.1195. Heterozygous alpha-thalassaemia 2 (- alpha/alpha alpha) was encountered at a frequency of 0.121, while homozygous alpha-thalassaemia 2 (- alpha/- alpha) occurred at a frequency of 0.0046. HbH disease and hydrops fetalis were not encountered. One case with triple alpha-gene arrangement, alpha alpha alpha anti-3.7, was identified. The G6PD deficiency gene frequency was 0.08 and 0.032 in males and females, respectively. Several cases with 2 abnormal genes were encountered. The haematological and biochemical data from the patients with sickle cell disease suggest that the disease in this population is more severe in comparison with cases reported from the eastern population.

This paper describes the case of a 6-year-old Saudi male who had sickle cell heterozygosity, beta +-thalassaemia and possessed three alpha-genes of the haplotype alpha alpha alpha anti-3.7/as diagnosed by restriction endonuclease studies using Hpa I, Bam HI, Bgl II, Hind III and Xba I. Since the iron level was found to be normal, it is proposed that the coexistence of beta-thalassaemia with triple alpha-genes in Hb S heterozygotes may be the cause of the anemia. A possible mechanism for severe anaemia is presented.

The haematological and clinical expression of haemoglobin S (Hb S) was investigated in a group of male and female Saudis of haemoglobin genotype AS and SS, and the results compared with those from normal individuals (AA). The influence of alpha thalassaemia in each genotype was also investigated. The total haemoglobin concentration (Hb), red blood cell count (RBC) and packed cell volume (PCV) were significantly lower in the SS group without thalassaemia. In the thalassaemic group Hb, RBC and PCV levels were higher, while MCV and MCH were considerably lower. The clinical investigations reveal that almost 30% of the SS cases had not required blood transfusion, and none of the patients had suffered from leg ulceration or hand and foot syndrome. Comparison of the results obtained for Saudi sickle cell patients with those reported for Jamaicans show several differences, indicating a milder disease in the Saudis.

In an attempt to investigate beta-globin gene polymorphism in the Saudi population, DNA samples were analysed using restriction endonucleases, Mst II and Hpa I. Both beta A and beta S genes showed extensive polymorphism and were found to be linked to 13.0 kb, 7.6 kb, 7.0 kb, and 5.6 kb Hpa I fragments. Three DNA samples out of a total of 436 analysed, had beta-globin gene linked to three Hpa I fragments of the sizes 13.0 kb, 7.6 kb, and 5.6 kb. In this paper we present our findings and discuss the possibility of multiple beta-globin loci.

Forty-five (45) cases of ectopic pregnancy are reported, an incidence of 1:742 pregnancies. Approximately (40%) of these patients gave a positive history of infertility, pelvic infection or abdominal surgery. Eighty-five percent (85%) of the cases were among gravida 1-5; nullipara and grand-multipara constituted the low-risk group. In 88% of the cases, the pregnancy was tubal ectopic, with 58.5% in the right fallopian tube. History of amenorrhea and lower abdominal pain with tenderness were the presenting features in 95% of the cases, while vaginal bleeding was reported by 50%. Vaginal examination is singled out as of poor diagnostic value, and laparoscopy is found to be the best diagnostic procedure. The pertinent medical literature is reviewed.

The prevalence of hepatitis B surface antigen (HBsAg) was studied in 3020 pregnant Saudi women. All the sera of 119 (3.9%) HBsAg-positive asymptomatic carrier mothers were titrated for HBsAg and investigated for hepatitis Be antigen (e-Ag) and its antibody (anti-e-Ag). Only 13 (10.9%) of the carrier mothers were e-Ag-positive compared with 89 (74.8%) who had anti-e-Ag. There was a positive correlation between the titres of HBsAg and the presence of e-Ag. Studies on 49 mother-child pairs revealed that vertical transmission occurred from six of seven carrier mothers (85.7%) who were e-Ag positive compared with two of 32 mothers (6.25%) who were e-Ag negative but had anti-e-Ag. On the basis of these results, the low prevalence of e-Ag in asymptomatic Saudi mothers contrasts markedly with the situation in asymptomatic carrier mothers from the Orient, but its presence, as shown by other studies, is a good predictor of vertical transmission.

Vaginal swabs from 2715 consecutive unselected women with vaginal discharge were examined for Gardnerella vaginalis, Candida albicans and Trichomonas vaginalis. Of 2715 women, 2043 had non-specific vaginitis and G. vaginalis was isolated from 269 cases (13.2%). Thirty five of the strains were isolated together with C. albicans, eight with T. vaginalis, six with Bacteroides species and three each with group B Streptococcus and Staphylococcus aureus. Two hundred and sixteen (80%) of the isolates were from females between the age of 20 and 34. All 269 strains hydrolysed hippurate and fermented starch; 161 (60%) were isolated from swabs without clue cells. Although facts suggest that vaginal discharge in most of these cases had been associated with G. vaginalis, a possible aetiological role for other micro-organisms has not been ruled out. However, successful therapy with metronidazole in 80% of those cases suggests that G. vaginalis is one cause of non-specific vaginitis. The prevalence rate of G. vaginalis in 160 randomly selected women without vaginal discharge was 5%.

The use of contraceptives can have an impact on better spacing between children, better child care, improvement of children's health and preservation of the mother's health. In this study 2675 Saudi women attending a gynaecology out-patient clinic were interviewed about their contraceptive practices. The majority of the women (56.0%) were using or had used some form of contraceptive. Oral contraceptives were the most common method; 94.8% of the 1497 women who practised contraception were using or had used this form of contraception. Sterilization accounted for 0.9% of contraceptive practices, while the intrauterine device was a more common form of contraceptive among the more educated women.