Essay --

2) The Three Main Fashion Centers Within France Paris, Lyon and Marseille are the three biggest urban areas in France, however they are likewise the primary design habitats in the nation. Every city has assumed an interesting job in forming France as a style mecca. France has been known as the world style capital for a long time. France’s capital and biggest city, Paris is home a portion of the world’s most tip top French design houses. The Golden Triangle is a name given to Avenue Champs-Élysã ©es, Avenue Marceau, and Avenue Montaigne, the principle locale for extravagance shopping in Paris. These regions brag stores of the most noteworthy names in style, for example, Chanel, Dior, Hermes, Louis Vuitton, Christian Louboutin, Balmain and some more. There are additionally some top of the line retail establishments like Printemps, Bon Marchã ©, and Les Galeries Lafayette, which draw a large number of local people and vacationer consistently. Different areas, similar to La Marais are home to numerous littler boutiques, and significantly more reasonable shops. It appears like wherever you turn in Paris, there are rich style houses, contemporary boutiques, and one of a kind t... Exposition - 2) The Three Main Fashion Centers Within France Paris, Lyon and Marseille are the three biggest urban communities in France, however they are additionally the fundamental design habitats in the nation. Every city has assumed a special job in molding France as a design mecca. France has been known as the world style capital for a long time. France’s capital and biggest city, Paris is home a portion of the world’s most first class French style houses. The Golden Triangle is a name given to Avenue Champs-Élysã ©es, Avenue Marceau, and Avenue Montaigne, the fundamental regions for extravagance shopping in Paris. These regions brag stores of the most elevated names in design, for example, Chanel, Dior, Hermes, Louis Vuitton, Christian Louboutin, Balmain and some more. There are additionally some very good quality retail establishments like Printemps, Bon Marchã ©, and Les Galeries Lafayette, which draw a huge number of local people and traveler consistently. Different regions, similar to La Marais are home to numerous littler boutiques, and considerably more moderate shops. It appears like wherever you turn in Paris, there are lavish style houses, contemporary boutiques, and one of a kind t...

Analyzing the American Revolution and the American Civil War Research Paper

Breaking down the American Revolution and the American Civil War - Research Paper Example Regardless, after the war, the new state had run its self in tremendous obligations (Middlekauff 96) because of the advances it had taken so as to battle the war. The Revolution was incredibly indispensable from a social perspective moreover. It demonstrated to the world that the solid and ground-breaking military of England were exposed. It consented to an arrangement with France and a ton of different nations. It would moreover be the base of America's collusion with Britain. The American upset was not just war. It was because of this war America picked up its freedom. After the Civil war, America experienced a great deal of changes. The change which the Civil War brought has permanently affected the quality of America. It has transformed the nation into a superpower. The Civil War significantly influenced the country. President Lincoln had guaranteed that he was not going to meddle with servitude anyway the south had no real option to pull back from the Union. So dark experts proceeded to possess slaves in any event, when the association armed force was planning to attack South Carolina in 1864 (Koger 85). South Carolina was the primary state to pull back yet different states before long followed, Lincoln realized that he would need to assume control over this issue and instituted his capacity as both the Commander in Chief and the Chief Executive. In Document A South Carolina felt contrastingly about this issue. They felt that there is nothing written in the Constitution that says that can't withdraw and in light of the fact that the individuals were troubled they had the right, as a sovereign state, to withdraw. The southern states withdrawing was the initial move towards the requirement for remaking. Not for the equivalent rights principally, yet for the unlawful subjugation that was occurring.â

Free Essays on Hospitality

The Breakers At he start of the semester when the term venture was doled out I realized immediately what resort I was going to pick. I picked The Breakers at Palm Beach Florida since I have awesome recollections with my family at this property. So I called the inn and request pamphlets and whatever extra data they could send me. Short of what multi week later I had the entirety of the data I required and I will introduce it to you in the following hardly any pages. Henry Morrison Flagler fabricated a lodging â€Å"The Palm Beach Inn† on the sea shore front part of the Royal Poinciana’s property (one of his clench hand inns). The Palm Beach Inn, which opened on January 16, 1896, was completely reserved for a large portion of that season since it was littler and calmer than the huge Royal Poinciana and in such a case that ignored the Atlantic Ocean. Rather than requesting rooms at the Royal Poinciana, numerous ordinary Palm Beach visitor requested rooms â€Å"over by the breakers.† The name stuck. When Flagler multiplied the size of the Palm sea shore Inn for the 1901 season, he renamed it the Breakers. On June 9, 1903, as laborers were growing the wood working for the fourth time in under decade, The Breakers burned to the ground. The seventy multi year old Flagler was stunned by the loss of his preferred lodging yet unquestionably not beaten. After fourteen days he declared that The Breakers would not exclusively be remade yet in addition would open for the up and coming winter season! On February 1, 1904, The Breakers revived to general praise. The new Breakers, a meandering aimlessly four-story, frontier style building built altogether of wood, contained 425 rooms and suites. Rooms began at four dollars every night, including three dinners per day. As did its predecessor’s, The Breakers visitor register genuine line a â€Å"who’s who† of mid twentieth-century America: different Rockefellers, William Randolph Hearts; the five-and dime kigs W.T Grant and J.C. Penney; an even varying European honorability and U.... Free Essays on Hospitality Free Essays on Hospitality The Breakers At he start of the semester when the term venture was relegated I realized immediately what resort I was going to pick. I picked The Breakers at Palm Beach Florida since I have generally excellent recollections with my family at this property. So I called the lodging and request handouts and whatever extra data they could send me. Short of what multi week later I had the entirety of the data I required and I will introduce it to you in the following not many pages. Henry Morrison Flagler assembled a lodging â€Å"The Palm Beach Inn† on the sea shore front part of the Royal Poinciana’s property (one of his clench hand inns). The Palm Beach Inn, which opened on January 16, 1896, was completely reserved for a large portion of that season since it was littler and calmer than the tremendous Royal Poinciana and supposing that ignored the Atlantic Ocean. Rather than requesting rooms at the Royal Poinciana, numerous ordinary Palm Beach visitor requested rooms â€Å"over by the breakers.† The name stuck. When Flagler multiplied the size of the Palm sea shore Inn for the 1901 season, he renamed it the Breakers. On June 9, 1903, as laborers were expanding the wood working for the fourth time in under decade, The Breakers burned to the ground. The seventy multi year old Flagler was stunned by the loss of his preferred lodging yet certainly not beaten. After fourteen days he reported that The Breakers would not exclusively be reconstructed yet in addition would open for the up and coming winter season! On February 1, 1904, The Breakers revived to all inclusive approval. The new Breakers, a meandering aimlessly four-story, pioneer style building built totally of wood, contained 425 rooms and suites. Rooms began at four dollars per night, including three suppers every day. As did its predecessor’s, The Breakers visitor register genuine line a â€Å"who’s who† of mid twentieth-century America: different Rockefellers, William Randolph Hearts; the five-and dime kigs W.T Grant and J.C. Penney; an even different European honorability and U....

