Estimation of the Black Economy of Pakistan through the Monetary Approach

In the recent years the “black economy” has held immense attraction for academics as well as policy-makers. This is because the presence of the black economy is responsible for distortions in the official estimates of macro-economic variables like income generation, employment, rate of inflation, etc., and thus the possible effect on the economic policies cannot be ascertained properly. It, therefore, becomes imperative to investigate this area of research. Researchers have defined the underground economy in alternative ways. The underground economy defined by varied names like black, shadow, hidden, informal, clandestine, second, parallel economy has been divided in four categories for the use of a standard basis of classification.

USE OF CATCHMENT SPECIFIC SOCIAL AND ECONOMIC INFORMATION IN MANAGING NATURAL RESOURCES

Catchment specific economic and social information assists catchment management authorities in natural resource planning and decision making. It gives a context to the natural resource management (NRM) planning and decision making by providing an understanding of the economic and social characteristics in a region and tracks economic and social changes overtime. It also enables analysis of factors that influence a community’s competence in undertaking NRM activities. Catchment specific economic and social data is available from the Australian Bureau of Statistics but there are gaps in the availability of this data that may hinder NRM planning and decision making. The aim of this paper is two fold: firstly, it provides a snapshot of the economic and social information of selected catchments in NSW and secondly, it emphasises the need for further data availability that can facilitate NRM planning and decision making at a catchment level.economic, social, data availability, natural resource management, catchment management authorities, decision making, Resource /Energy Economics and Policy,

Estimation of the Black Economy of Pakistan through the Monetary Approach

In the recent years the “black economy” has held immense attraction for academics as well as policy-makers. This is because the presence of the black economy is responsible for distortions in the official estimates of macro-economic variables like income generation, employment, rate of inflation, etc., and thus the possible effect on the economic policies cannot be ascertained properly. It, therefore, becomes imperative to investigate this area of research. Researchers have defined the underground economy in alternative ways. The underground economy defined by varied names like black, shadow, hidden, informal, clandestine, second, parallel economy has been divided in four categories for the use of a standard basis of classification [Feige (1990)]

Cardiac involvement in kawasaki disease in Pakistani children

Introduction: Coronary artery involvement is the most dreaded long-term complication of Kawasaki disease. Our aim was to look at the pattern of cardiovascular involvement in Pakistani children admitted with Kawasaki disease.Methods: This study included children admitted with Kawasaki disease at the Aga Khan University Hospital Karachi over a period of 14 years from January 1997 to December 2010. Information gathered included patient demographics, clinical features, investigations, echocardiographic findings, treatment and follow-up. Those with coronary artery involvement on initial echocardiogram remained on long-term follow-up with clinical examination and echocardiogram.Results: A total of 56 patients were admitted. (Mean age at diagnosis 33 ± 30 months, age range 2 months to 9 years). 18% of patients had incomplete features. Twenty-five percent (14/56) patients presented after 10 days of fever. Cardiac examination was normal except for tachycardia. Abnormal coronary arteries were seen in 23 patients (41%) - left main coronary artery in 23 (41%), left anterior descending and right main coronary artery in 20 (36%), circumflex branch in 17 (30%). Risk factors for cardiac involvement were male sex, fever \u3e10 days duration at the time of initial presentation and neutrophil percentage \u3e75% in the initial white blood cell counts. Fifty four of 56 cases received intravenous immunoglobulin (IVIG), Seventy-five percent of the patients received IVIG within 10 days of illness. Mean duration of follow-up was 2.5 years. Eight percent of the patients still continue to have abnormal coronaries. There was no mortality.Conclusions: A higher incidence of coronary artery involvement was found in our study. Presentation after 10 days of illness increases the risk of coronary artery involvement. High index of suspicion among the general pediatricians about the disease can possibly be helpful for early referral and treatment

Pulmonary arteriovenous malformation in cryptogenic liver cirrhosis

The cause in 10 - 20% cases of liver cirrhosis (LC) cannot be elucidated, and are thus termed cryptogenic. Pulmonary arteriovenous malformations (PAVMs) are relatively rare, but the most common anomaly involving the pulmonary tree. Although the rare correlation between LC and PAVM is well-known, there have been no reports of PAVMs occurring in cryptogenic LC. We report a case of PAVM that occurred in cryptogenic liver cirrhosis in a 3 years old male child. The child presented with complaints of malena, hematemesis and variceal bleed. The examination revealed a child with respiratory distress, irritability, tachycardia, clubbing and abdominal distention. He was worked up for recurrent variceal bleeding secondary to portal hypertension but the oxygen saturation during hospital stay kept deteriorating. The diagnosis of hepatopulmonary syndrome as the cause of persistent hypoxemia in the absence of other cardio-pulmonary causes was then made by enhanced echocardiogram using agitated saline. He improved significantly after liver transplantation performed abroad. At a 6 months follow-up, the child was stable with no evidence of intrapulmonary shunting on repeat echo

Surgical correction of aorto-pulmonary window: a rare and lethal cause of pulmonary hypertension

Aorto-pulmonary window is a relatively rare congenital cardiac malformation with an overall incidence of 0.1%. Pulmonary hypertension develops quickly if the lesion is left untreated hence early surgical intervention is warranted after diagnosis. The surgery for correction of APW has evolved over years, currently an open repair on cardiopulmonary bypass (CPB) with a single patch technique yields good results. Mortality is affected by association of pulmonary hypertension and other cardiac malformations. We present a case of an infant with a large type II APW with a relatively low pulmonary vascular resistance. Hospital stay was complicated because of pulmonary arterial disease making it an important reason for correction in the first few months of life

