National Finance Commission Awards in Pakistan : A Historical Perspective

This study explores the evolution of fiscal resource distribution in Pakistan. Pakistan is a federation comprising four provinces, federallyadministered areas, and the Islamabad Capital Territory. Being a central type of government, most of the revenues are collected by the centre and then redistributed vertically between the federal and the provincial governments, and horizontally among the provinces. Provinces then also redistribute revenues among lower tiers of the government, through a revenue-sharing formula. A thorough look at the history indicates that this process has been complex and has a far-reaching impact. A less systematic approach has been adopted to decentralise the financial matters. Over time, the divisible pool has expanded due to heavy reliance on indirect taxes as well as improvement in the collection. Population is the sole distribution criteria, adopted in all NFC awards from the divisible pool. This has raised friction among the provinces, necessitating inclusion of other potential variables evolved from international best practices. In addition to that, absence of technical experts and permanency of the NFC is another impediment. The NFC is supposed to provide the framework for amicable distribution of resources between the federal and the provincial governments for the joint goal of development and prosperity.NFC, Pakistan, fiscal federalism, Rule and Discretion, political economy, Population, Subventions, Doing the Business of Government

National Finance Commission Awards in Pakistan: A Historical Perspective

This study explores the evolution of fiscal resource distribution in Pakistan. Pakistan is a federation comprising four provinces, federally-administered areas, and the Islamabad Capital Territory. Being a central type of government, most of the revenues are collected by the centre and then redistributed vertically between the federal and the provincial governments, and horizontally among the provinces. Provinces then also redistribute revenues among lower tiers of the government, through a revenue-sharing formula. A thorough look at the history indicates that this process has been complex and has a far-reaching impact. A less systematic approach has been adopted to decentralise the financial matters. Over time, the divisible pool has expanded due to heavy reliance on indirect taxes as well as improvement in the collection. Population is the sole distribution criteria, adopted in all NFC awards from the divisible pool. This has raised friction among the provinces, necessitating inclusion of other potential variables evolved from international best practices. In addition to that, absence of technical experts and permanency of the NFC is another impediment. The NFC is supposed to provide the framework for amicable distribution of resources between the federal and the provincial governments for the joint goal of development and prosperity.NFC, Pakistan, Fiscal Federalism, Rule and Discretion, Political Economy, Population, Subventions, Doing the Business of Government

Emotional Intelligence and Psychological Adjustment among Doctors and Nurses in a Tertiary Care Hospital in Rawalpindi-Pakistan: A Cross Sectional Study

Objective: This study aimed to determine the relationship between EI and the quality of nursing care from the viewpoint of nurses and patients. Methods: This cross-sectional study was conducted at a public sector tertiary care hospital in Rawalpindi, Pakistan, over 6 months from November 2019 to April 2020. The convenience sampling technique was employed. The study groups were qualified practising doctors and nurses including nursing assistants and paramedics. Study groups were provided with a self-administered questionnaire that was filled out after getting consent from the study participants. Data analysis was done by entering it into SPSS version 22. The relationship between emotional intelligence and psychological adjustments among the two groups was assessed by applying an independent T-test. Results: The current study explored that doctors were emotionally intelligent and psychologically well-adjusted as compared to nurses. Females were more emotionally intelligent than males; however, males were better adjusted psychologically. Years of experience had no significant results between both groups, while there was a positive correlation between the department of practice and psychological well-being. Conclusions: It shows that harmonious work environments and friendly interpersonal relationships positively affect the well-being of HCWs and patients. What this indicates is a need to bring about changes within work environments to produce friendly interpersonal relationships and a positive impact on the well-being of HCWs and patients.

Red blood cell transfusion in critically-ill children and its association with outcome

Objective: To determine the indications and threshold of haemoglobin levels for packed red blood cell transfusion and its association with outcomes in a paediatric intensive care setting.Methods: The retrospective study was conducted in the paediatric intensive care unit of the Aga Khan University Hospital, Karachi, and comprised medical records of all inpatients with age between 1 month and 16 years who received packed red blood cell transfusions between January and December 2017. Data was retrieved from the hospital database and was analyzed using SPSS 22.Results: Of the 147 subjects with a mean age of 67.89±65.8 months, 76(51.7%) were males. Mean paediatric risk of mortality score was 11.72±7.86. Major admitting diagnosis included sepsis and multiorgan dysfunction 50(34%), respiratory diseases 26(17.7%) and haematology/oncology diseases 22(15%). The indications for transfusion was low haemoglobin in 90(61.2%) patients, shock 29(19.7%) and hypoxia 28(19%). Acute transfusion reaction was observed in 1(0.7%) patient; 120(82%) required mechanical ventilation; and 94(64%) required inotropic support. Of the total, 88(59.9%) patients survived. Paediatric risk of mortality score, need for inotropic support and mechanical ventilation were associated with mortality (p\u3c0.05).Conclusions: Packed red blood cell transfusion, which is frequently prescribed in intensive care settings, was not found to be associated with favourable outcome

