New Keynesian Macroeconomic Model and Monetary Policy in Pakistan

The New Keynesian (NK) models have advantage over the Real Business Cycle (RBC) models as they allow rigidities in the structure of the model, hence provide built-in mechanism to incorporate the structural shocks. The estimation of the NK model for Pakistan’s economy remains a relatively unexplored area. This study attempts to estimate a closed economy version of the NK model using robust econometric technique. On the empirical side macroeconomic dynamics have been investigated in response to unanticipated monetary shock. The reaction of the monetary authority (the State Bank of Pakistan) in response to structural shocks has been assessed by exploring the role of forward looking expectations. The SVAR model has been employed to estimate the structural parameters. The response of macroeconomic aggregates to structural shocks has also been simulated along with discussing the forecast error variance decomposition. The role of forward looking expectations is found to play prominent role in the prevailing market structure of the country. The State Bank of Pakistan (SBP) has been found to respond to shocks after a lag of one or more periods indicating time inconsistency problem which is due to discretionary monetary policy stance being adopted by the monetary authority. The distorted beliefs of economic agents about the stance of monetary policy have pointed towards weak effectiveness of the monetary policy. The results suggest that the SBP would have to adopt an independent and transparent monetary policy by following some sort of Taylor-type rule. JEL Classification: C32, C51, E52, E58 Keywords: New Keynesian Models, Real Business Cycle Models, Forward Looking Expectations, SVAR Model, Price Puzzl

An Emergence and Paradigm Shift of Biographical Research in Electronic Era

The present era which is called the Research century has raised and diversified the elements of research in many different aspects, categories and subcategories. This research paper has first developed the theme for clearing the mirror of biographical research. The biographical research is based on an individual life and it revolves around aspects of life. This research owns the diamond shape because it includes method, experience, ethnography, oral history, life story, history, autobiography, life, personal history, ethnography story, epiphany, life history, case, and biography, self-story, narrator, writing presence, personal experience story, discourse and fiction. The core concept of this research is to draw the clear picture of biographical research by analyzing common and agreed techniques from different researchers and practitioners. The biographical research revolves around the human life and it observes it how a person’s acts, behave, react and understand towards a particular condition or event. Furthermore, researcher of a biographical research interprets in such a way that the reader feels himself as the part of that particular event and is able to conclude and learn from the experiences. Keywords: Biographical research, Life story, Life history, Paradigm

Acute unilateral hearing loss as an unusual presentation of cholesteatoma

BACKGROUND: Cholesteatomas are epithelial cysts that contain desquamated keratin. Patients commonly present with progressive hearing loss and a chronically discharging ear. We report an unusual presentation of the disease with an acute hearing loss suffered immediately after prolonged use of a pneumatic drill. CASE PRESENTATION: A 41 year old man with no previous history of ear problems presented with a sudden loss of hearing in his right ear immediately following the prolonged use of a pneumatic drill on concrete. The cause was found to be a fractured long process of incus which had been eroded by the presence of an attic cholesteatoma. A tympanomastoidectomy and ossiculoplasty was performed with good result. CONCLUSION: Cholesteatomas may be asymptomatic and insidious in their onset. This case illustrates the point that an indolent disease such as this may present in unusual ways and the clinician must always have a high index of suspicion combined with thorough assessment and examination of every patient

Development of Environment-Friendly Concrete through Partial Addition of Waste Glass Powder (WGP) as Cement Replacement

This paper presents the study carried out on the utilization of Waste Glass Powder (WGP) as supplementary cementitious material in concrete. The evaluation of the influence of WGP on the mechanical properties of concrete was carried out by casting and testing of concrete samples as per ASTM standards (cylinders and beam elements). The control samples were designed to represent field conditions with a target compressive strength of 20,000 kPa. The Portland cement in concrete was substituted with WGP in proportions of 0%-35% by weight, in increments of 5%. Two curing domains were adopted in the preparation of the test samples to evaluate the effect of pozzolanic material wherein the tested samples were cured for 28, 56, and 84 days. The study results indicated a reduction in compressive strength of concrete up to 10% with partial replacement of cement with 25% of WGP when standard curing of 28 days was adopted. Furthermore, with the same replacement proportion and prolonged curing for 84 days, the gap in strength reduction was reduced by 5%. However, a significant decrease in workability was noted between the control concrete samples and glass powder infused concrete. Furthermore, the Waste Glass Powder Concrete (WGPC) exhibited an improved flexural strength with the modulus of rupture for WGPC being 2% higher than control concrete at the age of 84 days. Based on the results of this study it was concluded that 25% replacement of cement with WGP provides an optimum replacement ratio. Doi: 10.28991/cej-2020-03091620 Full Text: PD

Impact of Length and Percent Dosage of Recycled Steel Fibers on the Mechanical Properties of Concrete