Dual chamber pacemaker implants--a new opportunity in Pakistan for children with congenital and acquired complete heart block

Implantation of cardiac pacemakers has been practiced for at least five decades with continuous developments of the hardware. The invention of dual chamber pacemakers has initiated a debate concerning its superiority over single chamber ventricular pacemakers. Throughout the world, surgeons have been using dual chambered permanent pacemakers with successful follow ups. However, Pakistan has not yet taken the advantage of such pacemaker devices till now. We report three cases that underwent a dual chamber permanent pacemaker implantation for the first time in children less than 8 kg with successful follow ups

Anomalous origin of the left coronary artery from the pulmonary artery: A surgical certainty

This study aims to assess the clinical presentation and the outcomes of a surgical correction of an anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). A retrospective review was carried out on the charts of six patients admitted for ALCAPA surgery at Aga Khan University Hospital, Karachi from March 2017 to May 2018.Dyspnoea, palpitation, poor feeding, fatiguability, pallor and a murmur of mitral regurgitation were the main presenting features. The pre-operative median left ventricular ejection fraction (LVEF) was 64%. Coronary reimplantation was performed in all the patients with a mitral valve repair being done in only one patient. The mea n LV EF was 66 .3%,p ost- ope rativel y. Mitra l regurgitation (MR) improved in patients post-operatively with trace in 2 patients and mild MR in one. Surgical correction by coronary re-implantation yields favourable outcomes in ALCAPA and significantly reduces the morbidity and mortality rates associated with the disease

Anthracycline-induced cardiotoxicity: prospective cohort study from Pakistan

Objectives: To identify anthracycline-induced acute (within 1 month) and early-onset chronic progressive (within 1 year) cardiotoxicity in children younger than 16 years of age with childhood malignancies at a tertiary care centre of Pakistan. Design: Prospective cohort study. Setting: Aga Khan University, Karachi, Pakistan. Participants: 110 children (aged 1 month–16 years). Intervention: Anthracycline (doxorubicin and/or daunorubicin). Outcome measurements: All children who received anthracycline as chemotherapy and three echocardiographic evaluations (baseline, 1 month and 1 year) between July 2010 and June 2012 were prospectively analysed for cardiac dysfunction. Statistical analysis including systolic and diastolic functions at baseline, 1 month and 1 year was carried out by repeated measures analysis of variance. Results: Mean age was 74±44 months and 75 (68.2%) were males. Acute lymphoblastic leukaemia was seen in 70 (64%) patients. Doxorubicin alone was used in 59 (54%) and combination therapy was used in 35 (32%). A cumulative dose of anthracycline /m2was used in 95 (86%). Fifteen (14%) children developed cardiac dysfunction within a month and 28 (25%) children within a year. Of these 10/15 (66.6%) and 12/28 (43%) had isolated diastolic dysfunction, respectively, while 5/15 (33.3%) and 16/28 (57%) had combined systolic and diastolic dysfunction. Seven (6.4%) patients expired due to severe cardiac dysfunction. Eight of 59 (13.5%) children showed dose-related cardiotoxicity (p= Conclusions: Incidence of anthracycline-induced cardiotoxicity is high. Long-term follow-up is essential to diagnose its late manifestations

Isolation of a promising antidiabetic compound from the leaves of tetracera indica merr., and in vivo toxicological studies in diabetes induced experimental animals

Diabetes mellitus is a chronic disorder together with other metabolic abnormalities, usually developed due to insulin resistance or deficiency as well as increased hepatic glucose output [1]. The prevalence of diabetes mellitus among Malaysians adults more than 30 years of age has escalated by more than two fold over a 20-year period [2]. On the other hand, many plants have been used for the treatment of diabetes mellitus in modern system of medicine and in other ancient systems of the world. As a result, plants are now-a-days regarded as promising and significantly attractive natural sources to enrich the current therapy options against diabetes. However, so far, not many active agents have been successfully isolated and extensively studied [3]. Hence, we prompted to evaluate the antidiabetic potential of a flavonoid (5,7-dihydroxy-8-methoxyflavone [4], Figure 1) isolated from the leaves of Tetracera indica Merr., a Malaysian medicinal plant which is traditionally used to treat diabetes in Malaysia. The study was carried out using Sprague-Dawley rats (diabetic as well as normal) to evaluate antidiabetic potential of 5,7-dihydroxy-8-methoxyflavone at three different concentrations, viz. 1 mg/kg b.w., 5 mg/kg b.w. and 25 mg/kg b.w. At 5 mg/kg b.w. and 25 mg/kg b.w., it was found to exhibit significant anti-hyperglycemic activity in alloxan induced diabetic rats and in normal rats, no hypoglycemic activity was observed at all concentrations, when compared with +ve and –ve controlled groups. The antidiabetic activity was found to be comparable with glibenclamide (GLBC), a known oral hypoglycemic agent (50 mg/kg b.w.) (Table 1). The LD50 of 5,7-dihydroxy-8-methoxyflavone was found to be more than 500 mg/kg b.w. and no lethal toxicity was observed within this range. Three weeks later, the in-vivo study, histopathology of kidney and pancreas from alloxan-induced rats demonstrated the clinical manifestation of diabetic affected kidney and pancreas (Figures 2 & 3). It is concluded that the 5,7-dihydroxy-8-methoxyflavone from the leaves of T. indica is a safe and promising antidiabetic agent that could prove useful in the management of diabetes and might also provide lead for the synthesis of a new class of safe antidiabetic drugs. Keywords: 5,7-dihydroxy-8-methoxyflavone, Tetracera indica, antidiabetic agen