A Shift From Logistic Software to Service Model: A Case Study of New Service-Driven-Software for Management of Emergency Supplies During Disasters and Emergency Conditions by WHO

World Health Organization (WHO) states access to medicine as a priority area for universal health coverage, wherein a well-functioning medicine supply chain is indispensable. Optimization of supply chains to cut losses related to overstocking, expiration, and inefficiencies protect the investments and strengthen health systems to better deliver the health services. This article shares the experience of developing a service-driven-software for pharmaceutical supplies during emergency conditions and disasters, and the advantages gained. In 2005, Logistic Support System (LSS), the updated version of SUMA (Supply Management), was introduced by WHO during the earthquake in Pakistan which had offered valuable but limited services to many countries. Moving from ad hoc to a more organized approach, the medical donations and stockpiles of essential medicinal supplies were inventoried on LSS database for managing the dispatch of medical supplies to the disaster-hit area in a shortest possible time. Post disaster rescue and rehabilitation work further instigated the need for development of a new software, Pharmaceutical Information Management System (PIMS), that was effective in the emergency as well as routine inventory operations. It was used for efficient and improved access of medicines and faster decision making. The new systems proved vital to anticipate over/under stocking through proactive alerts and prompting. The updated information on epidemiological and drug utilization needs were crucial for the effective quantification and ordering throughout the supply chain. Implementation of PIMS demanded appreciable customization including conversion of system from stand-alone to online system with consolidation of information on stocks from all locations. Provision of multi-user option allowed facilitation according to the user authorization, and was equipped with improved-speed, efficiency, and security. PIMS was successfully replicated by the pioneer team of pharmacist from Pakistan in other countries

Exploration of promising optical and electronic properties of (non-polymer) small donor molecules for organic solar cells

Abstract Non-fullerene based organic compounds are considered promising materials for the fabrication of modern photovoltaic materials. Non-fullerene-based organic solar cells comprise of good photochemical and thermal stability along with longer device lifetimes as compared to fullerene-based compounds. Five new non-fullerene donor molecules were designed keeping in view the excellent donor properties of 3-bis(4-(2-ethylhexyl)-thiophen-2-yl)-5,7-bis(2ethylhexyl) benzo[1,2-:4,5-c′]-dithiophene-4,8-dione thiophene-alkoxy benzene-thiophene indenedione (BDD-IN) by end-capped modifications. Photovoltaic and electronic characteristics of studied molecules were determined by employing density functional theory (DFT) and time dependent density functional theory (TD-DFT). Subsequently, obtained results were compared with the reference molecule BDD-IN. The designed molecules presented lower energy difference (ΔΕ) in the range of 2.17–2.39 eV in comparison to BDD-IN (= 2.72 eV). Moreover, insight from the frontier molecular orbital (FMO) analysis disclosed that central acceptors are responsible for the charge transformation. The designed molecules were found with higher λmax values and lower transition energies than BDD-IN molecule due to stronger end-capped acceptors. Open circuit voltage (Voc) was observed in the higher range (1.54–1.78 V) in accordance with HOMOdonor–LUMOPC61BM by designed compounds when compared with BDD-IN (1.28 V). Similarly, lower reorganization energy values were exhibited by the designed compounds in the range of λe(0.00285–0.00370 Eh) and λh(0.00847–0.00802 Eh) than BDD-IN [λe(0.00700 Eh) and λh(0.00889 Eh)]. These measurements show that the designed compounds are promising candidates for incorporation into solar cell devices, which would benefit from better hole and electron mobility

Diosgenin normalization of disrupted behavioral and central neurochemical activity after single prolonged stress

Introduction: Post-traumatic stress disorder (PTSD) is a chronic mental illness triggered by traumatic experiences such as wars, natural disasters, or catastrophes, and it is characterized by anxiety, depression and cognitive impairment. Diosgenin is a steroidal sapogenin with known neuroprotective and antioxidant properties. This study aimed to assess the pharmacological potential of diosgenin in a single prolonged stress (SPS) model of PTSD, plus other behavioral models along with any consequent alterations in brain neurochemistry in male mice.Methodology: SPS was induced by restraining animals for 2 h, followed by 20 min of forced swim, recuperation for 15 min, and finally, exposure to ether to induce anesthesia. The SPS-exposed animals were treated with diosgenin (20, 40, and 60 mg/kg) and compared with the positive controls, fluoxetine or donepezil, then they were observed for any changes in anxiety/depression-like behaviors, and cognitive impairment. After behavioral screening, postmortem serotonin, noradrenaline, dopamine, vitamin C, adenosine and its metabolites inosine and hypoxanthine were quantified in the frontal cortex, hippocampus, and striatum by high-performance liquid chromatography. Additionally, animal serum was screened for changes in corticosterone levels.Results: The results showed that diosgenin reversed anxiety- and depression-like behaviors, and ameliorated cognitive impairment in a dose-dependent manner. Additionally, diosgenin restored monoamine and vitamin C levels dose-dependently and modulated adenosine and its metabolites in the brain regions. Diosgenin also reinstated otherwise increased serum corticosterone levels in SPS mice.Conclusion: The findings suggest that diosgenin may be a potential candidate for improving symptoms of PTSD

