Public Provision of Education and Government Spending in Pakistan

The study has been carried out to measure the incidence of government spending on education in Pakistan at the provincial (both rural and urban) level, using the primary data of the Pakistan Social Standard Living Measures Survey (PSLM), 2004-2005, and by employing the three-step Benefit Incidence Approach methodology. The paper reviews the national policies emphasising provision of education in Pakistan, as well as the trend in coverage and public sector spending on education facilities in Pakistan. The study examines the inequalities in resource distribution and service provision in relation to the government education expenditure. The rural areas of Pakistan are the more disadvantaged in the provision of the education facilities. Overall, the expenditure on the education sector is progressive, both at the regional and the provincial levels. However, variation exists in the shares of different income groups benefit from the provision of educational facilities created by public expenditure.education, public expenditure, Public Policy, Gini Coefficient, Concentration Coefficient, Benefit Incidence Approach

Public Provision of Education and Government Spending in Pakistan

The study has been carried out to measure the incidence of government spending on education in Pakistan at the provincial (both rural and urban) level, using the primary data of the Pakistan Social Standard Living Measures Survey (PSLM), 2004-2005, and by employing the three-step Benefit Incidence Approach methodology. The paper reviews the national policies emphasising provision of education in Pakistan, as well as the trend in coverage and public sector spending on education facilities in Pakistan. The study examines the inequalities in resource distribution and service provision in relation to the government education expenditure. The rural areas of Pakistan are the more disadvantaged in the provision of the education facilities. Overall, the expenditure on the education sector is progressive, both at the regional and the provincial levels. However, variation exists in the shares of different income groups’ benefit from the provision of educational facilities created by public expenditure.Education, Public Expenditure, Public Policy, Gini Coefficient, Concentration Coefficient, Benefit Incidence Approach

Health Care Services and Government Spending in Pakistan

The study has been carried out to measure the incidence of government spending on health in Pakistan at provincial, both rural and urban level; using the primary data of the Pakistan Social Standard Living Measures Survey (PSLM), 2004-05, and by employing the three-step Benefit Incidence Approach (BIA) methodology. The paper reviews the national policies emphasising health services as well as the trend in access to and public sector spending on health care facilities in Pakistan. The study explores the inequalities in resource distribution and service provision against the government health expenditures. The rural areas of Pakistan are the more disadvantaged in the provision of the health care facilities. The expenditures in health sectors are overall regressive in rural Pakistan as well as at provincial and regional levels. Mother and Child subhead is regressive in Punjab and General Hospitals and Clinics are regressive in all provinces. Only the Preventive Measures and health facilities sub-sector is progressive in Pakistan. Public health expenditures are pro-rich in Pakistan.health, Expenditure, Public Policy, Gini, Concentration Coefficient, Mother and Child, Preventive Measures, Hospital and Clinics

Health Care Services and Government Spending in Pakistan

The study has been carried out to measure the incidence of government spending on health in Pakistan at provincial, both rural and urban level; using the primary data of the Pakistan Social Standard Living Measures Survey (PSLM), 2004-05, and by employing the three-step Benefit Incidence Approach (BIA) methodology. The paper reviews the national policies emphasising health services as well as the trend in access to and public sector spending on health care facilities in Pakistan. The study explores the inequalities in resource distribution and service provision against the government health expenditures. The rural areas of Pakistan are the more disadvantaged in the provision of the health care facilities. The expenditures in health sectors are overall regressive in rural Pakistan as well as at provincial and regional levels. Mother and Child subhead is regressive in Punjab and General Hospitals and Clinics are regressive in all provinces. Only the Preventive Measures and health facilities sub-sector is progressive in Pakistan. Public health expenditures are pro-rich in Pakistan.Health, Expenditure, Public Policy, Gini, Concentration Coefficient, Mother and Child, Preventive Measures, Hospital and Clinics

Current status and overview of farm mechanization in Pakistan – A review

Economic growth in Pakistani agricultural sector lags behind growth in industry and services, creating an ever widening rural-urban income fissure.  Agricultural mechanization plays a strategic role in improving agricultural production and productivity in developing countries. The average farm size in Pakistan is small (2.5 acres) and small and marginal land holdings (less than 2.0 ha) account for 85% of land holdings.  Mechanizing small and non-contiguous group of small farms is against ‘economies of scale’ for individual ownership of farm machinery. It was observed that there was a direct correlation between farm power availability and productivity during the past six decades. Being an agrarian country, mechanization can be called as back bone of Pakistan’s economy as it optimizes the use of biological, chemical and hydrological inputs.  So far, Pakistan has only experienced selective farm mechanization as this concept has remained limited to use of tractors only and at the country level, the temporal analysis shows that an increase in tractor population from 1975 -1984 was about 341% while it was 61% from 1984-1994.  At present there are about 0.94 million tractors in Pakistan, which alone provides 0.84 hp/acre.  Land preparation is the only operation that is nearly 100% mechanized in the country for almost all crops with 901 thousand chisel plough and 108 thousand Mould board ploughs.  The market of planting and spraying machinery has grown from 70 and 21 thousands in 2004 to 295 and 1438 thousands in 2014 respectively due to the inclination of the farming community towards mechanized sowing and spraying.  The thrasher’s market in Pakistan is estimated at 20,000-30,000 units annually by sales resulting in nearly 100% mechanized threshing operation for cereal crops. By increasing the available horse power per hectare and by the proper management of agricultural machinery the average crop yield can be enhanced

