| خلاصه مقاله | INTRODUCTION and AIM
During Ramadan, Muslims should avoid eating, drinking, smoking, and sexual activity from dusk to dawn. The possible effects of Ramadan observance in patients with multiple sclerosis (MS) is a challenging concern that is addressed in this systematic review.
METHODS
Following the JBI and PRISMA methods, a broad search was conducted in PubMed, Scopus, Embase, and Web of Science databases, and clinical evidence regarding the probable effects of Ramadan fasting in MS patients was collected. Reviews, case reports, animal studies, editorials, letters, and commentaries were not included. The risk of bias was assessed using the JBI critical appraisal tools.
RESULTS
The initial search yielded 48 articles, of which five reports (total n= 544; 472 fasting and 72 non-fasting patients), including one conference abstract, were found to meet the eligibility criteria. The study settings were Iran (two studies), Egypt, Morocco, and one multicenter study performed in Egypt, Morocco, and Saudi Arabia. Ramadan fasting was not found to be associated with increasing frequency of MS relapsing or worsening of disability; evidence suggests benefits regarding the quality of life. Moreover, a higher level of disability and longer disease duration are found to increase the risk of MS activation during Ramadan.
CONCLUSIONS
Current evidence does not support the fact that Ramadan fasting is harmful to MS patients, especially in patients with mild levels of disability, and it can be associated with improvements in the quality of life. Reported outcomes in this investigation should be interpreted with circumspection as these effects were observed in small studies, all in the Eastern Mediterranean Region. |