The global rapid increase in waste tyres accumulation, as well as the looming social and environmental concerns, have become major threats in recent times. The use of Recycled Steel Fiber (RSF) extracted from waste tyres in fiber reinforced concrete can be of great profitable engineering applications however the choice of suitable length and volume fractions of RSF is presently the key challenge that requires research exploration. The present experimental work aims at investigating the influence of varying lengths (7.62 and 10.16 cm) and dosages (1, 1.5, 2, 2.5, 3, 3.5, and 4%) of RSF on the various mechanical properties and durability of concrete. Test results revealed that the varying lengths and dosages of RSF significantly affect the mechanical properties of concrete. The improvements in the compressive strength, splitting tensile strength, and Modulus of Rupture (MOR) of RSF reinforced concrete observed were about 26, 70, and 63%, respectively. Moreover, the RSF reinforced concrete showed an increase of about 20 and 15% in the yield load and ultimate load-carrying capacity, respectively. The durability test results showed a greater loss in compressive strength and modulus of elasticity and a smaller loss in concrete mass of SFRC. Based on the experimental findings of this study, the optimum dosages of RSF as 2.5 and 2% for the lengths 7.62 and 10.16 cm lengths, respectively are recommended for production of structural concrete. Doi: 10.28991/cej-2021-03091750 Full Text: PD

Therapy Of Endocrine Disease: Surgery In Microprolactinomas: Effectiveness And Risks Based On Contemporary Literature

Microprolactinomas are the most common pituitary adenomas. In symptomatic patients, dopamine agonists are the first-line treatment of choice; when cabergoline is used, biochemical control rates between 85 and 93% have been reported. Long-term treatment is needed in most of the cases with compliance, patient convenience, and potential adverse effects representing areas requiring attention. Based on the literature published in the past 15 years, transsphenoidal surgery can lead to normal prolactin in the postoperative period in usually 71–100% of the cases with very low postoperative complication rates. Surgical expertise is the major determinant of the outcomes, and it may be a cost-effective option in young patients with life expectancy greater than 10 years (provided it is performed by experienced surgeons at high volume centers with confirmed optimal outcomes). Larger series of patients with adequate follow-up could further validate the place of transsphenoidal surgery (particularly through the endoscopic approach for which long-term results are currently limited) in the management algorithm of patients with microprolactinoma.</jats:p

Diagnostic value of bronchoalveolar lavage in the subset of patients with negative sputum/smear and mycobacterial culture and a suspicion of pulmonary tuberculosis

Background: The diagnostic value of bronchoalveolar lavage in patients with negative sputum/smear for tuberculous bacilli has been well studied. However, its value in the subset of patients with both negative sputum/smear and culture is seldom reported. Methods: A retrospective study of patients referred for diagnostic bronchoscopy for the suspicion of pulmonary tuberculosis during the period from April 1st, 2015 to March 30th, 2016, and who had negative sputum/smear and culture for tuberculous bacilli. Results: One hundred and ninety patients fulfilled the inclusion criteria. Bronchoalveolar lavage detected further 61/190 (32.1%) pulmonary tuberculosis cases. Bronchoalveolar lavage mycobacterial culture and polymerase chain reaction (positive in 60/190 (31.6%) and 58/190 (30.5%) of patients respectively) provided the highest diagnostic yield, whereas direct smear provided the lowest yield. Bronchoalveolar lavage had a sensitivity of 89.7%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 94.6%, and a test accuracy of 96.3% in suspected pulmonary tuberculosis cases with negative sputum/smear and culture. Positive bronchoalveolar lavage yield for tuberculosis was significantly associated with a positive QuantiFERON-TB Gold In-Tube test, positive purified protein derivative skin test, radiological evidence of upper zone abnormality and patient's origin being from the Indian subcontinent. Conclusion: Bronchoalveolar lavage should be pursued as a useful diagnostic tool for suspected pulmonary tuberculosis cases when sputum/smear and culture are negative. Its value is higher in the subset of patients with positive QuantiFERON-TB Gold In-Tube test, positive purified protein derivative skin test, upper zone abnormality on radiograph or being from the Indian subcontinent.Scopu

The Burden of Revision Sinonasal Surgery in the UK – Data from the Chronic Rhinosinusitis Epidemiology Study (CRES); a cross sectional study

Objectives/Hypothesis The aim of this study was to investigate the surgical revision rate in patients with Chronic Rhinosinusitis (CRS) in the UK CRS Epidemiology Study (CRES). Previous evidence from national Sinonasal Audit showed that 1459 CRS patients demonstrated a surgical revision rate 19.1% at 5 years, with highest rates seen in those with polyps (20.6%). Setting Thirty secondary care centres around the UK. Participants A total of 221 controls and 1249 patients with CRS were recruited to the study including those with polyps (CRSwNPs), without polyps (CRSsNPs) and with allergic fungal rhinosinusitis (AFRS). Interventions Self-administered questionnaire. Primary outcome measure The need for previous sinonasal surgery. Results A total of 651 patients with CRSwNPs, 553 with CRSsNPs and 45 with AFRS were included. A total of 396 (57%) of patients with CRSwNPs/AFRS reported having undergone previous endoscopic nasal polypectomy (ENP), of which 182 of the 396 (46%) reported having received more than one operation. The mean number of previous surgeries per patient in the revision group was 3.3 (range 2 to 30) and a mean duration of time of 10 years since the last procedure. The average length of time since their first operation up to inclusion in the study was 15.5 years (range 0-74). Only 27.9% of all patients reporting a prior ENP had received concurrent endoscopic sinus surgery (ESS) (n=102). For comparison, surgical rates in patients with CRSsNPs were significantly lower; 13% of cases specifically reported ESS and of those only 30% reported multiple procedures (chi-squared p < 0.001). Conclusions This study demonstrated there is a high burden of both primary and revision surgery in patients with CRS, worst in those with AFRS and least in those with CRSsNPs. The burden of revision surgery appears unchanged in the decade since the Sinonasal Audit

