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Beshyah AS, Elamouri JS, Almagdub I, Abdulrahman H, Hafidh K, Beshyah SA. Burden and Patterns of Medical Emergencies during Ramadan Fasting: A Narrative Review. IBNOSINA JOURNAL OF MEDICINE AND BIOMEDICAL SCIENCES 2023. [DOI: 10.1055/s-0043-1764355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
Abstract
Introduction Acute medical problems may occur more frequently during Ramadan fasting (RF). We aimed to provide a narrative overview of the global literature on medical emergencies during RF.
Methods This is a nonsystematic review of the international literature from one major medical online database (PubMed, National Institutes of Health, United States). The relevant literature was narrated in a concise thematic account.
Results There is a variable impact in the burden and time distribution of emergency services and hospitalization during RF that may require readjustment of resource allocation. Studies of the risk of accidents and injuries may be increased overall or at specified times, around Iftar time. A classical impact of emergencies has been the risk of worsening peptic ulcer disease. RF impacts diabetic emergencies such as severe hypoglycemia, hyperglycemia, and diabetic ketoacidosis, particularly in type 1 diabetes and poorly controlled patients. Glucocorticoid replacement therapy may represent a challenge to patients and physicians that require education and dose adjustment. Acute neurological conditions of interest include the “first day of Ramadan headache,” epilepsy, and strokes. Several studies evaluated the risk of the acute coronary syndrome and heart failure with inconsistent findings. RF may impact the renal and urological systems through stone disease, renal colic, and acute kidney. The impact on hematological conditions was mostly focused on the safety of anticoagulant therapy during Ramadan.
Conclusion The review addresses the emergency medical encounters of the fasting patient during Ramadan to allow a holistic and ethnically sensitive approach to medical care under circumstances where decisions have to be taken with no delay.
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Affiliation(s)
- Anas S. Beshyah
- Department of Gastroenterology, Wythenshawe Hospital, Manchester, United Kingdom
| | - Jamila S. Elamouri
- Nephrology Unit, Department of Internal Medicine, Tripoli Central Hospital, Tripoli, Libya
| | - Ihab Almagdub
- Department of Medicine, Sheikh Khalifa Medical City, SEHA, Abu Dhabi, United Arab Emirates
| | - Husen Abdulrahman
- Department of Medicine, Sheikh Khalifa Medical City, SEHA, Abu Dhabi, United Arab Emirates
| | - Khadija Hafidh
- Department of Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
| | - Salem A. Beshyah
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
- Department of Medicine, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
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Hassanein M, Al Sifri S, Al Awadi F, Alessa T, Shaaban A. A Real-World Study in Patients with Type 2 Diabetes Treated with Gliclazide Modified Release during Fasting in Gulf Cooperation Council Countries: An Analysis from the International DIA-RAMADAN Study. DUBAI DIABETES AND ENDOCRINOLOGY JOURNAL 2022. [DOI: 10.1159/000525074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> The safety and effectiveness of gliclazide modified release (MR) in patients with type 2 diabetes mellitus (T2DM) who fasted during Ramadan were previously published. Here, we carried out a regional analysis among patients living in Gulf Cooperation Council (GCC) countries. <b><i>Patients and Methods:</i></b> DIA-RAMADAN was a real-world, observational, international, noncomparative study conducted in nine countries that included >1200 T2DM adults receiving gliclazide MR for at least 90 days before inclusion. The study comprised 2 visits: at inclusion, 6–8 weeks before the start of Ramadan (V0) and 4–6 weeks after the end of Ramadan (V1). The primary endpoint was the proportion of patients reporting ≥1 symptomatic hypoglycemic event as collected using a patient diary. Changes in HbA<sub>1c</sub>, fasting plasma glucose (FPG), and weight were also analyzed. This manuscript represents data collected in GCC countries (Kuwait, Saudi Arabia, and United Arab Emirates). <b><i>Results:</i></b> Data from 161 patients were analyzed: mean (SD) age 56.8 (10.6) years, 30.4% women, body mass index 29.1 (3.7) kg/m<sup>2</sup>, T2DM disease duration 6.7 (3.3) years, baseline HbA1c 7.9% (0.8). The proportions of patients reporting ≥1 symptomatic hypoglycemic event or confirmed hypoglycemia during Ramadan were 4.3% and 0.6%, respectively. No cases of severe hypoglycemia were reported. Significant reductions in main variables were observed before the start of Ramadan (V0) and 4–6 weeks after the end of Ramadan (V1): HbA1c (from 7.9 [0.8] to 7.6 [0.7]%; <i>p</i> value <0.001), FPG (from 143.5 [24.3] to 137.9 [25.2] mg/dL; <i>p</i> value = 0.031), and weight (from 79.0 [73.0–86.0] to 78.0 [72.0–85.0] kg; <i>p</i> value = 0.018). <b><i>Conclusions:</i></b> These real-world data indicate that patients with T2DM treated with gliclazide MR during Ramadan in the selected GCC countries have a low risk of hypoglycemia and maintain glycemic control and weight while fasting.
