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.

A total of 64 male obese subjects were randomized to observe the effect of 40 g of walnut in daily breakfast on lipid profile and Body Mass Index (BMI), total Cholesterol (CHO), Triglyceride (TG) High Density Lipoprotein (HDL) cholesterol and Low Density Lipoprotein (LDL) cholesterol in obese male subjects of various ethnics i.e. Baloch (B), Pathan (P), Hazara (H) and Punjabi (PU) residing in Quetta region of Balochistan for this purpose four weeks controlled study was designed. A batch of 32 obese male subjects 8 from each ethnic group as a control and another batch of 32 obese males 8 from each ethnic group as treated were selected. Twelve hour fasting blood samples a day after stoppage of walnut were taken from obese control and obese treated subjects. Daily walnut consumption in obese male subjects evidently demonstrated reduced BMI in all ethnic groups. Walnut supplementation in obese exhibited significant reduction in cholesterol level in Baloch (P < 0.001) and Punjabi (P < 0.01) males. There was profound and statistically significant [B (P < 0.05), P (P < 0.05), H (P < 0.01) and PU (P < 0.05)] elevation in HDL-C in all male ethnic groups. In male sub-population LDL-C was significantly [P (P < 0.01), H (P < 0.001) and PU (P < 0.05)] reduced in these groups. In these subjects walnut supplementation showed pronounced reduction [B (P < 0.001), P (P < 0.05), H (P < 0.001) and PU (P < 0.001)] in triglyceride levels. The constructive influence of walnut on lipid profile suggests that walnut rich diet may have advantageous effects beyond changes in plasma lipid level.

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Introduction: Caesarean section is one of the most common obstetric operations performed. Primary caesarean section in multiparous women means the first caesarean section done in the multiparity who had previously delivered vaginally. This study aimed to find out the prevalence of primary caesarean section among multiparous pregnant women visiting a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among multiparous women in a tertiary care centre from 15 June 2020 to 14 June 2021. Ethical approval was obtained from the Institutional Review Committee (Registration number: F-NMC/420/075/076). Demographic data were collected using predesigned proforma in parous women who had a previous vaginal delivery. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 1158 multiparity, primary caesarean section was found in 155 (13.39%) (11.43-15.35, 95% Confidence Interval). Most women 62 (40%) belong to 21-25 years and the majority were second gravida 51 (32.90%). The emergency caesarean section was done in 149 (96.12%). Indications for primary caesarean section were fetal distress 63 (40.63%), non-progress of labour and breech 12 (7.74%). Post-operative complications were uneventful in 110 (70.96%) cases. Conclusions: The prevalence of primary caesarean section in multiparous women was found to be higher than the other studies done in similar settings.