Reasons for low modern contraceptive use—Insights from Pakistan and neighboring countries

This literature review forms part of an extensive research project to determine why, despite evident demand, contraceptive prevalence remains so low in Pakistan, especially for modern methods. The research has been conducted by the Population Council with the support of the Research and Advocacy Fund (RAF) and comprises four component studies: review of relevant academic, program, and policy literature; qualitative study of perspectives of men, women, and service providers in the country on family planning; situation analysis of contraceptive quality, supply, and access factors at health facilities; and examination of supply-chain issues affecting the availability of contraceptives. This review presents the first study, i.e., the review of relevant academic, program, and policy literature on contraceptive demand and supply in Pakistan, and neighboring regions where relevant

The Second Demographic Transition Theory: A Review and Appraisal

References to the second demographic transition (SDT) concept/theoretical framework have increased dramatically in the last two decades. The SDT predicts unilinear change toward very low fertility and a diversity of union and family types. The primary driver of these changes is a powerful, inevitable and irreversible shift in attitudes and norms in the direction of greater individual freedom and self-actualization. First, we describe the origin of this framework and its evolution over time. Second, we review the empirical fit of the framework to major changes in demographic and family behavior in the U.S., the West, and beyond. As has been the case for other unilinear, developmental theories of demographic/family change, the SDT failed to predict many contemporary patterns of change/difference. Finally, we review previous critiques and identify fundamental weaknesses of this perspective, and provide brief comparisons to selected alternative approaches

Globalization and its impact on the local identity of architecture

This paper explores the concept of architectural identity and its relationship with globalization. It analyzes the various dimensions of architecture and its development, as well as the phenomenon of globalization and its impact on local architectural identity. The paper identifies two opposing trends in this context - globalization ideology and the emphasis on architectural identity. The research problem is focused on the impact of globalization on the local architectural identity of structural design. It aims to find ways to maintain, promote, and develop architectural concepts and local architectural identity. The paper provides a literature review of globalization and explains its constituent parts, aims, and features, including its positive and negative aspects and associated risks. It also explores the findings regarding cultural dimensions of globalization, focusing on the cultural dimension. The paper discusses the relationship between culture, globalization, architecture, and architectural identity while considering an intellectual extent as defined by one of its definitions. Overall, this research aims to provide an optimal solution to counteract the negative impact of globalization on architectural identity and promote its development

Eating air pollution using building's façade technology

The research is concerned with pollution in general and air pollution in particular. Through description and analysis, the research tackles the most prominent methods and means used in order to reduce air pollution using modern technologies. It also tackles the extent of the impact of the built environment on the natural environment. Thereby, the research seeks to reduce this effect through the architectural designer’s utilization of technology systems. Thus, the general research problem is formed; showing a lack of knowledge on how to deal with the pollution problems resulting from vehicle exhaust. Further, the research tackles the studies related to the special research problem, which is the lack of knowledge of modern techniques such as (biological filters) used in the buildings, its importance in dealing with air pollution resulting from vehicle exhaust, and its impact on the local environment. The aim of the research is to study and describe architectural buildings that use such technologies and demonstrate their importance in improving local environment. This is made by forming a methodology that includes two parts; the first is represented by air pollution, its sources and cause and the second is represented by studying the technologies, indicating their types and differences and how the architectural designer used it in buildings to reduce air pollution caused by vehicle exhaust. The research reached many conclusions and recommendations

Is Stylet Use During Intubation Associated with Post Intubation Complications

Objective: The basic objective is to evaluate the impacts of placing stylet during tracheal intubation on the post-operative pharyngeal pain in anesthetized patients. Methodology: This randomized control trail was conducted in the department of Anesthesia and ICU, Ch. Pervaiz Ellahi Institute of Cardiology and  Nishter Hospital Multan from   May 2017 to December 2018. All these patients were divided into two groups group S (stylet group) and group C (control group) by lottery method. All the data was entered and analyzed by the computer software SPSS version 23.2. Results: A total number of 100% (n=386) patients were included in this study, both genders. Gender distribution showed that there were more males than females i.e. 56.2% (n=217) and 43.8% (n=169) respectively. The main outcome variables of this study were pharyngeal pain, airway maintenance and sore throat. It was also noted that group (S) showed easy airway maintenance in 95.9% (n=185) patients. It was observed that, in group (S), 63.2% (n=122) patients were complained from sore throat and 67.4% (n=130) were complained about pharyngeal pain.  While on the other hand, in group (C), only 8.3% (n=16) patients were complained about sore throat and 11.4% (n=22) were complained about pharyngeal pain Conclusion: Use of stylet during endotracheal intubation decreases the incidences multiple attempts and make the airway maintenance easy for the anesthetist but on the other side it have complications like sore throat and post intubation pharyngeal pain than those patients in which stylet was not usede. Keywords: Pharyngeal pain, Tracheal Intubation, Stylet, Post-operative. DOI: 10.7176/JMPB/53-05 Publication date:March 31st 201