Speculation on Richard IIIs Malignity - Literature Essay Samples

Distortum vultum sequitur distortio morum.'[Distortion of character follows a distorted countenance.] Thomas MoreShakespeares Richard III from the so-titled play shares the unsettling characteristic of being expressly determined to prove a villain (I.i.30) with other Shakespeare creations, most notably, Iago of Othello, and Aaron the Moor of Titus Andronicus, who, like Richard is quite obviously a physical outsider. Richards statement, which Shakespeare includes in the first scene, carries an ambiguous, double-edged meaning. First, Richard is saying by this that he is resolved to prove himself a villain. This interpretation requires that the reader imbue Richard with free will. The OEDs definition of resolving as the act of making up ones mind shows why. If life is pre-ordained then a man can never make up his own mind, only destiny can. Being resolved is the subjects demonstration of free will. The second possible interpretation directly contradicts the first. That is, Ric hard might be saying that he is determined as by fate (or perhaps his author, Shakespeare) to prove a villain. In this case, he has no choice, no freedom. When we examine the most obvious question that Richard III raises What motivates Richard to be evil? we must remember that the question, as revealed in Richards opening soliloquy, might not be applicable. In a world of fate, personal motivation doesnt exist.This said, Richards dense line only half suggests that the tragedy takes place in a universe controlled by fate. And, there are some interesting methods of trying to understand Richard without immediately resorting to describing him, as Granville Barker reductively described Richards descendent, Iago, as only a poisoned and poisonous ganglion of cravings after evil (Spivack 3). Firstly, most easily, Richard himself gives a reason from the start for acting as he does. He characterizes himself as deformed, unfinished, unfashionable, and this ugliness, he claims, keeps hi m from being a lover, keeps him want[ing] loves majesty. So, he justifies, to entertain these fair well-spoken days, he is determined to prove a villain (I.i.20-30). Superficially this makes sense until, in the very next scene, he successfully seduces the single woman, Lady Anne, who is (or, at least, should be) the absolutely most difficult one for him to get. If her last match counts for anything, she is presumably very pretty, but, more importantly, she is the widow and daughter-in-law of two men whom Richard himself murdered. If this doesnt yet prove that, while his physique leaves something to be desired, his charisma is overwhelming and makes being a lover potentially easy for him, we see him sexually attract the only other woman who should be as difficult as Anne for him to get in a later scene. This is the Queen, his dead brothers widow, whose sons, brothers, and brother-in-law Richard himself has killed. After a witty banter between the two, Richard and the Queen, whe rein he convinces her to marry her own daughter to him, he bestows on her a true loves kiss (IV.iv.349). She too succumbs to him as a lover, despite his known evil and his physical deformity. Additionally, when Lady Anne has the opportunity to bewail her marital conditions, she complains that never yet one hour in his bed have I enjoyed the golden dew of sleep Besides, he hates me (IV.ii.78-81). She specifically doesnt complain about his prowess in bed while awake, and doesnt even say that she has fallen out of love with him, rather, she only notes that he is not in love with her. It seems, if anything, that Richard is a fantastic lover (insofar as being such classically requires none of the true emotion). Through these two examples of nearly impossible, and yet successful, seductions, Shakespeares audience sees that Richard IIIs tragic evil star is unreliable in the motives he attributes to himself. He can, if he wants, be a lover. Having dismissed the possibility that Ric hard himself provides us wth an answer, we come back to what we started with. Either Richard doesnt possess any motives as such, or else, they arent so obvious as to be defined by him or anyone else directly. The latter of these two options leaves us open to a more intriguing answer than Richards own to the question of Richards motivation.It is a paradox plausible in a piece of literature that employs such paradoxical lines as Cursed be the heart that had the heart to do it (I.ii.15). Richard, being ugly, is classically equated with being evil. Thomas More, in his History of King Richard III, the text upon which Shakespeare primarily based his play, makes the connection between appearance and reality clear, when More describes Richard as having evil-featured limbs, crook-backed, the left shoulder much higher than the right. As Jowett points out, Mores vocabulary is telling in itself: the limbs are, as it were, wicked of feature rather than simply ugly; crook or crooked can me an deviating from rectitude, and the left side of the body, here dominating, was associated with evil. (Jowett 32)Shakespeares own secondary characters make similar equations. Margaret, the old Queen, curses Richard with dreams of a hell of ugly devils and goes on to cry, thou elvish-markedThou that wast sealed in thy nativity the slave of nature and the son of hell (I.iii.224-7). Not only does she paint her devils as ugly, thereby implying the connection between ugliness and treachery, she makes the more outright connection in the phrase, elvish-marked, which, as Jowett cites in his footnote to the phrase, Refers to a belief that physical defects were left by malignant elves to mark an infant out for wicked deeds. Margaret categorically sees Richards physical body as a testament to his souls sinfulness, and she tells him so. Likewise, Richards own mother draws a link, saying, He [Richard] was the wretchedst thing when he was young (II.iv.18). Rather than using a less powerful word than wretched that might refer solely to his physical being, the Duchess employs this strong one with many negative connotations. Finally, in Richmonds last speech, he closes the play calling England a fair land (V.vii.39, italics mine). Like More, Richmond uses a word that simultaneously means something moral and something superficial. In this case, the single adjective brings together justice and attractiveness. Knowing, as Richard does, that the nature of someones true person is commonly derived from his outward appearance, and knowing, as Richard does, that he is ugly, it makes sense that he should want to undermine the equation. This conjecture would explain his will to deception. If he can trick people, he will effectively demonstrate that appearance does not reveal reality, in fact, he will prove just the opposite. Logically, this would show that his ugliness does not make him evil. One of Richards shining moments comes when he gives advice to his nephew, Your Gra ce attended to their [your uncles] sugared words, he says, But looked not on the poison of their hearts (III.i.13-14). In expressing this sentiment, he is simultaneously able to deceive magnificently by taking the Christian moral high-ground, and expounding the basic philosophy he wants to convey, that appearance does not necessarily reflect reality. His co-conspirators, Buckingham and Catesby, both recognize the importance of deception as well, I can counterfeit the deep tragedian (III.v.6), declares the first, while the latter states, My heart is ten times lighter than my looks (V.iii.3). And, Richards skill in deception successfully teaches his lesson to his enemies. Hastings, for instance, realizes, as he goes to his Richard-ordained death, Who builds his hopes in air of your [worldly mans] fair looks Lives like a drunken sailor on a mast, Ready with every nod to tumble down Into the fatal bowels of the deep (III.v.103-6). Richards mother, the Duchess of York, makes a simil ar statement when she sees that her son has duped his nephew, her grandchild, O that deceit should steal such gentle shapes, she laments, and with a virtuous visor hide foul guile! (II.ii.26-7). Even Richards brother, Clarence, unwittingly has a visually powerful revelation along the same lines the night Richard incites his death. Here, he sees in a dream, Some [jewels] lay[ing] in dead mens skulls, and in those holes where eyes did once inhabit there were crept reflecting gems (I.iv.27-9). Although Clarence himself is unaware of his dreams meaning, the audience knows it is a prophesy of his near death. It is also a clue as to what he has failed to see up to that point, that what something seems to be is the opposite of what it really is inside: the skull, impoverished of life and humanity on the outside is rich with unvalued items on the inside just as Richard is brimming with kindness on the outside while he is a deceiving wretch within.Ironically though, Richards method of pr oving the appearance / reality opposition by seem[ing] a saint when I most play the devil (I.iii.338) actually proves the initial assumption he was working against. That is, he shows himself to be terribly evil, and this perfectly reflects his physical deformity on the traditional level Margaret so callously outlines. As Aaron the Moor makes his heart black like his face, so too does Richard make his heart crooked like his body. The night before Richards bloody death on the battlefield, his mostly successful attempts to divide himself into opposing factions, one inner, the other outer, comes to haunt him in wakefulness. Is there a murderer here? he asks, alone, terrified, No. Yes, I am, he replies, Then fly. he orders, What, from myself? he again retorts. His ability to divide himself has not only crushed those around him, it has also crushed and hurt himself. The unnatural division he inspired in himself to try make a point to those around him results in being the beginning of the end for him.This all aside though, it might be, as Bernard Spivack implies in his book, Shakespeare and the Allegory of Evil, and, as Richard himself accounts for in his opening soliloquy, that looking for a motivation in Richard to account for his acting evil is unnecessary and unfounded. Spivack draws our attention to the fact that Richard compares himself to Iniquity (III.i.79), the popular name of for the comic character that represented vice in the old morality plays. Spivack further says that Richard draws his unmistakable vocabulary from the morality play, and this shows Richard IIIs cradle in allegory (399). Specifically, Richard is a brilliant user of homily, albeit ironically, which is the principal technique morality plays adopted in order to achieve their aim of spiritually edifying their audiences. Spivack reminds us that Elizabethan drama was preceded and deeply influenced by [this] popular dramatic convention that was not naturalistic (453). Perhaps look ing for Richards motives is simply a Freudian anachronism.Works CitedShakespeare, William. The Tragedy of King Richard III. Ed. John Jowett. Oxford: Oxford University Press, 2000. Including Jowetts Introduction and notes.Spivack, Bernard. Shakespeare and the Allegory of Evil: the history of metaphor in relation to his major villains. New York: Columbia University Press, 1964.

Scary Story - Free Essay Example

Sample details Pages: 2 Words: 748 Downloads: 7 Date added: 2018/12/15 Category Literature Essay Type Review Level High school Tags: Experience Essay Fear Essay Did you like this example? I used to live in a quiet neighborhood that nobody knew too much about the other. It is not as if anyone had grudges with anyone, although there was a naturally strange old man living right in our apartment who owned a painfully beautiful parrot. With my young age and native nature, I had this urge to go and at least get to know him, since no one ever did. One evening, I gathered enough courage to approach his house. Assuming that probably his old age had landed him to bed and did not hear my knocks, I voluntarily opened the door which was apparently unlocked. The creepy sound of the door made me begin thinking that this was a bad idea and that I should retreat. One thing led to another, I was standing somewhere in the middle of the room, and the door had locked itself. Don’t waste time! Our writers will create an original "Scary Story" essay for you Create order As I made my way further into the house, I noticed that cobwebs filled the room. For a moment, I stopped and cleaned my glass owing to the dust that filled the room. Not only had it collected on my glasses, but my hair and hood as well. Making my way further, I found myself in the resting room. He did not have much, and the room had a single chair at the center that swayed voluntarily from its western design. Directly in front was a television that kept making noise without showing any signal. There was also furniture that was seemingly the resting point of the parrot. There was a significant framed picture of someone who looked like the owner of the house, and a young woman who I assumed had been the wife. I was already restless and had it not been for my eagerness; I would have raced back home. The room was stuffy and dusty. Instantaneously, I heard some sound in the room. On looking back, I could see nothing and decided it was in my mind. I did not want to believe that is real. At this moment I had already made up my mind to leave. Then the voice came clear. Apparently, it was the parrot. I have been expecting this, so it did not move me. Nearing the door leading to upstairs, I noticed a shadow, enormous and frightening. Just before I could contemplate the view of what I saw, it went missing. Eventually, I found myself up the stairs trying to catch a glimpse of where the sound of the parrot came from. I am not sure, but I believe I thought that I wanted to rescue the animal. I entered the first room upstairs which must have been the owners bedroom. Everything was misplaced in this place I wondered if he ever found anything he wanted. It was beginning to get dark. I could not see well, but there appeared to be something like human blood smeared on the walls. Water was running in the dirty bathtub and a human hand, flimsy and hairy, was hanging from the sink. I immediately turned around to run away and on whipping my head, whoop! There was the scary old man! He stood right in front of me with his supporting stick and the parrot right on his shoulder. Blood was drooping from the parrots beaks with entirely blackened eyes. I said to myself this was a scary dream; nothing as frightening as this would merely happen, and to an innocent sole like me. The mans eyes were wide open; his hair looked like he had just got an electric shock. His hands looked messy, with what appeared like humans intestines and his tongue was licking his lips like the way a prey contemplates on a meal. Worse still, every second that passed, the man came nearer, and I just stood there unable to move. Whatever his method, the man would obviously decapitate me. I noticed an open window behind me. I wanted to believe that there would be a branch of the old tree that stood beside the house. Without time to think, I turned around and jumped. Holding on to the branch, I did not take time to land and just let myself do. Of course, I got hurt from the landing, but that was not a problem at that moment. I ran home and decided to keep quiet since it would sound a home alone story. I never wanted to think, leave alone having a glimpse of the house ever again.

Essay about Socrates Argument with Crito - 536 Words

Socrates Argument with Crito Socrates has presented a period of questions and answers through dialogue with Crito to examine if he going into exile will damage his reputation. Socrates questions and answers with Crito establishes that a person must decide whether the society he or she lives has a just reasoning behind its own standards of right and wrong and that a person must have pride in the life that he or she leads. By confirming these two concepts through questions, Socrates attempted to prove to his companion Crito, that the choice that he has made is just: I am the kind of man who listens only to the argument that on reflection seems best to me. I cannot, now that this fate has come upon me, discard the arguments I used;†¦show more content†¦By living in Athen for 70 years Socrates has agreed to have faith in the cities virtues and in the force of decisions that are imposed upon him and as a citizen he respects them. Any person that disobeys these laws deliberately attempts to destroy these laws and the society that has created them: However, that whoever of you remains when he sees how we conduct our trials and manage the city in other ways, has in fact come to an agreement with us to obey our instructions. (51e). If the decisions of the city are not respected as honourable, the structure of that civilization will fall to pieces. If a person is found violating the standards of his or her society and does not accept the consequences of his or her actions there cant be a system of law that construct order. You must either persuade it or obey its orders, and endure in silence whatever it instructs you to endure, whether blows or bonds, and if it leads you into war or be wounded or killed you must obey.(51b) Socrates adjusts these theories to the option to escape from his captors and abandon their conclusion on his future. Crito begins to understand Socrates view in his suggestion. the only valid consideration is whether we should be acting rightly in giving with the escape, or whether in truth we shall do wrong in doing all this. (49c) Socrates concludes that if he followed Critos advice he would be committing several dishonest actions against his own society that wereShow MoreRelatedThe Argument In The Crito By Socrates762 Words   |  4 PagesThe Crito Analysis In The Crito by Socrates, both Crito and Socrates present arguments, one that Socrates should escape prison, and one that he should not. Crito’s argument contains logic fallacies that undermine his argument and make it weak. Therefore, Socrates argument that he should remain in prison and face his death is valid and strong, and is better than Crito’s. Crito argues that Socrates should escape jail, and relies on the premises that he must consider the opinion of the public andRead MoreSocrates Argument in the Crito1105 Words   |  5 PagesIntroduction Socrates argues in the Crito that he shouldnt escape his death sentence because it isnt just. Crito is distressed by Socrates reasoning and wishes to convince him to escape since Crito and friends can provide the ransom the warden demands. If not for himself, Socrates should escape for the sake of his friends, sons, and those who benefit from his teaching. Socrates and Critos argument proceeds from this point. As an aside, I would like to note that, though I believe that a furtherRead MoreThe Argument On Crito And Socrates Debate817 Words   |  4 Pageswent over the Crito and Socrates debate; how Crito tries to convince Socrates that he should flee his execution and how Socrates thinks on his arguments. The Global argument on Crito has two parts. The first half assumes fleeing is morally wrong and draws out the consequences of Socrates fleeing if the moral experts saw it as such. The second half follows up on the assumption that fleeing is morally wrong and that Socrates would be morally wrong if he was to flee. Crito pressed Socrates with a multitudeRead MoreSocrates s Argument On Plato s Crito 2097 Words   |  9 PagesPlato’s Crito In this essay, I aim to prove that Socrates’s committed just act by examine surrendering his life. To do this, I will examine the arguments made by Plato to convince Socrates to escape from prison, as well as evaluating Socrates’s arguments against escaping from prison, while arguing that Socrates’s arguments were stronger. I will start by examining Plato’s arguments, and then move into Socrates’s arguments, while pointing out the strengths and weaknesses of both. I will touch onRead MoreTry to Persuade Socrates Friends to Save Him Against His Will1191 Words   |  5 PagesTry to persuade the Socrates`s friends to save him, against his will. Socrates Is one of the most colorful figures of the ancient Greek world, who the strangeness of privacy life have always been of special philosophical and political science. He was convict to death because he does not believe in God and corrupted the youth people to do the same. In Plato`s dialogue Crito, Socrates spent his last time in the prison. Crito is coming to save Socrates and have plans how toRead MoreEssay on Plato’s Crito: The Last Days of Socrates 1134 Words   |  5 Pages As Socrates awaits his upcoming execution; he is visited before dawn by a close old friend Crito. Crito has made arrangements to help Socrates escape from prison. Socrates is grateful to his old friend for his willing to help aide him in the escape. However, Socrates is quite willing to await his execution. Crito tries to change Socrates mind about escaping by presenting him with several arguments. The first is that if Socrates choices to stay, his death will reflect poorly on Crito. The peopleRead MoreTrial of Socrates914 Words   |  4 PagesTrial of Socrates What do Jesus, Joan of Arc, Martin Luther King Jr., and Socrates all have in common? All of them died for their beliefs. The Trial of Socrates depicts a scene where Socrates is in prison condemned to death and he is speaking with an acquaintance Crito. Socrates is being put to death because he was charged with corrupting the youth and not acknowledging the gods. Although over the course of the trial Socrates has numerous opportunities to evade the death penalty, he doesRead MoreSocrates : The Three Reasons Of Escape By Socrates919 Words   |  4 PagesFor Socrates it just to question his fellow citizens about how they live, even if they were a law that forbid to do so. If there was a law against asking doing philosophy, he would break that law because this is what he lives for. He is now in jail because is accused of introducing new gods and corrupting the virtue of youth, moving away from the principles of democracy. He thinks that is unjust for him to escape from his punishme nt. Crito tries to convince Socrates presenting three arguments on whyRead MoreSocrates Views On Plato s Dialogue856 Words   |  4 PagesPlato’s dialogue â€Å"Crito,† Socrates is awaiting his execution in prison when his friend Crito comes to convince him to escape. Socrates argues against Crito with his belief being that escaping from prison would by an unjust act. It is Socrates’ belief that you should never commit an injustice act for any reason, and that it is in your best interest to act justly. In the arguments presented in â€Å"Crito,† we see Socrates’ belief as underlying factor and recurring theme. Crito goes to see Socrates and startsRead MoreThe Rational Vs. The Emotional1573 Words   |  7 Pagesdefinitely the case with Crito and Socrates in â€Å"Crito† by Plato. Socrates and Crito are having an intimate conversation about reasons why Socrates should escape. Socrates is charged on corrupting the minds of the youth in Athens. Crito, who is Socrates student and close friend, tries to persuade him to escape because he did not believe Socrates committed any actual crime. Socrates, on the other hand, gives his own reasons for staying in jail. Crito’s argument for Socrates to escape from jail are more

