EFFECTS OF RAMADAN FASTING ON BLOOD PRESSURE IN NORMOTENSIVE MALES.

BACKGROUND: Research has been done to investigate the effect of intermittent complete fasting on human physiological parameters but the effect of fasting on blood pressure remains relatively unexplored. Research in animal models suggests a hypotensive effect with an undetermined mechanism. Muslims worldwide fast daily from dawn to dusk throughout the Islamic month of Ramadan. This study was to investigate the proposed hypotensive effect of Ramadan fasting in males over A period of 20 days and to study the relationship of the pattern of blood pressure variation with body mass index change. METHODS: A repeated measures observational study design was implemented with convenient sampling. Study group included 40 normotensive, non-smoker males with no known comorbidities between the ages of 18-40 who fasted daily in the month of Ramadan. One set of BP readings, each, was taken one week before the start of Ramadan and on the 7th, 14th and 21st day of Ramadan which included pre and post Iftar measurements along with other variables. Data was analysed by repeated measures ANOVA using SPSS. The differences were compared with critical values generated by Tukey's Method. RESULTS: There was a significant drop in systolic BP of 7.61 mmHg before Iftar, 2.72 mm-Hg after Iftar (p<0.005). There was a significant effect of Ramadan on diastolic BP (p<0.005), the drop being 3.19 mmHg. The drop in body mass index was significant only before Iftar at 0.3 kg/m2 (p<0.005). Pulse rate showed a significant drop of 7.79 bpm before Iftar and a significant rise of 3.96 bpm (p<0.005). CONCLUSIONS: Intermittent fasting causes a drop in both systolic and diastolic blood pressure in normotensive males.

Role of low-level laser therapy in neurorehabilitation.

This year marks the 50th anniversary of the discovery of the laser. The development of lasers for medical use, which became known as low-level laser therapy (LLLT) or photobiomodulation, followed in 1967. In recent years, LLLT has become an increasingly mainstream modality, especially in the areas of physical medicine and rehabilitation. At first used mainly for wound healing and pain relief, the medical applications of LLLT have broadened to include diseases such as stroke, myocardial infarction, and degenerative or traumatic brain disorders. This review will cover the mechanisms of LLLT that operate both on a cellular and a tissue level. Mitochondria are thought to be the principal photoreceptors, and increased adenosine triphosphate, reactive oxygen species, intracellular calcium, and release of nitric oxide are the initial events. Activation of transcription factors then leads to expression of many protective, anti-apoptotic, anti-oxidant, and pro-proliferation gene products. Animal studies and human clinical trials of LLLT for indications with relevance to neurology, such as stroke, traumatic brain injury, degenerative brain disease, spinal cord injury, and peripheral nerve regeneration, will be covered.

Prevalence of mistreatment or belittlement among medical students--a cross sectional survey at a private medical school in Karachi, Pakistan.

BACKGROUND: Mistreatment or belittlement of medical students either by faculty or fellow students has often been reported. Perception of mistreatment has also been associated with increased degree of psychological morbidity. There is a lack of such studies being conducted amongst the medical students of Pakistan. The aim of this study was to determine the prevalence and forms of perceived mistreatment and presence of mental health morbidity in a private medical school in Pakistan. Also, any association between mental health morbidity and mistreatment was to be identified. METHODS: A cross sectional study was carried out on medical students from Aga Khan University Hospital, Karachi, Pakistan during the period of June-September 2007. A self administered questionnaire, adapted from Frank et al and Baldwin et al was distributed to a total of 350 students. The questionnaire consisted of three parts: the first dealing with the demographics of the population, the second concerning the various forms of mistreatment, while the third assessed the mental health of students using the General Health Questionnaire 12(GHQ12). Descriptive statistics were performed. The Chi-square test and Fisher's exact tests were applied. RESULTS: A total of 350 students were approached out of which 232 completed the questionnaire giving a response rate of 66.2%. Mistreatment was reported by 62.5% (145/232) of the respondents. Of these, 69.7% (83/145) were males and 54.9% (62/145) were females. There was a significant relationship between gender, year division, stress at medical school and possible use of drugs/alcohol and reported mistreatment but no statistical relationship was seen with psychiatric morbidity. The overall prevalence of psychological morbidity was 34.8% (77/221). CONCLUSION: This study suggests high prevalence of perceived mistreatment and psychological morbidity among Pakistani medical students. However, no association was found between these two aspects of medical student education. There is a need to bring about changes to make the medical education environment conducive to learning. Increased student feedback, support systems and guidance about progress throughout the year and the provision of adequate learning resources may provide help with resolving both of these issues.