Monitoring and Evaluation: Civil Society Organisations’ Competitive Edge in Effective Poverty Alleviation

The role of Civil Society Organisations as preferred partners in development is strongly emerging across the globe. Among many reasons, one is reasonably good governance. The social sector has shown the acumen to learn and apply corporate management practices and international standards fast enough to start leading the competition. Notwithstanding the fact that a large part of development funding under soft loans and grants is channeled to the government, the CSOs receive a significant share directly and indirectly to implement development projects in communities. It has opened tremendous opportunities for CSOs to experiment and evolve new approaches in project management, community organisation, service delivery, product development, resource mobilisation and financial management. What makes the civil society organisations different from the public sector organisations? Fundamentally two things; these are non-governmental and nonprofit. However, the real difference is in the way civil society organisations are managed. It includes leadership, commitment, professionalism, systems and practices, thrust of work and most of all performance.

Monitoring and Evaluation: Civil Society Organisations’ Competitive Edge in Effective Poverty Alleviation

The role of Civil Society Organisations as preferred partners in development is strongly emerging across the globe. Among many reasons, one is reasonably good governance. The social sector has shown the acumen to learn and apply corporate management practices and international standards fast enough to start leading the competition. Notwithstanding the fact that a large part of development funding under soft loans and grants is channeled to the government, the CSOs receive a significant share directly and indirectly to implement development projects in communities. It has opened tremendous opportunities for CSOs to experiment and evolve new approaches in project management, community organisation, service delivery, product development, resource mobilisation and financial management. What makes the civil society organisations different from the public sector organisations? Fundamentally two things; these are non-governmental and nonprofit. However, the real difference is in the way civil society organisations are managed. It includes leadership, commitment, professionalism, systems and practices, thrust of work and most of all performance

Spherically Symmetric Gravitational Collapse

In this paper, we discuss gravitational collapse of spherically symmetric spacetimes. We derive a general formalism by taking two arbitrary spherically symmetric spacetimes with $g_{00}=1$. Israel's junction conditions are used to develop this formalism. The formulae for extrinsic curvature tensor are obtained. The general form of the surface energy-momentum tensor depending on extrinsic curvature tensor components is derived. This leads us to the surface energy density and the tangential pressure. The formalism is applied to two known spherically symmetric spacetimes. The results obtained show the regions for the collapse and expansion of the shell.Comment: 12 pages, 4 figures, accepted for publication in Mod. Phys. Lett.

Role of Ultrasound in the Diagnosis of Endometritis- A Systemic Review

Endometritis is the most sustainable disease of the endometrium that leads to infertility in premenopausal women and many other pathologies in postmenopausal women. The role of ultrasound in the diagnosis of endometritis is indefinite, the sonographic signs of endometritis are most helpful for early detection and management. The aim to the study was to evaluate the role of ultrasound, as a diagnostic tool, for the diagnosis and management of endometritis. For this purpose, the literature of 2005-2020 from different search engines includes PubMed, Google Scholar, Science Direct, MEDLINE, Embase, and ResearchGate were studied and reviewed using MeSH (medical subject heading). Different retrospective studies were included, which had the same and diverse criteria for the diagnosis, to compare and find the accuracy of sonography as a first line tool. The exclusion criteria were not to include any prospective study, case-control study, and study former than 2005. The results of this systematic review indicated that the transvaginal ultrasound, hysterosonography, and abdominal ultrasonography can be used as a basic tool of investigation because of its availability and non-invasive technique. The other methods of molecular microbiology aided the diagnosis by confirming and to indicate the pathogens which cause endometritis. Hence, it is concluded that although the importance of ultrasound cannot be neglected but shouldn’t be limited to it. The other techniques used together provide much more authentic results. Keywords: Endometritis, Ultrasonography, Infertility. DOI: 10.7176/JHMN/84-04 Publication date: December 31st 202

Comparison of clinical and CSF profiles in children with tuberculous and pyogenic meningitis; role of CSF protein: Glucose ratio as diagnostic marker of tuberculous meningitis

