Ramadan Periods Research Articles

Transient increase in glucose variability during Ramadan fasting in patients with insulin-treated type 2 diabetes: A preliminary study

AimWe aimed to examine the effect of Ramadan fasting on interstitial glucose control and variability before, during, and after Ramadan in type 2 diabetes patients receiving insulin therapy. MethodsParticipants received a flash glucose monitoring (FGM) system one week before Ramadan that was removed on the sixth or seventh day (pre- and early Ramadan periods) of Ramadan and a second FGM system one week before the end of Ramadan that was removed one week after the end of Ramadan (late and post-Ramadan periods). Fasting blood samples were collected during the pre-, early, and late Ramadan study visits and tested for HbA1c, serum creatinine, and plasma glucose levels. ResultsThirty-four patients were prospectively included. The standard deviation and coefficient of variation of glucose concentrations were higher in the early Ramadan period than in the pre-Ramadan period, but did not differ in the late or post-Ramadan periods. Changes in the early Ramadan period were restricted to males and patients aged <55 years. No significant changes were observed in the average glucose level, glucose management indicator, time in range, time in hyperglycemia, or time in hypoglycemia at any time point. ConclusionsRamadan fasting in patients with insulin-treated type 2 diabetes is associated with an initial increase in glucose variability that quickly returned to pre-Ramadan levels. Ramadan fasting was not associated with any significant changes in glycemic control measures.

A Thirty-Minute Nap Enhances Performance in Running-Based Anaerobic Sprint Tests during and after Ramadan Observance.

The purpose of this study was to determine the impact of a 30 min nap (N30) on the Running-Based Anaerobic Sprint Test (RAST) both during and after Ramadan. Ten physically active kickboxers (age: 21.20 ± 1.61 years, height: 174.80 ± 4.34 cm, body mass: 73.30 ± 7.10 kg and body mass index (BMI): 24.00 ± 2.21 kg/m2) voluntarily performed the RAST test after an N30 and in a no-nap condition (NN) during two experimental periods: the last ten days of Ramadan (DR) and ∼3 weeks after Ramadan (AR). During each DR-NN, DR-N30, AR-NN and AR-N30 protocol, kickboxers performed RAST performance. A statistically significant difference was found between Ramadan periods (DR vs. AR) in terms of max power (W) (F = 80.93; p1 &lt; 0.001; η2p = 0.89), minimum power (W) (F = 49.05; p1 &lt; 0.001; η2p = 0.84), average power (W) (F = 83.79; p1 &lt; 0.001; η2p = 0.90) and fatigue index (%) results (F = 11.25; p1 = 0.008; η2p = 0.55). In addition, the nap factor was statistically significant in terms of the max power (W) (F = 81.89; p2 &lt; 0.001; η2p = 0.90), minimum power (W) (F = 80.37; p2 &lt; 0.001; η2p = 0.89), average power (W) (F = 108.41; p2 &lt; 0.001; η2p = 0.92) and fatigue index (%) results (F = 16.14; p2 = 0.003; η2p = 0.64). Taking a daytime nap benefits subsequent performance in RAST. The benefits of napping were greater after an N30 opportunity for DR and AR.

A Real-World Observational Study of Gla-300 in Adults with Type 2 Diabetes Who Fast During Ramadan in the South Asia Region: A Subgroup Analysis of the ORION Study