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Radwan AB, Paramparambath S, Cabibihan JJ, Al-Ali AK, Kasak P, Shakoor RA, Malik RA, Mansour SA, Sadasivuni KK. Superior Non-Invasive Glucose Sensor Using Bimetallic CuNi Nanospecies Coated Mesoporous Carbon. BIOSENSORS 2021; 11:bios11110463. [PMID: 34821679 PMCID: PMC8615784 DOI: 10.3390/bios11110463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 05/14/2023]
Abstract
The assessment of blood glucose levels is necessary for the diagnosis and management of diabetes. The accurate quantification of serum or plasma glucose relies on enzymatic and nonenzymatic methods utilizing electrochemical biosensors. Current research efforts are focused on enhancing the non-invasive detection of glucose in sweat with accuracy, high sensitivity, and stability. In this work, nanostructured mesoporous carbon coupled with glucose oxidase (GOx) increased the direct electron transfer to the electrode surface. A mixed alloy of CuNi nanoparticle-coated mesoporous carbon (CuNi-MC) was synthesized using a hydrothermal process followed by annealing at 700 °C under the flow of argon gas. The prepared catalyst's crystal structure and morphology were explored using X-ray diffraction and high-resolution transmission electron microscopy. The electrocatalytic activity of the as-prepared catalyst was investigated using cyclic voltammetry (CV) and amperometry. The findings show an excellent response time of 4 s and linear range detection from 0.005 to 0.45 mM with a high electrode sensitivity of 11.7 ± 0.061 mA mM cm-2 in a selective medium.
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Affiliation(s)
- Ahmed Bahgat Radwan
- Center for Advanced Materials (CAM), Qatar University, Doha P.O. Box 2713, Qatar; (S.P.); (P.K.); (R.A.S.)
- Correspondence: (A.B.R.); (K.K.S.)
| | - Sreedevi Paramparambath
- Center for Advanced Materials (CAM), Qatar University, Doha P.O. Box 2713, Qatar; (S.P.); (P.K.); (R.A.S.)
| | - John-John Cabibihan
- Department of Mechanical and Industrial Engineering, Qatar University, Doha P.O. Box 2713, Qatar;
| | - Abdulaziz Khalid Al-Ali
- Department of Computer Engineering, Qatar University, Doha P.O. Box 2713, Qatar;
- KINDI Center for Computing Research, Qatar University, Doha, P.O. Box 2713, Qatar
| | - Peter Kasak
- Center for Advanced Materials (CAM), Qatar University, Doha P.O. Box 2713, Qatar; (S.P.); (P.K.); (R.A.S.)
| | - Rana A. Shakoor
- Center for Advanced Materials (CAM), Qatar University, Doha P.O. Box 2713, Qatar; (S.P.); (P.K.); (R.A.S.)
| | - Rayaz A. Malik
- Weill Cornell Medicine-Qatar, Qatar Foundation-Education City, Doha P.O. Box 24144, Qatar;
| | - Said A. Mansour
- Qatar Energy and Environment Research Institute, Hamad bin Khalifa University, Qatar Foundation, Doha P.O. Box 34110, Qatar;
| | - Kishor Kumar Sadasivuni
- Center for Advanced Materials (CAM), Qatar University, Doha P.O. Box 2713, Qatar; (S.P.); (P.K.); (R.A.S.)
- Correspondence: (A.B.R.); (K.K.S.)
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