Pak-US Strategic Partnership in the War on Terror to Curb Militant Bloodbath

Pakistan’s involvement in the US war on terrorism was a tragic decision. No option was left for the ruling elite of Pakistan except to join the global war on terrorism and to take a U-turn from the support of Taliban’s regime in Afghanistan which was duly recognized by Pakistan’s government in 1996. It was expected by the policy-makers of the US that the alliance with Pakistan would provide extraordinary strength in combating the Al-Qaeda and other affiliated conglomerates in Afghanistan as well as in borderland area. However, after fifteen years of war, the alliance has enfeebled despite their mutual understanding regarding the objectives envisaged in the Strategic Partnership. The war on terrorism has now been escalated from Afghanistan to Pakistan and it has provided space to religious extremism, militancy, intolerance, ethnic division and sectarianism. There is no denial to the fact that religious extremism and terrorism are common threat and have damaged both the countries yet Pakistan has sacrificed more than the US in terms of human and material loss. Nevertheless, blame game and trust deficit is on the rise from both sides. This article focuses first on the joint ventures that the US and Pakistan mutually initiated to curb militant bloodbath in Afghanistan as well as in the border region. Secondly, it will explore factors responsible for increasing trust deficit between the partners. The study will not only provide deep understanding about the prevailing issues between Pakistan and the US but will also give true pictures to streamline the methodology for negotiating with each other in  future.