Ependymal tumors with oligodendroglioma like clear cells: Experience from a tertiary care hospital in Pakistan

Background: Ependymal tumors with oligodendroglioma like clear cells have never been reported from Pakistan. We aimed to see the features and outcomes of this rare entity.Methods: It was retrospective cohort conducted at the Department of Neurosurgery, Aga Khan University from 2003 to 2013. The medical records and radiology of patients with proven histopathology were reviewed. Analysis was done on SPSS 20.Results: Eleven cases of ependymal tumors with clear cells were found, which equated to 1.5% of the total tumor burden in 11 years. The median age was 49 years. Most common presenting symptom was headache 54.5%. Out of 11 patients, 9 patients had a supratentorial tumor. Magnetic resonance imaging showed hypointense signals on T1 and hyperintense signals on T2-weighted images in all cases. Contrast enhancement was found in 9 patients (77.8%), necrosis and hemorrhage was found in 4 (36%) and 3 (27%) patients, respectively. Immunohistochemistry showed glial fibrillary acidic protein and epithelial membrane antigen positivity in all cases. Ki-67 showed high proliferative index in 6 patients. According to the World Health Organization grading of ependymal tumors, 2 patients had Grade II tumors, and 9 patients had Grade III tumors with clear cells. Gross total resection was achieved in 6 (54.5%) and subtotal resection in 5 patients (45.4%). Recurrence was observed in 9 patients. Six patients died of the disease. Median progression-free survival and overall survival was 8 months and 10 months, respectively.Conclusion: Ependymal tumors with clear cells presented more commonly in Grade III lesions and were more aggressive in behavior with poorer outcome compared to similar studies

Anterior Cervical Corpectomy with Cage Fixation for Cervical Spondylotic Myelopathy

Objective:  This study aimed to report the clinical outcome of anterior cervical corpectomy with cage fixation in patients with cervical spondylotic myelopathy. Material and Methods:  This observational retrospective study included 36 patients from the Neurosurgery department of Lady Ready Hospital MTI, Peshawar from 2014 January to 2015 December. After performing surgery, the patients were followed up for six months for neurological outcome and various post-operative complications such as infection, transient recurrent laryngeal palsy, screw displacement and improvements in paresthesias and gait ataxia. Results:  Most of the patients have no post-operative complications. Seventy-five percent (n = 27) of patients reported an immediate improvement in paresthesia and fine hand movements and gait. The major reported complications were implant failure (5.55%) and recurrent laryngeal nerve transient palsy in two patients (5.55%) each. Conclusion:  In patients with cervical spondylotic myelopathy, with anterior compression, cervical corpectomy with cage fixation is less invasive and an effective procedure with acceptable outcomes

Delayed spinal cord infarction following anterior cervical surgical decompression

Anterior cervical discectomy and fusion (ACDF) for cord compression is a safe and effective procedure with good outcomes. However, worsening of myelopathy is the most feared adverse event of the surgery. We report the case of a 36-year-old male patient who presented with an acute non-traumatic C5-6 cervical disc herniation causing incomplete quadriparesis. He underwent an uncomplicated ACDF at C5-6, and after an initial period of improvement, he developed a delayed onset of an anterior cord syndrome on day 3, without any discerning cause. We have reviewed similar cases reported in the literature and believe that our patient\u27s postsurgical course is consistent with a delayed ischaemic/reperfusion injury to the cord following surgical decompression and restoration of blood flow through the anterior spinal artery and we make suggestions for management of such clinical events

Pre-operative voriconazole in patients undergoing surgery for central nervous system fungal infections: Special report

Fungal infections of the central nervous system (CNS) are uncommon. Despite several advancements in diagnosis and treatment of these infections, the mortality rates remain high. The current retrospective study was planned to define the demographic and clinical features of patients with CNS fungal infections. Conducted at Aga Khan University Hospital, Karachi, and comprising CNS fungal infections operated between January 2000 and December 2015. The study analysed whether a short course of pre-operative anti-fungal therapy may improve outcomes in these patients. There were 47 cases confirmed on histopathology and/or microbiology. Outcome measures used were Glasgow coma score (GCS), Glasgow outcome score (GOS) and Karnofsky performance score (KPS). The overall 30-day mortality was 20(42.5%). Fungal infections of the CNS can occur in both immune-compromised and immune-competent patients. Early diagnosis, radical surgery, pre-operative anti-fungal therapy for at least 2 weeks, pre- and postoperative Voriconazole therapy results in more favourable outcomes