5,7-Dimethoxycoumarin ameliorates vincristine induced neuropathic pain: potential role of 5HT 3 receptors and monoamines

Vincristine is the drug of choice for Hodgkin’s lymphoma, acute lymphoblastic leukemia, and non-Hodgkin lymphoma. Despite its significant anticancer effects, it causes dose-dependent neuropathy, leading to compulsive dose reduction. The available drugs used for vincristine-induced neuropathic pain (VINP) have a range of safety, efficacy, and tolerability issues prompting a search for new therapies. 5,7-Dimethoxycoumarin (5,7-DMC) also known as citropten, is a natural coumarin found in the essential oils of citrus plants such as lime, lemons, and bergamots, and it possesses both antidepressant and anti-inflammatory effects. This study was designed to investigate the possible analgesic and antiallodynic effects of 5,7-DMC in a murine model of VINP. Vincristine was administered to groups of BALB/c male mice (0.1 mg/kg intraperitoneally) once daily for 14 days to induce VINP. Thermal hyperalgesia and mechanical allodynia were quantified using the tail immersion test and von Frey filament application method. The levels of monoamine neurotransmitters and vitamin C in frontal cortical, striatal and hippocampal tissues, as well as the TNF-α level in plasma, were quantified using high performance liquid chromatography and ELISA respectively. On day 15 of the protocol, acute treatment with 5,7-DMC clearly reversed VINP thermal hyperalgesia, mechanical static allodynia, mechanical dynamic allodynia, and cold allodynia. The activity of 5,7-DMC against hyperalgesia and allodynia was inhibited by pretreatment with ondansetron but not naloxone, implicating a 5-HT3 receptor involvement. VINP vitamin C levels were restored by 5,7-DMC in the frontal cortex, and changes in serotonin, dopamine, adenosine, inosine and hypoxanthine levels caused by vincristine were reversed either fully or partially. Additionally, the vincristine-induced rise in hippocampal serotonin, dopamine, inosine and striatal serotonin was appreciably reversed by 5,7-DMC. 5,7-DMC also reversed the vincristine-induced increase in the plasma level of TNF-α. In negating the changes in the levels of some neurotransmitters in the brain caused by vincristine, 5,7-DMC showed stronger effects than gabapentin. It was concluded that, there is a potential role of 5-HT3 receptors and monoamines in the amelioration of VINP induced by 5,7-DMC, and the use of this compound warrants further investigation

Knowledge, attitude, and practice of exclusive breastfeeding among mothers of childbearing age

BackgroundThe American Academy of Pediatrics and the World Health Organization recommend exclusive breastfeeding (EBF) for up to 6 months. Despite the importance of breast milk, EBF is far less prevalent in Nigeria than is recommended for developing countries. Worse still, the odds of EBF practice are very low in rural communities. Hence, the aim of this study was to assess the knowledge, attitude, and practice of EBF as well as identify the factors associated with EBF practice among mothers of childbearing age in Chamo town, Jigawa State, Nigeria.MethodsThe study is a cross-sectional design using a questionnaire to assess the required information. The methodology involved the use of simple random sampling to select mothers of reproductive age from Chamo town, which is a rural community located in Jigawa State, Nigeria. A semi-structured questionnaire was used to assess the mother’s knowledge, attitude, and practices regarding EBF. Simple and multiple logistic regression analyses were performed to determine the factors associated with the practice of EBF.ResultsA total of 400 mothers between the ages of 18 and 41 took part in the study. More than half of the participants (57.8%) were between the ages of 26 and 33 and had a primary level of education (30.5%). Only 26.8% of the respondents practice EBF. Those with a tertiary education (AOR = 10.00, p < 0.001), civil servants (AOR = 12.51, p < 0.001), those aware of EBF (AOR = 3.65, p = 0.002), those with correct EBF knowledge (AOR = 4.61, p < 0.001), those with a positive attitude toward EBF demand (AOR = 0.51, p = 0.050), and those who received encouragement from their community (AOR = 9.87, p < 0.001) were more likely to practice EBF.ConclusionThe findings of the study revealed that the majority of the respondents’ knowledge, attitude, and practice of EBF were minimal. This shows the need to step up efforts to educate mothers about the advantages of EBF for both their own health and that of their children while they are in the hospital recovering from childbirth