The Impact of Financial Development, Tourism, Population Density and Political Stability on Environmental Degradation in Case of Pakistan

This study examined the impact of financial development, tourism, population density and political stability on environmental degradation in Pakistan over the time 1986-2017. Data of these variables is taken from World Development Indicator (WDI), World Tourism Organization (WTO), International country risk guide (ICRG) database and federal bureau of Statistics of Pakistan. To investigate the findings, three separate models are constructed by using three different indicators of financial development. Firstly, Co-Integration among variables is confirmed through Bound test of Co-Integration. The result of this test reveals that co-integration among all the variables exists in the long run. Auto Regressive Distributed Lag (ARDL) technique is used to examine short run and long run estimates. Findings of the study concluded that in all the models financial development has considerable positive relationship with CO2 related pollution in the long run while in the short run results depend on which dimension of financial development is used. As, M2 has significantly negative impact on environmental degradation whereas, Population density has negatively significant role in explaining carbon dioxide emissions in the long run but it is positive and inconsequential in the short run. Tourism has negative and significant effect on environmental deterioration in case of Political stability has statistically significant and inverse relationship with CO2 emissions both in short and long run. These outcomes may also become fruitful for Government regarding decision making. The result recommends that Government should try to focus on financial development, tourism sector and political stability more keenly. Government should impose some restrictions on financial sector as, loans and finance should only be given for productive and environment friendly projects. Taxes should be imposed on most visited tourist’ places. Awareness among people regarding depreciation of environment should be promoted by different activities or programs conducted by Government

Clinical outcome of post placental IUD CuT380 insertion in terms of expulsion

Background: Insertion of an intrauterine contraceptive device (IUD) immediately after delivery has been recommended by the World Health Organization (WHO), as one of the safe and effective methods of temporary contraception. In the immediate post delivery period the women are highly motivated and need an effective method for contraception so that the child can be brought up with a relaxed mind without the worry of unintended pregnancy. This approach is more applicable to our country where delivery may be the only time when a healthy woman comes in contact with health care personnel. However, immediate post-partum IUD insertion may have disadvantages as well. The risk of spontaneous expulsion may be unacceptably high.Methods: After taking approval from hospital ethical committee, all women planning vaginal delivery desiring IUD, admitted through OPD and emergency were evaluated in detailed on design Performa Performa include patient’s identity, age, parity, gestational age, no of alive children, outcome and timings of insertion. Informed consent was obtained. With aseptic precautions IUD was inserted with kellys forceps in the uterine cavity up to the fundus, then cervix was examined for thread (that should not be visible at cervix if proper insertion done). The procedure was performed by myself. Patients were followed at 6week by examining the threat of IUD. All the information was recorded by myself. Follow up was done by taking patients contact number.Results: In our study, out of 300 cases, 63.67% (n=191) were between 18-30 years of age while 36.33% (n=109) were between 31-40 years of age, mean+sd was calculated as 29.49+4.62 years, mean gestational age was calculated as 38.53+0.94 weeks, mean parity was calculated as 3.49+1.06 paras. Frequency of expulsion in post placental intra uterine device cuT 380 insertions reveals in 8.67% (n=26).Conclusions: We concluded that the frequency of expulsion in post placental intra uterine device cuT 380 insertions is not significantly higher and appears to be safe and effective method of contraception.

Prevalence of “Persistent Low Grade Morbidities” in a Section of Urban Youth Population

To determine the frequency and pattern of persistent low grade morbidities (PLGMs) in youth and also to identify life style factors which may influence their occurrence. Methods: In this cross-sectional study 200 younger urban people (19-24Y) were inquired by a self designed questionnaire by direct interviewing. Results: Mean age was 21years. Sixty four percent were female, 69% students, 6.5% smokers and 90.5% were unmarried. Distribution of PLGMs found was depressive mood swings(62%), frequent headache (46.5%), pain in lower limbs (44.5%), neck shoulder & back pain (44%) , easy fatiguability (42.5%), difficulty in falling asleep (38%) and epigastric discomfort (28%). More females (64.04%) were found affected. Statistically important co-variations between healthy behaviours and the absence of selected PLGMs (OR=1.01 – 2.09) was seen. Conclusions: Study findings are close to presumptions and are enough to sensitize relevant public health stake holders for needed measures. Clinical studies would help to find the ultimate causes of morbid states in focu

