{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T15:51:12Z","timestamp":1793029872773,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To study Ramadan's effect on migraine from the start to the end of the month and the tolerability of patients with migraine to fasting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fasting is a well\u2010known trigger for migraine. Whether this effect on migraine is the same throughout the whole month, or whether it varies from the first to the last days of the month, has not been studied yet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort observational study was carried out on persons with migraine who fasted from 24 April to 23\u00a0May during Ramadan 2020. Each patient was asked to fill out their headache diary starting from Shaaban (the month before Ramadan) to the end of Ramadan. The Ramadan diary was divided by 10\u00a0days each, by which the patient was asked to accurately describe their migraine attacks in terms of frequency, duration, and intensity by using the Visual Analog Scale. Migraine attacks during the first day of fasting were assessed separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 292\u00a0known persons with migraine from Egypt completed the study. Their median age was 33\u00a0years; 72\/292 (24.7%) were male, and 220\/292 (75.3%) were female. About 126\/236 (53.4%) of the patients had migraine attacks on Ramadan's first day, most of them during fasting. The frequency of migraine attacks was significantly increased in Ramadan (median 4, interquartile range [IQR] 2\u20137) compared with Shaaban (median 3, IQR 1\u20136),\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.009. The number of attacks was significantly reduced in both the second (median 1, IQR 0\u20132.25) and the third 10\u00a0days of Ramadan (median 1, IQR 1\u20133) compared with the first 10\u00a0days (median 3, IQR 1\u20135) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001 for each).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ramadan's potential exacerbating effect on the frequency of migraine attacks should be discussed with patients with migraine. This effect appears to be limited to the first 10\u00a0days of Ramadan and then subsides with successive days of fasting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14231","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T16:25:42Z","timestamp":1635870342000},"page":"1493-1498","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Changes in migraine characteristics over 30\u00a0days of Ramadan fasting: A prospective study"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6973-3956","authenticated-orcid":false,"given":"Amany H.","family":"Ragab","sequence":"first","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirmeen A.","family":"Kishk","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Yacoub","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lobna","family":"El Ghoneimy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Elmazny","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"},{"name":"Department of Internal Medicine Arabian Gulf University  Manama Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enji H.","family":"Elsawy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doaa","family":"Mekkawy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alshimaa S.","family":"Othman","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoda Ibrahim","family":"Rizk","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Edrees","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatem S.","family":"Shehata","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nevin","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehab","family":"Magdy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasr\u2010Alainy Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Why Muslims are the world's fastest\u2010growing religious group. 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