Reproductive Behaviour in Pakistan: Insights from the Population, Labour Force, and Migration Survey 1979-80

Pakistan, with a population of83 million at the 1981 census, ranks as the ninth largest nation in the world. Owing to the persistently high levels of fertility and the concomitant relatively low levels of mortality, Pakistan's population has registered an annual growth rate of about 3 percent over the last two decades. This high growth rate poses a problem to all those concerned with the effects of rapid population growth in the face of limited global resources. Although a slight decline in Pakistan's fertility had been recorded in 1975, it was considered to be of little significance and a phenomenon too recent to influence population growth [I). A 12•percent decline in fertility during the 1970- 75 period, as suggested by the Pakistan Fertility Survey (PFS) data, however, generated hopes that Pakistan may well be entering into an era of declining fertility. There is an urgent need to investigate whether this decline was real and whether it continued in the late Seventies. Answers to these queries are of paramount importance both for population related research and for policy formulation. In this context, the data collected for Studies in Population, labour Force, and Migration (PLM) - a PIDE/ILO-UNFPA project [5] - may be extremely useful

Clinical evaluation of efficacy and safety of α-keto analogs of essential amino acids supplementation in patients of chronic kidney disease

Background: The objective was to evaluate the efficacy and safety of α-keto analogs of essential amino acids (KAA) as a supplement in chronic kidney disease (CKD).Methods: A prospective comparative study was conducted in patients of CKD of a tertiary care center of North India. Patients were randomly divided into two interventional groups. Group I (control) was advised conservative management and placebo while Group II (KAA) given conservative management along with KAA (600 mg, thrice daily) for 12 weeks. Hemogram, renal function tests, lipid profiles were done, and adverse effects were recorded at 0, 4, 8, and 12 weeks of treatment.Results: There was progressive improvement in clinical features in both groups after 12 weeks of treatment, but KAA group showed more marked improvement as compared with the control group. Both groups showed gradual improvement in the biochemical parameters as compared to their pre-treated values, which was more marked in KAA supplemented group. There was a reduction in blood glucose, blood urea, serum creatinine, and 24 h total urine protein. There was an increase in hemoglobin, 24 h total urine volume and glomerular filtration rate. KAA group showed significant (p<0.05) improvement in lipid profiles as compared with the control group. There was no statistical difference in two groups with respect to side-effects (p>0.05).Conclusion: KAA supplementation along with conservative management is efficacious and safe in preventing the progression of disease in patients of CKD

Reproductive behaviour in Pakistan: insights from the population, labour force, and migration survey 1979-80

This paper is in two parts. Part I is essentially a comparison with the results of the Pakistan Fertility Survey(1970-75) and basically a few themes have been thrown up. One is whether the 12-percent decline in fertility claimed by the PFS can be substantiated. The second presents multivariate analysis and coefficients of age at marriage, birth intervals and length of breast-feeding, and infant mortality. So Part I is basically a description of how those results can be substantiated or refuted or made inconsistent with this four-in-one venture of Migration, Fertility and so forth. Part II goes into statistics and details of a particular model to estimate the determinants of the children ever born

Role of rhubarb and α-keto analogues of essential amino acids supplementation in halting progression of chronic kidney disease

