Objectives: The aim of present study was to investigate the effect of fasting during Ramadan on plasma adiponectin and TNF-α levels. Methods: This is a cross sectional study, conducted at Federal Urdu University of Arts, Science & Technology (FUUAST), Karachi, comprising a total of 55 (50%) females and 55 (50%) males whose ages ranged between 20 and 40 years, and fasted during Ramadan (June-July 2014) were enrolled in the study. Subjects were separated into normal weight, overweight and obese males and females. Anthropometric measurements and Fasting venous blood samples were taken at first and last (29th) day of Ramadan. Plasma adiponectin and TNF-alpha levels were assayed with ELISA kits. All values were calculated and presented as mean ± standard error of the mean (SEM) and by using analysis of variance (ANOVA) for repeated measures. P values < 0.05 were accepted as significant. Results: Body mass index (BMI) (Kg/m2) in over-weight and obese male subjects exhibited considerable reduction (P<0.05; P<0.05), post Ramadan when compared to their respective pre Ramadan fasting weights. Noticeable and significant reduction was also observed in BMI of obese females (P<0.05). Post Ramadan Overweight Males (P<0.05) and Post Ramadan Obese Males (P<0.001) exhibited significantly elevated plasma adiponectin (μg/mL) values. While plasma adiponectin mean concentration of only obese females were significantly improved at last week of Ramadan (P<0.01). Fasting in Ramadan significantly decreased TNF-α (pg/mL) levels of post obese males and females than Pre-Ramadan-groups (P<0.05; P<0.01) respectively. Conclusion: The study reports of noticeable changes with Ramadan fasting resulting increase of plasma adiponectin and decrease of TNF-α levels as well as body weight. The study strongly suggests further investigations on larger sample sizes with possible association of dietary restrictions and weight loss on mechanism of enhanced adiponectin and reduced TNF-α in obese and overweight persons who fast on Ramadan pattern. How to cite this:Mushtaq R, Akram A, Mushtaq R, Khwaja S, Ahmed S. The role of inflammatory markers following Ramadan Fasting. Pak J Med Sci. 2019;35(1):77-81. doi: https://doi.org/10.12669/pjms.35.1.95 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: The present study was planned to investigate the level of cholesterol in obese/nonobese (normal) individuals according to their body mass index (BMI) and age in different population residing in Karachi. Aim: Comparison of serum cholesterol values of obese with normal subjects and comparison of BMI of obese and normal individuals. Methods: Selection of obese subjects was according to the WHO (1998) criteria. A total of 40 subjects 18-55 years of age participated in the study, among which 30 subjects (Mean Age = 29.47 ± 1.99) were obese (Mean BMI = 35.41 ± 0.878) and 10 were controls with Mean age = 21.00 ± 0.547 and BMI = 19.96 ± 0.432. An overnight fasting blood sample was obtained and serum total Cholesterol (T-CH) level was estimated. Results: Obese persons having Mean T-CH = 202.6 ± 14.3 and controls having Mean T-CH = 173.3 ± 14.0. The data were further divided into males and females. Obese females were 11 with their BMI 31.836 ± 0.21, mean age ranged at 28.73 ± 4.04 and T-CH 191.8 ± 21.8, while that of control females were 6 in number with their BMI ranged at 19.183 ± 0.507, age 21.000 ± 0.894 and Cholester 148.7 ± 16.0 in controls. Total numbers of obese males were 19 with their BMI ranged at 37.49 ± 1.14, age ranged at 29.89 ± 2.19 and cholesterol level ranged at 208.89 ± 19.1. Control males were 4 in number with their BMI ranged at 21.125 ± 0.075, age 21.250 ± 0.479 and their T-CH 128.7 ± 8.72. Conclusion: The results of current study have reflected that BMI and total cholesterol concentration are higher in obese subjects.

The main purpose of this study was to find out a possible association between ABO blood groups or Rh and diabetes mellitus (DM) in the local population of eight (8) different towns of Karachi, Pakistan. For this purpose a survey was carried out in Karachi to have a practical observation of these towns during the period of 9 months from June 2019 to Feb. 2020. Out of eighteen (18) towns of Karachi, samples (N= 584) were collected from only eight (8) Towns of Karachi and gave a code-number to each town. Diabetic group sample was (n1=432) & pre-diabetes sample was (n2 =152). A standard Abbot Company Glucometer for Random Blood Sugar (RBS) and Fasting Blood Sugar (FBS) tests, standard blood anti sera were used for ABO/Rh blood type. Health assessment techniques were performed ethically by taking informed consent from all registered subjects. Finally data was analyzed by SPSS version 20.0. In our current study, the comparison of ABO blood groups frequencies between diabetic and pre-diabetic individuals were carried out. The percentage values of blood Group-B as given as: (32% in DM vs. 31% in pre-diabetics), followed by blood Group-O as: (18% in DM vs. 11% in pre-diabetics). Contrary to Group-“B” & “O”, blood Group-A and Group-AB were distribution percentage higher pre-diabetic as compared to DM patients, as given as: Group-A (32% in pre-diabetics vs. 26% in DM) & Group-AB (26% in pre-diabetics vs. 24% in diabetic’s patients). In addition, percentage distribution of Rh system was also calculated, in which Rh+ve Group was high and more common in DM patients as compared to pre-diabetics; numerically given as: Rh+ve Group (80% in DM vs. 72% in pre-diabetics). Different views and dimensions of the research topic were studied through literature support, some have found no any association and some established a positive association still some were not clear in making a solid conclusion. It is concluded that DM has a positive correlation with ABO blood groups, and people with Group-B have increased susceptibility to DM disease.

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A743reviewing how the use of a structured model for emotions can improve PRO instrument development by strengthening the role of emotions during CE. Methods: A literature review of CE with emotional motivations was undertaken to identify the most salient aspects for PRO instrument development. Results: The method for eliciting emotional motivations is based on motivation research and extraction techniques (see Forbes, 2010) containing, nine distinct categories of emotional motivation. The CE protocol relies upon neuroscience research (see Damasio 2010) which points to the power of a sub-800 millisecond response frame for eliciting purely emotional reactions to stimuli. Images validated in large sample research as uniquely evoking one of the nine motivational emotions are the stimuli for this emotional evocation procedure. This augmentation to typical CE has been used repeatedly to identify needs for emotional health among sufferers of diabetes, arthritis, and heart disease -in each case linking evocations to absence of needed emotional energies that could promote self-care and disease recovery. ConClusions: CE techniques for most PRO development do not allow investigators to sufficiently understand the patient experiences of physical symptoms, effect of ADLs, and the emotional consequences of a disease or condition of interest. Adding emotional motivation techniques to CEs will broaden our ability to capture the emotional experiences of patients so that related PRO instrument items may better represent the experiences of patients' suffering from various medical conditions.