Inaugural Address

Mr. Chairman, Distinguished Guests, Ladies and Gentlemen. It gives me great pleasure to inaugurate the First Annual General Meeting of the Pakistan Society of Development Economists. Based in the Pakistan Institute of Development Economics, the Society is intended to play a key role in disseminating information on pressing economic problems and in providing a permanent forum for a free and dispassionate exchange of ideas among professional economists and policy-makers. I am confident that the Society will set in motion a process of interplay between the ideas produced by the economists and the pragmatic application of these ideas by the policy-makers in the world of reality, thereby engendering efficiently functioning models of growth and development. Economics is a living and practical science which must draw its inspiration from and determine the parameters of its theories on the basis of actual organisation of economic life around us and the nature of economic problems faced at a particular stage of development. Theories and models, in turn, must stand the test of practical application in the market-place. A dialogue between the economists and the policy-makers, if they have to be at all placed into separate categories as a part of product discrimination, would represent the most desirable synthesis of professional energy, and for such a dialogue this Society, I am sure, will provide an ideal forum

Awareness and Knowledge on Epilepsy Among Undergraduate Medical Students in Pakistan

Background:  Epilepsy is a common neurological disorder which affects millions of people throughout the world. However, it has been discovered that there is a great degree of ignorance regarding the science of epilepsy among the general masses as well as the populace of medical students.  Studies have been conducted whose results have shown that, there has been fabrication regarding the clinical presentation & treatment of epilepsy among the common man. Numerous appear to link epilepsy to evil spirits and possession that can be healed by spiritual treatments by certain specialists given the designations of ‘demonologists’,’ paranormal investigators’ or ‘mystics’. In such circumstances, medical students can prove to be a major source to educate the society at large. Therefore, it is crucial that their knowledge & attitude towards epilepsy is accurate and thus, must be evaluated at an early stage in their medical career, so that these future physicians may play a pivotal role in the public awareness of epilepsy.  Method:  This study was conducted in Pakistan, at a Government sector medical college, namely, Karachi Medical and Dental College. This is a cross-sectional study. Data was collected between October to December of the year 2014. 270 medical students were given the KAP (knowledge, attitude & practice) form of epilepsy to fill out. The software used to interpret and tabulate the results was SPSS v.16 for Windows. The chi-square test was employed to determine the proportion of knowledge of epilepsy among medical students. The p-value calculated was equal to 0.05.   Findings:  In this study, 270 medical students were recruited, of which 90 were males (33.3%) where as 180 were females (66.6%). The ages of the student participants were within the range of 18 to 24 years. The analysis of our study demonstrates that: 85.1% of the medical students consider epilepsy to be a neurological disorder; 6.66% believe epilepsy is an infectious disease; 4.44% believe it to be a hereditary disease, whereas, 3.7% of the students reckon it is a psychiatric illness. Generalized tonic clonic seizures was deemed to be the most common form of epilepsy (25.5%) with complex partial seizures being the least common form(1.85%) , as well as relatively unknown by the students.             It was discovered through this study that, students were much less acquainted with the knowledge regarding the treatment of the disorder: multiple drug therapy was considered as the treatment by 56.66% of the students, spiritual treatment by 3.7%, spiritual treatment with medication by 20%, surgical treatment by 17.4% & 2.22% deemed epilepsy as a self limiting disease.  Conclusion:  It has been observed with this survey that the medical students of Pakistan are well aware of the knowledge of epilepsy and it being a medical condition. However, the students need to be educated early on in their training to be physicians, about certain aspects and details of the neurological disorder, for instance, the appropriate treatment of epilepsy, where their knowledge is lacking

Loss-to-follow-up and delay to treatment initiation in Pakistan's national tuberculosis control programme

