Participatory Development Praxis: A Case Study from Pakistan’s Punjab

A programme, which began with the goal of overcoming poverty in rural Punjab within a decade, is historically unprecedented in this province for both its magnitude and complexity of effort. It was therefore clear from its inception that the PRSP would have to bring together a talented team of managers, each of whom could combine creativity with commitment. The challenge was to create a work culture in which this creativity and commitment could be sustained through an intensive work schedule and collective synergy. Since we were facing a unique set of circumstances in each of the eight regions where we started work, it was necessary to develop a management system that permitted sufficient space to each member of the team for independent thought and action, while at the same time, creating an environment for collective reflection and conceptualisation through which we could deepen the quality of social action. This report attempts to present the principles underlying the initial management style and work procedures of PRSP, while also reporting on the strategic plan we devised through initial field visits, the objectives we specified for the programme and the remarkable results that were achieved in the first four months

Institutional Imperatives of Poverty Reduction

The high food inflation in the last three years has pushed 11 million people into a state of hunger and poverty. Given the present trend, if no policy action is taken, an additional 22 million people will be impoverished over the next four years (see Table 7). According to the World Food Programme Survey for the Vulnerability Analysis and Mapping Unit as many as 77 million people upto March 2008 are deemed “food insecure”1, where the food insecure population is defined as those consuming less than 2350 calories per person per day. The statistical evidence clearly shows Pakistan is in the grip of a poverty crisis. Ms. Bushra’s action stands as stark testimony of the human experience of poverty. It also poses a challenge to policy makers as much as to economists to undertake urgent policy action on the basis of a scientific analysis of the problem

Mechanism of saline deposition and surface flashover on high-voltage insulators near shoreline:mathematical models and experimental validations

This paper deals with sea salt transportation and deposition mechanisms and discusses the serious issue of degradation of outdoor insulators resulting from various environmental stresses and severe saline contaminant accumulation near the shoreline. The deterioration rate of outdoor insulators near the shoreline depends on the concentration of saline in the atmosphere, the influence of wind speed on the production of saline water droplets, moisture diffusion and saline penetration on the insulator surface. This paper consists of three parts: first a model of saline transportation and deposition, as well as saline penetration and moisture diffusion on outdoor insulators, is presented; second, dry-band initiation and formation modelling and characterization under various types of contamination distribution are proposed; finally, modelling of dry-band arcing validated by experimental investigation was carried out. The tests were performed on a rectangular surface of silicone rubber specimens (12 cm × 4 cm × 8 cm). The visualization of the dry-band formation and arcing was performed by an infrared camera. The experimental results show that the surface strength and arc length mainly depend upon the leakage distance and contamination distribution. Therefore, the model can be used to investigate insulator flashover near coastal areas and for mitigating saline flashover incidents.</p

Design and implementation of hybrid vehicle using control of DC electric motor

The electric motors and its control technology are key components of hybrid electric vehicles (HEVs). Control of the electric motor is a fundamental issue for traction application in electric vehicles and HEVs. This paper presents the design, development and implementation of a hybrid vehicle using both an electric motor and petrol engine to increase efficiency and decrease carbon footprint. Initially, a prototype of a HEV is designed and the performance values are calculated, before a control system is developed and implemented to control the DC motor speed using a microcontroller as the vehicle’s electronic control unit along with simple proportional integral derivative (PID) control using speed as a feedback mechanism. The prototype made incorporated voltage, current, speed and torque sensors for feedback resulting in a closed loop control system which successfully matched the speed input of a user-controlled pedal sensor. A user interface was developed to show the driver of the vehicle key variables such as the revolutions per minute (RPM) of the motor, the speed of the vehicle along with the current being drawn, and the voltage applied to the motor with overall power. To output a variable voltage from the Arduino, a digital output was used with pulse width modulation (PWM) capabilities in order to provide a variable DC voltage to the speed controller

A qualitative study exploring perspectives towards rational use of medicines in Pakistan's Malaria Control Program (MCP)

A malária é um dos mais importantes problemas sanitários globais, que ameaça a saúde população devido às condições socioeconômicas e por razões epidemiológicas no Paquistão. Este estudo qualitativo focou-se nas perspectivas no sentido do uso racional da intervenção médica entre os funcionários do programa de controle da malária. Oito entrevistas semiestruturas com todos os funcionários que trabalham no programa de controle da malária foram conduzidas em Islamabad. As entrevistas, que eram gravadas e transcritas, foram avaliadas por análise temática do conteúdo e por todos os autores. Todos os respondentes concordaram com o êxito da implementação do programa de controle da malária no Paquistão por meio do aprimoramento do diagnóstico e de facilidades do tratamento, promovendo a gestão racional por meio do treinamento dos prescritores. Entretanto, o financiamento é, ainda, o principal desafio enfrentado para a implementação futura do programa.Malaria is one of the most important global public health problems threatening the health of the population owing to prevailing socio-economic conditions and epidemiological reasons in Pakistan. This qualitative study has focused on the perspectives held towards the rational use of medicine intervention among malaria control program officials. Eight semi-structured interviews with all officials working for the malaria control program in Islamabad were conducted. The interviews, which were audio-taped and transcribed verbatim, were evaluated by thematic content analysis and by all authors. All respondents agreed on successful implementation of the malaria control program in Pakistan for controlling malaria by improving diagnostic and treatment facilities and promoting rational case management through training of prescribers. However, funding is still the major challenge faced by the program for its future implementation