Pertinent Hormones and Their Functional Adaptations in Obese Subjects of Karachi

Background: Obesity is a worldwide epidemic. Excess body fat accumulation and less energy expenditure result into Obesity. There are so many causes of obesity like over-nutrition, change of eating habits, physical inactivity, urbanization, consumption of energy dense diet, and metabolic disorders. Body mass index is mainly used to measure the obesity. This study sought to explore the interactions among different hormones produced by adipose tissue in obese people. Methodology: Assortment of overweight and obese individuals was following to the WHO (1998) criteria. A total of 150 adults both males and females of 18 to 40 years of age group participated in our study. Subjects were categorized into three BMI groups, Control/ normal weight, overweight and obese. Total control subjects (n=30) with mean age 21.73 ± 0.60 years, Total overweight (n=20) mean age 25.4 ± 1.90 years while total obese were (n=100) mean age 31.07 ± 1.18 years. Participants signed a consent form and completed a demographic opinion poll. Anthropometric measurement of height, weight, waist and hip circumferences, arm and wrist circumference was determined, then BMI (Kg/m2) and WHR were calculated, as well as BPs were taken. Subjects were considered to be Hypertensive with SBP ≥ 140 mmHg or DBP ≥ 90 mmHg. An overweight fasting blood sample was obtained for evaluation of biochemical parameters. FBG (mg/dl) was estimated by GOD-PAP method with the help of commercially available kit (Innoline, merck, France), while serum insulin (µlU/ml), serum leptin (ng/ml), plasma adiponectin (µg/ml) and plasma TNF-α (pg/ml) is analyzed by ELISA (Commercially available kits). IFG was determined based on American Diabetes Association Criteria. Insulin sensitivity index was calculated by QUICKI method. Statistical analysis included descriptive statistics, t-test and one-way ANOVA; P value of 0.05 was considered statistically significant. Results: Comparison of control males (n=15) with overweight males (n=10) the significantly higher values were noted in BMI (P<0.001), SBP (P<0.01), DBP (P<0.05), serum insulin level (P<0.001) and serum leptin level (P<0.001) while decreased in plasma adiponectin (P<0.001) of overweight male subjects. Comparison of control and obese males (n=50) showed significantly higher mean values of age “(P<0.01)”, BMI“(P<0.001)”, WHR“(P<0.01)”,SBP“(P<0.001),DBP“(P<0.01)”, FBG (P<0.01), insulin (P<0.001) serum leptin (P<0.001), plasma TNF-α level (P<0.001) and reduced plasma adiponectin (P<0.001) levels of obese males. When control females (n=15) were compared with overweight females (n=10) significantly higher levels were observed in BMI “(P<0.001)”, WHR “(P< 0.01)”, SBP “(P<0.001)”, DBP“(P<0.001)”, FBG level (P<0.01), serum insulin level (P<0.001), serum leptin level (P<0.001) of overweight females while significantly lower plasma level of adiponectin was found in overweight females (P<0.01). Obese females (n=50) versus control female subjects exhibited significantly higher mean values of age (P<0.01), BMI (P<0.001), WHR (P<0.001), SBP (P<0.001), DBP (P<0.01), FBG (P<0.01) serum insulin level (P<0.001), serum leptin concentration (P<0.001) and plasma TNF-α levels (P<0.001) while significantly lower plasma adiponectin values in obese females (P<0.05). When control males were compared with control females, the statistically significant reduction was noted only in SBP (P<0.05) and serum leptin levels (P<0.01). Overweight males versus females exhibited that both BMI and plasma adiponecin values were significantly higher in overweight females (P<0.05; P<0.05). Obese males and females comparison showed the significant higher values of leptin as well as adiponectin in obese females (P<0.001; P<0.001). Conclusion: We observed that BMI had significant relationship with WHR and BP among male and female participants. Both BP and WHR increased in overweight and obese subjects as compared to normal weight subjects, higher level of FBG and serum insulin was also noted in these subjects. Adiposity and gender are the major determinants of leptin and adiponectin concentration. Women had significant higher leptin and adiponectin level than men with similar BMI values. Inflammatory cytokine the TNF-α also increased significantly in obese males and females. This suggests that when adipose tissues mass increases in obesity the production of TNF-α also increases. Further study is required to find out the mechanism of leptin and adiponectin sexual dimorphism. Ramadan and Obesity Experiment Background: Ramadan fasting is compulsory for all healthy and adult Muslims. Muslim fasts during the whole month of Holy Ramadan by avoiding food and fluid intake from dawn to dusk. This experiment was planned to observe the impact of fasting during Ramadan on various anthropometric indices, physiological parameter and some adipose tissue hormones. Methods: This experiment was carried out during Ramadan 2013, on healthy Muslims adults (both males and females) aged between 18-40 years. All the subjects fasted throughout the Ramadan, and average Fasting time was about 15 hours a day. As females do not fast during menstruation according to Islamic rules but they followed the same 15 hours fasting routine for experiment. All of them were put on dietary restrictions. Subjects appeared at 1st day of Ramadan (Pre group) and the same subject appeared at the last day of Ramadan (Post group). An intravenous blood was obtained after completion of 10 hours fasting, and serum as well as plasma was separated for biochemical analysis. Anthropometric measurements like weight, height, WC, HC, Arm and wrist C were taken. BMI and WHR were calculated. SBP and DBP were measured. Serum insulin, serum leptin, plasma adiponectin and TNF- α levels were analyzed by ELISA (Commercially available kits). FBG was measured by GOD-PAP method with the help of commercially available kit (Innoline, merck, France). Insulin sensitivity index was calculated by QUICKI. Results: Comparison of pre and post control, pre and post overweight and pre and post obese male group showed significantly reduced level of BMI, SBP, DBP and WHR of overweight and obese males (P<0.05). While FBG, serum insulin and plasma TNF-α concentration of only post obese males were significantly reduced than pre obese males (P<0.05), however, Insulin index was improved significantly (P<0.05). Serum leptin concentrations of post overweight “(P<0.05)” and obese males “(P<0.01)” were significantly reduced. While plasma adiponectin level of overweight and obese males were significantly increased than pre overweight and obese group respectively (P<0.05; P<0.001). Comparison of pre and post control, pre and post overweight and pre and post Ramadan obese females exhibited significant reduction in BMI (P<0.05), WHR (P<0.05), DBP (P<0.05) Serum leptin (P<0.05) and plasma TNF-α (P<0.01) in post obese females. And plasma adiponectin levels (P<0.01) were significantly elevated in post obese females. While pre and post control and obese females showed significant reduction in DBP “(P<0.05; P<0.05)” and FBG level “(P<0.001; P<0.05)”. Conclusion: This study conclude that BMI, WHR, BP significantly reduced in both male and female subjects. FBG, serum insulin, serum leptin and plasma TNF alpha concentration of obese and overweight subjects of both the genders also decreased. While Insulin sensitivity index as well as plasma adiponectin level of these subjects increased significantly. Ramadan fasting plays a decisive role in regulation of the biochemical and physiological processes of the body as well as affect antiinflammatory responses. Ramadan fasting down regulates the inflammatory cytokines (TNF-α). However, further research is needed to find out the molecular action involved due to Ramadan fasting involved in obesity and weight gain. Obesity and Menopause Experiment Background: Obesity is more prevalent in middle-aged women over the age of 40 years. The burden of obesity after menopause is rapidly growing worldwide. Fat is redistributed among various fat reservoirs after menopause from hypodermic to internal fats resevoirs of abdomen causing an increase in abdominal circumferences and BMI. This study aims to check the link between the obesity and anthropometric, physiological and clinical factors in postmenopausal women. Methods: This experiment was conducted in Karachi, Pakistan from January 2015- April 2015. Women with ceased menstruation for at least 12 months and had natural menopause with 45-60 years of age participated. The home visits with questionnaire and written consents were obtained. A total of 84 post-menopausal women, among them normal weight (n=13) and obese were (n=71). Anthropometric measurements were taken, blood pressure was measured at sitting position and blood sample of 5ml was drawn from each subject. Blood samples were centrifuged for serum and plasma separation, and stored at -80°C for further biochemical and hormonal assays. Results: Results of our experiment showed significantly higher values of BMI (P<0.001), WHR (P<0.01), arm circumference (P<0.001), SBP (P<0.001), DBP (P<0.01), FBG (P<0.001), Serum leptin (P<0.001) and plasma TNF-α (P<0.001) were noted in postmenopausal obese women as compared to normal weight postmenopausal women. Significantly lowered level of plasma adiponectin was noted (P<0.001), while no significant results were found in waist circumference serum insulin and insulin sensitivity index (P>0.05). Conclusion: BMI, WHR, arm circumference, BP, FBG, Serum leptin and plasma TNF-α values were higher in obese as compared to normal weight post-menopausal women. Women are more at risk for being obese as they progress menopause. Abdominal obesity increases inflammatory cytokines and adipokines with increased risk of metabolic syndrome. So post menopausal women are especially vulnerable population. It is therefore, important for health care authorities to understand the health issues of obesity and public awareness and imply these into health promotion policies for post-menopausal women." xml:lang="en_US