Down syndrome is a chromosomal disorder - Myassignmenthelp.Com

Question: Discuss about the Down syndrome is a chromosomal disorder. Answer: What is Down Syndrome? Down syndrome is a chromosomal disorder caused due to the abnormal division of cells which leads to an extra full or partial copy of chromosome 21 (Sherman et al, 2007). Jerome Lejeune, a French physician, developed the cause of down syndrome in 1959 (National Down Syndrome Society). In case of down syndrome, the count of chromosomes is 47 instead of 46 (half chromosomes comes from the mother and half from the father i.e. 23 from each). So this is due to having one extra chromosome number 21 in addition to the already existing normal pair. This type of down syndrome is called trisomy 21 which accounts for 95% of the down syndrome cases (Spencer, 2014). According to researchers the extra copy of chromosome 21 affects the normal course of development of an individual, and also there is an increased risk of health problems associated with this disorder (Dekker, De Deyn, Rots, 2017). Mosaicism is the least common form of down syndrome which accounts for only one percent of cases. This occurs due to a mixture of two type of cells, with some containing the usual count of 46 and some containing 47 chromosomes. People suffering from mosaic down syndrome have very fewer characteristics as compared to other types of down syndrome). Translocation type of down syndrome accounts for the remaining 4% cases of the down syndrome. In this type the additional full or partial copy of chromosome 21 attaches to the another chromosome (chromosome 14) (Dekker, De Deyn, Rots, 2017). The hereditary component is present only in one third cases of translocation down syndrome, that accounts for one percent of the total cases of down syndrome as a whole. This genetic disorder further affects the physical and mental wellbeing of the individual by slowing the development growth both physically and mentally. An individual with down syndrome may also suffer from heart and gastrointestinal disorders. Early interventions and better knowledge about down syndrome will greatly help in increasing the quality of life of the children or adult facing this disorder (Centre for Arab Genomic Studies, 2013). Small stature, low muscle tone, an upward slant to the eyes and a single deep crease across the center of the palm are some of the physical changes that are rightly noticeable in an individual facing this disorder (Dekker, De Deyn, Rots, 2017). However, these are not necessarily the only physical changes that an individual face. Language development is also very slow amongst the children facing this disorder. The study of Aburawi, et al, (2015) also finds that children suffering with down syndrome are significantly shorter and heavier in weight than normal children. Obesity is also a significant problem among such children. There can be behavioral issues also like attention problem, stubborn nature, obsessive and compulsive behavior etc. Autism spectrum disorder is also found in a very small percentage of people facing this disorder which affects communication and social interaction (Dekker, De Deyn, Rots, 2017). A gradual decline in thinking ability is also seen among the people with down syndrome as they age. Prevalence and cause of Down Syndrome Down syndrome is considered as the most common congenital anomalies that is affecting 1 in every 800 births. An individual with down syndrome may have a full extra or partial part of chromosome 21 present. However, the cause of this extra full or partial chromosome 21 is still unknown. The prevalence of down syndrome differs from country to country because of the various social and environmental factors. For, example the incidence of down syndrome may be lower in the developed countries, in comparison to developing countries. This could be because the developed countries in the Arab world may have better application and uptake of the antenatal diagnostic service and also receives the permission to terminate the pregnancy if such case is discovered. According to the study of Al-Biltagi (2015) the estimated incidence of down syndrome is between 1 to 10/1000 live births worldwide (p. 85). The only factor linked to an increased chance of having a baby with down syndrome is the maternal age (National Down Syndrome Society, 2016) and the risk increases with an increase in maternal age. According to a report the risk is 1:1000 at the age of 30 while at the age of 35 the risk is 1:400 (Centre for Arab Genomic Studies, 2013). According to a report the incidence of down syndrome in some Arab countries is slightly higher as compared to the other countries globally. The incidence of down syndrome in Dubai is 1:319, in Oman it is 1:500, Qatar (1:546), Saudi Arabia (1:554), Kuwait (1:581), Israel is 1:547 (Al-Biltagi, 2015). There are a number of factors associated with the higher number of incidence rate in Arab countries such as consanguineous marriages (marriages among first cousins), increased maternal age and having a high number of children, lack of prenatal detection which further to terminate pregnancies with down syndrome fetuses (Hamamy et al, 2011). Risk Factors For Down Syndrome People with Down syndrome often take some drugs and supplements to support their brain activities but according to a research the medicines are not able to make any specific change or there are no medicines developed till date that helps a person to recover from this disorder. The burden of this disease is very high in Arab world, because it results in significant morbidity, mortality and disability among the infants. The rate of children suffering with down syndrome in many Arab countries is increasing from 1.2-1.7 per 1000 mainly in the industrialized countries. This mainly due to the high proportion of the child birth. Having large number of children is a traditional and cultural element in the Arab world and they prefer having many children in family. This is a significant risk factor, as the mothers keeping giving birth to children till very old age that affects the health and well-being of the children being born in older age of mother. There are various social and economic trends associated with a high maternal age in the Arab world. This is due to the fact that most of the women in the Arab world choose high level of professional development in the early 20s and the early 30s (Al-Biltagi, 2015). The only reason associated with it is to provide better financial conditions to the family for a healthy living. So now the Arab world is also experiencing similar trends as that of the western world throughout the shift to industrialization, so there is a need to take the same measures or to adopt the same practices as that of the western world like antenatal screening using ultrasounds, amniocentesis and chronic villus sampling as well as preserving the oocyte (an egg bank) (Acikbas et al, 2012). This results in creating a significant burden of the disease. The high prevalence of down syndrome in Arabs is due to their socio-economic and religious belief that includes the common practice of consanguineous marriages, multi party and increased maternal age. Lack of educational awareness can also affect the prevalence and incidence of down syndrome. The lack of education also affects the health outcome of the people in Arab world. The people, who are not educated, do not understand the significance of the antenatal screening tests, which is significant for detecting the down syndrome in the babies (Korayem, AlKofide, 2013). Therefore, lack of knowledge and education of the parents also prevents them from taking antenatal screening and terminating such pregnancies. The people in Arab world are at the risk of genetic problem even if they have the family history of genetic disorder or not. Various countries in Arab world have also made the provisions for the premarital screening and antenatal screening. However, the poor access of people to such programs and facilities results in increasing the burden of disease (Al-Gazali, Hamamy, Al-Arrayad, 2006). Attitude of People The children suffering from down syndrome have different physical features, physical structure and also have language problems. Such children may face many difficulties in social interaction and may not get appropriate opportunity of social inclusion (Al-Kindi, Al-Juhaishi, Al-Saffar, 2012). Studies have found that there is a lack of awareness among the people towards the individuals suffering from down syndrome and this may result in discriminatory behavior towards them. The burden of the disease on the patients and families increases, due to the problem of stigmatization and social exclusion. Perception of the people towards down syndrome has been found to be very poor (Al-Kindi, Al-Juhaishi, Al-Saffar, 2012). People often hold negative opinion and negative attitude about people suffering from down syndrome. This can also result in many psychological consequences and can increase the burden of the disease Al-Biltagi, (2015). However, there is a lack of qualitative and quantitativ e evidences of the community attitude and attitude of people in Arab World. Although, it has been found that parents do have positive attitude towards the social inclusion of their children in schools, yet, in general, people in Arabian countries lack the awareness towards the intellectual disability disorders. Aims of Review Aim of the review is to provide significant and important evidences found in the literature. The search for the articles is conducted through PubMed also some of the articles are also added from the cross reference and other important journals. Down syndrome is a common congenital anomaly in Saudi Arabia. The frequency of such anomalies differ from country to country on the basis of various factors. Although, there have been decrease in the prevalence of such disease with the increasing technological advancement and treatment range, yet Down syndrome still significantly prevails and result in significant childhood mortality. Therefore, it has also been found that genetic disorder causes significant morbidity, mortality and disability among children in Middle East. Genetic disorder is the major problem in the Arab world. This review is mainly focused on discussing the current knowledge and understanding about the genetic disorders, such as down syndrome and its prevalence in Arab Worl d. The inclusion criteria that has been applied for the research is that only published studies and government reports are select for the purpose of this review. This inclusion criterion is applied in order to maintain the quality of the evidences. PubMed is specifically used to locate the articles, cross-sectional studies and quantitative studies for preparing this review. The statistically significant results can be appropriately obtained from the quantitative study. Therefore, the review has focused on finding and locating the appropriate and current studies that could provide the current rate of prevalence, incidence and effects of Down Syndrome in Arab World. Therefore, this review aims towards providing the effective and readable synthesis of the quality resources and could also help in enhancing the knowledge about the current area of research. The review also provides the directions for the future research in reference to down syndrome and its effect on population in Arab World. Methods The qualitative method and inductive approach has been used in preparing this review. Keyword research method have been used for locating the resources in PubMed. Some of the keywords that are used for locating the appropriate resources are Down syndrome, what is down syndrome, prevalence of down syndrome, risks associated with down syndrome, burden of down syndrome on population, incidence of down syndrome in Arab World, risk factors and down syndrome, prevalence of down syndrome in Arab World and reasons of down syndrome prevalence. Flowchart of the Final Number of Articles Retrieved for this Review Study Methodology is a very important approach for preparing the research articles and research studies. The key word search requires to enter the correct keywords and must be in line with the requirements and objectives of the study. The main objective of the study to provide the review of literature in order to find the evidences that can help in developing knowledge about the current scope and disease prevalence. Results This study is found to be significant because it provides important and current evidences related to down syndrome. The study also defines the genetic disorder, however, it lacks to provide the empirical evidences about the epidemiology of the down syndrome. This study can be beneficial in exploring the epigenetics associated with down syndrome. This is a very important study as it is focused on the Arab country and can help in informing about prevalence and epidemiology of down syndrome. UAE is a significant part of Arab World and a developed country. The prevalence of disease in this country provides a strong in sight about the reasons of disease occurrence and also inform that what challenges children have to face, who are suffering from down syndrome. This article helped in gaining the epidemiological information about disease. This study has been helpful in informing about the incidence and prevalence of down syndrome around the world. This study provides some strong evidences about the epidemiology of this genetic disorder and what are the major risk factors associated with it. However, the study lacks some significant empirical evidences. Study identifies down syndrome as the most common genetic disorder globally. One significant limitation of the study is that it provides the evidences from the sample of children from United States. This study is significant because it informs about the antenatal screening, which is significant for identifying the genetic disorder in babies. Screening is considered as the important and successfully developed as the biochemical marker and algorithms for identifying the risks mainly associated with trisomy 21 and 18. This study is very significant for increasing the awareness towards the process of screening that is mainly important in the Arab world, because the incidence of down syndrome in children is higher in Arab countries. This is a document that significantly address the issue of down syndrome in relation to Arab World. One significant limitation of the study is that it is not a journal article or papers, yet is associated with Arab Genomics, therefore, provides many significant evidence mainly associated with Arab countries. It provides the information about prevalence and incidence rate. The only limitation of the study