Family Business Groups and Tunneling Framework : Application and Evidence from Pakistan

In Pakistan there is a ubiquity of firms in which there exists a controlling shareholder, usually in the form of the family. By and large this control is maintained via crossshareholding and inter-locked directorships which in turn is facilitated by the pyramidal organization of these firms. Moreover, these controlling families have often been alleged of tunneling resources from firms in which they have few cash flow rights to ones in which they have more cash flow rights. This paper attempts to quantify the extent of tunneling prevalent in Pakistani family business groups. The framework that is adopted is one that has been presented by Mullainathan et al. (2000) : we use the responses of different firms to performance shocks and map out the flow of resources within a group of firms to quantify the extent to which the marginal rupee is tunneled. We apply this technique to data on Pakistan business groups.Pakistan, tunneling, business groups, crossshareholding

ROLE OF SERUM ALKALINE PHOSPHATASE IN DISEASE SEVERITY AMONG PATIENTS HAVING CARCINOMA BREAST AT A TERTIARY CARE HOSPITAL

Background; This study was carried out to determine the role of total serum alkaline Phosphatase in bone metastasis among patients of breast cancer. Study setting; Department of Surgery, Nishtar Medical University, Multan in collaboration with breast clinic MINAR. Study Duration; January 2016 to June 2017 Subjects and methods; It was a retrospective study carried out at breast clinic MINAR, Multan. The medical record of the female patients having breast cancer aged 25 to 70 years (who presented from January 2016 to June 2017) was scrutinized. All the registered patients during above mentioned period having breast carcinoma with metastatic bone disease, as depicted on bone scan, were taken as index cases. All the cases underwent total serum alkaline Phosphatase estimation. We collected 86 cases for this research study. Primary bone tumours, lymphomas, sarcomas and bone metastasis due to other primary visceral malignancies were excluded. All the required data were entered and analyzed using computer program SPSS version 20.0. Results; The mean age of the breast cancer patients was 46.51 ± 11.11 years (ranging from 25 – 70 years).  Eighty four (97.7%) were married. All the patients presented with lump breast. Only 3 (3.5%) of the cases gave family history of breast cancer and history of contraceptive pills was positive in 4 (3.7%) of the cases. History of breast feeding was positive in 63 (73.3%) of the cases. Mean age at menarche was 13.21± 0.896 years in our study cases. Mean age at menopause in our study was 46.86 ± 5.66 years. Total serum alkaline Phosphatase was raised in 27 (31.4%) cases. Only 6 (6.9%) of the cases showed its level more than 500 IU/L. Conclusion; Our study results don’t favor total serum alkaline Phosphatase estimation as biological marker of bone metastasis among breast cancer patients. Bone scan is more reliable and hence be employed for detection of bone metastasis. Further studies on bone ALP and total ALP estimation are required to generate further evidence on this subject. Keywords; Serum alkaline Phosphatase, breast cancer, bone metastasis

PRETERM LABOUR IN PATIENTS WITH INTERPREGNANCY INTERVAL LESS THAN 6 MONTHS.

Background; The time interval between pregnancies is considered to be an important and modifiable risk factor in terms of adverse perinatal outcomes. Traditionally women with a short inter-pregnancy interval will not have sufficient time to recover and get ready for the subsequent pregnancy. This includes socio-economic, cultural, psychological and physical body preparedness. This study was conducted to document the frequency of preterm labor in women having short interpregnancy interval, as there is no such study done in Pakistan on this topic. Objective: To determine the frequency of preterm labour in patients with interpregnancy interval less than 6 months. Material and methods; Patients were selected from OPD of department of Obstetrics and Gynecology, Nishtar hospital Multan, according to inclusion and exclusion criteria of this study. Detailed history was taken regarding demographic distribution, parity, BMI  and duration of pregnancy. Duration of gestation was calculated form patient’s last menstrual period (LMP). Examination was done including general physical examination such as per abdominal examination (SFH, uterine contractions and engagement of head) and per vaginal examination (cervical dilation & effacement and leaking per vaginum). Patients were followed till delivery for outcome variable i.e. preterm birth. Data was transferred and analyzed by SPSS version 20. Results; Mean age of our study cases was noted to be 28.00 ± 4.82 years (with minimum age of our study cases was 20 years while maximum age was noted to be 39 years). Our study results have indicated that majority of our study cases i.e. 151 (67.7 %) were aged 20 – 30 years of age. Of these 90 study cases, 125 (56.1%) were from rural areas, 179 (80.3 %) were normal weight 27(12.1%) were overweight and 17 (7.6 %) were obese. One hundred ninety two (86.1 %) were illiterate. Of these 223 study cases, 178 (79.8 %) were having poor socioeconomic status and 45 (20.2%) were having middle income status, 27 (12.1%) were taking steroid therapy. Of these 223, 36(16.1%), 72 (32.3%) were Saraiki, 27 (12.1%) were Urdu speaking, 62 (27.8%) were baloch, 18 (8.1%) were pathan and 8 (3.6%) were having Sindhi ethnicity. Mean body mass index (BMI) of our study cases was noted to be 21.98 ± 2.21 Kg/m2 (with minimum BMI was 18.9 kg/m2 while maximum BMI was 32.1 kg/m2). Mean interpregnancy interval was 4.52 ± 1.03 months (with minimum interpregnancy interval was 2 months while maximum interpregnancy interval was 6 months). Mean gestational age of our study cases was noted to be 36.19 ± 3.68 weeks (with minimum gestational age was 28 weeks while maximum gestational age was 40 weeks). Preterm labor was noted in 63 (28.3 %) our study cases and 170 (76.2%%) of our study cases were having parity more than 3. Conclusion; Short interpregnancy interval less than 6 months leads to adverse pregnancy outcomes. Very high frequency of preterm labor was noted in our study cases having interpregnancy interval less than 6 months. Short interprgnancy interval was common in poor, uneducated and rural  ladies. Preterm labor was significantly associated with age, residential status, obesity, ethnicity, steroid therapy and parity. Birth spacing is an issue which women should have some control over. Educational interventions, including birth control, should be applied during prenatal visits and following delivery. Keywords; Short interpregnancy Interval, gestational age, preterm labor

