Circadian rhythm of stroke onset during the month of Ramadan

El‐Mitwalli, Ashraf; Zaher, Ashraf Ahmed; Menshawi, E. El

doi:10.1111/j.1600-0404.2009.01265.x

Cited by 38 publications

(13 citation statements)

References 39 publications

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“…Most of the previous studies compared heterogeneous groups of patients (both ischemic stroke and intracerebral hemorrhage),20 and did not include a non‐fasting group at the time of Ramadan 19, 21, 22…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors include medical conditions (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, sleep apnea, and others), lifestyle (smoking, physical activity)12, 13 and environmental factors (air temperature and air pollution14, 15, 16, 17, 18). Ramadan associated changes such as poor drug therapy compliance; reduced glycemic control, and dehydration may temporarily contribute to stroke risk, yet such an increased stroke risk during Ramadan has not been reported 19, 20, 21, 22…”

mentioning

confidence: 99%

“…Ramadan associated changes such as poor drug therapy compliance; reduced glycemic control, and dehydration may temporarily contribute to stroke risk, yet such an increased stroke risk during Ramadan has not been reported. [19][20][21][22] It is estimated that 23% of the world population is Muslim. The understanding of Ramadan-associated stroke morbidity may have profound impact on stroke prevention; therefore, we sought to evaluate stroke risk during Ramadan using the Bedouin Arabs who reside in the Negev region as a Muslim sample group and adjusting for the environmental factors.…”

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confidence: 99%

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Increase in Ischemic Stroke Incident Hospitalizations Among Bedouin Arabs During Ramadan Month

Zimhony

Abu-Salameh

Sagy

et al. 2018

JAHA

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BackgroundPrevious 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 ResultsThis 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.ConclusionThe 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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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Increase in Ischemic Stroke Incident Hospitalizations Among Bedouin Arabs During Ramadan Month

Zimhony

Abu-Salameh

Sagy

et al. 2018

JAHA

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“…This study confirmed the findings from previous studies that the higher frequency of stroke onset time was from 6:00 AM to noon one month before Ramadan, whereas contrary to the previous studies, the frequency was higher from noon to 6:00 PM during Ramadan. They concluded that when fasting, the changes in food intake or sleep timings, affect the circadian rhythm and influence the onset time of acute coronary events (43).…”

Section: Discussionmentioning

confidence: 99%

Circadian Variation in the Incidence of Stroke-Induced Aphasia Types in Ahvaz, South-West of Iran

Zamani

Mousavi

Rezai

et al. 2015

Jentashapir J Health Res

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Background: The incidence of the stroke and its associated disorders has a multifactorial nature. Nowadays, researchers are looking for the relationship between circadian variations and the stroke incidence. Objectives: The current study aimed to compare the incidence of the different types of stroke-induced aphasia in Ahvaz, Iran, on seasonal, diurnal (weekly), and circadian variations. Patients and Methods:In this retrospective hospital-based study, the medical records of 1817 patients with stroke were reread in Ahvaz hospitals in 2011. Types of aphasia were diagnosed based on speech and language symptoms in their records. The data were transferred into the SPSS version 16, for statistical comparison. Results: According to the obtained results 39.9% of the studied patients had a stroke-induced aphasia. The highest incidence rates of aphasia due to the stroke in Ahvaz were, in the summer (38.2%), on Saturdays (16.1%), and 21.1% between 8:00 AM to noon. Chi-square test indicated a significant difference between the mentioned times and other time (P < 0.05). Conclusions: It seems that the incidence of different types of stroke-induced aphasia in Ahvaz is influenced by the calendar-temporal changes. According to the findings, to prevent the occurrence of stroke-induced aphasia, necessary counseling should be provided for lifestyle changes.

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“…Circadian periodicity in the onset of cerebrovascular events has been reported with a predominantly morning surge during the diurnal variability (1)(2)(3). But the effects of the periodicity on acute outcome have not been adequately addressed.…”

Section: Introductionmentioning

confidence: 99%

Is there any circadian variation consequence on acute case fatality of stroke? Takashima Stroke Registry, Japan (1990-2003)

Turin

Kita

Rumana

et al. 2011

Acta Neurologica Scandinavica

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Circadian rhythm of stroke onset during the month of Ramadan

Abstract: A significant shift of the circadian pattern of stroke onset time from the period between 6:00 a.m. and noon to that between noon and 6:00 pm has been found during the month of Ramadan.

Cited by 38 publications

References 39 publications

Increase in Ischemic Stroke Incident Hospitalizations Among Bedouin Arabs During Ramadan Month

Increase in Ischemic Stroke Incident Hospitalizations Among Bedouin Arabs During Ramadan Month

Circadian Variation in the Incidence of Stroke-Induced Aphasia Types in Ahvaz, South-West of Iran

Is there any circadian variation consequence on acute case fatality of stroke? Takashima Stroke Registry, Japan (1990-2003)

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