title: Is long-term hunger (Ramadan model) a risk factor for acute appendicitis?
abstract: OBJECTIVE
  To investigate whether long-term hunger and the changes in nutritional routines during Ramadan constitute risk factors in acute appendicitis on the model of Ramadan fasting in this study.
  
  
  METHODS
  This retrospective study was carried out in 2 different hospitals (Istanbul Haydarpasa Numune Training and Research Hospital and Kars State Hospital, Kars, Turkey) between January 2004 and December 2007. The data obtained from the patients were classified according to age, gender, age group, and pathological characteristics of the appendix. The data obtained during the Ramadan fasting period was compared with the periods before and after.
  
  
  RESULTS
  Nine hundred and ninety-two of the 4288 patients who received a diagnosis of acute appendicitis during the 4 years received their diagnosis during the 3 periods. Three hundred sixty-eight (37.1%) patients underwent surgery before Ramadan, 318 (32.1%) during, and 306 (30.8%) after. No significant difference was observed in terms of perforated and non-perforated AA frequency, age, age group, and gender (p>0.05).
  
  
  CONCLUSIONS
  There are changes in the nutritional routines during the Ramadan fasting period due to long-term hunger; and limitations were seen in the fluid and food intake. We detected that these changes did not constitute risk factors for acute appendicitis formation as a result of our study.
authors.affiliation: Department of General Surgery, Faculty of Medicine, Kafkas University Kars, Pasacayiri 36100, Kars, Turkey. barlas.sulu36@gmail.com
authors.forename: Barlas
authors.initials: B
authors.lastname: Sulu
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Gunerhan
authors.forename: Baris
authors.initials: B
authors.lastname: Ozturk
authors.forename: Hasan
authors.initials: H
authors.lastname: Arslan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D005215:Fasting / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006815:Hunger / Q000502:physiology*; D007514:Islam; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult