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Pishbin E, Ziyaei M, Vafadar Moradi E, Foroughipour M, Javadzadeh R, Foroughian M. Ten-year Causes of Cerebral Venous Sinus Thrombosis in Patients Referred to Ghaem Hospital from 2009 to 2019. Bull Emerg Trauma 2024; 12:8-14. [PMID: 38689792 PMCID: PMC11057450 DOI: 10.30476/beat.2024.100510.1472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/13/2023] [Accepted: 12/27/2023] [Indexed: 05/02/2024] Open
Abstract
Objective Cerebral Venous Sinus Thrombosis (CVST), a complex and infrequent cerebrovascular disorder characterized by the formation of clots within the cerebral venous sinuses, occurs as a result of multiple risk factors and casualties, and its epidemiological picture should be investigated. Methods This descriptive study was conducted retrospectively on patients with a final diagnosis of cerebral vein thrombosis, who were referred to the emergency room of Ghaem Hospital (Mashhad, Iran) between 2009 and 2019. The study included all patients with cerebral vein thrombosis who were older than 18 years. Clinical symptoms and causes were documented and contrasted according to demographics. Results During the 10 years of this study, 749 cases of cerebral vein thrombosis were observed, with women accounting for the majority (72.8%). The most prevalent symptom was headache (554 cases; 74.0%), followed by seizures (23.1%), blurred vision (16.0%), nausea (7.5%), vomiting (6.9%), double nose (4.9%), and dizziness (3.3%). There was no significant difference in the frequency of symptoms between the two genders (p<0.05). The most commonly identified risk factors were OCP (110 cases; 14.7%), followed by infection (103 cases; 13.8%), malignancies (78 cases; 10.4%), and fasting (15 cases; 2.0%). There was no significant difference in risk factors between the two genders, with the exception that all cases of fasting were in women, and the differences were significant (p=0.015). The most common site of involvement according to Magnetic Resonance Venography (MRV) was the upper sagittal sinus (427 cases; 57.0%). There was no significant difference in terms of the site of the conflict between the two genders (p<0.05). Conclusion The findings of the present study showed that deep vein thrombosis occurred mainly in women and manifested itself mostly as a headache. Moreover, the upper sagittal sinus was the most common site of involvement.
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Affiliation(s)
- Elham Pishbin
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Ziyaei
- Department of Emergency Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Elnaz Vafadar Moradi
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Foroughipour
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Rahim Javadzadeh
- Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Foroughian
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Jahrami H, Trabelsi K, Alhaj OA, Saif Z, Pandi-Perumal SR, BaHammam AS. The impact of Ramadan fasting on the metabolic syndrome severity in relation to ethnicity and sex: Results of a systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2022; 32:2714-2729. [PMID: 36333203 DOI: 10.1016/j.numecd.2022.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
Abstract
AIMS The primary goal of this meta-analysis was to examine the changes in various components of metabolic syndrome (MetS) in healthy adults who observed Ramadan fasting (RF) before Ramadan (T1) and at the end of RF (T2). A secondary goal was to assess the impact of RF on MetS severity in various ethnic and sex groups using the MetS z-score. DATA SYNTHESIS Using PRISMA2020, seven databases were searched for relevant studies published between January 1950 and March 2022. Data extraction involved high-density lipoprotein cholesterol (HDL), triglycerides (TG), fasting blood glucose (FBG), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) for T1 and T2, respectively. The MetS z-score was computed according to international diabetes federation criteria. At T1, the pooled estimates of HDL, TG, FBG, WC, SBP, DBP, and MAP were 1.20 [1.13; 1.27] mmol/L, 1.32 [1.23; 1.42] mmol/L, 4.98 [4.82; 5.15] mmol/L, 87.21 [84.21; 90.21] Cm, 114.22 [101.45; 126.99] mmHg, 76.80 [70.12; 83.47] mmHg, and 89.27 [80.56; 97.98] mmHg, respectively. At T2, the pooled estimates of HDL, TG, FBG, WC, SBP, DBP, and MAP were 1.24 [1.18; 1.31] mmol/L, 1.24 [1.14; 1.34] mmol/L, 4.77 [4.55; 4.99] mmol/L, 85.73 [82.83; 88.64] Cm, 109.48 [97.20; 121.75] mmHg, 74.43 [68.01; 80.85] mmHg, and 86.11 [77.74; 94.48] mmHg, respectively. The MetS z-score showed improvement at T2 for all ethnic groups and both sexes by -0.22 [-0.24; -0.01]. CONCLUSIONS The current meta-analysis suggests that the RF positively impact the MetS components and the overall MetS z-score. PROSPERO REGISTRATION NUMBER ID CRD42022329297 OPEN SCIENCE FRAMEWORK IDENTIFIER: DOI 10.17605/OSF.IO/U9H7T.
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Affiliation(s)
- Haitham Jahrami
- Ministry of Health, Manama, Bahrain; Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax 3000, Tunisia.
| | - Omar A Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan.
| | | | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., College Street, Toronto, Canada; Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.
| | - Ahmed S BaHammam
- The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia; Department of Medicine, University Sleep Disorders Center and Pulmonary Service, King Saud University, Riyadh, KSA6, Saudi Arabia.