Cytokine Registry Database of Stroke Patients (CRISP)

Purpose/Background: The aim of the study is to identify molecular biomarkers involve in patients who present with stroke and to determine their clinical usefulness as potential biomarkers in stroke patients as compared to patients without stroke. Materials & Methods: All patients presenting with ischemic stroke and hemorrhagic stroke at University of New Mexico Hospital (UNMH) will be screened for potential participation in this study based on following inclusion and exclusion criteria: Inclusion criteria: male/female of ages ≥ 18 years, patients whose standard stroke admission order sets are obtained for clinical care. Exclusion criteria: Patients \u3c18 year, with the history of prior stroke or any neurodegenerative or neuroinflammatory disease except multiple sclerosis (MS), pregnant women and prisoners. Cytokines will be measured in serum at two different time points: on admission and after 24 hours of admission. The biomarkers which will measured in serum will include interleukin (IL)-1, 4, 6, 10, 17, 23, 33, 36, 37, PDGF, VEGFM, TNF-a, ANNULIN, MMP-9, 12, NFk-B, MPO and glial factors; GMF, SI000-B and GM-6001. These biomarkers will be evaluated using enzyme linked immunosorbent assay (ELISA). Twenty-five percent of the total stroke patient serum samples will be matched by controls without ischemic or hemorrhagic stroke. The study was approved by UNM institutional review board (IRB). All sample and data collection is being done after patient or legally authorized individual sign the informed consent form. All the data is being collected on secured RedCAP database. Results: A total of 105 patients will be enrolled during the study period. Two sets of samples; one at baseline and the other after 24 hours of admission, will collected from each enrolled patient. At present, two patients are enrolled and their samples have been collected and stored per study protocol. The study is currently under recruitment phase and it is anticipated that the enrollment will be completed within next 2 months. Biomarker analysis will be done sequentially as patients will be enrolled per study protocol. Discussion/Conclusion: The CRISP study will give us understanding about the role of various cytokines and/or other biomarkers in the pathogenesis of formation of stroke. These biomarkers can potentially serve as identifiers in the clinical surveillance for acute stroke patients. The data from this study can be beneficial in the acute management of stroke patients

Seroprevalence and Risk factor of Brucella Abortus in Cattle (Indigenous and crossbred) in District Layyah

Background: Brucellosis is very important infectious, zoonotic disease all over the world affecting variety species, causing severe economic losses in animals and severe illness in human beings. This study was planned to find the seroprevalence and associated risk factors with Brucella Abortus in indigenous and crossbreed cattle of District Layyah.Methods: The blood sample were collected from 350 blood animals and screened by Rose Bengal plate test (RBPT) using anti-Brucella antibodies. The seropositive samples were confirmed through indirect ELISA tests. The information on risk factors associated with brucellosis were collected on pre-designed questionnaires.Results: The result of the present study showed the overall prevalence of 6.97% in cattle in district Layyah. It was more prevalent in the age group of 2-5 years (14.6%) as compared to that of the age group 5-10 years (6.25%). The prevalence was significantly higher in the cattle with history of abortion (52.38%) as compared to the non-aborted cattle (3%). The crossbreed animals were found to be more affected than indigenous animals.Conclusion: There is a dire need to eliminate the seropositive animals by application of proper control programme and eradicate this zoonotic disease in developing countries especially in Pakistan.Keywords: Brucellosis; Cattle; Seroprevalence; Layyah

Recent advancements of n-doped graphene for rechargeable batteries: A review

Graphene, a 2D carbon structure, due to its unique materials characteristics for energy storage applications has grasped the considerable attention of scientists. The highlighted properties of this material with a mechanically robust and highly conductive nature have opened new opportunities for different energy storage systems such as Li-S (lithium-sulfur), Li-ion batteries, and metal-air batteries. It is necessary to understand the intrinsic properties of graphene materials to widen its large-scale applications in energy storage systems. In this review, different routes of graphene synthesis were investigated using chemical, thermal, plasma, and other methods along with their advantages and disadvantages. Apart from this, the applications of N-doped graphene in energy storage devices were discussed

