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Title: Association of peptic ulcer perforation with ramadan related lifestyle modifications.
Authors: Attiya Nasir Siddique, Muhammad Usama, Sophia Asif Khan, Muhammad Umer Faheem, Hizbullah Riaz Ansari, Muhammad Naveed
Journal: The Professional Medical Journal (TPMJ)
Publisher: Independent Medical College, Faisalabad- Pakistan
Country: Pakistan
Year: 2023
Volume: 30
Issue: 2
Language: English
DOI: 10.29309/TPMJ/2023.30.02.7149
Keywords: Risk FactorGastric PerforationPeptic Ulcer Perforation
Objective: To look into the relationship of Ramadan with peptic ulcer perforation. This will include assessing the effect of fasting as well as other Ramadan related factors like changes in eating and smoking habits. Study Design: Retrospective Analysis. Setting: Three Tertiary care hospitals of Peshawar i-e Hayatabad Medical Complex, Khyber Teaching Hospital and Lady Reading Hospital. Period: 6th May 2019 to 26th May 2020. Material & Methods: Patients presenting with the aforementioned complication of peptic ulcer during the research period were divided into two groups. Patients presenting during the two Ramadan months were designated as cases (Group 1). While those presenting during the rest of the period i-e 11 months, were the controls (Group 2). So comparison of these groups was done on basis of various predisposing factors of the disease. Inferences were drawn by applying Student’s t, Chi-square and Fischer’s exact chi-square tests. Results: A total of 129 patients were considered. Among these, 36 were cases (Group 1) and 93 were controls (Group 2) as per our study design. Number of perforations per month were statistically higher in Group 1 in comparison to Group 2 (i-e 18 patients per month vs 8.4 patients per month, p<0.05). Patients with dyspepsia and preference for fried food were significantly higher in Group 1 (p<0.001 and p=0.022 respectively). Whereas smoker were significantly lower in Group 1 (p=0.048). Conclusion: Analysis concluded that the incidence of perforation is higher during the Ramadan. Since Ramadan is not only about fasting, and it affects eating and smoking habits, this rise in rate of perforations can be considered to be an interplay of such changes and the complication of peptic ulcer.
To investigate the relationship between Ramadan and peptic ulcer perforation, assessing the impact of fasting and associated lifestyle changes such as alterations in eating and smoking habits.
Retrospective analysis of patients presenting with peptic ulcer perforation at three tertiary care hospitals in Peshawar. Patients were divided into two groups: Group 1 (cases) presenting during two Ramadan months, and Group 2 (controls) presenting during the remaining 11 months of the study period (May 6, 2019, to May 26, 2020). Data on demographic details, clinical history, comorbidities, and predisposing factors (dyspepsia, smoking, NSAID use, H. pylori, preference for fried food) were collected and analyzed using Student's t-test, Chi-square test, and Fischer's exact chi-square test.
graph TD
A["Identify Patients with Peptic Ulcer Perforation"] --> B["Divide into Groups"];
B --> C["Group 1: Patients during Ramadan"];
B --> D["Group 2: Patients during Non-Ramadan"];
C --> E["Collect Data: Demographics, History, Factors"];
D --> E;
E --> F["Analyze Data: Student's t-test, Chi-square, Fischer's Exact"];
F --> G["Draw Inferences and Conclusions"];
The study suggests that the increased incidence of peptic ulcer perforation during Ramadan is likely due to an interplay of fasting, changes in eating habits (particularly increased consumption of fried food), and pre-existing dyspepsia. While smoking reduction during Ramadan might offer a protective effect, the overall lifestyle modifications during the holy month contribute to the observed rise in perforations.
The incidence of peptic ulcer perforations was statistically higher during Ramadan (Group 1) compared to non-Ramadan periods (Group 2). Patients in Group 1 had a significantly higher prevalence of dyspepsia and preference for fried food. Smokers were significantly lower in Group 1. No significant differences were found in NSAID use or H. pylori infection between the groups.
The rate of peptic ulcer perforation is significantly higher during Ramadan. Patients with a history of dyspepsia and those who consume excessive fried food are at increased risk. Abstinence or reduction in smoking during Ramadan may have a protective effect.
1. A total of 129 patients were included in the study.
2. The incidence of perforations per month was statistically higher in Group 1 (Ramadan) (18 patients/month) compared to Group 2 (non-Ramadan) (8.4 patients/month) (p<0.05).
3. Patients with dyspepsia were significantly higher in Group 1 (75%) compared to Group 2 (30.1%) (p<0.001).
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