How Do the Poor Respond to Rising Prices?

Recent estimates show that after falling in the 1980s, poverty has made a comeback in Pakistan during the 1990s. The Government of Pakistan (GOP) estimate show an increase in caloric poverty headcount from 17 percent in 1987-88 to 33 percent in 1998-99 and also rising income inequality during the 1990s.1 In contrast preliminary estimates by the World Bank show that poverty may not have risen as rapidly during the 1990s and may even have stagnated.2 Slow down in economic growth, rising open unemployment, rising food and non-food prices, reduction in the fiscal space for pro-poor public programmes, poor governance hampering delivery of social services to the poor; are factors that have been attributed to the growing poverty and vulnerability of households in recent years. The Government has recently taken some important initiatives to deal with rising poverty. These include the Rs 21 billion Integrated Rural Urban Development public works programme, establishment of the Khushali Bank (Micro-Finance Bank) and the Food Support Programme for poor households with income less than Rs 2000/ PM. These programmes are in addition to the existing public social safety net programmes such as Zakat/Ushr and Pakistan Baitul Maal, and the Social Action Programme. The ongoing work on the Poverty Reduction Strategy Paper (PRSP) is a laudable effort by the government to take poverty issues seriously and to come up with a poverty reduction strategy in a consultative and participatory manner.

Effectiveness of Ozone Treatment for Chronic Anal Fistula

Objective: To find out if the ozone treatment is promising for chronic anal fistula. Study Design: Non Randomized Trial.Study Location and Duration: General Surgery Department Bahawal Victoria Hospital Bahawalpur. From 20 December 2017 to 28 February 2019. Material and methods: A total of 57 patients were included in our study. Success of the treatment was based upon the cessation of the discharge and closure of the anorectal fistula at the end of the treatment. Statistical analysis was done using computer software SPSS version 23. Mean and standard deviation was calculated for continuous variables like age etc. and frequency and percentage was taken for categorical variables like, gender etc. Comparison of number of sessions for healing and non healing patients was done using a t test. P value of less than or equal to 0.05 was taken as significant. Results: A total of 57 patients presenting with anorectal fistula were included in the study. A total of 19 patients received 60 volume of ozone, 23 received 120 volume of ozone and remaining 15 received 180 volume of ozone. Means and standard deviation of sessions of treatment with ozone was 8.29±3.66. Closure of the fistula was seen in only 14 patients while 43 did not show any improvements or they had reoccurrence of anorectal fistula after getting treatment with ozone.  Conclusion: On the basis of the results of this study, it can be concluded that ozone insufflation is not a promising treatment option for the treatment of anorectal fistula. There were no associated side effects of ozone insufflation. Further studies are required with larger sample size. Keywords: Ozone Insufflation, Anal Fistula, Enterocutaneous Fistula DOI: 10.7176/JMPB/55-20 Publication date:May 31st 201

Whether Alvarado scoring system is A Reliable Diagnostic Tool for Acute Appendicitis.

Objective: to evaluate the diagnostic accuracy (discrimination) and implementation performance of Alvarado score. Methodology: This cross sectional study was done in Surgerical unit of Bahawal Victoria  hospital Bahawalpur under supervision of consultant Surgeons of department. Study duration was 1 year from March 2018 to March 2019. For quantitative variables like age of patients Mean and SD was calculated, and frequency percentages were calculated for categorical data like gender. Negative appendectomy rate, positive predictive value, negative predictive value, sensitivity, specificity was calculated by using 2-2 contingency table. Results: Total 300patients enrolled in this study, both genders. Alvarado scoring at presentation, 15% (n=45) patients were categorized into Group I. 13% (n=39) patients were included in Group II. While, 72% (n=216) were enrolled in Group III. Diagnostic test was positive in 223 patients. While, acute appendicitis was confirmed histo-pathologically in 160 patients. Gangrenous appendicitis observed in 3 patients. Chronic appendicitis, perforated appendicitis, appendicular abscess, no specific pathology, gangrenous intestine and salpingo-oophoritis was observed as 31, 6, 9, 6,3 and 5 respectively. There were 174 patients true positive, 49 were false positive, 59 were false negative and 18 were true negative. Sensitivity, specificity, negative predictive value and negative predictive value were 74.68% 26.87%, 78.02% and 23.37% respectively. Conclusion: Alvarado scoring system is useful tool in diagnosis of appendicitis in pre-operative period which can be useful for surgeons at any level of health care. According to our study observations Alvarado scoring system has better sensitivity 74.68% but specificity 26.87% which shows that Alvarado scoring system is helpful in diagnosis of appendicitis but not much helpful in preventing negative laparotomies. Keywords: Right lower quadrant pain, Appendicitis scoring, Faecal peritonitis, Ultrasound abdomen, Perforated appendix. DOI: 10.7176/JMPB/55-15 Publication date:May 31st 201

The Interest of the Supreme Audit Institution in Sustainable Economic, Social and Environmental Development on the Audit Quality Performance