Objectives: To compare the clinical and laboratory features of tuberculous meningitis with bacterial meningitis and to determine if protein glucose ratio in the cerebrospinal fluid can be predictive of the condition.Methods: It was a retrospective descriptive study at the Paediatric Ward of Aga Khan University Hospital, Karachi, for which records of 46 patients with tuberculous meningitis and 33 with bacterial meningitis were reviewed. All records related to the study period that was from January 2005 to October 2010. The records were retrieved in December 2010. Tuberculous meningitis was defined as illness \u3e or = 14 days, basal enhancement or tuberculoma on computerised tomography scan and response to anti-tuberculous therapy. Pyogenic meningitis was defined by the presence of a pathogenic isolate inthe cerebrospinal fluid (bacterial culture) or by positive latex particle agglutination or a pathogen on cerebrospinal fluid gram stain and clinical improvement with antibiotics. Logistic regression was used to model the probability of having tuberculous meningitis. To define the optimal protein-glucose ratio, cutoff point for the diagnosis of tuberculous meningitis, a receiver operating characteristic curve was applied. All analysis were done using SPSS 16.Results: Features predictive of a diagnosis of tuberculous meningitis were protein:glucose ratio of \u3e or = 2 (OR 21 95% CI 4.7-93); cerebrospinal fluid total leukocyte count \u3c 800 (OR 58, 95% CI 5-649); and the presence of hydrocephalus (OR 19, 95% CI 3.3-109).Conclusion: A set of simple clinical, laboratory and radiological criteria can help in predicting tuberculous meningitis. The value of cerebrospinal fluid protein:glucose ratio needs to be validated in larger studies with bacteriologically-confirmed cases of tuberculous meningitis

Reepithelialization in noise exposed skin wound

Objective: To observe the effect of noise on reepithelialization in rat skin wound. Methodology: A Quasi experimental study was conducted in Anatomy Department of Al-Nafees Medical College Isra University Islamabad & National Institute of Health (NIH) Islamabad from June 2015 to February 2016. Thirty male sprague Dawley rats were divided into control and experimental groups by convenient sampling. Each main group comprised of 15 rats. An incision of 2 cm was made on dorsal region of all rats. Control sub groups were left to heal with routine background noise exposure, while experimental sub groups underwent a 4 hour/day intermittent noise exposure of 85-95 db, five days a week for two consecutive weeks. Five rats from each group were sacrificed on day 3, 7 and 14. Wounds were excised, fixed and processed for haematoxilin and eosin stain to see the thickness of epithelium in rat skin wounds Results: Process of reepithelialization was not as significant in noise induced group as noticed in control group (routine noise exposed) Conclusion: Noise adversely affects the skin wound healing by interfering with epidermal regeneratio

Coping styles and depression among patients with solid organ cancers attending two tertiary care hospitals of Karachi: a cross sectional study.

Cancer undoubtedly affects patients in all aspects. Cancer diagnosis is a stressful event and coping is the primary mechanism used to adjust and counteract the stress. This study aims to assess the coping styles and prevalence of depression among solid organ cancer patients during treatment phase, attending two tertiary care hospitals of Karachi. A cross-sectional survey was conducted among solid organ cancer patients at Aga Khan University Hospital and Jinnah Post Graduate Medical Center. Coping and depression were assessed by Brief COPE and Self Reporting Questionnaire (SRQ) 20 respectively. Purposive sampling technique was used to recruit 488 patients. Coping styles are reported as mean ± SD. Prevalence has been computed for depression and Chi-square test is used to assess the relationship of depression with different variables. Correlation was assessed for coping styles and depression. The frequently used coping styles were active coping, acceptance, religion and self-distraction. 48.4% depression was estimated among patients. The significantly positive correlation of depression was found with active coping, planning, self-blame, venting, use of emotional support and substance use. While depression correlated negatively with acceptance, religion, self-distraction and humor. Depression was significantly associated with study sites, age, socioeconomic quintiles, past history of hospitalization and substance use. Our research addressed the missing element of mental health in oncology. Depression is a common mental ailment and often the initial manifestation towards deterioration of mental health. Each cancer patient copes differently which either promotes or hinders their fighting spirit. Hence, mental health screening and counseling are recommended in the treatment protocol of cancer patients. Also, support group interventions can help cancer patients to cope effectively

Lifestyle changes and glycemic control in type 1 diabetes mellitus: A trial protocol with factorial design approach