IntroductionIn this ORION study subgroup analysis, the safety and effectiveness of insulin glargine 300 U/mL (Gla-300) was evaluated in people from the South Asia region with type 2 diabetes mellitus (T2DM) before, during, and after Ramadan, in a real-world setting.MethodsThe ORION study was a real-world, prospective, observational, non-comparative study conducted across 11 countries. The current subgroup analysis included participants from the South Asia region (India and Pakistan) who fasted during Ramadan. The primary endpoint was the percentage of participants experiencing ≥ 1 event of severe and/or symptomatic documented hypoglycemia with self-monitored plasma glucose (SMPG) ≤ 70 mg/dL during Ramadan. Secondary endpoints analyzed were changes in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), SMPG, insulin dose, and adverse events (AEs).ResultsThis subgroup analysis included 106 participants from the South Asia region with mean (standard deviation) age of 51.3 (10.9) years and mean number of 29.8 (4.0) fasting days. The number of severe and/or symptomatic documented hypoglycemia events was low in the pre-Ramadan (SMPG ≤ 70 mg/dL: 1 event [0.9%]; SMPG < 54 mg/dL: 1 event [0.9%]) and Ramadan periods (SMPG ≤ 70 mg/dL: 1 event [0.9%]; SMPG < 54 mg/dL: 0 events), and none in the post-Ramadan period. One participant reported severe hypoglycemia (any time of the day: nocturnal or daytime) throughout the pre-Ramadan period. A reduction in HbA1c and FPG levels was seen during the pre- to post-Ramadan period; however, a slight increase in SMPG levels was reported during this same period. Gla-300 daily dose was reduced from 21.6 (9.6) U to 20.2 (8.9) U during the pre-Ramadan to Ramadan period. The incidence of AEs was 1.9%.ConclusionsThe real-world data from the ORION study indicate that Gla-300 is effective, with low risk of hypoglycemia, for the management of T2DM during Ramadan in the South Asian population.Trial RegistrationCTRI/2019/02/017636.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-022-01234-y.

Does fasting during Ramadan influence the therapeutic effect of warfarin?

The changes in the therapeutic effect of warfarin during Ramadan fasting are controversial. Hence, we carried out the present study to assess if there are any alterations in the anticoagulation response to warfarin and identify the associated risk factors. Patients receiving warfarin for at least 1year were included in the present study. Their demographic details, warfarin doses, prothrombin time-international normalized ratio (PT-INR) values and concomitant diseases/drugs were retrieved. The dates of Ramadan periods for the calendar years were obtained, and these periods were considered as Ramadan periods. One month before the start dates of Ramadan was considered as pre-Ramadan, and 1month later than the last dates was considered as post-Ramadan periods. Warfarin sensitivity index (WSI), PT-INR category and time spent in therapeutic range (TTR) were assessed. National Institute of Clinical Health Excellence (NICE) criteria for anticoagulation status were adhered to where TTR (%) <65 was considered as poor anticoagulation. One hundred and eighty-three patients were recruited. No significant differences were observed in warfarin doses between the study participants between pre-Ramadan, Ramadan and post-Ramadan periods. Significantly more numbers of PT-INR tests were carried out during Ramadan compared with pre- and post-Ramadan periods. A higher WSI was akin to PT-INR, and lower intra-individual variability was observed in middle-aged and older adults in the post-Ramadan period. Significantly fewer patients had their PT-INR in the therapeutic range and more in the subtherapeutic range during Ramadan periods. Greater proportion of patients had PT-INR in the supratherapeutic range during post-Ramadan periods, particularly the elderly. Although 38.3% had poor anticoagulation status overall, 92.4% met the NICE criteria for poor anticoagulation during the 3months (pre-Ramadan, Ramadan and post-Ramadan periods). Ramadan fasting influences the therapeutic effect of warfarin in terms of lowered TTR (%), reduced proportion of patients achieving therapeutic PT-INR and increased risk of poor anticoagulation control. Greater caution is required during the post-Ramadan period, particularly in the elderly category as they are more prone for over-anticoagulation and consequently the risk of bleeding.

Health and Safety in Crowded Large Size Buildings: The Effect of Perceived Safety on User Behaviour in the Holy Mosque