Background: Chronic kidney disease (CKD) is an emerging chronic disease due to rapidly increasing incidence of diabetes and hypertension worldwide. Newer drugs are being searched which can stop nephron damage and are cost effective. This study was undertaken to compare the efficacy and safety profile of rhubarb and α-keto analogues of essential amino acids supplementation in patients of chronic kidney disease.Methods: A prospective comparative study was conducted in patients of chronic kidney disease attending Renal Clinic of a tertiary care centre. Randomization of patients was done into three interventional groups: conservative management along with placebo was given in first group (Control); conservative management along with Rhubarb capsule (350 mg, thrice daily) was given in second group (Rhubarb) and conservative management along with α-keto analogues of essential amino acids (600 mg, thrice daily) was given in third group (KAA). The treatment was given for 12 weeks. Clinical and biochemical parameters were assessed at 0, 4, 8 and 12 weeks of treatment.Results: Patients of all three groups showed gradual improvement in clinical features and biochemical parameters as compared to their pre-treated values which was more marked in KAA supplemented group. There was reduction in: fasting blood glucose (12.51%, 19.15% and 20.78%), PPBG (14.80%, 19.00% and 20.89%), serum creatinine (25.00%, 30.54% and 39.52%), blood urea (25.55%, 33.64% and 38.09%), and 24-hour total urine protein (TUP) (19.80%, 30.18% and 38.34%) in Group I, II and III respectively. There was increase in: haemoglobin level (12.64%, 14.99% and 19.77%), 24-hour total urine volume (TUV) (19.41%, 28.82% and 33.32%) and GFR (22.6%, 46.5% and 49.2%) in Group I, II and III respectively. Rhubarb and KAA supplementations were safe and well-tolerated.Conclusions: KAA is more effective than Rhubarb as add on therapy with conservative management in patients of chronic kidney disease

Parental Characteristics, Supply of Schools, and Child School-enrolment in Pakistan

In recent years, due to a virtual unanimity about the critical role of human capital in economic development, increased efforts are being made in the developing countries to eradicate illiteracy. Despite a significant increase over time in the number of educational institutions and the government's expenditure on education in Pakistan, the performance of the education sector in terms of output has been at best meagre. This non-correspondence between the growth in the educational institutions and the resultant output implies that failure to enlist the participation of the population in education can hardly be attributed exclusively to an insufficiency of the schools. To the extent that child schooling reflects parental capacity to invest in human capital formation, there is a need to reckon with factors bearing parental decision regarding child schooling. This paper investigates family's decision regarding child schooling through an assessment of the determinants of child school-enrolment, using choice theoretic framework. The regression results are indicative of the influence of household status, both economic and social, on the propensity to invest in child schooling. A positive association between the household income, parental education, and tenurial status as land-owner bear out the importance of these factors in shaping the household's decision regarding investment in human capital formation. The study also finds traces of the quantity-quality trade-off in family's preferences regarding the number of children, and it is found to be male-specific. The most disturbing finding of the study appears to be the predominance of the influence originating from parental education. It is this inter-generational transfer of human capital which needs more attention as it also implies that illiteracy, and hence poverty, of the parents gets transmitted to the off-spring. The analysis also brings out the fact that the labour market hiring practices serve as an important feedback to the household's human capital formation behaviour.

Correlation of TP53 overexpression and clinical parameters with five-year survival in oral squamous cell carcinoma patients

Abstract Introduction TP53 mutation and overexpression have been correlated with poor survival in many cancers including oral squamous cell carcinoma (OSCC). We aim to understand the role of TP53 overexpression in OSCC in our population and correlate it with five-year survival to test its viability as a prognostic marker for OSCC patients. Materials and methods Patients with biopsy proven OSCC at Aga Khan University Hospital from January 2000 to January 2008 were recruited. Immunohistochemistry was used to establish TP53 status and the results were published. Following up on these patients, five-year data were collected and correlated with TP53 status and other clinicopathologic parameters. Results Overexpression of TP53 was not significantly associated with five-year survival (hazard ratio [HR]: 1.543; 95% CI: 0.911-2.612; p = 0.107). Conclusion Although we had proven statistical relevance when correlated with overall survival in our previous study, we were unable to extend the same relevance to TP53 overexpression when it comes to five-year survival

The Hero as a Deep-Diver: Existential Problematics in Kurt Vonnegut’s Breakfast of Champions & Jerzy Kosinski’s Pinball

American novelists of the late nineteenth century and twentieth century have been quite adept at creating deep memorable characters. These novelists often used their protagonists for higher purposes, such as endeavouring to construct a critique of the times by placing the characters in opposition to their respective societies. As a result, in American novel, the hero often became an unassuming type of hero who courageously defied the conventional beliefs and ignorant assumptions of society. The American fictional hero is constantly confronted by an ugly challenging reality; that is society and its pressures of conformity. In American tradition society is never a neutral force; rather it is intrusively active force which encroaches on the lives of individuals. The hero can never ignore or neglect it. He is forced to fight against a suffocating society and repelling reality