is that it lacks empirical evidences from literature. The study discusses a very significant risk factor that results in high occurrence of down syndrome around the world. Study discusses the Consanguineous marriages as the significant risk factor for the occurrence of genetic disorder including down syndrome. This study is included in the research because Consanguineous marriages are customary and common in Arab World ad a significant reason of occurrence of down syndrome. This study is considered to be very important because its views the genetic disorder from the epidemiological perspective. It provides the prevalence data related to down syndrome in Arab world and also in many other countries. The limitation of the study is that it lacks empirical data. However, it also identifies the genetic and environmental factors that can result in causing down syndrome in children. However, study consider maternal age as an risk factor in occurrence of down syndrome. This study is conducted in Turkey, which is also a Muslim natation and also follows the traditions and belief according to people in Arab World. The author informs that down syndrome is the most common chromosome abnormality among the live births. Maternal age and lack of antenatal screening are considered as major risk factor. The study is a cross sectional study and provide empirical evidences. This study informs about the gap in literature, as very limited evidences are available on the prevalence of the congenital anomaliesin Middle East countries. This cross sectional study informs that prevalence of congenital anomalies in Saudi Arabian children is high because of the high consanguinity rate and high maternal age. This study is also important because it is community based and provide empirical evidences regarding the prevalence, incidence, risk factors and gaps in knowledge. This study compares the main characteristics of the individuals suffering from down syndrome with the normal subjects with the help of cephalometric radiographs. This study can be help in directing the future research regarding the treatment of individuals suffering with down syndrome. This study defines the down syndrome, however, lack data regarding the incidence and prevalence of the disease. This study is mainly focused on the prevalence and incidence of genetic disorder in Arab World. This study identifies the major risk factors such as high level of inbreeding, high maternal and paternal age and also large family sizes. This study found that there are various factors affecting the knowledge of people about disease. Therefore, it required that focus should be placed on enhancing knowledge and education of people and also improve the access of people to specialized genetic services. This study is very significant because it informs about the attitude of the people towards the individuals suffering from down syndrome. It explains about the burden of the disease on the people and their families. These evidences are important in order to design the future interventions for improving the life of people suffering with down syndrome in Arab nations. Name of Author and year Title Study Population Study Type Main Results Dekker, De Deyn, Rots,. (2017). Epigenetics and Down syndrome Cross sectional study The study help in explaining the genetic disorder of down syndrome and helps in providing the information about the genetic issues and epigenetics associated with down syndrome. Aburawi et al (2015) National growth charts for United Arab Emirates children with Down syndrome from birth to 15 years of age UAE Retrospective and cross-sectional growth study of Emirati children The incidence rate of down syndrome is found to be high in UAE. Study helps in explaining the others problems that children have to face with the genetic disorder of down syndrome. Sherman, S. L., Allen, E. G., Bean, L. H., Freeman, S. B. (2007). Epidemiology of Down syndrome Infants in United Nations Qualitative study Study provides the important information about the epidemiology of down syndrome. Study includes the information about the world prevalence rate of down syndrome and the risk associated with this genetic disease. Study determines the clinical cause, prevalence and incidence of down syndrome. Spencer, K. (2014). Screening for Down syndrome. United Kingdom Qualitative study Study informs about the definition and occurrence of down syndrome. Study also related the prevalence of down syndrome with the maternal age that is a significant factor for increasing the risk of disease. Centre for Arab Genomic Studies. (2013) Down Syndrome in the Arab world Arab population Review Study This study is very important as it provides the specific insight in the prevalence and epidemiology of down syndrome in Arab population Hamamy, Antonarakis, Cavalli-Sforza, Temtamy, Romeo, Ten Kate, Bathija,. (2011) Consanguineous marriages, pearls and perils: Geneva international consanguinity workshop report Geneva Qualitative review study The focus of the study is on the countries, where the consanguineous marriages are customary, which means the marriage in first cousins. This is a significant factor that affects the genetic factors of infants in Arab world. Study also explains that how such marriages and maternal age result in prevalence of down syndrome. Mohammed Al-Biltag (2015) Down syndrome from Epidemiologic Point of View World Population Review Study Study mainly focuses on informing about the various factors that affect the rate of occurrence of down syndrome across various population in different continents and countries. Paper recognized various genetic and environmental factors that result in increasing incidence of down syndrome in infants. Study also discussed potential risk factors. Acikbas, Tomatir, Akdag, Koksal, (2012) Retrospective analysis of live birth prevalence of children with Down syndrome in Denizli, Turkey Turkey Retrospective study Study examines the prevalence variation of down syndrome. Retrospective analysis of live birth prevalence of children with Down syndrome in Denizli, Turkey. study extracts the 16 years of the survey result to understand the prevalence and risk factors associated with down syndrome. AlSalloum et al (2015) Prevalence of selected congenital anomalies in Saudi children: a community-based study Saudi Children The stidy focused on the Saudi Children and also discussed the prevalence of the congenital anomalies in the children. Study found that down syndrome is the most common genetic congenital anomalies in the children and risk factors are maternal age and consanguineous marriages. Mohammed A. Korayema and Eman A. AlKofide. (2014) Characteristics of Down syndrome subjects in a Saudi sample Saudi Arabia Quantitative study The study focused on differentiating the characteristics of the individuals with down syndrome and compare them with the normal subjects. Study also provide the in-sight to many risk factors associated with this genetic disorder. Al-Gazali, Hamamy, Al-Arrayad, (2006). Genetic disorders in the Arab world Arab Population Cross Sectional Study The main findings of the study inform that genetic disorders are common in Arab countries that result in significant disabilities among individuals. Study informs that there is lack of interventions and programs directed towards the prevention of congenital and genetic disorders. Study also discussed that lack of antenatal screening also results in increasing the risk and prevalence of down syndrome. Sadeer G. Al-Kindi,Taha Al-Juhaishi,Atheer J. Al-Saffar. (2012) Community Attitudes Towards People with Downs Syndrome: A Sample From Iraq Iraq Cross-Sectional study The study used the self-administered questionnaire to understand the response of the people towards the inclusion of the people suffering from down syndrome in community. Study concludes that there is a need of organized campaigns and programs to increase awareness of people towards down syndrome. Discussion Down syndrome is considered and found to be the most common genetic disorder in the Arab World. The findings of the paper inform about various reasons that increases the risk of this genetic disorder in children. The findings of the study inform that some of the major reasons behind prevalence of this disorder are Consanguineous marriages, traditional and religious custom of marrying the first cousins, high maternal age and also multiparty. There are various genetic, environmental and social factors that can increase the prevalence of this disorder. Study found that antenatal screening is very helpful in finding the genetic disorder in the fetus and after knowing parents can terminate the pregnancy. However, due to religious and social restrictions and also due to economic and ethnic factors, abortion is not allowed and women have to give birth to children, even after knowing that child suffers from genetic disorder and will not be able to lead a normal life. In comparison to evidences from France and Europe, it has been found that abortion is allowed in France and Europe, therefore, the birth prevalence of down syndrome is reduced in these countries. For example, it was found that incidence rate of down syndrome in live births in Dubai is 1:319, it is 1:500 in Oman, 1:554 in Saudi Arabia, and 1 in 700 in Egypt in Egypt, while the incidence rate in China is 2/1000, 0.83/1000 in India and it is 1:1700 in Australia (due to high termination rate). Therefore, the above data informs that prevalence and incidence rate is higher in Arab countries. There are various reasons identified for high incidence and prevalence. One of the religious or cultural reason is that Arab people believe in making large families and giving birth to many children. Giving birth to many children through Consanguineous marriages affects the chromosomes and results in creating genetic anomalies. Also one reasons are that mother keep giving birth to children even after t he age of 40 and age is a significant risk factor. Therefore, maternal age affects the health and well-being of the children. Due to contemporary changes in the culture and society, one reason is that women are also now taking an active part in economy. Women are participating in receiving higher education and are making careers. This restricts them to give birth to children in early or appropriate age. Also, in many part of the Arab world, the population is still tribal and are uneducated. Therefore, they lack the significance of understanding the disease, disadvantages of giving birth to many children and understanding the importance of antenatal screening. The hereditary problems and genetic disorder in the tribal people increases the overall burden of the disease. Also, it has been found that 50% of the children that are born with the down syndrome disorder are born to mothers, who are 40 years or above in age. There is a significant gap in the literature, regarding the prevalence and major risk factors associated with it. It has also been found that there is a lack of extensive healthcare programs, campaigns and interventions that could encourage women more towards antenatal and premarital screening about chromosomal abnormality. The nation where the risk is higher and as it is scientifically proved, it becomes very significant to increase the awareness of people. There is also a lack of healthcare counselling that could be provides to the couples, in order to enhance their knowledge about this genetic disorder. Therefore, there is a significant loop hole on policy level. Another problem is identified on the social and legal level. For example, termination of pregnancy is not legally and religious allowed in the Arab countries, even when a ruling in 1990 allowed the termination of pregnancy in the first 120days, if the fetus was found to be significantly affected by sever malformation that could not be even improved after the treatment. However, people are still restricted from terminating pregnancy. Therefore, there is requirement of making a strong law and policy that could address such problem and may also help in reducing the prevalence of down syndrome in Arab countries. A family oriented approach is required to be designed and applied that could help in informing people about the risks of giving birth to large number of children and how proper screening approaches can benefit them in having healthy children. Also, the clinical screening of the new born can help the clinicians in detecting the abnormalities. This way parents could be better prepa red to take care of such children and provide them better environment. Increasing the awareness of parents and people in community can help in better inclusion of such children in community. References Standard Journal Articles Acikbas, I., Tomatir, A. G., Akdag, B., Koksal, A. (2012). Retrospective analysis of live birth prevalence of children with Down syndrome in Denizli, Turkey.Genet Mol Res,11(4), 4640-5. Aburawi, E. H., Nagelkerke, N., Deeb, A., Abdulla, S., Abdulrazzaq, Y. M. (2015). National growth charts for United Arab Emirates children with Down syndrome from birth to 15 years of age.Journal of epidemiology,25(1), 20-29. Al-Biltagi, M. (2015). Down syndrome from Epidemiologic Point of View.EC Paediatrics,2, 82-91. (PubMed) Al-Gazali, L., Hamamy, H., Al-Arrayad, S. (2006). Genetic disorders in the Arab world.Bmj,333(7573), 831-834.(PubMed) Al-Kindi, S. G., Al-Juhaishi, T., Al-Saffar, A. J. (2012). Community attitudes towards people with downs syndrome: A sample from Iraq.Public Health Research,2(4), 102-105. AlSalloum, A., ElMouzan, M. I., AlHerbish, A., AlOmer, A., Qurashib, M. (2015). Prevalence of selected congenital anomalies in Saudi children: a community-based study.Annals of Saudi medicine,35(2). (PubMed) Dekker, A. D., De Deyn, P. P., Rots, M. G. (2017). Epigenetics and Down syndrome. InNeuropsychiatric Disorders and Epigenetics(pp. 163-184). Hamamy, H., Antonarakis, S. E., Cavalli-Sforza, L. L., Temtamy, S., Romeo, G., Ten Kate, L. P., ... Bathija, H. (2011). Consanguineous marriages, pearls and perils: Geneva international consanguinity workshop report.Genetics in Medicine,13(9), 841. (PubMed) Korayem, M. A., AlKofide, E. A. (2013). Characteristics of Down syndrome subjects in a Saudi sample.The Angle Orthodontist,84(1), 30-37. (PubMed) Sherman, S. L., Allen, E. G., Bean, L. H., Freeman, S. B. (2007). Epidemiology of Down syndrome.Developmental Disabilities Research Reviews,13(3), 221-227. (PubMed) Spencer, K. (2014). Screening for Down syndrome.Scandinavian Journal of Clinical and Laboratory Investigation,74(sup244), 41-47. (PubMed) Electronic Material Centre for Arab Genomic Studies. (2013). Down Syndrome in the Arab world. Retrieved from https://www.cags.org.ae/Down%20Syndrome-English.pdf

