Metabolic alterations during Ramadan fast

Some biochemical parameters in 12 young Muslim students who underwent fasting during the entire one month period of Ramadan were investigated. There was a significant reduction in their body weight (72.5±4.0 to 69.4±3.0 kg) and blood glucose levels (99.6±3.5 to 82.9±7.3 mg/dl). Though the morning plasma cortisol fell (215.2±22.1 to 105±11.2 μg/l) and the evening plasma cortisol rose (58.4±5.1 to 64.4±4.8 μg/l) significantly there was no reversal of the circadian rhythm of cortisol secretion. A decline in the diastolic blood pressure (80 to 75±6 of Hg) of these individuals though not significant was also noted. However, cholesterol (160.9±12.8 to 178.2±40.6 mg/dl) and HDL-Cholesterol (42.6±2.2 to 48.1±2.4 mg/dl) showed a tendency for increase. All the changed values were within the normal range.     

Serum and platelet sialic acid in acute myocardial infarction

Blood samples from 39 patients with acute myocardial infarction and 15 healthy controls were analysed for serum and platelet sialic acid. Serum sialic acid levels in patients with acute myocardial infarction were significantly higher than controls (mean 2.7±0.46 μmol/ml Vs. 1.91±0.17 μmol/ml respectively). Levels of serum orosomucoid, an acute phase reactant, containing sialic acid, were also higher in these patients, suggesting a possible non-specific mechanism of increase in serum sialic acid concentration. In contrast, platelets contained significantly less sialic acid in patients with acute myocardial infarction than control (26.73±1.57 nmol/mg protein and 31.97±2.68 nmol/mg protein respectively).     

Effect of vitamin E on platelet enzymatic anti-oxidants in the patients of myocardial infarction

Effect of administration of 600 mg. vitamin E each day, for six days, was observed on activity of some of the anti-oxidant enzymes and levels of malondialdehyde (as an index of free radical mediated damage) in the platelets of patients reperfused after myocardial infarction. It has been found that vitamin E administration significantly lowers the level of malondialdehyde in the patients. Vitamin E administration increases the activities of anti oxidant enzymes (viz. superoxide dismutase, glutathione reductase and catalase) tested both in the patients and healthy controls. Vitamin E administration causes general stimulation of anti-oxidant enzyme activities both in healthy persons and the patients, however, lowering of lipid per-oxidation upon administration of vitamin E is specific for patients. These findings exhibit beneficial role of vitamin E administration in the management of the patients reperfused after myocardial infarction.     

Transformational change and business process reengineering (BPR): Lessons from the British and Dutch public sector

Facilitated by electronic government, public agencies are looking for transformational change by making a radical improvement. At first glance, this development is similar to the business process re-engineering (BPR) movement in the private sector. While policy makers and practitioners in the public sector have branded their recent improvements as BPR, the academic and research community have thus far eluded from making any comparisons. This has left a vacuum in terms of understanding the complexity of the challenges facing e-Government re-engineering and resultant change in public agencies. The aim of this paper is to translate the BPR movement findings to the field of e-Government induced change in the public sector. BPR characteristics and challenges are derived using normative literature and compared with two cases of public sector transformation in the UK and Netherlands. The results of these cases show that e-Government-induced change requires a plan for a radical improvement which, in contrast to BPR, is obtained by incremental steps and has a high level of participation. The findings offer policy makers valuable insights into the complexities and possible strategies that may need to be followed in order to succeed in e-Government implementation.     

Blood Lead Level (BLL) in the Adult Population of Jodhpur: A Pilot Study

Lead interferes with a variety of body processes and is toxic to many organs and tissues including the heart, bones, intestines, kidneys, and reproductive and nervous systems. Routes of exposure to lead include contaminated air, water, soil, food, and consumer products. The possibility of lead exposure in humans is therefore of great significance from health point of view. Occupational exposure is a common known cause of lead poisoning in adults but current status of adults exposed otherwise is not known. School teachers representing wide local population were selected and asked to furnish information regarding possible lead exposure. Blood lead level (BLL) was estimated using anodic stripping voltammetry. The mean BLL was 6.89 ± 9.5 μg/dl (<3.5–>65 μg/dl) in representative adult population. Out of the total 16 % were found to be having BLL >10 μg/dl which has significantly decreased from leaded gasoline era. Those with increased BLL (>10 μg/dl) were found to have common determinants like usage of old metallic pipes for plumbing, water consumption without any purification system, usage of cosmetics and Ayurvedic/herbal medicines.     

Microalbuminuria in Obese Young and Middle Aged Population: A Potential Marker of Cardiovascular Risk

Microalbuminuria is an established cardiovascular risk indicator in diabetes, hypertension and the general population. There is lack of information on MAU in healthy obese Indian adults and an ongoing debate whether obese adults deserve targeted identification and clinical intervention for MAU and prediabetes. We aimed to screen the healthy obese, young (group I) and middle aged (group II) adults for prevalence of MAU and prediabetes and study its association with Framingham risk score. The study included 50 healthy obese young (20–30 years) and middle aged adults (31–50 years), attending the outpatient clinic of Dept. of Medicine for a duration of 2 months (July–August). The patients were screened for fasting blood sugar, lipid profile and MAU. Of the total patients 28 % had MAU, 32.14 % of which had prediabetes and 33.33 % had diabetes whereas 10 % were normoglycemic. The group I patients had 50 % cases of MAU and group II had 25 % patients with MAU. Group II 63.63 % pre-diabetics. The values of MAU obtained were correlated with age, gender, body mass index, systolic and diastolic blood pressure, FBS, waist to hip ratio using Pearson’s Coefficient (p < 0.05). The 10 year CVD risk calculated using FRS in subjects with MAU was higher as compared to those without MAU. Thus we conclude that Indian, young and middle aged obese adults to be at a risk of prediabetes, MAU and CV risk warranting their routine screening for better clinical outcomes.