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3
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Trabelsi K, Ammar A, Boujelbane MA, Puce L, Garbarino S, Scoditti E, Boukhris O, Khanfir S, Clark CCT, Glenn JM, Alhaj OA, Jahrami H, Chtourou H, Bragazzi NL. Religious fasting and its impacts on individual, public, and planetary health: Fasting as a "religious health asset" for a healthier, more equitable, and sustainable society. Front Nutr 2022; 9:1036496. [PMID: 36505246 PMCID: PMC9729557 DOI: 10.3389/fnut.2022.1036496] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/26/2022] [Indexed: 11/25/2022] Open
Abstract
Religious fasting is practiced by people of all faiths, including Christianity, Islam, Buddhism, Jainism, as well as Hinduism, Judaism, and Taoism. Individual/clinical, public, global, and planetary health has traditionally been studied as separate entities. Nevertheless, religious fasting, in conjunction with other religious health assets, can provide several opportunities, ranging from the individual to the population, environmental, and planetary levels, by facilitating and supporting societal transformations and changes, such as the adoption of healthier, more equitable, and sustainable lifestyles, therein preserving the Earth's systems and addressing major interconnected, cascading, and compound challenges. In this review, we will summarize the most recent evidence on the effects of religious fasting, particularly Orthodox and Ramadan Islamic fasting, on human and public health. Further, we will explore the potential effects of religious fasting on tackling current environmental issues, with a special focus on nutrition/food restriction and planetary health. Finally, specific recommendations, particularly around dietary intake during the fasting rituals, will be provided to ensure a sustainable healthy planet.
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Affiliation(s)
- Khaled Trabelsi
- Research Laboratory: Education, Motricity, Sport and Health, Sfax, Tunisia
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- UFR SESS-STAPS, Paris-East Créteil University, LIRTES (EA 7313), Créteil, France
| | - Mohamed Ali Boujelbane
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Luca Puce
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Egeria Scoditti
- National Research Council, Institute of Clinical Physiology, Lecce, Italy
| | - Omar Boukhris
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Saber Khanfir
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Jordan M. Glenn
- Department of Health, Exercise Science Research Center Human Performance and Recreation, University of Arkansas, Fayetteville, AR, United States
| | - Omar A. Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Haitham Jahrami
- Department of Psychiatry, Ministry of Health, Manama, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Hamdi Chtourou
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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The Association between Acute Myocardial Infarction-Related Outcomes and the Ramadan Period: A Retrospective Population-Based Study. J Clin Med 2022; 11:jcm11175145. [PMID: 36079072 PMCID: PMC9457160 DOI: 10.3390/jcm11175145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/22/2022] [Accepted: 08/28/2022] [Indexed: 11/24/2022] Open
Abstract
Fasting throughout the Muslim month of Ramadan may impact cardiovascular health. This study examines the association between the Ramadan period and acute myocardial infarction (AMI)-related outcomes among a Muslim population. The data were retrospectively extracted from a tertiary hospital (Beer-Sheva, Israel) database from 2002–2017, evaluating Muslim patients who endured AMI. The study periods for each year were: one month preceding Ramadan (reference period (RP)), the month of Ramadan, and two months thereafter (1840 days in total). A comparison of adjusted incidence rates between the study periods was performed using generalized linear models; one-month post-AMI mortality data were compared using a generalized estimating equation. Out of 5848 AMI hospitalizations, 877 of the patients were Muslims. No difference in AMI incidence between the Ramadan and RP was found (p = 0.893). However, in the one-month post-Ramadan period, AMI incidence demonstrably increased (AdjIRR = 3.068, p = 0.018) compared to the RP. Additionally, the highest risk of mortality was observed among the patients that underwent AMI in the one-month post-Ramadan period (AdjOR = 1.977, p = 0.004) compared to the RP. The subgroup analyses found Ramadan to differentially correlate with AMI mortality with respect to smoking, age, sex, diabetes mellitus, and hypertension, suggesting the Ramadan period is a risk factor for adverse AMI-related outcomes among select Muslim patients.
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Aydin E, Aydin S, Gül M, Yetim M, Demir M, Özkan C, Karakurt M, Burak C, Bayraktar MF, Temizer O, Erbay İ, Muştu M, Karagöz A, Üzoğullari İR, Şen T, Özeke Ö, Topaloğlu S, Aras D, Tanboğa Hİ. Influence of Intermittent Fasting During Ramadan on Circadian Variation of Symptom-Onset and Prehospital Time Delay in Acute ST-Segment Elevation Myocardial Infarction. Angiology 2022; 74:569-578. [PMID: 35975875 DOI: 10.1177/00033197221114087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ramadan interferes with circadian rhythms mainly by disturbing the routine patterns of feeding and smoking. The objective of this study was to investigate the circadian pattern of ST elevation acute myocardial infarction (STEMI) during the month of Ramadan. We studied consecutive STEMI patients 1 month before and after Ramadan (non-Ramadan group-NRG) and during Ramadan (Ramadan group-RG). The RG group was also divided into two groups, based on whether they chose to fast: fasting (FG) and non-fasting group (NFG). The time of STEMI onset was compared. A total of 742 consecutive STEMI patients were classified into 4 groups by 6 h intervals according to time-of-day at symptom onset. No consistent circadian variation in the onset of STEMI was observed both between the RG (P = .938) and NRG (P = .766) or between the FG (P = .232) and NFG (P = .523). When analyzed for subgroups of the study sample, neither smoking nor diabetes showed circadian rhythm. There was a trend towards a delay from symptom onset to hospital presentation, particularly at evening hours in the RG compared with the control group. In conclusion, there was no significant difference in STEMI onset time, but the time from symptom onset to hospital admission was significantly delayed during Ramadan.