Down syndrome is a chromosomal disorder - Myassignmenthelp.Com

Question: Discuss about the Down syndrome is a chromosomal disorder. Answer: What is Down Syndrome? Down syndrome is a chromosomal disorder caused due to the abnormal division of cells which leads to an extra full or partial copy of chromosome 21 (Sherman et al, 2007). Jerome Lejeune, a French physician, developed the cause of down syndrome in 1959 (National Down Syndrome Society). In case of down syndrome, the count of chromosomes is 47 instead of 46 (half chromosomes comes from the mother and half from the father i.e. 23 from each). So this is due to having one extra chromosome number 21 in addition to the already existing normal pair. This type of down syndrome is called trisomy 21 which accounts for 95% of the down syndrome cases (Spencer, 2014). According to researchers the extra copy of chromosome 21 affects the normal course of development of an individual, and also there is an increased risk of health problems associated with this disorder (Dekker, De Deyn, Rots, 2017). Mosaicism is the least common form of down syndrome which accounts for only one percent of cases. This occurs due to a mixture of two type of cells, with some containing the usual count of 46 and some containing 47 chromosomes. People suffering from mosaic down syndrome have very fewer characteristics as compared to other types of down syndrome). Translocation type of down syndrome accounts for the remaining 4% cases of the down syndrome. In this type the additional full or partial copy of chromosome 21 attaches to the another chromosome (chromosome 14) (Dekker, De Deyn, Rots, 2017). The hereditary component is present only in one third cases of translocation down syndrome, that accounts for one percent of the total cases of down syndrome as a whole. This genetic disorder further affects the physical and mental wellbeing of the individual by slowing the development growth both physically and mentally. An individual with down syndrome may also suffer from heart and gastrointestinal disorders. Early interventions and better knowledge about down syndrome will greatly help in increasing the quality of life of the children or adult facing this disorder (Centre for Arab Genomic Studies, 2013). Small stature, low muscle tone, an upward slant to the eyes and a single deep crease across the center of the palm are some of the physical changes that are rightly noticeable in an individual facing this disorder (Dekker, De Deyn, Rots, 2017). However, these are not necessarily the only physical changes that an individual face. Language development is also very slow amongst the children facing this disorder. The study of Aburawi, et al, (2015) also finds that children suffering with down syndrome are significantly shorter and heavier in weight than normal children. Obesity is also a significant problem among such children. There can be behavioral issues also like attention problem, stubborn nature, obsessive and compulsive behavior etc. Autism spectrum disorder is also found in a very small percentage of people facing this disorder which affects communication and social interaction (Dekker, De Deyn, Rots, 2017). A gradual decline in thinking ability is also seen among the people with down syndrome as they age. Prevalence and cause of Down Syndrome Down syndrome is considered as the most common congenital anomalies that is affecting 1 in every 800 births. An individual with down syndrome may have a full extra or partial part of chromosome 21 present. However, the cause of this extra full or partial chromosome 21 is still unknown. The prevalence of down syndrome differs from country to country because of the various social and environmental factors. For, example the incidence of down syndrome may be lower in the developed countries, in comparison to developing countries. This could be because the developed countries in the Arab world may have better application and uptake of the antenatal diagnostic service and also receives the permission to terminate the pregnancy if such case is discovered. According to the study of Al-Biltagi (2015) the estimated incidence of down syndrome is between 1 to 10/1000 live births worldwide (p. 85). The only factor linked to an increased chance of having a baby with down syndrome is the maternal age (National Down Syndrome Society, 2016) and the risk increases with an increase in maternal age. According to a report the risk is 1:1000 at the age of 30 while at the age of 35 the risk is 1:400 (Centre for Arab Genomic Studies, 2013). According to a report the incidence of down syndrome in some Arab countries is slightly higher as compared to the other countries globally. The incidence of down syndrome in Dubai is 1:319, in Oman it is 1:500, Qatar (1:546), Saudi Arabia (1:554), Kuwait (1:581), Israel is 1:547 (Al-Biltagi, 2015). There are a number of factors associated with the higher number of incidence rate in Arab countries such as consanguineous marriages (marriages among first cousins), increased maternal age and having a high number of children, lack of prenatal detection which further to terminate pregnancies with down syndrome fetuses (Hamamy et al, 2011). Risk Factors For Down Syndrome People with Down syndrome often take some drugs and supplements to support their brain activities but according to a research the medicines are not able to make any specific change or there are no medicines developed till date that helps a person to recover from this disorder. The burden of this disease is very high in Arab world, because it results in significant morbidity, mortality and disability among the infants. The rate of children suffering with down syndrome in many Arab countries is increasing from 1.2-1.7 per 1000 mainly in the industrialized countries. This mainly due to the high proportion of the child birth. Having large number of children is a traditional and cultural element in the Arab world and they prefer having many children in family. This is a significant risk factor, as the mothers keeping giving birth to children till very old age that affects the health and well-being of the children being born in older age of mother. There are various social and economic trends associated with a high maternal age in the Arab world. This is due to the fact that most of the women in the Arab world choose high level of professional development in the early 20s and the early 30s (Al-Biltagi, 2015). The only reason associated with it is to provide better financial conditions to the family for a healthy living. So now the Arab world is also experiencing similar trends as that of the western world throughout the shift to industrialization, so there is a need to take the same measures or to adopt the same practices as that of the western world like antenatal screening using ultrasounds, amniocentesis and chronic villus sampling as well as preserving the oocyte (an egg bank) (Acikbas et al, 2012). This results in creating a significant burden of the disease. The high prevalence of down syndrome in Arabs is due to their socio-economic and religious belief that includes the common practice of consanguineous marriages, multi party and increased maternal age. Lack of educational awareness can also affect the prevalence and incidence of down syndrome. The lack of education also affects the health outcome of the people in Arab world. The people, who are not educated, do not understand the significance of the antenatal screening tests, which is significant for detecting the down syndrome in the babies (Korayem, AlKofide, 2013). Therefore, lack of knowledge and education of the parents also prevents them from taking antenatal screening and terminating such pregnancies. The people in Arab world are at the risk of genetic problem even if they have the family history of genetic disorder or not. Various countries in Arab world have also made the provisions for the premarital screening and antenatal screening. However, the poor access of people to such programs and facilities results in increasing the burden of disease (Al-Gazali, Hamamy, Al-Arrayad, 2006). Attitude of People The children suffering from down syndrome have different physical features, physical structure and also have language problems. Such children may face many difficulties in social interaction and may not get appropriate opportunity of social inclusion (Al-Kindi, Al-Juhaishi, Al-Saffar, 2012). Studies have found that there is a lack of awareness among the people towards the individuals suffering from down syndrome and this may result in discriminatory behavior towards them. The burden of the disease on the patients and families increases, due to the problem of stigmatization and social exclusion. Perception of the people towards down syndrome has been found to be very poor (Al-Kindi, Al-Juhaishi, Al-Saffar, 2012). People often hold negative opinion and negative attitude about people suffering from down syndrome. This can also result in many psychological consequences and can increase the burden of the disease Al-Biltagi, (2015). However, there is a lack of qualitative and quantitativ e evidences of the community attitude and attitude of people in Arab World. Although, it has been found that parents do have positive attitude towards the social inclusion of their children in schools, yet, in general, people in Arabian countries lack the awareness towards the intellectual disability disorders. Aims of Review Aim of the review is to provide significant and important evidences found in the literature. The search for the articles is conducted through PubMed also some of the articles are also added from the cross reference and other important journals. Down syndrome is a common congenital anomaly in Saudi Arabia. The frequency of such anomalies differ from country to country on the basis of various factors. Although, there have been decrease in the prevalence of such disease with the increasing technological advancement and treatment range, yet Down syndrome still significantly prevails and result in significant childhood mortality. Therefore, it has also been found that genetic disorder causes significant morbidity, mortality and disability among children in Middle East. Genetic disorder is the major problem in the Arab world. This review is mainly focused on discussing the current knowledge and understanding about the genetic disorders, such as down syndrome and its prevalence in Arab Worl d. The inclusion criteria that has been applied for the research is that only published studies and government reports are select for the purpose of this review. This inclusion criterion is applied in order to maintain the quality of the evidences. PubMed is specifically used to locate the articles, cross-sectional studies and quantitative studies for preparing this review. The statistically significant results can be appropriately obtained from the quantitative study. Therefore, the review has focused on finding and locating the appropriate and current studies that could provide the current rate of prevalence, incidence and effects of Down Syndrome in Arab World. Therefore, this review aims towards providing the effective and readable synthesis of the quality resources and could also help in enhancing the knowledge about the current area of research. The review also provides the directions for the future research in reference to down syndrome and its effect on population in Arab World. Methods The qualitative method and inductive approach has been used in preparing this review. Keyword research method have been used for locating the resources in PubMed. Some of the keywords that are used for locating the appropriate resources are Down syndrome, what is down syndrome, prevalence of down syndrome, risks associated with down syndrome, burden of down syndrome on population, incidence of down syndrome in Arab World, risk factors and down syndrome, prevalence of down syndrome in Arab World and reasons of down syndrome prevalence. Flowchart of the Final Number of Articles Retrieved for this Review Study Methodology is a very important approach for preparing the research articles and research studies. The key word search requires to enter the correct keywords and must be in line with the requirements and objectives of the study. The main objective of the study to provide the review of literature in order to find the evidences that can help in developing knowledge about the current scope and disease prevalence. Results This study is found to be significant because it provides important and current evidences related to down syndrome. The study also defines the genetic disorder, however, it lacks to provide the empirical evidences about the epidemiology of the down syndrome. This study can be beneficial in exploring the epigenetics associated with down syndrome. This is a very important study as it is focused on the Arab country and can help in informing about prevalence and epidemiology of down syndrome. UAE is a significant part of Arab World and a developed country. The prevalence of disease in this country provides a strong in sight about the reasons of disease occurrence and also inform that what challenges children have to face, who are suffering from down syndrome. This article helped in gaining the epidemiological information about disease. This study has been helpful in informing about the incidence and prevalence of down syndrome around the world. This study provides some strong evidences about the epidemiology of this genetic disorder and what are the major risk factors associated with it. However, the study lacks some significant empirical evidences. Study identifies down syndrome as the most common genetic disorder globally. One significant limitation of the study is that it provides the evidences from the sample of children from United States. This study is significant because it informs about the antenatal screening, which is significant for identifying the genetic disorder in babies. Screening is considered as the important and successfully developed as the biochemical marker and algorithms for identifying the risks mainly associated with trisomy 21 and 18. This study is very significant for increasing the awareness towards the process of screening that is mainly important in the Arab world, because the incidence of down syndrome in children is higher in Arab countries. This is a document that significantly address the issue of down syndrome in relation to Arab World. One significant limitation of the study is that it is not a journal article or papers, yet is associated with Arab Genomics, therefore, provides many significant evidence mainly associated with Arab countries. It provides the information about prevalence and incidence rate. The only limitation of the study