Glycosylated Haemoglobin Essay Example | Topics and Well Written Essays - 3000 words

Glycosylated Haemoglobin - Essay Example In case blood glucose level is well within control and gives stable results, the test is performed every six months intervals. The long-term or chronic complications of diabetes are those that characteristically occur after years of high blood sugar levels. These are diabetic macrovascular and microvascular diseases. The long term complications correlate well with A1c levels.(Web ref 2). Wild and Bains (2004) cautioned clinical laboratories and point-of-care testing to be careful of the interferences produced in assays by variant Hbs. The majority arise from point mutations in the , , , or Hb chains. Herman et al (2007) also raised the important question of whether A1c can be used as a diagnostic test for diabetes detection and control in ethnic minorities whose mean A1c concentration vary significantly from whites. In the light of these observations the current project intends to analyse literature particularly on blood glucose tests, long term complications of high blood sugar and applicability of HbA1c test to ethnic diabetics. Studies have shown that glycohaemoglobin values in the "better ranges" correlate with less incidences of diabetic complications later in life (Table 1; Fig 1 b). Type 1 diabetics will typically have hemoglobin A1c levels determined every 3 to 4 months, while Type 2 diabetics will require measurements less often (Web ref 3; Web ref 1). It so because Red blood cells are replaced in about 90 days thus test gives blood glucose levels for that period. Normal blood glucose levels are below 6 percent HbA1c however these vary laboratory to laboratory (McCool and Woodruff 1999; Web ref 1) HbA1c levels compare well with blood glucose levels as shown below: Table 1. Comparison of HbA1c test and Blood glucose levels (from McCool and Woodruff 1999) HbA1c Level of control Blood glucose (mg/dl) 5 % 6% 7% 8% 9% 10% 11% 12% Excellent Excellent Good Acceptable Poor Poor Poor Poor 90 mg/dl 120 mg/dl 150 mg/dl 180 mg/dl 210 mg/dl 240 mg/dl 270 mg/dl 300 mg/dl The rapid fluctuations in blood glucose that normally occur are smoothed out and the long-term level of glucose is now available to clinicians as a HbA1c test, because glycosylated hemoglobin has been shown to correlate with the integrated average blood consumption of glucose over the preceding six to eight weeks (Nathan 1990). Moreover, No preparation is necessary. Fig1 b) Controlled and uncontrolled diabetes conditions. (from Web ref 1) Controlled diabetes, less blood glucose results in less glycosylated haemoglobin Uncontrolled diabetes, more blood glucose results in high glycosylated haemoglobin HbA1c is also a reasonably sensitive test for gestational diabetes mellitus (GDM) which occurs in pregnant women. The test when conducted on pregnant women, it could pick up 87.1 cases of GDM successfully. The study gives a good alternative to OGTT (oral glucose tolerance test) which is inconvenient and requires fasting (Aldasouqi et al, 2008). The HbA1c test earlier done in laboratories only is now available in relatively economical home version as well (Web ref 4). The control of HbA1c and avoiding long term diabetic complications are discussed later. Diabetes: An overview The word 'diabetes'

An Occurrence at Owl Creek Essay Example | Topics and Well Written Essays - 750 words

An Occurrence at Owl Creek - Essay Example Hence, with the exemption of past time, time itself is a matter that is not real but is just perceived, with surprising and dramatic effects, to convey a conclusion. This essay will discuss the aspect of time in Ambrose Bierce’s writing, An Occurrence at Owl Creek. An Occurrence at Owl Creek refers to a short story written by Ambrose Bierce, an American author. The tale, set during the Civil war, is identified for its irregular time sequence, as well as a twisting ending (Bierce, 1948). The book is Bierce’s most anthologized writing. An Occurrence at Owl Creek, according to critics, is a richly devised explanation on the fluid of time during the civil war. The book’s structure, which shifts from the current to the past to what is portrayed to be the anticipated present, mirrors this fluidity along with the tension that which exists between competing notions of time. The second section, in the writing, interrupts what, at first, seems to be the ongoing flow of the execution happening in the present moment. Farquhar, posed on the edge of the bridge, closes his eyes as an indication of slipping into his own edition of reality (Bierce, 1948). Farquhar’s reality is one that is unburdened by numerous responsibilities to the law of time. As the minutes/ticking of Farquhar’s watch slows and more time elapses between the strokes, he moves into a timeless reality. When Farquhar pictures himself falling into the water, the author compares him to a "vast pendulum" immaterial, as well as spinning madly out of control. At this instance, Farquhar moves into a transitional space, which is neither death nor life, but a ghostly realization in a globe with its own regulations (Bierce, 1948). In the brief window of time between Farquhar’s actual death time and the officer stepping of the plank, time slows and changes in order to accommodate a comforting view of the subject’s safe return to his family. In spite of Farquhar’s m anipulation of time, he however, cannot escape realm. Whether Farquhar days are prolonged or just a few moments, death ultimately claims him (Bierce, 1948). Trying to blend time to his personal will is meaningless. One of the most remarkable elements in the book is Bierce’s sensible rendering of Farquhar’s alternating conception of time. The author’s suggestion of time is that the nature of time is, to some level, subjective (Bierce, 1948). Time, according to the author, is even more disorienting since it turns out that all of the long accounts, as well as events, which should have taken a lot of time happen within the marvel of a thought, took a short moment in time. Also, some of the themes discussed in Ambrose Bierce’s writing are as discussed earlier the fluid nature of time and the blurred line between illusion and reality. Some of the significant quotes are discussed below: 1. â€Å"As these thoughts, which have here to be set down in words, were f lashed into the doomed man’s brain rather than evolved from it the captain nodded to the sergeant. The sergeant stepped aside.† This line appears at the end of the first part of the story, right before Farquhar falls into his death and shows a significant turning point in the story (Bierce, 1948). The execution itself resumes in the third part of the story where Bierce gives details concerning Farquhar’s past. Following this flashback, in the second part, the writing comes back, not in truth, but in fantasy. 2. â€Å"