MIMAP Synthesis Report: Major Conclusions and Policy Implications

Despite the imperfections and complications in the evaluative procedures, the effects of SAP have been assessed in many developing countries. Research carried out by the PIDE-based project “Micro Impact of Macro Adjustment Policies” (MIMAP)1 is a pioneering venture that assesses the impact of various versions of SAP implemented by Pakistan since the mid-1980s. The general objective of the MIMAP project has been to facilitate the formulation of policies aimed at growth and improved welfare levels particularly of vulnerable groups, in Pakistan. The three specific objectives include: (1) To highlight and quantify the impact of macroeconomic and adjustment policies on poverty levels thereby yielding policy relevant insights; (2) To achieve the above specific objective through the use of sample household survey, the use of existing secondary socio-economic data sources, and the development of a micro-macro modelling exercise; and (3) To disseminate the project’s results within the country and to other MIMAP groups through technical publications, policy papers and seminars. In order to operationalise these objectives, the project was divided into two integrated but stand-alone components: poverty monitoring and modeling. Under the poverty-mentoring component, a nationally representative survey was carried out, while the modeling component was designed to develop Social Accounting Matrix (SAM) and Computable General Equilibrium Models (CGE). During the first phase of the Pakistan MIMAP project in total 13 studies were completed. The present study brings out major conclusions and policy implications based on these studies. It also sets out future direction for research. The sample design of the household survey and its socio-economic and demographic characteristics are discussed in Section II, where a comparison has also been made with the results of the 1998-99 Pakistan Integrated Household survey. Four research studies representing first round of analysis of the MIMAP data set are briefly summarised in Section III. Findings of five studies covering SAM and CGE models are discussed in Section IV, followed by presentation of findings of other three studies in Section V. The next section contains some suggestions for extension of research and modeling efforts to realise the objectives of ongoing MIMAP project. Conclusions and policy implications are presented in the last two section of the report

MIMAP Synthesis Report: Major Conclusions and Policy Implications

Despite the imperfections and complications in the evaluative procedures, the effects of SAP have been assessed in many developing countries. Research carried out by the PIDE-based project “Micro Impact of Macro Adjustment Policies” (MIMAP)1 is a pioneering venture that assesses the impact of various versions of SAP implemented by Pakistan since the mid-1980s. The general objective of the MIMAP project has been to facilitate the formulation of policies aimed at growth and improved welfare levels particularly of vulnerable groups, in Pakistan. The three specific objectives include: (1) To highlight and quantify the impact of macroeconomic and adjustment policies on poverty levels thereby yielding policy relevant insights; (2) To achieve the above specific objective through the use of sample household survey, the use of existing secondary socio-economic data sources, and the development of a micro-macro modelling exercise; and (3) To disseminate the project’s results within the country and to other MIMAP groups through technical publications, policy papers and seminars. In order to operationalise these objectives, the project was divided into two integrated but stand-alone components: poverty monitoring and modeling. Under the poverty-mentoring component, a nationally representative survey was carried out, while the modeling component was designed to develop Social Accounting Matrix (SAM) and Computable General Equilibrium Models (CGE). During the first phase of the Pakistan MIMAP project in total 13 studies were completed. The present study brings out major conclusions and policy implications based on these studies. It also sets out future direction for research. The sample design of the household survey and its socio-economic and demographic characteristics are discussed in Section II, where a comparison has also been made with the results of the 1998-99 Pakistan Integrated Household survey. Four research studies representing first round of analysis of the MIMAP data set are briefly summarised in Section III. Findings of five studies covering SAM and CGE models are discussed in Section IV, followed by presentation of findings of other three studies in Section V. The next section contains some suggestions for extension of research and modeling efforts to realise the objectives of ongoing MIMAP project. Conclusions and policy implications are presented in the last two section of the report