is that it lacks empirical evidences from literature. The study discusses a very significant risk factor that results in high occurrence of down syndrome around the world. Study discusses the Consanguineous marriages as the significant risk factor for the occurrence of genetic disorder including down syndrome. This study is included in the research because Consanguineous marriages are customary and common in Arab World ad a significant reason of occurrence of down syndrome. This study is considered to be very important because its views the genetic disorder from the epidemiological perspective. It provides the prevalence data related to down syndrome in Arab world and also in many other countries. The limitation of the study is that it lacks empirical data. However, it also identifies the genetic and environmental factors that can result in causing down syndrome in children. However, study consider maternal age as an risk factor in occurrence of down syndrome. This study is conducted in Turkey, which is also a Muslim natation and also follows the traditions and belief according to people in Arab World. The author informs that down syndrome is the most common chromosome abnormality among the live births. Maternal age and lack of antenatal screening are considered as major risk factor. The study is a cross sectional study and provide empirical evidences. This study informs about the gap in literature, as very limited evidences are available on the prevalence of the congenital anomaliesin Middle East countries. This cross sectional study informs that prevalence of congenital anomalies in Saudi Arabian children is high because of the high consanguinity rate and high maternal age. This study is also important because it is community based and provide empirical evidences regarding the prevalence, incidence, risk factors and gaps in knowledge. This study compares the main characteristics of the individuals suffering from down syndrome with the normal subjects with the help of cephalometric radiographs. This study can be help in directing the future research regarding the treatment of individuals suffering with down syndrome. This study defines the down syndrome, however, lack data regarding the incidence and prevalence of the disease. This study is mainly focused on the prevalence and incidence of genetic disorder in Arab World. This study identifies the major risk factors such as high level of inbreeding, high maternal and paternal age and also large family sizes. This study found that there are various factors affecting the knowledge of people about disease. Therefore, it required that focus should be placed on enhancing knowledge and education of people and also improve the access of people to specialized genetic services. This study is very significant because it informs about the attitude of the people towards the individuals suffering from down syndrome. It explains about the burden of the disease on the people and their families. These evidences are important in order to design the future interventions for improving the life of people suffering with down syndrome in Arab nations. Name of Author and year Title Study Population Study Type Main Results Dekker, De Deyn, Rots,. (2017). Epigenetics and Down syndrome Cross sectional study The study help in explaining the genetic disorder of down syndrome and helps in providing the information about the genetic issues and epigenetics associated with down syndrome. Aburawi et al (2015) National growth charts for United Arab Emirates children with Down syndrome from birth to 15 years of age UAE Retrospective and cross-sectional growth study of Emirati children The incidence rate of down syndrome is found to be high in UAE. Study helps in explaining the others problems that children have to face with the genetic disorder of down syndrome. Sherman, S. L., Allen, E. G., Bean, L. H., Freeman, S. B. (2007). Epidemiology of Down syndrome Infants in United Nations Qualitative study Study provides the important information about the epidemiology of down syndrome. Study includes the information about the world prevalence rate of down syndrome and the risk associated with this genetic disease. Study determines the clinical cause, prevalence and incidence of down syndrome. Spencer, K. (2014). Screening for Down syndrome. United Kingdom Qualitative study Study informs about the definition and occurrence of down syndrome. Study also related the prevalence of down syndrome with the maternal age that is a significant factor for increasing the risk of disease. Centre for Arab Genomic Studies. (2013) Down Syndrome in the Arab world Arab population Review Study This study is very important as it provides the specific insight in the prevalence and epidemiology of down syndrome in Arab population Hamamy, Antonarakis, Cavalli-Sforza, Temtamy, Romeo, Ten Kate, Bathija,. (2011) Consanguineous marriages, pearls and perils: Geneva international consanguinity workshop report Geneva Qualitative review study The focus of the study is on the countries, where the consanguineous marriages are customary, which means the marriage in first cousins. This is a significant factor that affects the genetic factors of infants in Arab world. Study also explains that how such marriages and maternal age result in prevalence of down syndrome. Mohammed Al-Biltag (2015) Down syndrome from Epidemiologic Point of View World Population Review Study Study mainly focuses on informing about the various factors that affect the rate of occurrence of down syndrome across various population in different continents and countries. Paper recognized various genetic and environmental factors that result in increasing incidence of down syndrome in infants. Study also discussed potential risk factors. Acikbas, Tomatir, Akdag, Koksal, (2012) Retrospective analysis of live birth prevalence of children with Down syndrome in Denizli, Turkey Turkey Retrospective study Study examines the prevalence variation of down syndrome. Retrospective analysis of live birth prevalence of children with Down syndrome in Denizli, Turkey. study extracts the 16 years of the survey result to understand the prevalence and risk factors associated with down syndrome. AlSalloum et al (2015) Prevalence of selected congenital anomalies in Saudi children: a community-based study Saudi Children The stidy focused on the Saudi Children and also discussed the prevalence of the congenital anomalies in the children. Study found that down syndrome is the most common genetic congenital anomalies in the children and risk factors are maternal age and consanguineous marriages. Mohammed A. Korayema and Eman A. AlKofide. (2014) Characteristics of Down syndrome subjects in a Saudi sample Saudi Arabia Quantitative study The study focused on differentiating the characteristics of the individuals with down syndrome and compare them with the normal subjects. Study also provide the in-sight to many risk factors associated with this genetic disorder. Al-Gazali, Hamamy, Al-Arrayad, (2006). Genetic disorders in the Arab world Arab Population Cross Sectional Study The main findings of the study inform that genetic disorders are common in Arab countries that result in significant disabilities among individuals. Study informs that there is lack of interventions and programs directed towards the prevention of congenital and genetic disorders. Study also discussed that lack of antenatal screening also results in increasing the risk and prevalence of down syndrome. Sadeer G. Al-Kindi,Taha Al-Juhaishi,Atheer J. Al-Saffar. (2012) Community Attitudes Towards People with Downs Syndrome: A Sample From Iraq Iraq Cross-Sectional study The study used the self-administered questionnaire to understand the response of the people towards the inclusion of the people suffering from down syndrome in community. Study concludes that there is a need of organized campaigns and programs to increase awareness of people towards down syndrome. Discussion Down syndrome is considered and found to be the most common genetic disorder in the Arab World. The findings of the paper inform about various reasons that increases the risk of this genetic disorder in children. The findings of the study inform that some of the major reasons behind prevalence of this disorder are Consanguineous marriages, traditional and religious custom of marrying the first cousins, high maternal age and also multiparty. There are various genetic, environmental and social factors that can increase the prevalence of this disorder. Study found that antenatal screening is very helpful in finding the genetic disorder in the fetus and after knowing parents can terminate the pregnancy. However, due to religious and social restrictions and also due to economic and ethnic factors, abortion is not allowed and women have to give birth to children, even after knowing that child suffers from genetic disorder and will not be able to lead a normal life. In comparison to evidences from France and Europe, it has been found that abortion is allowed in France and Europe, therefore, the birth prevalence of down syndrome is reduced in these countries. For example, it was found that incidence rate of down syndrome in live births in Dubai is 1:319, it is 1:500 in Oman, 1:554 in Saudi Arabia, and 1 in 700 in Egypt in Egypt, while the incidence rate in China is 2/1000, 0.83/1000 in India and it is 1:1700 in Australia (due to high termination rate). Therefore, the above data informs that prevalence and incidence rate is higher in Arab countries. There are various reasons identified for high incidence and prevalence. One of the religious or cultural reason is that Arab people believe in making large families and giving birth to many children. Giving birth to many children through Consanguineous marriages affects the chromosomes and results in creating genetic anomalies. Also one reasons are that mother keep giving birth to children even after t he age of 40 and age is a significant risk factor. Therefore, maternal age affects the health and well-being of the children. Due to contemporary changes in the culture and society, one reason is that women are also now taking an active part in economy. Women are participating in receiving higher education and are making careers. This restricts them to give birth to children in early or appropriate age. Also, in many part of the Arab world, the population is still tribal and are uneducated. Therefore, they lack the significance of understanding the disease, disadvantages of giving birth to many children and understanding the importance of antenatal screening. The hereditary problems and genetic disorder in the tribal people increases the overall burden of the disease. Also, it has been found that 50% of the children that are born with the down syndrome disorder are born to mothers, who are 40 years or above in age. There is a significant gap in the literature, regarding the prevalence and major risk factors associated with it. It has also been found that there is a lack of extensive healthcare programs, campaigns and interventions that could encourage women more towards antenatal and premarital screening about chromosomal abnormality. The nation where the risk is higher and as it is scientifically proved, it becomes very significant to increase the awareness of people. There is also a lack of healthcare counselling that could be provides to the couples, in order to enhance their knowledge about this genetic disorder. Therefore, there is a significant loop hole on policy level. Another problem is identified on the social and legal level. For example, termination of pregnancy is not legally and religious allowed in the Arab countries, even when a ruling in 1990 allowed the termination of pregnancy in the first 120days, if the fetus was found to be significantly affected by sever malformation that could not be even improved after the treatment. However, people are still restricted from terminating pregnancy. Therefore, there is requirement of making a strong law and policy that could address such problem and may also help in reducing the prevalence of down syndrome in Arab countries. A family oriented approach is required to be designed and applied that could help in informing people about the risks of giving birth to large number of children and how proper screening approaches can benefit them in having healthy children. Also, the clinical screening of the new born can help the clinicians in detecting the abnormalities. This way parents could be better prepa red to take care of such children and provide them better environment. Increasing the awareness of parents and people in community can help in better inclusion of such children in community. References Standard Journal Articles Acikbas, I., Tomatir, A. G., Akdag, B., Koksal, A. (2012). Retrospective analysis of live birth prevalence of children with Down syndrome in Denizli, Turkey.Genet Mol Res,11(4), 4640-5. Aburawi, E. H., Nagelkerke, N., Deeb, A., Abdulla, S., Abdulrazzaq, Y. M. (2015). National growth charts for United Arab Emirates children with Down syndrome from birth to 15 years of age.Journal of epidemiology,25(1), 20-29. Al-Biltagi, M. (2015). Down syndrome from Epidemiologic Point of View.EC Paediatrics,2, 82-91. (PubMed) Al-Gazali, L., Hamamy, H., Al-Arrayad, S. (2006). Genetic disorders in the Arab world.Bmj,333(7573), 831-834.(PubMed) Al-Kindi, S. G., Al-Juhaishi, T., Al-Saffar, A. J. (2012). Community attitudes towards people with downs syndrome: A sample from Iraq.Public Health Research,2(4), 102-105. AlSalloum, A., ElMouzan, M. I., AlHerbish, A., AlOmer, A., Qurashib, M. (2015). Prevalence of selected congenital anomalies in Saudi children: a community-based study.Annals of Saudi medicine,35(2). (PubMed) Dekker, A. D., De Deyn, P. P., Rots, M. G. (2017). Epigenetics and Down syndrome. InNeuropsychiatric Disorders and Epigenetics(pp. 163-184). Hamamy, H., Antonarakis, S. E., Cavalli-Sforza, L. L., Temtamy, S., Romeo, G., Ten Kate, L. P., ... Bathija, H. (2011). Consanguineous marriages, pearls and perils: Geneva international consanguinity workshop report.Genetics in Medicine,13(9), 841. (PubMed) Korayem, M. A., AlKofide, E. A. (2013). Characteristics of Down syndrome subjects in a Saudi sample.The Angle Orthodontist,84(1), 30-37. (PubMed) Sherman, S. L., Allen, E. G., Bean, L. H., Freeman, S. B. (2007). Epidemiology of Down syndrome.Developmental Disabilities Research Reviews,13(3), 221-227. (PubMed) Spencer, K. (2014). Screening for Down syndrome.Scandinavian Journal of Clinical and Laboratory Investigation,74(sup244), 41-47. (PubMed) Electronic Material Centre for Arab Genomic Studies. (2013). Down Syndrome in the Arab world. Retrieved from https://www.cags.org.ae/Down%20Syndrome-English.pdf