Abstract Crowded large space buildings are today becoming highly desirable facilities for communities, towns, and cities. Due to stricter health, safety requirements, and environmental effects, such buildings are of greater interest for research. The buildings are used for a variety of functions, including sporting, entertainment, and religious events. The Holy Mosque in Makkah Saudi Arabia is an excellent example of a crowded large space building with a maximum capacity reaching up to 2 million users, especially at the Hajj and Ramadan periods. Quite often, designer and facility managers of crowded large space buildings pay keen attention to normative and substantive (objective) safety, but research shows that perceived (subjective) safety which should also be important, is clear overlooked. To prove the significance of perceived safety, a theory has been adopted, which states that a reduction in perceived safety (PS) will negatively affect the user behaviour (UB) resulting in the occurrence of a disaster in crowded large size buildings. Initial research undertaken by the authors have identified 10 key factors affecting subjective safety in crowded large space buildings, this stage of the study is an empirical study to aimed at establishing how significant each factor affects PS and the effect of perceived safety on the UB in such types of buildings. The Holy Mosque was used as a case study. The research adopted the quantitative research methodology by collecting primary data using a group-administered questionnaire in electronic devices such as iPad from more than 1,940 Hajj pilgrims coming from 62 countries. This was analysed by SPSS and AMOS 22 for confirmatory factor analysis (CFA) and structural equation modeling (SEM) to test the interrelationships between the 10 identified factors and PS or between PS and UB through several hypotheses. The research has demonstrated that there is a significant influence on PS by most of the established factors and that PS has a significant influence on the behaviour of pilgrims in the Holy Mosque.

Impact of Ramadan on Physical Activity and Sleeping Patterns in Individuals with Type2 Diabetes: The First Study Using Fitbit Device.

IntroductionThe impact of Ramadan fasting, a type of intermittent fasting, on the management of diabetes has not been well investigated. Physical activity, sleep duration, and time of sleep are susceptible to alterations during Ramadan due to the changes in the times and numbers of meals. This study compared physical activity and sleep patterns of individuals with type 2 diabetes mellitus (T2DM) during and after Ramadan using the international physical activity questionnaire (IPAQ) and a Fitbit Flex 2 accelerometer.MethodsSaudi individuals (n = 36) with T2DM completed a self-reported questionnaire and wore a Fitbit device for seven consecutive days during and after Ramadan. Fitbit generated weekly step counts, activity intensities, sedentary time, and sleep durations and times. IPAQ was used to estimate the physical activity and sitting time of participants in each period. Sleep patterns were assessed in each period by a self-reported questionnaire.ResultsBoth Fitbit and IPAQ indicated a high prevalence of low physical activity among the participants with non-significant variances between the during and after Ramadan periods. Also, a significant short daily total sleeping hours and daily night-time sleeping hours was seen during the Ramadan period. The duration of night-time sleep was observed to be low in each period.ConclusionsThis is the first study to use a Fitbit device to monitor individuals with T2DM who chose to fast during Ramadan. The study shows a high prevalence of low physical activity among Saudi individuals with T2DM in each period, and short sleep durations in the during Ramadan period compared to after Ramadan period. A high prevalence of short night-time sleep duration and excessive daytime sleeping was observed in both periods and significantly in the during Ramadan period. A larger study is needed in the future covering before, during, and after Ramadan to evaluate the impact of lifestyle changes related to Ramadan fasting on type 2 diabetes.Electronic Supplementary MaterialThe online version of this article (10.1007/s13300-020-00825-x) contains supplementary material, which is available to authorized users.

Effects of Ramadan Fasting in Patients with Chronic Myeloid Leukemia in Chronic Phase