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Affiliation(s)
- Ertan Aydin
- Cardiology, Prof. Dr A. İlhan Özdemir Training and Research Hospital, Giresun University, Giresun, Turkey
| | | | - Murat Gül
- Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Mucahit Yetim
- Cardiology, Erol Olçok Training and Research Hospital, Hitit University, Çorum, Turkey
| | - Mevlüt Demir
- Cardiology, Evliya Celebi Training and Research Hospital, Kütahya Health Sciences University, Kutahya, Turkey
| | - Can Özkan
- Cardiology, Muş State Hospital, Muş, Turkey
| | - Mustafa Karakurt
- Cardiology, Kırıkkale Yuksek Ihtisas Hospital, Kırıkkale, Turkey
| | - Cengiz Burak
- Cardiology, Faculty of Medicine, 485644Kafkas University, Kars, Turkey
| | | | | | - İlke Erbay
- Cardiology, Muş State Hospital, Muş, Turkey
| | - Mehmet Muştu
- Cardiology, Faculty of Medicine, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Ahmet Karagöz
- Cardiology, Prof. Dr A. İlhan Özdemir Training and Research Hospital, Giresun University, Giresun, Turkey
| | | | - Taner Şen
- Cardiology, Evliya Celebi Training and Research Hospital, Kütahya Health Sciences University, Kutahya, Turkey
| | - Özcan Özeke
- Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serkan Topaloğlu
- Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Dursun Aras
- Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Alotaibi N, Aldriweesh MA, Alhasson MA, Albdah BA, Aldbas AA, Alluhidan WA, Alsaif SA, Almutairi FM, Alskaini MA, Al Khathaami AM. Clinical characteristics and outcomes of ischemic stroke patients during Ramadan vs. non-Ramadan months: Is there a difference? Front Neurol 2022; 13:925764. [PMID: 35937074 PMCID: PMC9353707 DOI: 10.3389/fneur.2022.925764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To study the clinical characteristics and outcomes of patients experiencing an ischemic stroke during Ramadan vs. non-Ramadan months in a tertiary academic center in an Islamic country. Methods We retrospectively reviewed all patients with ischemic stroke (IS) in Ramadan and non-Ramadan months for four consecutive years (February 2016–June 2019). All demographics, vascular risk factors, laboratory results, modified Rankin Scale (mRS) at admission and discharge, National Institute Stroke Scale (NIHSS), and in-hospital complication data were collected for all patients. Results One thousand and 58 patients were included (non-Ramadan, n = 960; during Ramadan, n = 98). The mean age during Ramadan was 59 ± 13 years. Most non-Ramadan IS patients during Ramadan were male (68.5%; 57.1%, respectively). There was no statistical difference in vascular risk factors and medical history between the two groups. However, Ramadan patients had higher median NIHSS scores at discharge (p = 0.0045). In addition, more ICU admissions were noted among Ramadan patients (p = 0.009). In the gender-specific analysis for Ramadan patients, we found a statistically significant difference in smoking and urinary tract infection (p = 0.006, p = 0.005, respectively). Conclusion Based on our results, there was no difference, in general, between patients with IS during Ramadan and non-Ramadan months. However, IS patients had higher NIHSS scores at discharge and more ICU admissions during Ramadan. Last, we suggest future studies with larger sample sizes, longer duration, and including all types of strokes.
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Affiliation(s)
- Naser Alotaibi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed A. Aldriweesh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Muath A. Alhasson
- Unaizah College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Bayan A. Albdah
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulaziz A. Aldbas
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Waleed A. Alluhidan
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | | | - Faisal M. Almutairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed A. Alskaini
- Department of Neurology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ali M. Al Khathaami
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
- *Correspondence: Ali M. Al Khathaami ;
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Feng J, Zhang S, Li W, Bai T, Liu Y, Chang X. Intermittent Fasting to the Eye: A New Dimension Involved in Physiological and Pathological Changes. Front Med (Lausanne) 2022; 9:867624. [PMID: 35685418 PMCID: PMC9171076 DOI: 10.3389/fmed.2022.867624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/25/2022] [Indexed: 12/01/2022] Open
Abstract
Intermittent fasting (IF) is gaining popularity as a therapeutic dietary strategy that regulates metabolism and can alter the development of metabolic disorders. An increasing amount of research has connected ocular diseases to IF and discovered that it has a direct and indirect effect on the eye’s physiological structure and pathological alterations. This article summarizes the progress of research on IF in regulating the physiological structures of the ocular vasculature, the anterior segment of the eye, the retina, and the choroid. We explored the therapeutic potential of IF for various common ocular diseases. In the future, a comprehensive study into the fundamental processes of IF will provide a direct and rigorous approach to eye disease prevention and therapy.