BACKGROUND: Researchers and policy-makers have identified loss to follow-up as a major programmatic problem. Therefore, the objective of this study is to quantify TB related pre-treatment loss to follow up and treatment delay in private sector health care facilities in Pakistan. METHODS: This was a retrospective, descriptive cohort study using routinely collected programmatic data from TB referral, diagnosis and treatment registers. Data from 48 private healthcare facilities were collected using an online questionnaire prepared in ODK Collect, for the period October 2015 to March 2016. Data were analysed using SPSS. We calculated the: (1) number and proportion of patients who were lost to follow-up during the diagnostic period, (2) number and proportion of patients with pre-treatment loss to follow-up, and (3) the number of days between diagnosis and initiation of treatment. RESULTS: One thousand five hundred ninety-six persons with presumptive TB were referred to the laboratory. Of these, 96% (n = 1538) submitted an on-the-spot sputum sample. Of the 1538 people, 1462 (95%) people subsequently visited the laboratory to submit the early morning (i.e. the second) sample. Hence, loss to follow-up during the diagnostic process was 8% overall (n = 134). Of the 1462 people who submitted both sputum samples, 243 (17%) were diagnosed with sputum smear-positive pulmonary TB and 231 were registered for anti-TB treatment, hence, loss in the pre-treatment phase was 4.9% (n = 12). 152 persons with TB (66%) initiated TB treatment either on the day of TB diagnosis or the next day. A further 79 persons with TB (34%) commenced TB treatment within a mean time of 7 days (range 2 to 64 days). CONCLUSION: Concentrated efforts should be made by the National TB Control Programme to retain TB patients and innovative methods such as text reminders and behavior change communication may need to be used and tested

Inaugural Address

It is my privilege to inaugurate the Sixth Annual General Meeting of the Pakistan Society of Development Economists. During the past seven years, the Society has become an institution in its own right, devoted to the creation of scientific knowledge in the general area of development economics. It has provided an effective forum for the exchange of views on problems and challenges faced by development economics in general, and by Pakistan's economy in particular. The massive outpouring of knowledge in the shape of Papers and Proceedings published by the Society each year sheds ample light on complex academic issues and also constitutes an invaluable source of information for policy formulation. I am happy to note that the Society has been pursuing its objectives with determination, and has sought to cultivate its intellectual pursuits unhindered by any extra-academic considerations. This is as it should be. For~ when it comes to academic excellence, the limits should only be those of the imagination. We are meeting today at a time when the world is changing - and changing at an unprecedented pace. The scary chapter of cold war, replete with memories sending cold waves down one's spine, seems to be drawing to a close. And a new happy chapter in international relations has begun to unfold itself, bringing relief and hope for weary humanity. Conflict is changing to detente and detente to cooperation. Walls cutting nations apart - all kinds of them from mental to concrete - are crumbling. A new pattern of global relations is emerging with more togetherness and greater openness as its distinctive features

ARDL as an Elixir Approach to Cure for Spurious Regression in Nonstationary Time Series

In conventional Econometrics, the unit root and cointegration analysis are the only ways to circumvent the spurious regression which may arise from missing variable (lag values) rather than the nonstationarity process in time series data. We propose the Ghouse equation solution of autoregressive distributed lag mechanism which does not require additional work in unit root testing and bound testing. This advantage makes the proposed methodology more efficient compared to the existing cointegration procedures. The earlier tests weaken their position in comparison to it, as they had numerous linked testing procedures which further increase the size of the test and/or reduce the test power. The simplification of the Ghouse equation does not attain any such type of error, which makes it a more powerful test as compared to widely cited exiting testing methods in econometrics and statistics literature

Reasons for Lack of Research In Dentistry; A Cross Sectional Survey on Dentists and Students in Teaching Hospitals of Pakistan: Lack of research in dentistry

