Does Ramadan Fasting Complicate Anticoagulation Therapy

Saour, Jalal; Sieck, Jens O.; Khan, Mehmood; Mammo, Layla

doi:10.5144/0256-4947.1989.538

Cited by 22 publications

(23 citation statements)

References 8 publications

(3 reference statements)

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“…As a corollary of these observations, routine testing of the hemostatic system in patients can be undertaken in Ramadan with no concern about any significant influence of the fast on the measured levels, as is the case with some biochemical [1][2][3][4][5][6][7] and hematological [3,6,8] parameters. Our study also strongly supports therecent findings of Saour et al [25] that Ramadan fasting has no adverse effect on the efficacy and safety of long-term oral anticoagulation. …”

supporting

confidence: 81%

The Effect of Fasting in Ramadan on Hemostatic Variables

Kordy

Gader

1991

Ann Saudi Med

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Hemostatic measurements were performed in 33 volunteers in the morning and afternoon in one day during the Muslim fasting month of Ramadan, and were then repeated on an ordinary nonfasting day. There were no significant diurnal fluctuations in plasmatic hemostatic parameters either in Ramadan or on a nonfasting day. There was no difference in the morning and afternoon platelet aggregation responses between Ramadan and the nonfasting period. However, aggregation responses to ADP (2 μM/L), adrenaline, collagen, and arachidonic acid were diminished during Ramadan as compared to the nonfasting day. It is concluded that the stress encountered during the Ramadan fast, as depicted in the platelet aggregation responses, is less than that encountered on an ordinary nonfasting day.MT Kordy, AGMA Gader, The Effect of Fasting in Ramadan on Hemostatic Variables. 1991; 11(1): 23-27 The fasting month of Ramadan is the ninth lunar month of the Muslim calendar. It is during this time when all Muslims are obliged to observe a dawn to sunset fast, but may consume any food and drink from sunset to dawn. Previous studies on the physiological responses to Ramadan fasting have documented biochemical [1][2][3][4][5][6][7], hematological [3,6,8], and hormonal [4] changes, but no studies have been done to investigate the responses of the hemostatic system. The total fast during an ordinary working day is stressful, and it is well established that a wide variety of stressful stimuli produce measurable effects on platelet function, coagulation, and fibrinolysis [9].We report the results of measurements of a variety of hemostatic variables, including platelet aggregation, in healthy volunteers observing the Ramadan fast. The same measurements were repeated in an ordinary working day. As far as we know, no similar study has been done before. Material and MethodsA total of 33 volunteers (30 males, 3 females) were studied (mean age, 32 ± 4.98 yr SD; mean weight, 69.9 ± 7.98 kg SD). They were members of the academic, technical, or clinical staff, or students at the College of Medicine, as well as members of the general public. Only three subjects smoked an average of less than 10 cigarettes per day; the rest were nonsmokers.Ramadan blood samples were obtained at 9:00 A.M. and 3:00 P.M., five and ten hours after the last intake of food or drink during a working day inthe third week of Ramadan (9:00 A.M. and 3:00 P.M. are the start and end of the working day during Ramadan). The same subjects were studied again during a nonfasting day (working hours, 7:30 A.M. to 4:30 P.M.), and blood samples were drawn at the same time of day as during the fasting period. The 7:30 A.M. sample was taken after the subject had ingested a cup of tea and biscuits but no fatty food; the 4:30 P.M. samples were collected approximately 2 to 3 hours after an ordinary lunch had been eaten. Blood samples were collected from an antecubital vein with the minimum of venous stasis and added to sodium citrate (0.11 M) in a vacutainer plastic tube (Sarstedt, West Germany) to ...

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confidence: 81%

The Effect of Fasting in Ramadan on Hemostatic Variables

Kordy

Gader

1991

Ann Saudi Med

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“…Long-acting oral anticoagulant medications could be employed as a single night-time dose without affecting the incidence of thromboembolic events or hemorrhagic complications. 89 As perhaps 400 million people fast each year during the month of Ramadan, further scientific research on the medical aspects of the Ramadan fast on health and disease is needed. Physicians practicing in Muslim countries and those caring for Muslims in various parts of the world should be aware of the physiological alterations during Ramadan, the effect of Islamic fasting on various disease conditions and pharmacodynamics of different medications during the Ramadan fast.…”

Section: Use Of Medications During Ramadanmentioning

confidence: 99%

Research in Islamic Fasting and Health

Azizi

2002

Ann Saudi Med

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Fasting during Ramadan is a religious duty for all healthy adult Muslims. Ramadan is the ninth month of the Islamic lunar calendar. Many of the world's great religions recommend a period of fasting or abstinence. The Islamic fast during the month of Ramadan during which a whole month is dedicated to fasting is particular to Islam, and is strictly observed by millions of Muslims worldwide. Since more than a billion people worldwide follow Islam, it is assumed that hundreds of millions of people observe the Ramadan fasting each year. The experience of fasting teaches Muslims self-discipline and self-restraint, and reminds them of the feelings of the impoverished. Fasting is not obligatory for children. Menstruating women as well as sick and travelling people are excused, and pregnant and lactating women are permitted to postpone the fasting during Ramadan, however, they should fast during another month of the year, when they have no reason for exemption. 1,2 During Ramadan, the majority of Muslims have two good-sized meals; one immediately after sunset and the other just before dawn. They are allowed to eat and drink between sunset and dawn but not after dawn. Since the Islamic calendar derives from a lunar cycle, the Islamic year contains 354 days. Therefore, the Ramadan month occurs 11 days earlier every year, and may occur in any of the four seasons, making the length of fasting hours variable from 11 to 18 hours in tropical countries. The month of Ramadan is either 29 or 30 days.From the physiological standpoint, Islamic fasting provides a unique model of fasting. It is distinct from regular voluntary or experimental fasting by the fact that the observant of the fast does not drink during fasting hours. In addition, Ramadan fasting is not just disciplining the body to restrain from eating and drinking. The eyes, ears, tongue, and indeed the whole body, are equally obligated to be restrained. Therefore, one may assume that physiological changes occurring during Islamic fasting would be different from those noted during an experimental fast. This review discusses the findings of research conducted on various aspects of Ramadan fasting and its impact on some disease processes. A comparison with the effects of experimental fasting is attempted whenever possible. The author conducted a Medline search, reviewed local journals in some of the Islamic countries, as well as some research findings from two international congresses on health and Ramadan. 3,4 Impact of Ramadan Fasting on Metabolism Carbohydrate MetabolismThe effects of experimental short-term fasting on carbohydrate metabolism have been reviewed extensively. 5,6The post-absorptive period of fasting is defined as 8 to 16 hours after eating, a period of very early adaptation to starvation. The primary metabolic priority of this period is the provision of adequate glucose for the cells of the brain, red blood cells, peripheral nerves and renal medulla. A slight decrease in serum glucose to around 3.3-3.9 mmol/L (60-70 mg/dL) occurs a few hours after fasting i...

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“…We thank Dr Skaik and his colleagues for their interest in our study [1,2] and sharing the works of Chamsi-Pasha et al [3] and Saour et al [4]. The former was an observational study that looked at general biochemical changes in cardiac patients who fasted.…”

Section: Disclosure Of Conflict Of Interestmentioning

confidence: 99%