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Affiliation(s)
- Jiaqing Feng
- The First Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Shijiao Zhang
- The First Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Wenning Li
- The First Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Tianle Bai
- The First Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Yulin Liu
- The First Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Xingyu Chang
- The First Clinical Medical College, Lanzhou University, Lanzhou, China
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Mahmood A, Dar S, Dabhad A, Aksi B, Chowdhury TA. Advising patients with existing conditions about fasting during Ramadan. BMJ 2022; 376:e063613. [PMID: 35101897 DOI: 10.1136/bmj-2020-063613] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Ammad Mahmood
- Institute of Neurosciences and Psychology, University of Glasgow, Imaging Centre of Excellence, Queen Elizabeth University Hospital, Glasgow
| | - Sahira Dar
- NHS Greater Glasgow and Clyde Primary Care Division, Glasgow
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Abstract
Fasting Ramadan, in which Muslims abstain from specific habits and behaviors from dawn to sunset, is one of the five Pillars of Islam. While there are several exemptions from fasting, many Muslim patients with acute or chronic medical conditions still choose to fast, which may adversely affect their health if not addressed properly. Some patients may not be well educated about the effects of some medical treatments and procedures on the validity of their fast, which can unnecessarily lead to suboptimal management of their conditions or treatment nonadherence. Since spirituality, religiosity, and personal beliefs affect patients' health behaviors and adherence to treatments, health-care providers need to learn how fasting Ramadan can affect the health of their Muslim patients, especially those with chronic medical conditions, and how to help them achieve safe fasting. This article aims to provide an overview of the main topics that primary care physicians may need to know in order to improve their cultural competence when caring for their fasting Muslim patients.
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Affiliation(s)
- Heba Abolaban
- Massachusetts Department of Public Health, Care Coordination Program, Boston, MA, USA
| | - Ahmad Al-Moujahed
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
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Gaeini Z, Mirmiran P, Bahadoran Z. Effects of Ramadan intermittent fasting on leptin and adiponectin: a systematic review and meta-analysis. Hormones (Athens) 2021; 20:237-246. [PMID: 33786736 DOI: 10.1007/s42000-021-00285-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 03/17/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Ramadan intermittent fasting may affect whole-body metabolism by affecting appetite-related hormones. This systematic review and meta-analysis aimed to clarify the possible effects of Ramadan intermittent fasting on the main hormones regulating appetite and satiety, including leptin and adiponectin. METHODS All English language papers in the PubMed, Scopus, and Embase databases were searched using the keywords "Ramadan fasting", "adiponectin", and "leptin", up to 2020. Data extraction was conducted based on the main data of the studies; the primary outcomes of the analysis were mean changes of adiponectin and leptin levels during the holy month of Ramadan in fasted subjects. MAIN RESULTS Data of 16 eligible studies, conducted between 2003 and 2020, were included in the systematic review. Of these, 10 studies with complete data on leptin and adiponectin were included in the meta-analysis. A significant decrease in leptin levels was observed after Ramadan fasting (WMD = -2.28 ng/ml, 95% CI = -3.72, -0.84). Ramadan fasting had no significant effect on adiponectin levels (WMD = 2.19 ng/ml, 95% CI = -0.29, 4.67). Sub-group analysis demonstrated a greater decrease in leptin levels among normal-weight subjects compared to those of overweight/obese subjects (WMD = -4.67 ng/ml, 95% CI = -6.03, -3.31 vs. WMD = -3.43 ng/ml, 95% CI = -5.69, -1.17). CONCLUSION Ramadan fasting may decrease leptin levels, especially in normal-weight subjects. There was high heterogeneity, which may be explained by the differences between the wide ranges of study conditions.
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Affiliation(s)
- Zahra Gaeini
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Human Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran.
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An observational study of the occurrence of acute coronary syndrome (ACS) among jordanian patients: Identifying the influence of Ramadan Fasting. Ann Med Surg (Lond) 2020; 59:171-175. [PMID: 33082945 PMCID: PMC7554320 DOI: 10.1016/j.amsu.2020.09.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/08/2020] [Accepted: 09/18/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction Patients with Acute Coronary Syndrome (ACS) tend to face several health issues during the Holy month of Ramadan, due to the change in dietary patterns. This study aims to investigate the influence of fasting during Ramadan on the occurrence of ACS. Methods The study followed a retrospective observational design, and was conducted in King Abdullah University Hospital (KAUH) of Jordan, during the period of June 06, 2016 to Aug 08, 2016 and May 27, 2017 to July 27, 2017. Data was collected from a sample of 226 male and female patients, aged between 20 and 80 years with major diagnosis of acute coronary syndrome. Therefore, this is a case series of ACS patients. Results Findings of the study indicated that, Ramadan fasting is insignificantly related to the occurrence of ACS, since no significant difference was found in the incidence of hypertension (65%), diabetes (51.7%), unstable angina (56.6%) and coronary artery disease (CAD) (57.6%) findings during and after Ramadan respectively. Similar, findings were attained for patients' final diagnosis which had normal Kidney Function Test (KFT) (72.5%), platelets (91.5%), and Ejection Fraction (EF) (64.6%). Also, no significant difference was found between patients' smoking status (61.0%), hospital stay (89.8%) and discharge rate (96.9%). Conclusion The study concluded that there is an insignificant association of Ramadan fasting on the cardiac patients and occurrence of acute coronary syndrome.