In the pursuit of sons: sex-selective abortion and differential stopping in Pakistan

Even though Pakistan is a highly patriarchal society, it has not featured prominently in studies focusing on son preference and sex ratios at birth. But with fertility declining and given strong son preference (Pakistan has one of the highest desired sex ratios in the world), how will Pakistani families respond? Using data for 2006-07, I show clear evidence of both sex selection practice and differential stopping behavior. An earlier survey (1990-91) shows only modest evidence of differential stopping behavior. The comparison of the two survey rounds also supports the increasing role of son preference in fertility behavior in Pakistan. With increasing access to contraceptive and sex selection technology, both differential stopping and sex selection are likely to continue increasing for some time.Master of Art

Comparison of APACHE II, SAPS II and SOFA Scoring Systems as Predictors of Mortality in ICU Patients

Objective: The comparison of the APACHE II, SAPS II and SOFA scoring systems as predictors of mortality in ICU patients. Study Design: A prospective observational study. Place and Duration of Study: Intensive care unit of Ch. Pervaiz Ellahi Institute of Cardiology and  Nishtar Medical University and Hospital, Multan, from May 13, 2018 to September 24, 2018. Methodology: For 36 patients included in study, results for APACHE II, SAPS II and SOFA were calculated with the worst values recorded. At the end of ICU stay, patient outcome was labelled as survivors and non-survivors. Data was analyzed with SPSS v.23. Descriptive data was stated as median (minimum-maximum) or percentages. Pearson Chi square test and non-parametric statistics were applied accordingly. Linear regression analysis was also performed. Cut off value for statistical significance was taken as ≤0.05. Results: Of 36 patients, 22 survived and 14 died after being observed for 12 (2-17) days. On linear regression analysis, all the scoring systems were significantly associated with the mortality rates (p<0.05). However, after adjustment, only the APACHE II was a significant predictor of mortality (p<0.001). APACHE II scoring system calculated highest estimated mortality rates i.e.  19.3%, while SAPS II and SOFA scoring systems estimated 8.6% and 13.5% mortality, respectively. Conclusion: APACHE II scoring system was much superior to SAPS II and SOFA scoring systems as a significant predictor of the mortality among the ICU patients. Keywords: Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II), Sequential Organ Failure Assessment (SOFA), Intensive care units (ICU), Mortality. DOI: 10.7176/JMPB/53-03 Publication date:March 31st 201

In the Pursuit of Sons: Additional Births or Sex-Selective Abortion in Pakistan?: In the Pursuit of Sons

Even though Pakistan is a highly patriarchal society, it has not featured prominently in studies focusing on sex-selective abortion and sex ratios at birth. But with fertility declining and existing strong son preference—Pakistan has one of the highest desired sex ratios in the world—how will Pakistani families respond? In the pursuit of sons, will they have additional children or resort to sex-selective abortions? Or is there evidence that the pursuit of sons is weakening? Using data from three rounds of the demographic and health survey, we show clear evidence of son preference in fertility intentions, patterns of contraceptive use and parity progression ratios. More specifically, we find pervasive evidence that Pakistanis continue childbearing to have a son, to have more than one son and to have at least one daughter. We do not find consistent and convincing evidence that sex ratios at birth (which indicate sex-selective abortion) are increasing

Minor Oral Surgery with Out Stopping the Daily Low Dose of Aspirin Therapy

OBJECTIVES Patients with the low-dose long-term aspirin regime have a severe risk of excessive bleeding during surgery, placing them at risk of "adverse thrombotic events". This study aims to evaluate the bleeding in patients undergoing minor oral surgery procedures without stopping daily low-dose aspirin therapy. METHODOLOGY A descriptive cross-sectional hospital-based investigation involved the patient with minor oral surgery at "Altamash Institute of Dental Medicine, Karachi, Pakistan" from mid-April 2021 to mid-June 2021, who were between the age group 30 to 75 with a low-dose aspirin regime. The data was collected via a questionnaire to record the variables, i.e. duration of aspirin, postoperative medications, platelets count, clotting time, normal bleeding time, and intraoperative bleeding time.  RESULTS 51 patients, of which 32 were males while 19, were females. The normal bleeding time was comparatively analyzed with the intraoperative bleeding time using SPSS statistical software version 22. The results revealed that the mean bleeding time for the patients with a low-dose aspirin regime during minor oral surgery was 5.49 ± 1.07, while for the patients with a stopped aspirin dose was 4.57 ± 1.07. The comparative analysis using a t-test doesn't reveal significant statistical differences of p<0.05 between both groups. CONCLUSION We concluded that minor oral surgical procedures could safely be done without altering or stopping the low-dose, long-term aspirin regime.

The power of girls\u27 schooling for young women\u27s empowerment and reproductive health

This report comprises evidence that increases our understanding of girls\u27 schooling in Pakistan. It is useful for policymakers, donors, civil society, program/intervention designers, evaluators, and researchers alike. The findings of this report should be used to guide points of influence and policies on girls\u27 education in Pakistan