Purpose: This research aims to Identify role of the Board of Supreme Audit has a significant role in achieving the dimensions of sustainable development (SD).   Theoretical framework: The research provides a conceptual framework for SD, its objectives and dimensions. It probes the role of supreme audit institution (SAI) in achieving the goals of SD.   Design/methodology/approach: The study examined the perceptions of 100 participants affiliated to the institution of financial supervision, department of technical studies and research. we are hypothesized that the SAI has an interest in SD, and that this interest is reflected in the quality of auditing performance. we are used Z-TEST to test the significance of the association hypotheses between the interest of SAI in economic, social and SD and the quality of the control audit performance.   Findings: The study found that the most supreme audit achieved the completion of the tasks entrusted with high levels of quality in performance. Results also showed that there is a statistically significant correlation between the SAI interest in sustainable economic, social and environmental development (SED) and the quality of auditing performance.   Research, Practical & Social implications: The interest of SAI in sustainable economic, SED on the quality of auditing performance.   Originality/value: the Originality of value in the article by the role of audit quality (AQ) over the organizing relationships, dividing work according to terms of reference, providing the necessary resources, and exerting the necessary professional care

Impact of Authentic Material on ESL Learners’ Receptive Vocabulary Size

In Pakistani pedagogical process, English is taught as foreign or second language and as a compulsory subject from class 1 to bachelor level. But the results are unsatisfactory in the whole process. Various studies (Heflin, & Alaimo, 2007) have been conducted to find out the reasons and remedies but vocabulary being the most important part of a language is not given due concern in pedagogical process. This research study is undertaken to observe the impacts of authentic material i.e. newspaper on ESL learners’ receptive vocabulary size at intermediate level. This is basically a quantitative research which borrowed the framework of an experimental research. The population was the ESL learners at bachelor level in Lahore. Through convenience sampling technique, the researchers have selected 50 students and formed them into control and experimental groups. The data were collected with pre-test and post-test tools. Later, data were analyzed statistically and shown in charts. In this research study, the researchers have found that good results can be obtained by teaching ESL learners with the help of authentic material i.e. newspaper as compared to the traditional methods of text book teaching. The EFL process can be enhanced with living and practical settings

Impact of Authentic Material on ESL Learners’ Receptive Vocabulary Size

In Pakistani pedagogical process, English is taught as foreign or second language and as a compulsory subject from class 1 to bachelor level. But the results are unsatisfactory in the whole process. Various studies (Heflin, & Alaimo, 2007) have been conducted to find out the reasons and remedies but vocabulary being the most important part of a language is not given due concern in pedagogical process. This research study is undertaken to observe the impacts of authentic material i.e. newspaper on ESL learners’ receptive vocabulary size at intermediate level. This is basically a quantitative research which borrowed the framework of an experimental research. The population was the ESL learners at bachelor level in Lahore. Through convenience sampling technique, the researchers have selected 50 students and formed them into control and experimental groups. The data were collected with pre-test and post-test tools. Later, data were analyzed statistically and shown in charts. In this research study, the researchers have found that good results can be obtained by teaching ESL learners with the help of authentic material i.e. newspaper as compared to the traditional methods of text book teaching. The EFL process can be enhanced with living and practical settings

Teaching shock pathophysiology by flipped classroom: Views and perspectives

Flipped classroom (FCR) is an active learning pedagogical method in which the students prepare prior to class using different modalities, for example, reading materials and videos, and afterward spend the time in class discussing the content and reinforcing the concepts. We chose to replace one problem-based case on Shock with flipped-style teaching in the respiration circulation module of a private medical university. Our objective was to use the clinical presentation of Shock to open a window to interrelate basic science concepts of cardiovascular physiology and pathology. It aimed to merge the case-based discussion with small-group discussions in the form of FCR activity. The qualitative study gives an overview of comments of facilitators, observers, and leadership of the Department and University obtained during focus group discussions and in-depth interviews. Thematic analysis of responses emphasized the importance of FCR as an effective teaching learning modality, which can be made more effective by careful selection of topic and provision of facilities to support technology-enhanced learning. The discussions with facilitators, observers, and leadership revealed its usefulness through student\u27s engagement and increased participation to build learning of the key concepts. Student satisfaction in these activities can be enhanced by construction of knowledge acquired in non-face-to-face component with substantial pre-reading materials, videos, peer discussions, quizzes, and prompt feedback

Overcrowding in the emergency departments: challenges and opportunities for improvement

With the advent of Emergency Medicine, one can observe an increase in the number of Emergency Departments (ED) across the country. However, most EDs struggle due to an overwhelming number of patients. Overcrowding can lead to delays in patient care. For a city like Karachi which is an active disaster zone, preemptive preparedness is required in the face of terror threats and such overcrowding needs to be decreased to a bare minimum. The most frequent causes of prolonged length of stay (LOS) in the ED include non-availability of in-hospital beds, delays in response to subspecialty consultations and escalating medical expenses. All of these can negatively impact patient care by putting patient safety at risk and patient care in jeopardy. There is an increased risk of unintentional medical errors and a concomitant increase in unwanted lawsuits. A few simple interventions which may help alleviate this situation to some extent have been discussed