Evaluation of smoking as a modifying factor in chronic rhinosinusitis

Importance: The negative association of smoking with the respiratory tract is well known; however, the association between smoking and chronic rhinosinusitis (CRS) has not been well characterized. Objective: To analyze whether active smoking was a risk factor for CRS development, smoking was associated with disease-specific quality of life, and smokers experience an increased symptom burden than nonsmokers.  Design, Setting, and Participants: This subanalysis of the Chronic Rhinosinusitis Epidemiology Study (CRES), a prospective, questionnaire-based case-control study conducted between October 2007 and September 2013 was conducted across 30 UK tertiary/secondary care sites. Participants were identified at ear, nose, and throat outpatient clinics and classified into CRS phenotypes as per European Position Paper on Rhinosinusitis and Nasal Polyps 2012 criteria. The overall response rate of those identified to take part in the study was 66%. A total of 1535 questionnaires were returned, with 1470 considered eligible for inclusion. Data analysis was conducted in January 2020.  Main Outcomes and Measures: The CRES was designed to distinguish differences in socioeconomic status, geography, medical comorbidities, lifestyle, and quality of life between patients with CRS and healthy controls.  Results: A total of 1450 patients completed the smoking question, comprising 219 controls (15.1%; mean [SD] age, 47.3 [14.9] years; 143 women [68%]), 546 participants with CRS (37.7%; mean [SD] age, 51.8 [15.3] years; 259 women [53%]) without nasal polyps (CRSsNPs), and 685 participants (47.2%; mean [SD] age, 56.0 [14.5] years; 204 women [33%]) with CRS and nasal polyps/allergic fungal rhinosinusitis (CRSwNPs+). The mean age was similar, with a greater female preponderance in the control group and male in the CRSwNP group. The greatest number of active smokers was found among control participants (33 [15%]), with a lower rate of smokers in the patients with CRSwNPs+ (9.9%) and CRSsNPs (13.9%), respectively. We found a clinically significant difference in the mean difference in Sino-nasal Outcome Test (SNOT-22) scores between active smokers and nonsmokers for both CRS phenotypes (4.49, 12.25). In both CRS subgroups active smokers had significantly worse SNOT-22 scores than nonsmokers by a mean (SD) magnitude of 10 (18.99, 24.14) points. Nonsmokers also demonstrated a higher percentage of surgical procedures (1 or more), although this was not clinically or statistically different (0.34, 1.10).  Conclusions and Relevance: This questionnaire-based case-control study demonstrated a clinically significant symptom burden associated with active cigarette smoking, with worse SNOT-22 scores in the smoking cohort by a mean magnitude of 10 points. We could find no demonstrable evidence that smoking increases the likelihood of need for revision sinus surgery. Clinicians should encourage smoking cessation alongside general CRS medical management

Delineation of nutrient management zones in Chunian using soil attributes database developed by soil fertility research institute, Punjab, Pakistan

A significant increase in food production, approximately 70%, is needed to feed the estimated 9.1 billion world population by 2050. Site-specific nutrient management through adoption of Precision Agriculture (PA) technologies can potentially increase crop productivity while keeping the use of chemical fertilizers at its minimum required level. In this study, agricultural land of tehsil Chunian was delineated into management zones using georeferenced soil attributes database developed by Soil Fertility Research Institute (SFRI), Punjab. Appropriate number of zones was determined after conducting fuzzy c -means unsupervised clustering analysis by using Management Zone Analyst (MZA) software and finally Quantum Geographic Information System (QGIS) was used to differentiate study area into five zones. Analysis of variance was performed to verify whether these defined zones reflect soil attributes. We concluded that tehsil Chunian could be categorized into five statistically different management zones based on soil electrical conductivity (EC), pH, soil organic matter (SOM), available potassium and available phosphorus levels. The highest crop yield was predicted in southeastern parts of tehsil Chunian represented by management zone-2 (4.4 t ha-1) followed by zone-1 (4.3 t ha-1). Whereas, northern and northwest areas were predicted with decreasing trend of wheat yield (zone-5, 3.7 t ha-1; zone-4, 4.0 t ha-1), respectively. We found that MZA and QGIS software could be used as supportive tools for making informed-decisions and the database of soil attributes developed by SFRI would serve as primary source of information for adoption of PA technology in coming years