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We report a 15-year-old Muslim boy with insulin-dependent diabetes mellitus (IDDM) who presented with diabetic ketoacidosis (DKA) during the Muslim Ramadan month of day-time fasting. DKA apparently occurred due to omitting pre-lunch insulin combined with dehydration and overeating during the permitted sunset-to-sunrise meals. It is well-known that fasting accelerates development of lipolysis and ketosis and increases glucagon levels. Thus, these pathophysiological aberrations related to fasting in ketosis-prone patients, in conjunction with fasting, endanger metabolic control in IDDM.

Chronic subdural hematoma presenting as transient ischemic attacks (TIA) is very rare. In a 74-year-old man in whom chronic subdural hematoma was responsible for recurrent attacks of local neurological deficiencies, the diagnosis was established by computerized tomographic (CT) scanning. Both TIA and chronic subdural hematoma usually occur in the elderly. Since the prognosis as well as the therapeutic approach are completely different in the 2 conditions, it is advisable to use imaging techniques, such as CT scanning, when there are recurrent TIA.