OBJECTIVES: The purpose of this study was to determine the barriers or factors preventing dentists from engaging in research in teaching institutes of Pakistan. METHODOLOGY: The descriptive, cross sectional online survey was conducted at the department of Prosthodontics, Rehman College of Dentistry, Peshawar over a period of six months. Sample size of 780 was taken in the descriptive study and questionnaires were communicated through emails and the response was noted. The data was analyzed using the IBM SPSS statistic version 20. Statistical analysis was done using counts and percentages and the results were further analyzed statistically by the Chi square test. RESULTS: Completed surveys were collected from 280 participants. Completed surveys were collected from 780 dentists, 40.7% were male and 59.3% were female. Participants’ age ranged between 20-50 years; about half of them (55%) were younger than 30 years of age. Other demographic characteristics of the participants such as designation, work experience, and qualification given in Table 1 were also recorded. Majority of the participants were dentists (35%), followed by senior registrar (10%) and assistant (10.7%), associate (and professors (4.3%). Details are depicted in Table 1. Overall, 47.9% participants were found to be involved in research and having publications. Simple graduates were more in number as compared to postgraduates. When inquired about publication published in an indexed journal or not 22.1% responded with yes and 46.4% responded with No. 65% participants had received workshops for writing papers and only 34.3% institute conducted continuous training programs. The main reason reported for lack of research was lack of motivation and don’t know how to do it. Other less common factors were lack of funds and no professional benefits as depicted in Table 2. CONCLUSION: Identifying and minimizing all the barriers in the way of research may help dental authorities to intervene for enhancing research friendly environments

Sensitivity and specificity of bedside troponin i kit (qualitative) test as compared with the standardized quantitative lab test for troponin I

Background: Our aim was to find out the sensitivity and specificity of (qualitative) troponin I kit against the quantitative lab kit for Troponin I. Methods: Admitted patients of ACS/NSTEMI at Karachi Institute of Heart Diseases of both gender, were administered a standardized questionnaire. Quantitative analysis of Trop I, was carried out by the hospital laboratory. At the same time sample was used for qualitative analysis of Troponin I by using Troponin I test kit Results: We recruited 50 patients in which 37 (74%) were male. Hypertensive 32 (64%), dyslipidemia in 13 (26%), family history in 15 (30%), DM in 16 (32%) smoking was prevalent in 11 (22%), previous MI in 10 (20%). The kit showed 100% sensitivity and 95% specificity as compared to the quantitative test with a cutoff of 0.30 ng/dl, i.e. quantitative test showed 32 positive and 18 negative cases, whereas qualitative test shows 31 positive and 19 negative. The difference in test results was on a value of 0.40 ng/dl , as qualitative test showed it as negative result. Conclusions: Study showed that qualitative kit is highly sensitive and specific at higher values of Troponin I, i.e., ≥ 0.5 ng/dl. The qualitative test could be very beneficial in cost and time saving for the non-conclusive patients, like NSTEMI and ACS, and whose Trop I values are not very close to the minimum cut off values. Sample size could be a limitation in our study, so a larger nationwide study is recommended Key words: Trop I, Sensitivity, Specificity, Qualitative, Quantitative, Myocardial Infarctio

Sports and Energy Drink Consumption, Oral Health Problems and Performance Impact among Elite Athletes

Frequent consumption of sports and energy drinks among athletes is of concern due to its detrimental impact on oral health. The present study aimed to assess sports and energy drink consumption, oral health status and impacts on daily activities and sports performance among elite athletes from Pakistan. Data regarding socio-demographic characteristics, sports and energy drink consumption, oral health and hygiene practices, self-reported oral health and psychosocial and performance impact was assessed using a self-administered, structured questionnaire followed by clinical oral examination by a single, experienced dentist. A total of 104 athletes, a majority of whom were male (80.8%), participated in the study. Around two third of the participants reported consumption of sports and energy drinks, energy gels or bars at least once a week, the commonest being Sting. Despite good oral hygiene practices, the athletes generally had poor oral health with high prevalence of dental caries (63.5%), gingivitis (46.1%), irreversible periodontitis (26.9%) and erosive tooth wear (21.2%). More than a quarter (28.8%) of the athletes rated their oral health as fair—very poor. Four in five athletes (80%) also experienced at least one oral problem with negative impacts on daily activities (64.4%) and participation training and sports performance (36.5%). Regression analyses revealed a significant association between periodontal disease and impact on both daily activities and sports performance. To our knowledge, this is the first study reporting that high-prevalence sports and energy drink consumption and oral problems among elite athletes from Pakistan has a negative impact on daily activities and sports performance. These findings may have important implications for oral health education programs, and the need to create awareness among the athletes regarding the use of sports and energy drinks, as well as regular oral health screening of athletes to minimize the impact on performance