Down syndrome is a chromosomal disorder - Myassignmenthelp.Com

Question: Discuss about the Down syndrome is a chromosomal disorder. Answer: What is Down Syndrome? Down syndrome is a chromosomal disorder caused due to the abnormal division of cells which leads to an extra full or partial copy of chromosome 21 (Sherman et al, 2007). Jerome Lejeune, a French physician, developed the cause of down syndrome in 1959 (National Down Syndrome Society). In case of down syndrome, the count of chromosomes is 47 instead of 46 (half chromosomes comes from the mother and half from the father i.e. 23 from each). So this is due to having one extra chromosome number 21 in addition to the already existing normal pair. This type of down syndrome is called trisomy 21 which accounts for 95% of the down syndrome cases (Spencer, 2014). According to researchers the extra copy of chromosome 21 affects the normal course of development of an individual, and also there is an increased risk of health problems associated with this disorder (Dekker, De Deyn, Rots, 2017). Mosaicism is the least common form of down syndrome which accounts for only one percent of cases. This occurs due to a mixture of two type of cells, with some containing the usual count of 46 and some containing 47 chromosomes. People suffering from mosaic down syndrome have very fewer characteristics as compared to other types of down syndrome). Translocation type of down syndrome accounts for the remaining 4% cases of the down syndrome. In this type the additional full or partial copy of chromosome 21 attaches to the another chromosome (chromosome 14) (Dekker, De Deyn, Rots, 2017). The hereditary component is present only in one third cases of translocation down syndrome, that accounts for one percent of the total cases of down syndrome as a whole. This genetic disorder further affects the physical and mental wellbeing of the individual by slowing the development growth both physically and mentally. An individual with down syndrome may also suffer from heart and gastrointestinal disorders. Early interventions and better knowledge about down syndrome will greatly help in increasing the quality of life of the children or adult facing this disorder (Centre for Arab Genomic Studies, 2013). Small stature, low muscle tone, an upward slant to the eyes and a single deep crease across the center of the palm are some of the physical changes that are rightly noticeable in an individual facing this disorder (Dekker, De Deyn, Rots, 2017). However, these are not necessarily the only physical changes that an individual face. Language development is also very slow amongst the children facing this disorder. The study of Aburawi, et al, (2015) also finds that children suffering with down syndrome are significantly shorter and heavier in weight than normal children. Obesity is also a significant problem among such children. There can be behavioral issues also like attention problem, stubborn nature, obsessive and compulsive behavior etc. Autism spectrum disorder is also found in a very small percentage of people facing this disorder which affects communication and social interaction (Dekker, De Deyn, Rots, 2017). A gradual decline in thinking ability is also seen among the people with down syndrome as they age. Prevalence and cause of Down Syndrome Down syndrome is considered as the most common congenital anomalies that is affecting 1 in every 800 births. An individual with down syndrome may have a full extra or partial part of chromosome 21 present. However, the cause of this extra full or partial chromosome 21 is still unknown. The prevalence of down syndrome differs from country to country because of the various social and environmental factors. For, example the incidence of down syndrome may be lower in the developed countries, in comparison to developing countries. This could be because the developed countries in the Arab world may have better application and uptake of the antenatal diagnostic service and also receives the permission to terminate the pregnancy if such case is discovered. According to the study of Al-Biltagi (2015) the estimated incidence of down syndrome is between 1 to 10/1000 live births worldwide (p. 85). The only factor linked to an increased chance of having a baby with down syndrome is the maternal age (National Down Syndrome Society, 2016) and the risk increases with an increase in maternal age. According to a report the risk is 1:1000 at the age of 30 while at the age of 35 the risk is 1:400 (Centre for Arab Genomic Studies, 2013). According to a report the incidence of down syndrome in some Arab countries is slightly higher as compared to the other countries globally. The incidence of down syndrome in Dubai is 1:319, in Oman it is 1:500, Qatar (1:546), Saudi Arabia (1:554), Kuwait (1:581), Israel is 1:547 (Al-Biltagi, 2015). There are a number of factors associated with the higher number of incidence rate in Arab countries such as consanguineous marriages (marriages among first cousins), increased maternal age and having a high number of children, lack of prenatal detection which further to terminate pregnancies with down syndrome fetuses (Hamamy et al, 2011). Risk Factors For Down Syndrome People with Down syndrome often take some drugs and supplements to support their brain activities but according to a research the medicines are not able to make any specific change or there are no medicines developed till date that helps a person to recover from this disorder. The burden of this disease is very high in Arab world, because it results in significant morbidity, mortality and disability among the infants. The rate of children suffering with down syndrome in many Arab countries is increasing from 1.2-1.7 per 1000 mainly in the industrialized countries. This mainly due to the high proportion of the child birth. Having large number of children is a traditional and cultural element in the Arab world and they prefer having many children in family. This is a significant risk factor, as the mothers keeping giving birth to children till very old age that affects the health and well-being of the children being born in older age of mother. There are various social and economic trends associated with a high maternal age in the Arab world. This is due to the fact that most of the women in the Arab world choose high level of professional development in the early 20s and the early 30s (Al-Biltagi, 2015). The only reason associated with it is to provide better financial conditions to the family for a healthy living. So now the Arab world is also experiencing similar trends as that of the western world throughout the shift to industrialization, so there is a need to take the same measures or to adopt the same practices as that of the western world like antenatal screening using ultrasounds, amniocentesis and chronic villus sampling as well as preserving the oocyte (an egg bank) (Acikbas et al, 2012). This results in creating a significant burden of the disease. The high prevalence of down syndrome in Arabs is due to their socio-economic and religious belief that includes the common practice of consanguineous marriages, multi party and increased maternal age. Lack of educational awareness can also affect the prevalence and incidence of down syndrome. The lack of education also affects the health outcome of the people in Arab world. The people, who are not educated, do not understand the significance of the antenatal screening tests, which is significant for detecting the down syndrome in the babies (Korayem, AlKofide, 2013). Therefore, lack of knowledge and education of the parents also prevents them from taking antenatal screening and terminating such pregnancies. The people in Arab world are at the risk of genetic problem even if they have the family history of genetic disorder or not. Various countries in Arab world have also made the provisions for the premarital screening and antenatal screening. However, the poor access of people to such programs and facilities results in increasing the burden of disease (Al-Gazali, Hamamy, Al-Arrayad, 2006). Attitude of People The children suffering from down syndrome have different physical features, physical structure and also have language problems. Such children may face many difficulties in social interaction and may not get appropriate opportunity of social inclusion (Al-Kindi, Al-Juhaishi, Al-Saffar, 2012). Studies have found that there is a lack of awareness among the people towards the individuals suffering from down syndrome and this may result in discriminatory behavior towards them. The burden of the disease on the patients and families increases, due to the problem of stigmatization and social exclusion. Perception of the people towards down syndrome has been found to be very poor (Al-Kindi, Al-Juhaishi, Al-Saffar, 2012). People often hold negative opinion and negative attitude about people suffering from down syndrome. This can also result in many psychological consequences and can increase the burden of the disease Al-Biltagi, (2015). However, there is a lack of qualitative and quantitativ e evidences of the community attitude and attitude of people in Arab World. Although, it has been found that parents do have positive attitude towards the social inclusion of their children in schools, yet, in general, people in Arabian countries lack the awareness towards the intellectual disability disorders. Aims of Review Aim of the review is to provide significant and important evidences found in the literature. The search for the articles is conducted through PubMed also some of the articles are also added from the cross reference and other important journals. Down syndrome is a common congenital anomaly in Saudi Arabia. The frequency of such anomalies differ from country to country on the basis of various factors. Although, there have been decrease in the prevalence of such disease with the increasing technological advancement and treatment range, yet Down syndrome still significantly prevails and result in significant childhood mortality. Therefore, it has also been found that genetic disorder causes significant morbidity, mortality and disability among children in Middle East. Genetic disorder is the major problem in the Arab world. This review is mainly focused on discussing the current knowledge and understanding about the genetic disorders, such as down syndrome and its prevalence in Arab Worl d. The inclusion criteria that has been applied for the research is that only published studies and government reports are select for the purpose of this review. This inclusion criterion is applied in order to maintain the quality of the evidences. PubMed is specifically used to locate the articles, cross-sectional studies and quantitative studies for preparing this review. The statistically significant results can be appropriately obtained from the quantitative study. Therefore, the review has focused on finding and locating the appropriate and current studies that could provide the current rate of prevalence, incidence and effects of Down Syndrome in Arab World. Therefore, this review aims towards providing the effective and readable synthesis of the quality resources and could also help in enhancing the knowledge about the current area of research. The review also provides the directions for the future research in reference to down syndrome and its effect on population in Arab World. Methods The qualitative method and inductive approach has been used in preparing this review. Keyword research method have been used for locating the resources in PubMed. Some of the keywords that are used for locating the appropriate resources are Down syndrome, what is down syndrome, prevalence of down syndrome, risks associated with down syndrome, burden of down syndrome on population, incidence of down syndrome in Arab World, risk factors and down syndrome, prevalence of down syndrome in Arab World and reasons of down syndrome prevalence. Flowchart of the Final Number of Articles Retrieved for this Review Study Methodology is a very important approach for preparing the research articles and research studies. The key word search requires to enter the correct keywords and must be in line with the requirements and objectives of the study. The main objective of the study to provide the review of literature in order to find the evidences that can help in developing knowledge about the current scope and disease prevalence. Results This study is found to be significant because it provides important and current evidences related to down syndrome. The study also defines the genetic disorder, however, it lacks to provide the empirical evidences about the epidemiology of the down syndrome. This study can be beneficial in exploring the epigenetics associated with down syndrome. This is a very important study as it is focused on the Arab country and can help in informing about prevalence and epidemiology of down syndrome. UAE is a significant part of Arab World and a developed country. The prevalence of disease in this country provides a strong in sight about the reasons of disease occurrence and also inform that what challenges children have to face, who are suffering from down syndrome. This article helped in gaining the epidemiological information about disease. This study has been helpful in informing about the incidence and prevalence of down syndrome around the world. This study provides some strong evidences about the epidemiology of this genetic disorder and what are the major risk factors associated with it. However, the study lacks some significant empirical evidences. Study identifies down