Background Chronic myeloid leukemia (CML), is a clonal bone marrow stem cell disorder that accounts for 10% of all leukemias. Generally, CML is one of the best examples of effective targeted therapy. Today, the overall survival of patients with CML treated by using tyrosine kinase inhibitors (TKIs) is very close to that of the healthy population. However, little is known about the effect of certain measures such as fasting especially during Ramadan period. In Islam, Ramadan fasting represents one of the five pillars of creed and considered as a mandatory religious duty, although in some instances among which, patients are exempted from observing this duty. The day fasting hours in Ramadan varies according to the geographical location of countries from 11 to 22 hours. To the best of our knowledge, this is the first quantatative study evaluating the effects of Ramadan fasting on patients with CML on TKIs. Objectives The main objective of this study was to evaluate the effect of fasting on CML patients receiving TKIs by evaluating their clinical course, hematological parameters, and BCR-ABL levels. Patients &amp; Methods A retrospective study was conducted by reviewing medical records for adult Muslim patients with CML in the state of Qatar, who fasted Ramadan month during the period of 2016, 2017 and 2018, therefore we evaluated: 1) Complete Blood Count before, during, and after Ramadan. 2) BCR /ABL level before, during, and after Ramadan. 3) Any loss of hematological response or clinical evidence of disease progression like increase in spleen size during Ramadan. Patients were retrospectively asked and confirmed that they're fasting during Ramadan period by a telephone call made by the study team. Results A total of 49 patients fulfilled the criteria of the study, with median age of 46 years (range from 22-86), of these 36 (73.5%) were males and 13 (26.5%) were females, with ratio of 2.8 : 1. 27 (55.1%) patients are middle eastern, while 16 (32.7%) patients came from the Indian subcontinent, and 6 (12.25) patients were black. Multiple TKIs were used, imatinib was the most common TKI; used in 25 patients (51%), nilotinib in 15 patients (30.6%), dasatinib in 8 patients (16.3%) and ponatinib used only in one patient. Repeated measure analysis of variance (ANOVA) statistical analysis showed that the mean White blood count, neutrophils and BCR-ABL was found to be reduced after Ramadan period compared to before and during Ramadan period, however their difference was statistically insignificant (P&gt;0.05). Mean platelet, hemoglobin, basophils and eosinophils values appeared to have similar trend before, during and after Ramadan periods. Unpaired t test revealed that the mean values of the most of the hematological parameters among male was found to be higher compared to females. Age was found to be negatively correlated (low to moderate correlation) with all hematological parameters and BCR-ABL levels (Pearson correlation (r) ranges from -0.10 to -0.46). Conclusion TKIs use during fasting in Ramadan period is poorly studied with scarce data. The use of TKIs during fasting in Ramadan period did not result in significant changes in hematological indices nor in BCR-ABL levels in our study. Patients who wish to fast during Ramadan period may be reassured in this regard, yet physicians can adopt the safe trial approach, where they allow the patients to fast, but with instructions as when to break fasting. On the other hand, further research is needed to reach a definite conclusion. Table Disclosures No relevant conflicts of interest to declare.

Measuring the effects of marketing expenses and external factors on housing sales transaction

Purpose- In recent years, with the support of urban regeneration movements, the real estate sector has become one of the locomotive sectors in terms of economic and social development, particularly for the developing countries. When the real estate sector is examined, it is seen that the housing sector, which directly touches to the end user and is considered sometimes for use sometimes for the investment purposes, comes to the forefront. It is observed that the competition among the developer firms also increased in parallel with the investments made. In this study, the 2004-2017 period was examined, the statistical models were created to help the developers in developing the housing marketing strategies, the marketing strategies affecting the house sales trends and the external factors were highlighted. Our paper is the first academic study that identifies this relationship in Turkish housing market. Methodology- Within the scope of this study; R programming language and Wilcoxon Rank was used to analyze the different housing marketing campaigns of one of the pioneer real estate firms in Turkey and their effect on the sales figures; the rank sum test was conducted; and, the VAR models were constructed and Impulse Response analysis, Pearson Correlation Coefficient were used for the relationship analyses. Findings- According to the results of the study, it is seen that the social events, long-term holidays, rainfall and snowfall, campaigns of the competitors have no statistically significant effect on the net sales and gross income. However, it was determined that the Ramadan period and the digital marketing had a significant effect on the net sales and gross income. It is determined that the use of outdoor billboard, which is expected to affect the housing sales, was inversely proportional to the net sales and gross income, that is, it had a negative effect when applied. Conclusion- It is thought that this study can be more improved as a result of including the followings into the model: more detailed classification of the social events, remodeling the Ramadan periods according to either they coincide with the summer month or the winter month, assessment of the effect of rainfall and snowfall considering the climate zone Turkey is in, more detailed analysis of the effect of the campaign of competitors, that the effect of digital marketing will be higher as the technology develops. It is expected that the modeling of the findings reached in this study (or which will be detailed in later studies) by using an algorithm will provide a cost-benefit optimization.

