Factors Associated within 28 Days In-Hospital Mortality of Patients with Acute Respiratory Distress Syndrome

Objective. To determine the factors leading to in-hospital mortality within 28 days in hospitalized patients with ARDS. It was a prospective observational cohort study conducted in Intensive Care Unit of Aga Khan University Hospital Karachi from March to August 2011. Methodology. Data was collected from patients admitted in the intensive care unit on the basis of inclusion and exclusion criteria. The patients were followed daily for 28 days to record any in-hospital complications and the outcome of patients. Results. Total of 46 patients were included during this period out of which 56% (26) were males and 43% (20) were females. Mean age was 44 ± 19 years. There were 11 (23.9%) patients with age \u3e65 and 35 (76%) had age \u3c65 years. There were 21 (45.6%) patients with pulmonary ARDS and 25 (54.3%) had extrapulmonary ARDS. APACHE II score of \u3e20 was present in 23 (50%) patients while the rest had score of \u3c20. Regarding in-hospital complications, 23 (50%) patients developed sepsis, 31 (67.4%) had multiorgan failure, 14 (30%) had refractory shock, and 15 (32.6%) developed refractory hypoxemia. Out of 46 patients, 26 (56.5%) died within 28 days. On univariate analysis, high APACHE score, multiorgan failure, refractory shock, and refractory hypoxemia were main causes of death. Conclusion. ARDS is a syndrome of high mortality with mortality rate of 56.5% in this study. High APACHE, sepsis, multiorgan failure, refractory shock, and refractory hypoxemia are the leading causes of death in our patients

Solving Poverty through Management: Experience in Pakistan

There has been a consensus in the development literature that the poor have received insufficient credit from the formal financial sector. This is because the department rated the poor as a dangerous borrower because of the lack of appropriate collateral. This provides, therefore, the rationale for promoting the policy position of the microfinance sector to strengthen access to credit for the poor. Microcredit is expected to reduce poverty by increasing household income. The purpose of this paper is to contribute to this debate. It is achieved by investigating the impact of microcredit on poverty in Pakistan. This paper uses the 1985-2015 time series data to assess the relationship between the human development index as a representative of poverty and its socioeconomic characteristics and microfinance visits. The error correction model is used to estimate the relationship between microcredit and household demographic variables and family poverty. Data analysis shows that there is a positive correlation between the human development index and small business credit, which is conducive to all previous expectations Thus, this evidence provides support for the "positive impact" of the debate and provides some guidance on how policy reform should focus on strengthening the performance of the Pakistani microfinance sector. In addition, the evidence for this study provides some guidance on policy reforms to improve Pakistan's microfinance performance

Solving Poverty through Management: Experience in Pakistan

There has been a consensus in the development literature that the poor have received insufficient credit from the formal financial sector. This is because the department rated the poor as a dangerous borrower because of the lack of appropriate collateral. This provides, therefore, the rationale for promoting the policy position of the microfinance sector to strengthen access to credit for the poor. Microcredit is expected to reduce poverty by increasing household income. The purpose of this paper is to contribute to this debate. It is achieved by investigating the impact of microcredit on poverty in Pakistan. This paper uses the 1985-2015 time series data to assess the relationship between the human development index as a representative of poverty and its socioeconomic characteristics and microfinance visits. The error correction model is used to estimate the relationship between microcredit and household demographic variables and family poverty. Data analysis shows that there is a positive correlation between the human development index and small business credit, which is conducive to all previous expectations Thus, this evidence provides support for the "positive impact" of the debate and provides some guidance on how policy reform should focus on strengthening the performance of the Pakistani microfinance sector. In addition, the evidence for this study provides some guidance on policy reforms to improve Pakistan's microfinance performance

Pharmacological Threat to Lungs: A Case Series and Literature Review

Drug-induced organ damage stands as a prevalent yet much-neglected issue globally. Keeping in view it\u27s rising frequency, health care providers stand obliged to be well versed with the de-merits of the agents they prescribe. Drug therapies causing damage present with a non-specific clinical presentation, histological findings or radiology, which further elaborates on the necessity of a conscientious diagnosis. Pulmonary architecture ranging from the airways, lung parenchyma, mediastinum, pleura, pulmonary vasculature or the neuromuscular system, all can fall victim to the dreaded outcomes of this menace. In order to establish successful diagnosis, the definite temporal relation between initiation of drug therapy and the development of the respiratory symptoms needs to be drawn. The most common form of pharmacologically arising lung toxicity is drug-induced pneumonitis or interstitial lung disease. Unfortunately, there is no adequate data available to review the extensiveness of this medication-associated risk in Pakistan which further highlights the necessity of carefully monitoring this overlooked yet assessable malady. Furthermore, identification and surveillance of this drug attributed peril shall help diminish burden on healthcare resources of the country. We present three recent cases of different types of drug-induced lung damage under treatment at our University Hospital