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Sarro AA, Payedimarri AB, Concina DD, Farsoni MF, Piu NN, Rinaldi C, Panella MP. The efficacy of fasting regimens on health outcomes: a systematic overview. Minerva Gastroenterol (Torino) 2020; 67:289-298. [PMID: 32914941 DOI: 10.23736/s2724-5985.20.02757-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Fasting can be defined as abstinence or reduction from food, drink, or both, for a defined period. There are many different types of fasting regimens, such as Ramadan fasting, intermittent fasting, Christian Orthodox fasting. The aim of this overview is to provide an exhaustive summary on the beneficial effects and harms associated with fasting regimens and discuss mechanisms by which this non-pharmacological approach might lead to improve human health. EVIDENCE ACQUISITION A systematic search was performed on MEDLINE (PubMed), Embase, Cochrane Library and CINHAL. We included systematic reviews (SRs) that report on impact of different types of fasting regimens on health. Selection of SRs, data extraction and quality assessment were undertaken in duplicate. EVIDENCE SYNTHESIS A total of 21 SRs were included. Cumulatively, 97 health outcomes were identified. Of them, cardiovascular risk factors were the most frequently analyzed. Ramadan fasting is associated with significant improvements in body weight and visceral lean mass, high-density lipoprotein cholesterol (HDL-c), and with reductions in low-density lipoprotein cholesterol (LDL-c) and total cholesterol (T-chol), especially in cardiac patients. Similarly, reviews on Intermittent and Orthodox fasting proved benefits of those on weight, BMI, lipidic and glucose profile, inflammatory markers. CONCLUSIONS Fasting regimens showed potential beneficial effects on several health indicators in adult populations. Nevertheless, evidence on some specific health dimensions (cognitive function, well-being, quality of life) is limited. Thus, in the future, further RCTs or cohort studies with good methodological quality and larger sample sizes are warranted to better understand the underlying biological mechanism and the benefits on multidimensional aspects of health.
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Affiliation(s)
- Andrea A Sarro
- Department of Translational Medicine (DIMET), University of Eastern Piedmont, Novara, Italy -
| | - Anil B Payedimarri
- Department of Translational Medicine (DIMET), University of Eastern Piedmont, Novara, Italy
| | - Diego D Concina
- Department of Translational Medicine (DIMET), University of Eastern Piedmont, Novara, Italy
| | - Marco F Farsoni
- Department of Translational Medicine (DIMET), University of Eastern Piedmont, Novara, Italy
| | - Nicola N Piu
- Department of Translational Medicine (DIMET), University of Eastern Piedmont, Novara, Italy
| | - Carmela Rinaldi
- Department of Translational Medicine (DIMET), University of Eastern Piedmont, Novara, Italy.,Maggiore della Carità University Hospital, Novara, Italy
| | - Massimiliano P Panella
- Department of Translational Medicine (DIMET), University of Eastern Piedmont, Novara, Italy
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13
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Iqbal MD, Askari S, Ahmedani MY. The frequency of major complications among fasting people with diabetes according to risk categories of IDF-DAR guidelines 2016. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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BaHammam AS, Almeneessier AS. Recent Evidence on the Impact of Ramadan Diurnal Intermittent Fasting, Mealtime, and Circadian Rhythm on Cardiometabolic Risk: A Review. Front Nutr 2020; 7:28. [PMID: 32219098 PMCID: PMC7078334 DOI: 10.3389/fnut.2020.00028] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/26/2020] [Indexed: 01/09/2023] Open
Abstract
In this article, we reviewed recent data that examined the relationship of circadian rhythm, mealtime, and intermittent fasting with the risk of cardiometabolic dysfunction. We also examined the effect of their interactions on cardiometabolic risks. Furthermore, since major differences exists between Ramadan diurnal intermittent fasting compared to other forms of experimental intermittent fasting, in this article, we further restricted the discussion to Ramadan diurnal intermittent fasting. PubMed and Google Scholar databases were searched using “intermittent fasting,” “time-restricted feeding,” “fasting,” “mealtime,” “circadian rhythm,” and “cardiometabolic risk,” focusing on human studies published after 2013. Recent evidence indicates that meal timing may influence circadian rhythm, as a result, it may also directly or indirectly impact cardiometabolic risk. In humans, several studies suggested that late mealtime is related to an increased risk of poor cardiometabolic health. Nevertheless, large clinical interventional studies are required to assess causality between late mealtime and cardiometabolic morbidity. Currently, evidence indicates that Ramadan diurnal intermittent fasting has several beneficial effects that may reduce the risk of cardiometabolic disorders, such as weight reduction, improvement in lipid profile and glycemic control, reduction in proinflammatory markers, and oxidative stress. Nevertheless, several changes in daily lifestyle routine, happening during the Ramadan month, may affect the all measured markers of cardiometabolic diseases. Summarily, no definitive conclusion about the impact of Ramadan intermittent fasting on oxidative stress can be formulated. Therefore, large, well-designed studies, which control for various confounding factors are required to assess the influence of Ramadan diurnal intermittent fasting on markers of cardiometabolic risk and disorders.