Month of Ramadan effect swings and market becomes adaptive

PurposeThis paper aims to enhance the existing literature on adaptive market hypothesis (AMH) as this study first time links the month of Ramadan with AMH that permits the performance of well-known Ramadan effect to fluctuate over time.Design/methodology/approachTo fulfill the purpose, the authors inspect the daily returns of 107 individual firms listed at Pakistan Stock Exchange over the period of 20 years. To explore the varying degree of return predictability during Ramadan, the authors use four different subsamples comprising equal length of observations of five years each. The authors use a GARCH (1,1) regression model which facilitates for time varying nature of volatility in equity returns. To facilitate the non-normal nature of stock return data, the authors use Kruskal–Wallis test statistic.FindingsThe authors find that behavior of Ramadan effect evolves over time, as performance of this effect varies from time to time and consistent with AMH. Finally, the paper proposes that AMH is well elucidation of behavior of Ramadan effect than traditional efficient market hypothesis.Research limitations/implicationsFirst limitation is related to the choice of sub-sample as the study uses a sub-sample of five years. Second, the authors ignore transection cost (commissions, fee and taxes) as it is freely negotiated and varies between 4 and 10% (Khan, 2013). Due to such varying information we ignore the transaction cost. It is suggested that a sub-sample analysis of long period may be a more appropriate method to elucidate the idea of AMH in future research and suggest the current method could be adapted and helpful to examine other calendar and market anomalies in different equity markets.Practical implicationsThe paper includes implications for investors to choose a better model for investment. Investors can exploit greater returns in future month of Ramadan periods. Furthermore, the researchers can easily extend the methodology used in the study to address multiple issues like adaptive behavior of returns from bonds, real estate investment trusts, cryptocurrencies and trading rules of strategies.Social implicationsStudy confirms from sample t-test and GARCH (1,1) model that Ramadan effect is present in the full and in certain sub-samples; therefore, based on these discrepancies investors can earn abnormal returns by developing specific investment strategies as investors usually make investments in share according to the religious context of Islamic Calendar. The results provide good references for suitable time of investment in stock market. The findings of this study will be helpful to investors and brokers as well as portfolio managers to capture favorable returns across the Islamic calendar.Originality/valueThe paper identified need to study why behavior of Ramadan effect varies over time. The data set comprises daily returns of 107 individual companies over the period of 20 years to better investigate the varying nature of anomalous effect of month of Ramadan. The findings are valuable for international investors and portfolio managers.

Ramadan fasting alters food patterns, dietary diversity and body weight among Ghanaian adolescents

BackgroundRamadan is a monthlong fast for healthy adolescents and adult Muslims. The quality of foods eaten and eating patterns in Ramadan may be different from other months of the year. Food intake of adolescents is a concern as energy and nutrient requirements are higher and needed to support the growth spurt of this stage. The objective of the present study was to describe the food patterns, dietary diversity and body weight changes among adolescents during Ramadan.MethodsA prospective cohort study design with four measurement points (baseline, midline, endline and post endline) was conducted among 366 adolescents in Junior High Schools. Food pattern was assessed with a food frequency questionnaire, a 24-h dietary recall was used to assess dietary diversity and body weight was measured using an electronic scale. A repeated measures ANOVA was used to compare changes in dietary diversity scores (DDS) and weight of pupils.ResultsHalf of the pupils (50.3%) were female and average age was 15.9 ± 1.8 years. Pupils fasted for an average of 28.3 ± 4.0 days and 14.3 ± 0.5 h a day (dawn to dusk) during Ramadan. The number and types of dishes taken at meal times differed substantially between Ramadan periods and outside Ramadan. Consumption of vitamin A-rich fruits, other fruits, and milk and milk products increased markedly during Ramadan. However, fasting came with a reduction in consumption of foods from roots and tubers, legumes and nuts, and dark green leafy vegetables while other food groups remained unchanged. Mean DDS increased significantly during Ramadan (F (2.933, 1070.573) = 7.152, p < 0.001) while mean daily meal frequency decreased (F (2.936, 1071.623) = 51.653, p < 0.001). There was significant body weight loss (-1.5 kg (95% CI: -1.1 kg to -1.6 kg)) among adolescents (F (2.656, 958.95) = 304.90, p < 0.001). Weight loss was short-lived; regained one month after Ramadan.ConclusionIn this prospective cohort study among schooling Ghanaian adolescents who fast during Ramadan, fasting was characterised by marked changes in usual food patterns, increased dietary diversity and significant body weight loss.

Population And Diversity Of Phytoplankton On Ramadan In Situ Gintung ‎Lake, South Tangerang, Banten Province, Indonesia

&lt;p&gt;&lt;em&gt;Changes in the social behavior of Moslems before, during and after Ramadan may impact on lake ecosystems. The aim of this study was to investigate temporal variation in the phytoplankton community of Situ Gintung lake, South Tangerang, Banten Province before, during and after of Ramadan periods 2015. Community composition, abundance, diversity (Shannon-Wiener index H'), dominance (D) and evenness (J) were measured for phytoplankton assemblages. Phytoplankton belonging to 7 divisions and 64 species were found. Phytoplankton belonging to 7 divisions and 64 species were found. &lt;/em&gt;&lt;em&gt;The &lt;/em&gt;&lt;em&gt;abundance, diversity and evenness indices of phytoplankton showed no significant temporal variation except &lt;/em&gt;&lt;em&gt;dominance index&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;/p&gt;

Diurnal Intermittent Fasting during Ramadan: The Effects on Leptin and Ghrelin Levels

We aimed to assess the effect of Islamic intermittent fasting, during and outside of Ramadan, on plasma levels of leptin and ghrelin while controlling for several potential confounding variables. Eight healthy male volunteers with a mean age of 26.6±4.9 years reported to the sleep disorders center (SDC) at King Saud University on four occasions: 1) adaptation; 2) 4 weeks before Ramadan while performing Islamic fasting for 1 week (baseline fasting) (BLF); 3) 1 week before Ramadan (non-fasting baseline) (BL); and 4) during the second week of Ramadan while fasting. Plasma leptin and ghrelin levels were measured using enzyme-linked immunoassays at 22:00, 02:00, 04:00, 06:00, and 11:00. During BLF, there were significant reductions in plasma leptin concentrations at 22:00 and 02:00 compared with the baseline concentrations (at 22:00: 194.2±177.2 vs. 146.7±174.5; at 02:00: 203.8±189.5 vs. 168.1±178.1; p<0.05). During Ramadan, there was a significant reduction in plasma leptin levels at 22:00 (194.2±177.2 vs. 132.6±130.4, p<0.05). No significant difference in plasma ghrelin concentrations was detected during the BL, BLF, or Ramadan periods. Cosinor analyses of leptin and ghrelin plasma levels revealed no significant changes in the acrophases of the hormones during the three periods. The nocturnal reduction in plasma leptin levels during fasting may be the result of the changes in meal times during fasting.

Evaluation of the Effects of Ramadan Fasting on Lymphocyte Subpopulations in a Two‐year Follow‐up

