Provincial Finance Commission: Options for Fiscal Transfers

The Provincial Finance Commissions were constituted in all four provinces of Pakistan in 2001. The Commissions were asked to formulate a formula for the distribution of resources among the districts in their respective province to ensure smooth functioning of the local governments and to minimise the poverty and income inequalities among the districts. This paper analyse to what extent the existing development transfers are based on the existing level of deprivation in the districts by looking at the Rank Correlation between them. This paper also runs different simulations to suggest different options for the provincial governments to improve the distribution formulas.

POLITICAL ECONOMY OF BALOCHISTAN, PAKISTAN: A CRITICAL REVIEW

This paper aims at exploring the political economy of Balochistan and the underlying causes of social and economic development of the province. The paper presents a brief and critical account on the historical development of the Baloch nation and nationhood. The paper argues that The Baloch notwithstanding having a huge and resourceful land has failed to keep the pace of socio-economic development and modernity with other fellow nations in the region. After the independence of Pakistan and the formation of Balochistan as a province of Pakistan, the Baloch because of her political disorganization and economic backwardness failed to exert herself within the federation to grab the resource share. The story of economic and social backwardness of the Baloch and Balochistan is a multifaceted puzzle. A section of the Baloch nationalists believe that the centralist nature of Pakistani federation is such that small nationalities like the Baloch would find it hard to accommodate within the federation. That is because, the resource distribution and representation to both elected bodies and state institutions are based upon population, and Balochistan in spite of having 44% of Pakistan territory accommodates only 5% of country’s total population. The paper also touches the geostrategic importance of Balochistan and underlines its economic difficulty in terms of the dearth of human resources, physical infrastructure, economic autonomy, productivity among others

Outcome of Subtrochanteric Femur Fractures Treated by Proximal Femoral Nail in a Tertiary Care Hospital

Background: Subtrochanteric femoral fractures are challenging for surgeons, as it has strong collapsing forces at fracture site.The management of sub-trochanteric fractures, especially nonunion is challenging.Proximal Femoral Nail can be helpful in achieving high success rate. But there was a lack of local evidence. Objective: To determine the Outcome of Subtrochanteric Femur Fractures Treated by Proximal Femoral Nail in a Tertiary Care Hospital. Material and methods: This prospective study was conducted from 1stJuly 2017 to 30th June 2019. The inclusion criteria were all the patients of both genders above 16 years of age presented to emergency department with subtrochanteric fractures of the femur. Exclusion criteria included pathological fractures, fractures in children, old neglected fractures and multiple fractures. Radiographs were taken and all the patients were classified according to Seinshemers classification. All the patients underwent internal fixation with Proximal Femoral Nail. The outcome of all patients were assessed by using Modified Harris Hip Score. Results: A total of 110 patients were included in the study. Mean age of patients was 30.05±8.59 years. 81 (73.63 %) patients were males and 29 (26.36%) were females. According to Seinshemers classification, we had 54 patients with Type II fracture, 35 patients with Type III fracture, 19 patients with Type IV fracture and 02 patients with Type V fracture. Mean duration of hospital stay was 06 days and mean time of full weight bearing was 12 weeks. In our study, excellent results were found in 71 patients (64.5%), good results in 28 patients (25.4%), fair results in 06 patients (5.4%) and poor results in 03 patients (2.7%).02 patients were lost in follow up. The mean Harris Hip score was 93.5± 5.42. 14 patients (12.7%) had minor complications including 06 patients with Superficial wound infections, 03 patients with Deep infection, 01 patient with Deep vein thrombosis and 04 patients had Fracture from distal tip of nail. All the fractures unite within 6 months period and no implant failure was observed. Conclusion: Proximal Femoral Nail is a good choice implant for the fixation of subtrochanteric femur fractures leading to high rate of union, fewer implant related complications and excellent functional outcome. Key words: Subtrochanteric, Femur fracture, Proximal Femoral Nail, Modified Harris Hip Score, Seinshemers classification, Complication

Inter-Governmental Funds Flows in Pakistan: Are they Reducing Poverty?

