Résumé
To evaluate headache in fasting state on first day of Ramadan in general population with respect to its character, relation with duration of fasting and effect of abstinence of caffeine and nicotine. Descriptive study Department of Medicine, Unit 6, Liyari General Hospital, Karachi, during the month of Ramadan. In this study, 180 people were taken, 57 of them were males and 123 were females. Age range in our study is 20-60 years. All people were interviewed in detail. Printed Performa was filled in inquiring about sehri, previous history of headache due to tension headache, migraine, pre-menstrual headache, history of smoking, diabetes mellitus, hypertension and psychiatric illnesses .They were also questioned about drug history. The male population consisted of 57 men. 8 out of 57 men had previous history of headache, 11 were smoker, 12 were diabetic, virtually all were on oral hypoglycemic agents, 6 were hypertensive while 21 had no history of any systemic illness. In female population out of 123 women, 50 had previous history of headache, there was no smoker, 2 were diabetic, and 10 were hypertensive while 60 had no history of any systemic illnesses. In general, this study has shown that 23.8% of the population complained of headache in the fasting state, the number of the headaches nearly doubled in afternoon. In female population 34/123 [27.6%] women complained of headache in the fasting state, 16 [32%] had previous history of headache. While in male population 9/57 [15.78%] complained of headache out of which 4[36.3%] were smoker and 3[37.5%] has pervious history of headache on the first day of Ramadan. One quarter of patients complained of headache in the fasting state, fasting is strong headache precipitator more so in chronic headache sufferers, frequency increases with the duration of fasting. Caffeine and nicotine withdrawal is also headache precipitator with some contributory role of relative lower glycemic values and dehydration