Today, the intractions of the immune system of the immune system, nutrition, and nervous system are one of the main research areas of interest in immunology and disease treatment. Due to changes in the mood, behavior, and diet of an individual during fasting period, the body's internal homeostasis is affected. The aim of the present study was to evaluate the effects of Ramadan fasting on lymphocyte subgroups, which are the main specific immune cells in the body. For this purpose, in years 1999 and 2000, thirty‐eight healthy Muslims (9 females and 29 males), within the age range of 17 to 51 years (mean age=35.4 years), were assessed before the start and one day before the end of Ramadan. The pre‐Lymphocytic subpopulations analysis was conducted using flow cytometery. The results showed that the percentage of total lymphocytes was 25.82% and 26.23% in the pre‐ and late‐Ramadan periods, respectively; the observed difference was insignificant. However, the absolute lymphocyte counts were 2.3×103 and 2.1×103 mm3 before and late Ramadan, respectively, and the difference was considered significant (P‐value=0.06). The percentage of CD3+ cells (T cells) was 70.12% before Ramadan and 70.25% late Ramadan, and the absolute lymphocyte counts were 1.6×103 and 1.5×103 mm3, respectively; therefore, the differences were not significant. Regarding the subgroups of CD4+cells (TH), the percentage ratios of the cells were 53.46% and 52.8% in the pre‐ and late Ramadan periods, and the absolute counts were 0.087×103 and 0.081×103 mm3, respectively; however, the differences were not significant in this cell subgroup. The percentage of CD8+ (TC) cells was 37.7% before Ramadan and 37.8% late Ramadan, and the absolute counts were 0.6×103 and 0.54×103 mm3 in the pre‐ and late‐Ramadan periods, respectively; therefore, the differences were considered insignificant. In addition, the percentage ratios of Blymphocytes cells were 14.56 % and 14.74% in the pre‐ and late‐Ramadan periods, and the absolute count changed from 0.35×103 to 0.3×103 mm3. According to the results, the differences were not significant, therefore, it seems Ramadan fasting does not affect these cells. Moreover, the percentage of activated T cells or TDR+, which are involved in specific immune responses, has not been affected by fasting. In fact, the percentage ratios were reported as 11.14% and 10.54% in the pre‐ and late‐Ramadan periods, and the absolute count changed from 0.14×103 to 0.11×103 mm3; the differences were not considered significant. Finally, the ratio of CD4+/CD8+ cells or TH/TC changed from 1.48% before Ramadan to 1.5% late this month; however, this difference was insignificant. Thus, the overall results indicate that Ramadan fasting during winter does not affect the lymphocyte count, percentage ratio, and the main lymphocyte subpopulations.

Does Ramadan Affect the Risk of Injury in Professional Football?

To investigate whether fasting during Ramadan influences injury incidence in professional Muslim and non-Muslim footballers. Prospective cohort study. Professional First Division League of Qatar. About 527 male football players (462 Muslim and 65 non-Muslim) from 7 league clubs (first year of data collection) and 8 clubs (second and third years). Daily collection of training and match exposure from August 2008 until April 2011 by club medical staff. Injuries during training and match play were recorded on standardized injury cards. Injury incidence was calculated as number of injuries per hour exposed to risk, and expressed as rate per 1000 hours. The probability of injury for different Arabic months between Muslims and non-Muslims was calculated using Generalized Estimating Equations (GEEs). There was no significant difference in total, match, and training injury incidence between the Ramadan and non-Ramadan periods. Non-Muslim footballers had a significantly higher injury incidence rate than Muslim footballers both during Ramadan (8.5 vs 4.0 injuries/1000 hours, P = 0.009) and non Ramadan (6.6 vs 4.9 injuries/1000 hours, P = 0.004) periods. The GEE analysis revealed that after adjusting for age and random factors (month and club), the probability of match injury among non-Muslims was the highest in Ramadan and the 2 consecutive following months (adjusted odds ratio of injury among non-Muslims compared with Muslims was 3.7 [95% confidence interval (CI), 1.7-7.9], P = 0.001 during Ramadan (ninth) month; 2.4 (95% CI, 1.1-4.9), P = 0.021 during 10th month; and 2.7 (95% CI, 1.2-5.8), P = 0.013 during 11th month). Finally, there was no change in injury patterns over the months of the Islamic calendar. Ramadan does not impact injury incidence for Muslim footballers in Qatar, suggesting the current adjustments and scheduling of football activities during Ramadan are sufficient. The increased match injury among non-Muslims during and 2 months post-Ramadan may suggest less effective coping strategies.

Comparison of the calcium intake during and before Ramadan in Marrakesh, Morocco

We studied the effect of Ramadan fasting on calcium intake in 2 groups of 500 healthy subjects from Marrakesh using the colloquial Arabic version of the Fardellone questionnaire. The first group was investigated 5 months before Ramadan and the second during Ramadan. No significant difference was observed between the 2 groups. However, comparison of the pre-Ramadan and Ramadan periods for each age group showed a significant increase in calcium intake in subjects over 60 years. During Ramadan, consumption of milk was significantly higher, while consumption of other dairy products was not different. Overall, no significant difference in calcium intake was noted between pre-Ramadan and Ramadan periods.