Effect of community-based kangaroo mother care package on neonatal mortality among preterm and low birthweight infants in rural Pakistan: Protocol for a cluster randomized controlled trial

Background: Neonatal mortality due to preterm birth and low birthweight remains a significant challenge in Pakistan. Kangaroo mother care (KMC) is a unique, low-cost intervention proven to reduce neonatal mortality and morbidity and increase exclusive breastfeeding rates. However, KMC has not been attempted in community settings in Pakistan. We aim to implement and evaluate the effectiveness of a community-based KMC package to reduce neonatal morbidity and mortality among preterm and low birthweight (LBW) infants, which will provide evidence for policy development and the large-scale implementation of KMC across the country.Objective: The primary objective of this trial is to reduce neonatal mortality among preterm and LBW infants. The secondary objectives are growth (measured as weight gain), reduced incidence of possible serious bacterial infection, and increased exclusive breastfeeding and continued breastfeeding practices.Methods: We designed a community-based cluster randomized controlled trial in one rural district of Pakistan. Stable, LBW babies (weighing 1200 grams to 2500 grams) are included in the study. The community KMC package, consisting of the KMC kit, information and counseling material, and community mobilization through KMC champions (village volunteers), was designed after preliminary research in the same geographical location and implemented in intervention clusters. The standard essential newborn care is offered in the control clusters. Infants are recruited and followed up by independent teams of data collectors. Data are collected on the duration of skin-to-skin contact, growth, breastfeeding practices, morbidities, neonatal mortality, and neurodevelopment status. Data analysis will be conducted based on the intention to treat principle. The Cox regression model will be used to assess the primary outcome of neonatal mortality. The secondary outcomes will be evaluated using linear or logistic regression.Results: The Ethics Review Committee of Aga Khan University, Pakistan, approved the study protocol in February 2017. Data collection began in August 2019 and will be completed in December 2021. Data analyses are yet to be completed.Conclusions: This intervention may be effective in preventing sepsis and subsequently improve survival in LBW newborns in Pakistan and other low-income and middle-income countries worldwide.Trial registration: clinicaltrials.gov NCT03545204; https://clinicaltrials.gov/ct2/show/NCT03545204.International registered report identifier (irrid): DERR1-10.2196/28156

Rational Design and Advance Applications of Transition Metal Oxides

An attractive class of transition metal oxides (TMOs) have been freshly concerned with increasing research interest worldwide concerning stoichiometric and non-stoichiometric configurations as well, that usually exhibits a spinel structure. These TMOs will contribute substantial roles in the production of eco-friendly and low-cost energy conversion (storage) devices owing to their outstanding electrochemical properties. The current chapter involves the summary of the latest research and fundamental advances in the effectual synthesis and rational design of TMOs nanostructures with meticulous size, composition, shape, and micro as well as nanostructures. Also applications of TMOs such as effective photocatalyst, gas sensing, biomedical, and as an electrode material that can be utilized for lithium-ion batteries, and photovoltaic applications. Additionally, certain future tendencies and visions for the development of next-generation advanced TMOs for electrochemical energy storage methods are also displayed

Understanding perceptions and practices for designing an appropriate community-based kangaroo mother care implementation package: Qualitative exploratory study

Background: Low birth weight (LBW) is a common outcome of preterm birth, which increases the risk of an infant\u27s morbidity and mortality. Approximately 20 million infants are born with LBW globally per year. Since a significant number of births in Pakistan take place at home, it is important to focus on the use of kangaroo mother care (KMC), the practice of skin-to-skin contact, in communities to prevent neonatal mortality and morbidity.Objective: We employed a formative research approach to understand the context of communities and facilities with regard to neonatal care and KMC practice. The broader aims were to inform the design and delivery of culturally appropriate platforms to introduce KMC in communities, and develop effective recruitment and retention strategies of KMC in rural areas of the Dadu district in the Sindh province of Pakistan.Methods: We conducted focus group discussions, in-depth interviews, and key informant interviews with families of LBW babies, community members, health care providers, and hospital administrators to identify barriers, enablers, and a knowledge base for KMC interventions.Results: Newborn care practices in communities were found to be suboptimal. The community was generally unaware of the KMC intervention for the care of LBW babies. However, facility health care providers, the community, and family members were willing to provide KMC to improve outcomes. We found significant support from the community members and health care providers for KMC practices. Mothers were also ready to provide intermittent KMC. The administrative staff at the hospitals accepted the introduction of KMC practices for LBW babies.Conclusions: KMC as a method of treating LBW babies is widely accepted in the community. This formative research provides strategically valuable information that will be helpful for developing effective implementation strategies by identifying common community practices for LBW babies, along with identifying the barriers and enablers to KMC practice