Dengue fever presenting as quadriparesis due to hypokalaemia: a rare presentation

Dengue is one of the leading causes of arthropod borne viral haemorrhagic fever. Majority of the times, it clinically manifests as fever, arthralgia and rash; however, we present a case of a young man who presented with progressively increasing weakness of all four limbs. Initial investigations showed low potassium, hence he was managed as hypokalaemic periodic paralysis. With initial history of fever and low platelets, dengue was suspected. Dengue antibody was checked which came out to be positive. Potassium was replaced which led to improvement in power of his limbs. He was discharged in a stable condition with a diagnosis of dengue with hypokalaemic quadriparesis

Emerging Capital Markets Development: A Case Study of Pakistani Equity Markets

The purpose of the study is to trace and review the growth and development of the Pakistani Equity Market. The capital markets in Pakistan has been undergoing a major restructuring programme. Number of measures have been taken to liberalise investment procedures and encourage capital formation through stock exchanges, enlarge size and depth of capital markets. We are witnessing globally a remarkable pace of change from a social and economic perspective. Capital markets being driven by the floods of competition and technology are experiencing so many new challenges and changes inducing them to incline more towards complex structures which would not have been considered possible few time back. Capital markets play an important role in the economic development of emerging capital markets. These markets are an important and efficient conduit to channel and mobilise funds to enterprises, and provide an effective source of investment in the economies they serve. Well functioning markets ensure that both corporations and investors get or receive fair prices for their securities. Their role for mobilising savings for investment in productive assets is acute which subsequently enhance the country’s long term growth prospects. Therefore we can deduce here that their role is like a major catalyst for transformation of the country’s economy into a more efficient and competitive emporium within the global workroom

MUSLIM WORLD ECONOMIC PROFILE 2004

Source : World Development Report 200

Determinants of Capital Structure in Non-Financial Companies of Pakistan

This paper analyzes the various factors which determine capital structure in non-financial companies listed on Karachi Stock Exchange. Panel data of 113 companies spanning over a period of 10 years is used as our sample. Data is obtained from balance sheet analysis of non-financial listed companies, published by State Bank of Pakistan. Panel data estimation models are employed for data analysis. Our results reveal the factors contributing to determination of capital structure in Pakistan. Profitability and liquidity are negatively related to debt ratio, while free cash flows, interest rates and earnings volatility are positively related to debt ratio. Firm size, growth opportunities, non-debt tax shields and asset tangibility appear to have no significant impact on debt ratio. Keywords?capital structure, debt ratio, profitability, liquidity, free cash flows, tangibility, firm size, earnings volatility, interest rate, non-debt tax shields, growth opportunities, Pakistan

Reliability and validity of WATCH: Warwick assessment instrument for clinical teaching

Objective: To determine the reliability, validity, feasibility, acceptability and perceived educational impact of WATCH: Warwick Assessment insTrument for Clinical teacHing among doctors in Pakistan.Study design: Cross-sectional research study.Place and duration of study: The College of Physicians and Surgeons, Pakistan, from September 2018 to August 2019.Methodology: Postgraduate trainees were asked to rate the clinical teaching sessions, using WATCH, which consists of 15 items. Percentage was used to calculate gender and participation from different specialties. Inter-item correlations of 15 items with individual mean scores, standard deviations and Cronbach\u27s Alpha were reported, including Friedman test, in order to observe the scores across multiple conditions. The Hotelling\u27s T2 test was used to test whether the answers provided by the study participants to the questionnaire were equal. Construct validity was determined using factor analysis while feasibility, acceptability, and educational impact was evaluated by seeking participants\u27 feedback on five semi-structured questions.Results: More than 80% ranked WATCH from good to excellent. Oveall 8 items were perceived as excellent, while 7 items received rating of good. Inter-item correlation ranged from 0.61 to 0.81. Cronbach Alpha was reported to be 0.975, with significant difference in mean scores of different items (Friedman\u27s Chi-Square=4285.54; p\u3c0.001). The Hotelling\u27s T2 test (21598.871 with F=185.249, df=14,2654; p\u3c0.001) indicated that the mean values of the responses of different questions in the instrument were statiscally different. Factor analysis indicated one factor accounting for 73.97 of variance. The majority (93%) of the participants found the instrument easy to complete, most participants (91.5%) indicated it as an acceptable method of assessment, and majority (90.8%) perceived that it can improve clinical teaching.Conclusion: WATCH demonstrated valid, reliable, feasible, and acceptable results for assessment of teaching of medical doctors and it can be used for providing feedback and rewarding teachers who excel in teaching. Key Words: Clinical teaching, Validity, Reliability, Feasibility, Medical students, Residents, Doctors