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Affiliation(s)
- Ahmed S BaHammam
- Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Aljohara S Almeneessier
- Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Department of Family Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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15
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Pellegrini M, Cioffi I, Evangelista A, Ponzo V, Goitre I, Ciccone G, Ghigo E, Bo S. Effects of time-restricted feeding on body weight and metabolism. A systematic review and meta-analysis. Rev Endocr Metab Disord 2020; 21:17-33. [PMID: 31808043 DOI: 10.1007/s11154-019-09524-w] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Restriction in meal timing has emerged as a promising dietary approach for the management of obesity and dysmetabolic diseases. The present systematic review and meta-analysis summarized the most recent evidence on the effect of time-restricted feeding (TRF) on weight-loss and cardiometabolic variables in comparison with unrestricted-time regimens. Studies involving TRF regimen were systematically searched up to January 2019. Effect size was expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). A total of 11 studies, 5 randomized controlled trials and 6 observational, were included. All selected studies had a control group without time restriction; hours of fasting ranged from 12-h until 20-h and study duration from 4 to 8-weeks. Most studies involved the Ramadan fasting. TRF determined a greater weight-loss than control regimens (11 studies, n = 485 subjects) (WMD: -1.07 kg, 95%CI: -1.74 to -0.40; p = 0.002; I2 = 56.2%), unrelated to study design. The subgroup analysis showed an inverse association between TRF and fat free mass in observational studies (WMD: -1.33 kg, 95%CI: -2.55 to -0.11; p = 0.03; I2 = 0%). An overall significant reduction in fasting glucose concentrations was observed with TRF regimens (7 studies, n = 363 subjects) (WMD: -1.71 mg/dL, 95%CI: -3.20 to -0.21; p = 0.03; I2 = 0%), above all in trials (WMD:-2.45 mg/dL, 95%CI: -4.72 to -0.17; p = 0.03; I2 = 0%). No between-group differences in the other variables were found. TRF regimens achieved a superior effect in promoting weight-loss and reducing fasting glucose compared to approaches with unrestricted time in meal consumption. However, long-term and well-designed trials are needed to draw definitive conclusions.
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Affiliation(s)
- Marianna Pellegrini
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy
| | - Iolanda Cioffi
- Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Andrea Evangelista
- Unit of Clinical Epidemiology, CPO, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Valentina Ponzo
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy
| | - Ilaria Goitre
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy
| | - Giovannino Ciccone
- Unit of Clinical Epidemiology, CPO, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Ezio Ghigo
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy
| | - Simona Bo
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy.
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16
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Almulhem M, Susarla R, Alabdulaali L, Khunti K, Karamat MA, Rasiah T, Tahrani AA, Hanif W, Nirantharakumar K. The effect of Ramadan fasting on cardiovascular events and risk factors in patients with type 2 diabetes: A systematic review. Diabetes Res Clin Pract 2020; 159:107918. [PMID: 31711857 DOI: 10.1016/j.diabres.2019.107918] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/02/2019] [Accepted: 11/05/2019] [Indexed: 12/21/2022]
Abstract
Ramadan is the fasting month in Islam. Muslims around the world observe Ramadan every year, including people with diabetes. Data on the association of fasting in people with diabetes are sparse. The purpose of this study is to assess the association of fasting on cardiovascular risk factors and events in people with diabetes. A comprehensive search was conducted in the following database: Embase, Medline, Cochrane library and CINAHL. The following key terms were used: Ramadan, Ramazan, Ramadhan, Muslim, Islam and fasting. Studies were eligible if they included people with Type 2 diabetes who fasted during Ramadan and reporting results on cardiovascular risk factors or events. Overall 22 studies met inclusion criteria for the review; five studies reported cardiovascular outcomes and 17 reported changes in risk factors. There is insufficient evidence to link Ramadan fasting with increased or reduced incidence of cardiovascular events in people with diabetes, though there were some indication stroke risk may be increased. Findings were inconsistent in term of risk factors as some favoured Ramadan and others did not..
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Affiliation(s)
- Munerah Almulhem
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, UK
| | - Radhika Susarla
- Institute of Translational Medicine, University of Birmingham, UK
| | - Luluh Alabdulaali
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | | | | | - Thayakaran Rasiah
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, UK
| | - Abd A Tahrani
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, UK.
| | - Wasim Hanif
- Diabetes Department, University Hospitals Birmingham NHS Foundation Trust, UK.
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17
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Faris MAIE, Jahrami HA, Alhayki FA, Alkhawaja NA, Ali AM, Aljeeb SH, Abdulghani IH, BaHammam AS. Effect of diurnal fasting on sleep during Ramadan: a systematic review and meta-analysis. Sleep Breath 2019; 24:771-782. [PMID: 31832984 DOI: 10.1007/s11325-019-01986-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/19/2019] [Accepted: 11/25/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE The current meta-analysis aimed to obtain a more stable estimate of the effect size of Ramadan diurnal intermittent fasting (RDF) on sleep duration and daytime sleepiness. METHODS Databases (Scopus, ScienceDirect, ProQuest Medical, PubMed/MEDLINE, Web of Science, EBSCOhost, Cochrane, CINAHL, and Google Scholar) were searched from database inception to the end of June 2019. The sleep quality measures analyzed were excessive daytime sleepiness (EDS) measured by the Epworth sleepiness scale (ESS) and total sleep time (TST). Subgroup analyses for age, sex, and levels of physical activity were conducted. RESULTS We identified 24 studies (involving 646 participants, median age 23.7 years, 73% men) conducted in 12 countries from 2001 to 2019. The results revealed that TST decreased from 7.2 h per night [95% confidence interval (CI) 6.7-7.8] before Ramadan to 6.4 h (95% CI 5.3-7.5) during Ramadan, while the ESS score increased slightly from 6.1 (95% CI 4.5-7.7) before Ramadan to 7.0 (95% CI 5.2-8.8) during Ramadan. Effect sizes on sleep quality measures during RDF demonstrated a moderate reduction in TST (number of studies, K = 22; number of subjects, N = 571, Hedges' g value of -0.43, 95% CI - 0.64 to -0.22, Q = 90, τ2 = 0.15, I2 = 78%, P < 0.001), while ESS score showed negligible effect on EDS (K = 9, N = 362, Hedges' g value of -0.06, 95% CI -0.43 to 0.28, Q = 21, τ2 = 0.13, I2 = 76%, P value = 0.001). CONCLUSION During the month of Ramadan, there is approximately a 1 hour reduction in TST and nearly a 1 point increase in the ESS score.