Assessing decision of inpatient or outpatient care in community acquired pneumonia: APT care study

Objective: To estimate the proportion of community-acquired pneumonia patients with disagreement between Confusion, Uraemia, Respiratory rate, Blood pressure, age \u3e 65 years recommendation and physician\\\\u27s decision to hospitalise or not.Methods: This cross-sectional nation-wide, non-interventional, cross-sectional study was carried out across 10 cities of Pakistan from December 2011 to May 2012, and recruited consenting adult patients with confirmatory diagnosis of community-acquired pneumonia on chest X-ray. Confusion, Uraemia, Respiratory rate, Blood pressure, age \u3e 65 years recommendation for each patient was determined at the time of analysis. This recommendation was compared with treatment decision made by the physician. Disagreement was considered when the physician\\\\u27s decision did not match with the recommendation. SPSS 18 was used for data analysis.Results: Of the 352 patients, 201(57.10%) were males. The overall mean age was 50.67±18.45 years. In 140(39.77%) patients there was disagreement between Confusion, Uraemia, Respiratory rate, Blood pressure, age \u3e 65 years recommendation and physician\\\\u27s decision regarding hospitalisation or outpatient care. Of the 352 cases 132(37.50%) were hospitalised despite the recommendation of outpatient treatment.Conclusion: In almost four out of every 10 patients there was disagreement between Confusion, Uraemia, Respiratory rate, Blood pressure, age \u3e 65 years recommendation and the physician\\\\u27s decision regarding hospitalisation of community-acquired pneumonia patients

Price and Income Elasticities of Crude Oil Demand: Cross Country Analysis

Volatility in crude oil price is the main issue in this era. Great volatility in price of crude oil affects the demand of oil directly and indirectly in developing countries because these countries are oil importing countries especially Pakistan, India and China. Crude oil therefore contributes to and thereby influences the GDP of the country as a source of energy. It is very critical and essential for any country to explore and produce gas to improve energy shortage, for some deliberate importance of gas because natural gas is very clean, cheap and sustainable source to produce energy within a country. This study aimed to analyze the price and income elasticities of crude oil demand in developing countries time series data used from the period of 1971-2014. ADF test was used to check the stationary of variables and it is seem that all variable are not stationary at level. ARDL used for co integration and all variables of the models have long run relation with dependent and explanatory variables. Price and income elasticities of crude oil demand were measured in short and long run for developing countries and it was concluded that long run elasticities of price and income were less inelastic or some cases like China was elastic than short run elasticities of price and income of crude oil demand. It was suggested that oil importer countries should explore the alternatives of oil within a country to fulfill the domestic demand

Tax Revenue, Stock Market and Economic Growth of Pakistan

Structured Abstract: Purpose – The purpose of this paper is to examine the effects of capital market and fiscal policy influences in determining the nexus of economic growth in Pakistan from July 2003 to July 2012. Design/methodology/approach – The authors utilise ADF unit root test, Johansen Cointegration test, VECM test, Granger causality test and variance decomposition analysis to test the relationship among tax revenue, stock market and economic growth in Pakistan. Granger causality analysis is used to answer questions whether “Does tax revenue cause the economic growth?” or “Does tax revenue cause the capital market?”. Findings – The results demonstrate that there is a bidirectional casualty between tax revenue and economic growth; and a unidirectional causality from capital market to tax revenue. The estimated result shows that growth of Pakistan economy is strongly contributed from the high collection of direct tax revenue and the development of financial market activity. Originality/value – The findings of this paper have important implications to current and potential investors in Pakistan economy to understand the economic condition of Pakistan and to assist them in making their investment decision.&nbsp

The Effect of Macroeconomic Uncertainty on Consumption Expenditure in Case of Pakistan

Government expenditure on consumption is the core issue in the macroeconomic theory. The determination of national economic growth and the improvement of economic production also play an important role in economic and technological progress. However, a high degree of macroeconomic uncertainty directly inhibits economic growth. This study empirically estimates the macroeconomic determinants of government spending in Pakistani economy. In this study, ARCH, GRACH model was used to calculate the volatility of different macroeconomic variables. Taking the period from 1975 to 2014 in Pakistan as an example, the ARDL model was used to examine the relationship between the volatility of macroeconomic variables and government spending. The research shows that the macroeconomic uncertainty caused by the fluctuation of macroeconomic variables has a significant impact on the government's consumption expenditure. Empirical results from the study show that Pakistan experienced more volatility in the macroeconomic variables, leading to more volatile government spending and private investment