Background: Type 1 diabetes (T1D) has been increasing globally over the past three decades. Self-monitoring of blood glucose is a challenge in both developed as well as developing countries. Self-management guidelines include maintaining logbooks for blood glucose, physical activity, and dietary intake that affect glycated hemoglobin (HbA1c) and a multitude of life-threatening acute complications. Innovative, cost-effective interventions along with beneficial lifestyle modifications can improve home-based self-monitoring of blood glucose in T1D patients. The overall objective of this study is to evaluate the relationship between maintaining log books for blood glucose levels, reinforcement by e-messages, and/or daily step count and changes in HbA1c.Methods/design: A randomized controlled trial will enroll participants aged 15 years and above in four groups. Each group of 30 participants will be working with a newly designed standard log book for documenting their blood glucose. The first group will be entirely on routine clinical care, the second group will be on routine care and will receive an additional e-device for recording step count (fit bit), the third group will receive routine care and daily motivational e-messages to maintain the log book, and the fourth group along with routine care will receive an e-device for measuring step count (fit bit) and e-messages about maintaining the log book. Patients will be enrolled from pediatric and endocrine clinics of a tertiary care hospital in Karachi. All groups will be followed up for a period of 6 months to evaluate outcomes. Log book data will be obtained every 3 months electronically or during a patient\u27s clinic visit. HbA1c as a main outcome will be measured at baseline and will be evaluated twice every 3 months. A baseline questionnaire will determine the socio-demographic, nutritional, and physical activity profile of patients. Clinical information for T1D and other co-morbidities for age of onset, duration, complications, hospitalizations, habits for managing T1D, and other lifestyle characteristics will be ascertained. Behavioral modifications for maintaining daily log books as a routine, following e-messages alone, fit bit alone, or e-messages plus using fit bit will be assessed for changes in HbA1c using a generalized estimated equation.Discussion: The proposed interventions will help identify whether maintaining log books for blood glucose, motivational e-messages, and/or daily step count will reduce HbA1c levels

A Comparative Study of Periodontal Disease Index (PDI) Scores in Type-2 Diabetics and Non-Diabetics

OBJECTIVES: The aim of this study was to compare the Type 2 diabetes mellitus patients and Non-Diabetics in terms of Periodontal Disease Index (PDI). METHODOLOGY: This comparative cross-sectional study recruited 105 subjects, 56 participants of Type 2 diabetes mellitus with periodontal disease and 49 non-diabetics (comparison group) having periodontal disease. Non-probability purposive sampling method was used for selecting the participants. This study was conducted at Peshawar Dental hospital, Prime Teaching hospital, and Sardar Begum Dental hospital. Determination of   HbA1c to diagnose diabetes and periodontal examination was conducted for both the groups to compare Type 2 diabetics and non-diabetics in terms of Periodontal Disease Index (PDI) score that is one of the clinical parameters of periodontal disease. Data analysis was performed by using SPSS version 23. RESULTS: Out of 105 total participants, 33 (31.4 %) were males and 72 (68.6%) were females. The mean age of subjects was 51.48±7.92. The mean PDI scores of the two groups were compared. Mean Periodontal Disease Index (PDI) was recorded, score was 2.58 (±0.67) in diabetics and 1.11 (±0.41) in non-diabetic (comparison group). P-value was measured by Chi-square test and was found to be significant. CONCLUSION: We concluded that significant difference exists between the mean PDI scores of Type 2 diabetics and non-diabetics

Efficient Removal of Chromium and Lead from Tanneries Effluent of Korangi Industrial Area Karachi Using Rotating Disk Mesh as Anode Electrode Electrocoagulation

The aim of this study was to examine the best electrode design for the electrocoagulation process with the best removal performance, reduced passivation on the electrode surface, and lower energy consumption requirements for removing Chromium (Cr) and Lead (Pb) from leather tannery effluent. Three different electrodes were compared: non-rotating disk electrode (NRDE), rotating disk electrode (RDE) and rotating disk mesh electrode (RDME). All electrodes were used to observe a reduction in passivation on the electrode surface and its effects on the removal performance of Cr and Pb. The material used for the electrodes was iron. The maximum removal efficiency obtained was Cr = 87.9% and Pb = 97.5% under the following operating conditions: pH = 7, treatment time = 90 min, current density = 6.57 mA/cm², and RPM = 80. The results show that the electrical energy requirement for treating chromium and lead using RDME was 4.5 kWh/m³, which was found to be lower than the energy requirement observed in various other studies for treating tannery effluent. According to the results, RDME shows the highest removal performance with lower specific energy consumption compared to NRDE and RDE. RDME can be efficiently employed at a larger scale for treating leather tannery effluent