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Affiliation(s)
- Mo'ez Al-Islam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Haitham A Jahrami
- Ministry of Health, Manama, Bahrain.,College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Fatema A Alhayki
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Noor A Alkhawaja
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ameera M Ali
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Shaima H Aljeeb
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Israa H Abdulghani
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ahmed S BaHammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia. .,The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia.
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18
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Lessan N, Ali T. Energy Metabolism and Intermittent Fasting: The Ramadan Perspective. Nutrients 2019; 11:nu11051192. [PMID: 31137899 PMCID: PMC6566767 DOI: 10.3390/nu11051192] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/06/2019] [Accepted: 05/09/2019] [Indexed: 01/06/2023] Open
Abstract
Intermittent fasting (IF) has been gaining popularity as a means of losing weight. The Ramadan fast (RF) is a form of IF practiced by millions of adult Muslims globally for a whole lunar month every year. It entails a major shift from normal eating patterns to exclusive nocturnal eating. RF is a state of intermittent liver glycogen depletion and repletion. The earlier (morning) part of the fasting day is marked by dominance of carbohydrate as the main fuel, but lipid becomes more important towards the afternoon and as the time for breaking the fast at sunset (iftar) gets closer. The practice of observing Ramadan fasting is accompanied by changes in sleeping and activity patterns, as well as circadian rhythms of hormones including cortisol, insulin, leptin, ghrelin, growth hormone, prolactin, sex hormones, and adiponectin. Few studies have investigated energy expenditure in the context of RF including resting metabolic rate (RMR) and total energy expenditure (TEE) and found no significant changes with RF. Changes in activity and sleeping patterns however do occur and are different from non-Ramadan days. Weight changes in the context of Ramadan fast are variable and typically modest with wise inter-individual variation. As well as its direct relevance to many religious observers, understanding intermittent fasting may have implications on weight loss strategies with even broader potential implications. This review examines current knowledge on different aspects of energy balance in RF, as a common model to learn from and also map out strategies for healthier outcomes in such settings.
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Affiliation(s)
- Nader Lessan
- Imperial College London Diabetes Center (ICLDC), Abu Dhabi, UAE.
| | - Tomader Ali
- Imperial College London Diabetes Center (ICLDC), Abu Dhabi, UAE.
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19
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Uyar E, Dogan U, Ulas F, Celebi S. Effect of Fasting on Choroidal Thickness and Its Diurnal Variation. Curr Eye Res 2019; 44:695-700. [DOI: 10.1080/02713683.2019.1584677] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Enes Uyar
- Department of Ophthalmology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Umit Dogan
- Department of Ophthalmology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Fatih Ulas
- Department of Ophthalmology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Serdal Celebi
- Department of Ophthalmology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
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20
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Elbarsha A, Elhemri M, Lawgaly SA, Rajab A, Almoghrabi B, Elmehdawia RR. Outcomes and hospital admission patterns in patients with diabetes during Ramadan versus a non-fasting period. Ann Saudi Med 2018; 38:344-351. [PMID: 30284989 PMCID: PMC6180216 DOI: 10.5144/0256-4947.2018.344] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Fasting during Ramadan is a challenge for Muslim patients with diabetes and for their healthcare providers. However, data on the effects of Ramadan fasting on hospital admissions and outcomes in patients with diabetes are scarce. OBJECTIVES Evaluate the characteristics of patients with diabetes admitted during the fasting month of Ramadan compared with the non-fasting month of Dhu al-Qidah. DESIGN A retrospective cohort study medical record review. SETTING A university teaching hospital. PATIENTS AND METHODS We reviewed the records of all patients with diabetes admitted to the medical department at Benghazi Medical Center, including medical ward, intensive care unit and coronary care unit, during the months of Ramadan and Dhu al-Qidah, 2016. We compared differences in reasons for admission, length of stay and in-hospital mortality between patients admitted during Ramadan and Dhu al-Qidah and between patients who were fasting at time of admission during Ramadan and those who were not. MAIN OUTCOME MEASURES Main reason for admission, length of stay and in-hospital mortality rate. SAMPLE SIZE 402 patients with diabetes. RESULTS During Ramadan, 186 patients were admitted compared with 216 during Dhul al-Qidah. There was no statistically significant difference in reasons for admission, length of hospital stay, or in-hospital mortality (borderline for mortality, P=.078), between patients with diabetes admitted during Ramadan and Dhu al-Qidah. Of those admitted in Ramadan, 59.1% were fasting on admission. Fasting patients admitted during Ramadan had a significantly higher proportion of the diseases of the circulatory system when compared with non-fasting patients (39.4% vs. 23.6%, P=.028) while in-hospital mortality was higher in non-fasting patients (29.2% vs. 8.7%, P less than .001). There was no significant difference in length of stay between fasting and non-fasting patients. CONCLUSIONS The frequency of admissions for most medical con.ditions were not changed during Ramadan but the frequency of acute coronary syndrome was higher in those who were fasting on admission. Patients with diabetes who were not fasting on admission had more high-risk features that prevented them from fasting and therefore are at increased risk of in-hospital mortality. LIMITATIONS Single center and retrospective. CONFLICT OF INTEREST None.