Current trends in the treatment of hepatitis C

Viral hepatitis, an inflammatory liver disease, is caused by various genotypes of hepatitis C viruses (HCV). Hepatitis C slowly sprouts into fibrosis, which progresses to cirrhosis. Over a prolonged period of time compensated cirrhosis can advance to decompensated cirrhosis culminating in hepatic failure and death. Conventional treatment of HCV involves the administration of interferons. However, association of interferon with the adverse drug reactions led to the development of novel anti-HCV drugs given as monotherapy or in combination with the other drugs. Advances in drug delivery systems (DDS) improved the pharmacokinetic profile and stability of drugs, ameliorated tissue damages on extravasation and increased the targeting of affected sites. Liposomes and lipid based vehicles have been employed with polyethylene glycol (PEG) so as to stabilize the formulations as PEG drug complex. Sofosbuvir, a novel anti-HCV drug, is administered as monotherapy or in combination with daclatasvir, ledipasivir, protease inhibitors, ribavirin and interferon for the treatment of HCV genotypes 1, 2 and 3. These drug combinations are highly effective in eradicating the interferon resistance, recurrent HCV infection in liver transplant, concurrent HIV infection and preventing interferon related adverse effects. Further investigations to improve drug targeting and identification of new drug targets are highly warranted due to the rapid emergence of drug resistance in HCV

Motor Stirling, alimentado por energia solar para áreas domésticas e rurais domésticas em Karachi, Paquistão

There is a critical need to use the abundantly available solar energy worldwide due to the global energy crisis. The goal of this study is to demonstrate the residential use of a stirling engine powered by solar energy in Karachi, Pakistan. The design was carried out to produce a power output of 5 kW in order to address the issues with household and rural area power generating. The design was simulated using MATLAB. The use of solar energy as the engine's heat input was one of the design's key components. This allowed the engine to be built for locations with a lot of solar radiation. In regions with abundant solar energy, solar cookers, sun air warmers, and other appliances may be used. For power generation, however, the Stirling engine was chosen. Calculations of the sun intensity showed that 5 kW of Stirling engine output could be generated from 12 kW of solar electricity. The concentrator for concentrating and reflecting the incoming radiations to the Stirling engine was selected as a solar parabolic dish. This process heated the engine's working fluid, which then expanded and contracted due to thermodynamic forces to produce the engine's power strokes.Existe una necesidad crítica de usar la energía solar abundantemente disponible en todo el mundo debido a la crisis de energía global. El objetivo de este estudio es demostrar el uso residencial de un motor Stirling alimentado por energía solar en Karachi, Pakistán. El diseño se llevó a cabo para producir una potencia de salida de 5 kW para abordar los problemas con la generación de energía del hogar y el área rural. El diseño se simuló usando MATLAB. El uso de la energía solar como entrada de calor del motor fue uno de los componentes clave del diseño. Esto permitió construir el motor para ubicaciones con mucha radiación solar. En regiones con abundante energía solar, se pueden usar cocinas solares, calentadores de aire solar y otros electrodomésticos. Para la generación de energía, sin embargo, se eligió el motor Stirling. Los cálculos de la intensidad del sol mostraron que 5 kW de salida del motor Stirling podrían generarse a partir de 12 kW de electricidad solar. El concentrador para concentrar y reflejar las radiaciones entrantes al motor Stirling se seleccionó como un plato parabólico solar. Este proceso calentó el fluido de trabajo del motor, que luego se expandió y contrajo debido a las fuerzas termodinámicas para producir los golpes de energía del motor.Há uma necessidade crítica de usar a energia solar abundantemente disponível em todo o mundo devido à crise energética global. O objetivo deste estudo é demonstrar o uso residencial de um motor Stirling alimentado pela energia solar em Karachi, Paquistão. O projeto foi realizado para produzir uma potência de 5 kW, a fim de abordar os problemas com a geração de energia da área doméstica e da área rural. O design foi simulado usando o MATLAB. O uso da energia solar como a entrada de calor do motor foi um dos principais componentes do design. Isso permitiu que o motor fosse construído para locais com muita radiação solar. Em regiões com abundante energia solar, fogões solares, aquecedores de ar solar e outros aparelhos podem ser usados. Para a geração de energia, no entanto, o motor Stirling foi escolhido. Os cálculos da intensidade do sol mostraram que 5 kW de saída do motor Stirling podem ser gerados a partir de 12 kW de eletricidade solar. O concentrador para se concentrar e refletir as radiações de entrada no motor Stirling foi selecionado como um prato parabólico solar. Esse processo aqueceu o fluido de funcionamento do motor, que então se expandiu e contraiu devido a forças termodinâmicas para produzir os golpes de energia do motor

Evaluation of Energy Production and Energy Yield Assessment Based on Feasibility, Design, and Execution of 3 × 50 MW Grid-Connected Solar PV Pilot Project in Nooriabad

The installation of 3 × 50 MW (150 MW DC) large utility scale solar power plant is ground based using ventilated polycrystalline module technology with fixed tilt angle of 28° in a 750-acre land, and the site is located about 115 km northeast of Karachi, Pakistan, near the town of ThanoBula Khan, Nooriabad, Sindh. This plant will be connected to the utility distribution system through a national grid of 220 kV outgoing double-loop transmission line. The 3 × 50 MW solar PV will be one of the largest tied grid-connected power projects as the site is receiving a rich average solar radiation of 158.7 kW/h/m2/month and an annual average temperature of about of 27°C. The analysis highlights the preliminary design of the case project such as feasibility study and PV solar design aspects and is based on a simulation study of energy yield assessment which has all been illustrated. The annual energy production and energy yield assessment values of the plant are computed using the PVSYST software. The assumptions and results of energy losses, annual performance ratio (PR) 74.73%, annual capacity factor 17.7%, and annual energy production of the plant at 232,518 MWh/year are recorded accordingly. Bear in mind that reference recorded data indicates a good agreement over the performance of the proposed PV power plant