Comparison of the Efficacy of Multi Dural Stab Craniectomy with Open Dural Flap Craniectomy in Patients Having Acute Subdural Hematoma

Background/Objective:  We compared the efficacy of multi-dural stab craniectomy with open dural flap craniectomy in patients having acute subdural hematoma. Materials and Methods:  A randomized controlled trial was conducted in the Department of Neurosurgery, Allied hospital, Faisalabad. 70 patients having acute subdural hematoma were included. All of the patients were randomized in two groups: group A received a multi-dural stab craniectomy, while group B received an open dural flap craniectomy. Efficacy was assessed after 3 months of treatment in terms of a good recovery. Results:  Out of 70 patients, the mean age was 34.51 ± 8.712 years. Because of similar age and presenting GCS, the data show a non-significant difference in clinical outcomes between patients undergoing multi dual stab and open dural flap operations. However, a significant difference between the clinical results occurred at 3 months after the surgery (p-value 0.004). The efficacy of the multi-dural stab procedure was significantly higher from the open dural flap surgery (p-Value 0.006). The efficacy of the multi-dural stab surgery was significantly higher in the under 35 years age group of patients compared to open dural flap surgery. The results highlight those better results were seen in both surgeries when the presenting GCS of patients was higher (GCS= 6 – 8) compared to poor outcomes in patients with GCS of less than 5/15. Conclusion:  Multi-dural stabs are a safer alternative to the open dural flap for removing acute SDH with satisfactory recovery

Comparison of Low – Versus Medium-Pressure Shunts in Pediatric Hydrocephalus – A Study of the Children Hospitals, Lahore

Objective:&nbsp;&nbsp;This prospective cross-sectional study was aimed to assess the effectiveness of low-pressure vs. medium-pressure shunts in children with hydrocephalus. Material and Methods: 52 children with different types of hydrocephalus were admitted through OPD and Surgical emergency at The Children Hospital, Lahore. All Children were gone through Ultrasonography and CT Brain plain after admission. The pediatric hydrocephalus was resolved into two groups. All patients treated with Chhabra differential pressure VP (ventriculoperitoneal) shunt in either low pressure or medium pressure. CT scans were used to assess the postoperative clinical and radiological outcomes to monitor the ventricle hemispheric ratio (VHR). Results:&nbsp;&nbsp;A low-pressure shunt was implanted in 26 individuals, whereas a medium-pressure shunt was implanted in 26 individuals. Patients varied in age from one day to thirteen years old. In group A, the average VHR was 57.58% preoperatively, but it dropped to 42.88% after surgery. Similarly, in group B, the pre-and postoperative VHR was 59.35% and 42.81%, respectively, which was statistically significant. In both groups, the incidence of shunt complications and redo shunt operation were not statistically significant. Conclusion:&nbsp;&nbsp;In this study, individuals with pediatric hydrocephalus who had a low-pressure shunt or a medium-pressure shunt had similar outcomes

Frequency of SCF Leakage in Post-operative Patients of Tethered Spinal Cord in A Tertiary Care Hospital

Objective:  The study aimed to report the incidence of CSF leakage in patients with a tethered spinal cord, post-operatively. Materials and Methods:  A total of 75 individuals aged more than 2 years and of either gender who were hospitalized for surgery for tethered cord syndrome were included. All patients had a preoperative MRI of the spine, and those above the age of 6 had urodynamic tests. Clinical evaluations were performed until hospital release, then again at 3, 6, and 12 months. Urodynamic tests and spine MRIs were redone one year following surgery. Under general anesthesia, all patients had microscopic untethering procedures to release tethering materials and heal the thecal sac. Results:  52% of patients fall under TCS type ‘simple’, whereas, 48% of patients found with complex TCS. The frequency of CSF leakage in post-operative patients with a tethered spinal cord was found in 17.33%. No CSF leak was reported in the majority of patients (49%) patients in the age group 2-30 years. 52% of patients with simple TCS reported no CSF leak, whereas, only 13(18%) patients with complex TCS reported CSF leaks. 40% of patients reported no CSF leak who was diagnosed with complex TCS. There existed a significant relationship between the types of TCS (simple/complex) for CSF leak distribution. Conclusion:  This study concluded that the frequency of CSF leakage in post-operative patients with tethered spinal cord was found in 17.33% of patients. Keywords:  Tethered Spinal Cord (TCS), CSF Leakage, Lipomyelomeningocele