syndrome as the most common genetic disorder globally. One significant limitation of the study is that it provides the evidences from the sample of children from United States. This study is significant because it informs about the antenatal screening, which is significant for identifying the genetic disorder in babies. Screening is considered as the important and successfully developed as the biochemical marker and algorithms for identifying the risks mainly associated with trisomy 21 and 18. This study is very significant for increasing the awareness towards the process of screening that is mainly important in the Arab world, because the incidence of down syndrome in children is higher in Arab countries. This is a document that significantly address the issue of down syndrome in relation to Arab World. One significant limitation of the study is that it is not a journal article or papers, yet is associated with Arab Genomics, therefore, provides many significant evidence mainly associated with Arab countries. It provides the information about prevalence and incidence rate. The only limitation of the study is that it lacks empirical evidences from literature. The study discusses a very significant risk factor that results in high occurrence of down syndrome around the world. Study discusses the Consanguineous marriages as the significant risk factor for the occurrence of genetic disorder including down syndrome. This study is included in the research because Consanguineous marriages are customary and common in Arab World ad a significant reason of occurrence of down syndrome. This study is considered to be very important because its views the genetic disorder from the epidemiological perspective. It provides the prevalence data related to down syndrome in Arab world and also in many other countries. The limitation of the study is that it lacks empirical data. However, it also identifies the genetic and environmental factors that can result in causing down syndrome in children. However, study consider maternal age as an risk factor in occurrence of down syndrome. This study is conducted in Turkey, which is also a Muslim natation and also follows the traditions and belief according to people in Arab World. The author informs that down syndrome is the most common chromosome abnormality among the live births. Maternal age and lack of antenatal screening are considered as major risk factor. The study is a cross sectional study and provide empirical evidences. This study informs about the gap in literature, as very limited evidences are available on the prevalence of the congenital anomaliesin Middle East countries. This cross sectional study informs that prevalence of congenital anomalies in Saudi Arabian children is high because of the high consanguinity rate and high maternal age. This study is also important because it is community based and provide empirical evidences regarding the prevalence, incidence, risk factors and gaps in knowledge. This study compares the main characteristics of the individuals suffering from down syndrome with the normal subjects with the help of cephalometric radiographs. This study can be help in directing the future research regarding the treatment of individuals suffering with down syndrome. This study defines the down syndrome, however, lack data regarding the incidence and prevalence of the disease. This study is mainly focused on the prevalence and incidence of genetic disorder in Arab World. This study identifies the major risk factors such as high level of inbreeding, high maternal and paternal age and also large family sizes. This study found that there are various factors affecting the knowledge of people about disease. Therefore, it required that focus should be placed on enhancing knowledge and education of people and also improve the access of people to specialized genetic services. This study is very significant because it informs about the attitude of the people towards the individuals suffering from down syndrome. It explains about the burden of the disease on the people and their families. These evidences are important in order to design the future interventions for improving the life of people suffering with down syndrome in Arab nations. Name of Author and year Title Study Population Study Type Main Results Dekker, De Deyn, Rots,. (2017). Epigenetics and Down syndrome Cross sectional study The study help in explaining the genetic disorder of down syndrome and helps in providing the information about the genetic issues and epigenetics associated with down syndrome. Aburawi et al (2015) National growth charts for United Arab Emirates children with Down syndrome from birth to 15 years of age UAE Retrospective and cross-sectional growth study of Emirati children The incidence rate of down syndrome is found to be high in UAE. Study helps in explaining the others problems that children have to face with the genetic disorder of down syndrome. Sherman, S. L., Allen, E. G., Bean, L. H., Freeman, S. B. (2007). Epidemiology of Down syndrome Infants in United Nations Qualitative study Study provides the important information about the epidemiology of down syndrome. Study includes the information about the world prevalence rate of down syndrome and the risk associated with this genetic disease. Study determines the clinical cause, prevalence and incidence of down syndrome. Spencer, K. (2014). Screening for Down syndrome. United Kingdom Qualitative study Study informs about the definition and occurrence of down syndrome. Study also related the prevalence of down syndrome with the maternal age that is a significant factor for increasing the risk of disease. Centre for Arab Genomic Studies. (2013) Down Syndrome in the Arab world Arab population Review Study This study is very important as it provides the specific insight in the prevalence and epidemiology of down syndrome in Arab population Hamamy, Antonarakis, Cavalli-Sforza, Temtamy, Romeo, Ten Kate, Bathija,. (2011) Consanguineous marriages, pearls and perils: Geneva international consanguinity workshop report Geneva Qualitative review study The focus of the study is on the countries, where the consanguineous marriages are customary, which means the marriage in first cousins. This is a significant factor that affects the genetic factors of infants in Arab world. Study also explains that how such marriages and maternal age result in prevalence of down syndrome. Mohammed Al-Biltag (2015) Down syndrome from Epidemiologic Point of View World Population Review Study Study mainly focuses on informing about the various factors that affect the rate of occurrence of down syndrome across various population in different continents and countries. Paper recognized various genetic and environmental factors that result in increasing incidence of down syndrome in infants. Study also discussed potential risk factors. Acikbas, Tomatir, Akdag, Koksal, (2012) Retrospective analysis of live birth prevalence of children with Down syndrome in Denizli, Turkey Turkey Retrospective study Study examines the prevalence variation of down syndrome. Retrospective analysis of live birth prevalence of children with Down syndrome in Denizli, Turkey. study extracts the 16 years of the survey result to understand the prevalence and risk factors associated with down syndrome. AlSalloum et al (2015) Prevalence of selected congenital anomalies in Saudi children: a community-based study Saudi Children The stidy focused on the Saudi Children and also discussed the prevalence of the congenital anomalies in the children. Study found that down syndrome is the most common genetic congenital anomalies in the children and risk factors are maternal age and consanguineous marriages. Mohammed A. Korayema and Eman A. AlKofide. (2014) Characteristics of Down syndrome subjects in a Saudi sample Saudi Arabia Quantitative study The study focused on differentiating the characteristics of the individuals with down syndrome and compare them with the normal subjects. Study also provide the in-sight to many risk factors associated with this genetic disorder. Al-Gazali, Hamamy, Al-Arrayad, (2006). Genetic disorders in the Arab world Arab Population Cross Sectional Study The main findings of the study inform that genetic disorders are common in Arab countries that result in significant disabilities among individuals. Study informs that there is lack of interventions and programs directed towards the prevention of congenital and genetic disorders. Study also discussed that lack of antenatal screening also results in increasing the risk and prevalence of down syndrome. Sadeer G. Al-Kindi,Taha Al-Juhaishi,Atheer J. Al-Saffar. (2012) Community Attitudes Towards People with Downs Syndrome: A Sample From Iraq Iraq Cross-Sectional study The study used the self-administered questionnaire to understand the response of the people towards the inclusion of the people suffering from down syndrome in community. Study concludes that there is a need of organized campaigns and programs to increase awareness of people towards down syndrome. Discussion Down syndrome is considered and found to be the most common genetic disorder in the Arab World. The findings of the paper inform about various reasons that increases the risk of this genetic disorder in children. The findings of the study inform that some of the major reasons behind prevalence of this disorder are Consanguineous marriages, traditional and religious custom of marrying the first cousins, high maternal age and also multiparty. There are various genetic, environmental and social factors that can increase the prevalence of this disorder. Study found that antenatal screening is very helpful in finding the genetic disorder in the fetus and after knowing parents can terminate the pregnancy. However, due to religious and social restrictions and also due to economic and ethnic factors, abortion is not allowed and women have to give birth to children, even after knowing that child suffers from genetic disorder and will not be able to lead a normal life. In comparison to evidences from France and Europe, it has been found that abortion is allowed in France and Europe, therefore, the birth prevalence of down syndrome is reduced in these countries. For example, it was found that incidence rate of down syndrome in live births in Dubai is 1:319, it is 1:500 in Oman, 1:554 in Saudi Arabia, and 1 in 700 in Egypt in Egypt, while the incidence rate in China is 2/1000, 0.83/1000 in India and it is 1:1700 in Australia (due to high termination rate). Therefore, the above data informs that prevalence and incidence rate is higher in Arab countries. There are various reasons identified for high incidence and prevalence. One of the religious or cultural reason is that Arab people believe in making large families and giving birth to many children. Giving birth to many children through Consanguineous marriages affects the chromosomes and results in creating genetic anomalies. Also one reasons are that mother keep giving birth to children even after t he age of 40 and age is a significant risk factor. Therefore, maternal age affects the health and well-being of the children. Due to contemporary changes in the culture and society, one reason is that women are also now taking an active part in economy. Women are participating in receiving higher education and are making careers. This restricts them to give birth to children in early or appropriate age. Also, in many part of the Arab world, the population is still tribal and are uneducated. Therefore, they lack the significance of understanding the disease, disadvantages of giving birth to many children and understanding the importance of antenatal screening. The hereditary problems and genetic disorder in the tribal people increases the overall burden of the disease. Also, it has been found that 50% of the children that are born with the down syndrome disorder are born to mothers, who are 40 years or above in age. There is a significant gap in the literature, regarding the prevalence and major risk factors associated with it. It has also been found that there is a lack of extensive healthcare programs, campaigns and interventions that could encourage women more towards antenatal and premarital screening about chromosomal abnormality. The nation where the risk is higher and as it is scientifically proved, it becomes very significant to increase the awareness of people. There is also a lack of healthcare counselling that could be provides to the couples, in order to enhance their knowledge about this genetic disorder. Therefore, there is a significant loop hole on policy level. Another problem is identified on the social and legal level. For example, termination of pregnancy is not legally and religious allowed in the Arab countries, even when a ruling in 1990 allowed the termination of pregnancy in the first 120days, if the fetus was found to be significantly affected by sever malformation that could not be even improved after the treatment. However, people are still restricted from terminating pregnancy. Therefore, there is requirement of making a strong law and policy that could address such problem and may also help in reducing the prevalence of down syndrome in Arab countries. A family oriented approach is required to be designed and applied that could help in informing people about the risks of giving birth to large number of children and how proper screening approaches can benefit them in having healthy children. Also, the clinical screening of the new born can help the clinicians in detecting the abnormalities. 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