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BACKGROUND AND AIM: The effects of Ramadan fasting on health are a little controversial. The present study is aimed at evaluating the metabolic effects on a group of 517 patients with ≥2 cardiovascular risk factors over a period running from 2012 to 2014. METHODS: Each patient was assessed at three visits: before, during, and after Ramadan. Demographical, clinical and biological tests were performed at each visit. RESULTS: Metabolically, we noted a significant and discrete rise in blood glucose level (+1.2 mmol/L), triglycerides (+0.3 mmol/L), cholesterol (+0.12 mmol/L) and creatinine (+3 µmol/L) during Ramadan. These disturbances decreased significantly after Ramadan. The same variations were observed among diabetics (n=323). However, there was a significant decrease in HbA1c after Ramadan (9.0% vs 7.6%, p<0.001). Our findings also revealed there was no significant correlation between variations of metabolic parameters and dietary intake. No acute metabolic incidents were reported during the study period. CONCLUSION: The current study showed that Ramadan is responsible for a transient but well tolerated disturbance of metabolic parameters followed by a significant post-Ramadan improvement. These changes did not seem to be directly related to dietary intake.
RESUMO
INTRODUCTION: The role of bacteria, including atypical organisms, in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) has been assessed in various ways in Tunisia. METHODS: This was a descriptive and analytical study of patients with a mean age of 68.3±10.5 years hospitalized for AECOPD. Bacteriological examination included a cytological sputum exam and serology for atypical organisms including Mycoplasma pneumoniae, Coxiella burnetii, Chlamydophila pneumoniae and Legionella pneumophila using standard techniques. RESULTS: Of the 240 patients enrolled, 175 sputum cultures (73%) were considered significant. Twenty-nine cultures were positive (16.5%) and 31 microorganisms were isolated of which the most frequent were P. aeruginosa (25.8%), K. pneumoniae (16.2%), H. influenzae (13%) and S. pneumoniae (9.7%). The prevalence of C. pneumoniae, M. pneumoniae and C. burnetii was 8.4%, 9% and 6.6%, respectively. No L. pneumophila infection was found. The Anthonisen criteria were associated with a positive culture (P=0.04). Almost half (40.9%) of the isolates were resistant to conventional first line antibiotics (43.7% to amoxicillin-clavulanic acid). CONCLUSIONS: Awareness of the low positivity of quantitative sputum bacteriology and the large percentage of resistant strains with a predominance of exclusively multi-resistant Pseudomonas should help in the management of patients with AECOPD.