Determine the frequency of peripartum hystrectomy in placenta previa

Background: Peripartum hysterectomy is one of the life saving procedure performed after vaginal delivery or caesarean birth or in the immediate postpartum period in cases of intractable haemorrhage due to uterine atony, rupture uterus and placental disorders and it is usually reserved for the situations where conservative measures fail to control the haemorrhage. The objective of the study was to determine the frequency of peripartum hysterectomy in placenta praevia.Methods: The study was cross-sectional. It was conducted at the Department of Obstetrics and Gynaecology, Punjab Medical College and affiliated Hospital, Faisalabad. Study was carried out over a period of six months from October 2010 to March 2011. Total 130 cases of placenta praevia undergone caesarean section were included in this study. In cases of primary postpartum haemorrhage conservative management was done first in the form of intramuscular syntometrine (Oxytocin 5 IU/ergometrine 0.5 mg). Intravenous infusion syntocinon (40 IU in 500ml 0.9% saline over 4-6 hours).Results: Mean age of the patients was found to be 30.9±6.7 years. Distribution of cases by gestational age shows, 52 (40.0%) patients had gestation of 28-36 weeks and 78 (60.0%) patients had gestation of 37-41. Mean gestational age was observed 37.5±3.4 weeks. Parity distribution was as follows: 76 (58.5%) patients had parity 0-3, 34 (26.1%) patients had parity 4-6 and 20 (15.4%) patients had parity > 6 with mean parity of 3.2±1.9. Conservative management was done in 129 patients (99.3%). Peripartum hysterectomy was found to be in 1 patient (0.7%).Conclusions: Placental pathology is the leading cause of postpartum hemorrhage and the main indications of peripartum hysterectomy. Timely operation minimizes the morbidity and mortality

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

A Clustered PD-NOMA in an Ultra-Dense Heterogeneous Network with Improved System Capacity and Throughput

In the current era of exponentially growing demand for user connectivity, spectral efficiency (SE), and high throughput, the performance goals have become even more challenging in ultra-dense 5G networks. The conventional orthogonal frequency division multiple access (OFDMA) tech-niques are mature but have not proven sufficient to address the growing user demand for high data rates and increased capacity. Therefore, to achieve an improved throughput in an ultra-dense 5G network with an expanded network capacity, the unified non-orthogonal multiple access (NOMA) technique is considered to be a more promising and effective solution. Throughput can be im-proved by implementing PD-NOMA, as the interference is managed with the successive inter-ference cancellation (SIC) technique, but the issue of increased complexity and capacity with compromised data rate persists. This study implements the clustered PD-NOMA algorithm to enhance user association and network performance by managing the users in clusters with fewer users per cluster with the implementation of the cooperative PD-NOMA within the clusters. In this study, we enhanced the user association in a network and ultimately improved the throughput, sum rate, and system capacity in an ultra-dense heterogeneous network (HetNet). By imple-menting the proposed clustered PD-NOMA scheme, the system throughput has improved by 23% when compared to the unified PD-NOMA scheme and 65% when compared to the OFDMA scheme with a varied number of randomly deployed users, along with an improvement in system capacity of 8% as compared to the unified PD-NOMA and almost 80% as compared to the conventional OFDMA scheme in a randomly deployed ultra-dense multi-tier heterogeneous network. Thus, we improved the network performance with the proposed algorithm and achieved increased capacity, throughput, and sum rate by outperforming the unified PD-NOMA scheme in an ultra-dense heterogeneous network

An Atypical Presentation of Extrapulmonary Sarcoidosis

Sarcoidosis is an idiopathic, chronic, multisystem, granulomatous, inflammatory disease involving almost all organs. Sarcoidosis can occur with an atypical presentation of hepatosplenic involvement, like in the case of our patient. In this case report, we present a rare case of extrapulmonary sarcoidosis with isolated involvement of the liver and spleen in a 39-year-old Caucasian female. There is a possibility of this isolated involvement of an organ in the complete absence of pulmonary disease, which makes the diagnosis of sarcoidosis very difficult as it is usually not suspected. Ultrasound and CT are important in ruling out other differential diagnoses, but a definitive diagnosis is possible only on histological examination, differentiating sarcoid lesions from tuberculosis, primary biliary cirrhosis, metastasis, malignancy, and other granulomatous infections or diseases. Hence, the most credible criterion for diagnosis remains histology. After diagnosis, regular follow-up for systemic manifestations is recommended. Asymptomatic patients with hepatosplenic sarcoidosis have a good prognosis without any medical intervention, while patients with abnormal labs or symptoms must commence treatment

Clustering Approaches for Efficient Radio Resource Management in Heterogeneous Networks

5G telecommunication industry promises to manage and accomplish the massive data traffic and growing network requirement complexities in heterogeneous networks (HetNets). HetNets are K-tier networks and are expected to be seamlessly connected networks with robust services for users anywhere at any time. In near future, the significance of 5G/B5G cellular networks; in both indoor and outdoor environments will be greater than before and it would add up to an exhaustive level. However, as a result of the increased density of networks, a rise in interference within these ultra-dense networks (UDN) will have an alarming impact on throughput, interference and latency.  To ensure high throughput with reduced interference in UDNs a clustered architecture is required. A HetNet with clustered approach enables the network to mitigate interference effectively and achieve efficient radio resource management (RRM). In this paper, we analyzed different clustering classifications and existing clustering techniques that are used for proficient radio resource management. The centralized clustering techniques and decentralized clustering techniques are analyzed and as a result, it is assumed that improved performance can be achieved by emphasizing on hybrid clustering approaches. In addition to this, performed a thoughtful review of existing hybrid clustering techniques to achieve improved throughput and mitigate interference in dense heterogeneous networks.  Our analysis shows that improved radio resource management and increased throughput in HetNets is achieved by applying hybrid clustering techniques with reduced inter and intra tier interference.