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Affiliation(s)
- Abdulwahab Elbarsha
- Dr. Abdulwahab Elbarsha, Department of Medicine, Benghazi Medical Center,, Second Ring Road, Foyhat,, Benghazi, Libya , ORCID: http://orcid.org/0000-0001-5973.308X
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21
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Zimhony N, Abu-Salameh I, Sagy I, Dizitzer Y, Oxman L, Yitshak-Sade M, Novack V, Horev A, Ifergane G. Increase in Ischemic Stroke Incident Hospitalizations Among Bedouin Arabs During Ramadan Month. J Am Heart Assoc 2018; 7:JAHA.117.008018. [PMID: 29728012 PMCID: PMC6015316 DOI: 10.1161/jaha.117.008018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Previous studies have not shown any significant effect on stroke incidence during Ramadan. We aimed to investigate the association between ischemic stroke incident hospitalizations and Ramadan, accounting for seasonality and temperature. Methods and Results This retrospective cohort study included all patients admitted with acute ischemic stroke to Soroka University Medical Center from June 2012 to June 2016. We obtained daily mean temperatures and relative humidity rates from 2 monitoring stations in South Israel. We analyzed the association between stroke incidence and Ramadan month, adjusting for weekly temperature and seasonality using Poisson regression models. We compared the first versus the last Ramadan fortnight. We performed an effect specificity analysis by assessing stroke incidence in the non‐Bedouin population. We identified 4727 cases of ischemic stroke, 564 cases of which were Bedouin Arabs. Fifty‐one cases occurred during Ramadan. Ramadan was significantly associated with an increased risk for ischemic stroke (RR 1.48; 95% confidence interval, 1.04–2.09), mainly during the first fortnight (RR 1.73, 95% confidence interval, 1.13–2.66) when compared with non‐Ramadan periods. Mean weekly temperatures and the summer season were not associated with stroke incidence among Bedouin Arabs (RR 0.98; 95% confidence interval, 0.82–1.18 and RR 0.77; confidence interval 0.56–1.06 accordingly). Such association was not observed in the non‐Bedouin population. Conclusion The Ramadan month, particularly in its first 2 weeks, is an independent and ethnicity specific risk factor for ischemic stroke hospitalizations among the Bedouin Arab fasting population.
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Affiliation(s)
- Noa Zimhony
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Ibrahim Abu-Salameh
- Department of Neurology, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Iftach Sagy
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Yotam Dizitzer
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Liat Oxman
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Maayan Yitshak-Sade
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.,Department of Environmental Health, Exposure, Epidemiology, and Risk Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Victor Novack
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Anat Horev
- Department of Neurology, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Gal Ifergane
- Department of Neurology, Soroka University Medical Center, Beer-Sheva, Israel .,Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
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Bastani A, Rajabi S, Kianimarkani F. The Effects of Fasting During Ramadan on the Concentration of Serotonin, Dopamine, Brain-Derived Neurotrophic Factor and Nerve Growth Factor. Neurol Int 2017; 9:7043. [PMID: 28713531 PMCID: PMC5505095 DOI: 10.4081/ni.2017.7043] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/24/2017] [Accepted: 05/17/2017] [Indexed: 11/25/2022] Open
Abstract
Neurotransmitters and neurotrophic factors are signaling molecules that play a crucial role in cell proliferation, differentiation, survival and functions of neurons. It is believed that caloric restriction could help the health of the nervous system by affecting the synthesis of neurotrophins and neurotransmitter and oxygen radical metabolism. The objective was to investigate the plasma levels of serotonin, dopamine, brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) in 29 healthy fasted subjects (22 women and 7 men) during the month of fasting in Ramadan. The levels of these factors were measured (using ELISA method) three times, 2 days before the fasting month as a control, on the 14th and 29th day of Ramadan as test groups. In addition, these factors were investigated in the group of women only. According to our investigation, the plasma levels of serotonin, BDNF and NGF were significantly increased during fasting month of Ramadan. In detail, the levels of these factors were increased in 14th and 29th day test groups compared to controls (P<0.05). Moreover, these levels were significantly increased on the 29th day compared to the 14th day test groups, but there were no differences between dopamine levels in all groups. Furthermore, the results obtained in women's groups were the same as those obtained in previous groups. Our findings suggest that plasma levels of serotonin, BDNF and NGF were significantly increased during fasting month of Ramadan.
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Affiliation(s)
- Abdolhossein Bastani
- Biochemistry Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadegh Rajabi
- Biochemistry Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Kianimarkani
- Biochemistry Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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