The purpose of this paper is to see whether any link can be found between the inter-governmental fiscal transfers and the deprivation index in the districts of Pakistan. The data for the study was collected from 98 districts of four provinces of Pakistan for the year 2003 and 2007. The results of the study shows the transfers have reduced deprivation across the board but unable to solve disparity issue. In fact the results show the extreme inequality (ratio of maximum to minimum) has increased over time but average disparity (coefficient of variation) gives mixed results. Keywords: Fiscal Federalism, Horizontal Inequity, Vertical Inequity, Intergovernmental Fiscal Transfer

Provincial Finance Commission: Options for Fiscal Transfers

The Provincial Finance Commissions were constituted in all four provinces of Pakistan in 2001. The Commissions were asked to formulate a formula for the distribution of resources among the districts in their respective province. The formula includes both transfers- the development transfer and current transfers. The purposes of the current transfers are to ensure the maintainability of existing services at the districts level and of the development grants to minimise the intradistrict poverty and inter-districts income differential. In this paper we compute the Rank Correlation between the existing development grants transfer index and the deprivation index. This will help the policy-makers understood whether the transfers are fiscal need based or not? That is to highlight to what extent the existing development transfers are based on the existing level of deprivation in the districts. If not, then what can be done to make the transfers pro-poor. To assist the policy maker in this regards this study carried out a simulation when 50 percent transfers are based on population and 50 percent on deprivation. This simulation will provide sufficient range in which the policy maker can exercise their discretion to minimise poverty and at the same time provide resources to maintain existing infrastructure. The distribution of funds among the districts which is based only on expenditure needs of the districts cannot help address poverty issue. The provinces therefore, have to use different indicators in the formula of PFC Award to achieve both objectives

Epidemiology, Causes and Outcome of Obstetric Acute Kidney Injury

Namrata Khanal, Ejaz Ahmed, and Fazal Akhta

An Unusual Case of Gallbladder Carcinoma with Pseudopancreatic Cyst

Generally, carcinoma of the gallbladder is an extremely unusual neoplasm, however, high incidence rates have been reported in certain parts of the world. The role of certain factors such as genetic susceptibility, lifestyle and infections of gallbladder in causing carcinogenesis is still not clearly understood. Due to its early vague symptoms and lack of serosa in the gallbladder to slow its spread, gallbladder carcinoma typically presents at an advanced stage with a five-year survival rate of less than 5%. Pseudopancreatic cyst is an uncommon but not a rare complication of acute pancreatitis and injury to the pancreas. However, it rarely presents with carcinoma of gallbladder. We present here an unusual case of gallbladder carcinoma with pseudopancreatic cyst in a 58-year old male

Quantum 3j3j-symbols for Uq(sl3)U_q(\mathfrak{sl}_3)

We propose an algebraic expression for $U_q(\mathfrak{sl}_3)$ quantum $3j$ symbols (quantum Clebsch-Gordan coefficients) appearing in the decomposition of tensor product of symmetric representations. Our compact form will be useful to write the spectral parameter dependent $R$-matrix elements for any bi-partite vertex model whose edges carry states of the symmetric representations

Achieving Universal Salt Iodisation (USI) in Pakistan: Challenges, Experiences and the Way Forward

This article aims to describe the history, progress, success and challenges of the Universal Salt Iodisation (USI) programme in Pakistan, which was launched in 1994. Revitalised in 2005 with financial assistance and technical, operational, logistic and commodity support from the Micronutrient Initiative (MI), it is now being implemented in 102 districts of Pakistan. With an increase in household utilisation of iodised salt from 17 per cent in 2001 to 69 per cent in 2011, severe iodine deficiency among women and school?aged children has decreased to 3 per cent and 2 per cent respectively. Strong government ownership and commitment, coupled with effective monitoring and supervision, have been the driving force of the USI Pakistan programme. These, combined with quality control measures, stringent regulatory and enforcement mechanisms, availability of fortificants in the open market and demand generation are the necessary requirements for programme sustainability