Private Power Generation—Opportunities and Challenges

POWER INDUSTRY DYNAMICS The concept of modern world is imperfect without electricity. The development of modern gadgets in past two decades has made human living as reflection of a science fiction movie. The fiction like living’s axis in fact is electricity and without electricity every thing comes to a grinding halt. Though this picture is portrait of the developed world, yet everyone would agree that wherever electricity has reached, it has transformed everything into power reliant. Whether it is Pakistan or any third world country, the industry; the commerce; the banking system; the methods of teaching in educational institutions; hospitals; control systems of civil aviation and civic traffic systems; and the domestic living, everything revolves around electricity. Whenever there is any break in electricity supply, output of every segment of society drops down to its lowest ebb. Many segments such as process industry and hospitals require highly reliable power supply systems. Truly, electricity is no more a luxury available to rich only; it has now become a basic need. However, scientists have not yet fully succeed in overcoming the challenges posed by the dynamics of electricity. First of all their failure to store electricity on commercial scale has made it necessary to keep generating electricity all the time. However, managing the generation quantum to meet the varying intra-day and inter-day power demand at places which are hundreds of miles apart require dedicated and sophisticated transmission and distribution infrastructure. The problem accentuated in countries like Pakistan where the generation capacity reduces in winter due to lower availability of its hydro power plants and lower availability of gas for thermal generation plants. The transmission cum distribution infrastructure as well as installation cum operations of power generating plants is very capital intensive. Hence it is very difficult for the governments and / or power utilities to develop the generation capacity and the transmission cum distribution network all by itself

Clinical features and outcome of surgery in 30 patients with acromegaly

Objective: To assess the surgical outcome of hypophysectomy in acromegalic patients, differences in response to surgery in micro and macroadenoma and the development of associated hormonal deficiency after surgery. Methods: Retrospective analysis of charts of acromegalic patients who were operated upon at Aga Khan University Hospital, Karachi, was done. Information regarding presentation, laboratory data, radiological assessment, details of surgery and postoperative outcome was recorded. Surgical outcome was classified depending on the degree of disease control after surgery as biochemical cure, remission and treatment failure. Results: Out of 30 patients, eighteen (60%) were males and 12 (40%) females with mean age at the time of diagnosis 35.6+/-10.4 years. The mean duration of symptoms was 3.2+/-2.4 years. Twenty-five patients had macroadenoma and five had microadenoma. Preoperative mean GH level was 42.4 ng/ml with range of 2.5 to 534 ng/ml. Following surgery, 13 had biochemical cure, 4 were in remission and 13 failed to respond. The outcome in microadenoma was better than in macroadenoma i.e. 100% vs. 32%. Preoperatively four patients had panhypopituitarism with additional six patients (20%) developing hypopituitarism postoperatively. Conclusion: Our study showed that acromegaly was seen at a much earlier age, outcome of surgery was comparable to other international studies and postoperative panhypopituitarism was seen in significant number of patients. The outcome in microadenoma was better than in macroadenoma but the number of patients seen with microadenoma was small

Clinical presentation of thyroid cancer patients in Pakistan--AKUH experience

Objective: To asses the clinical presentation of patients with thyroid cancer, their preferred diagnostic work-up and preferred surgical procedure. Methods: A retrospective chart review of patients that underwent partial or total thyroidectomy for thyroid cancer at AKUH between 1989 and 2002. SPSS was used to analyze data. Pearson\u27s chi square and likelihood ratios used to calculate tests of significance. Results: A total of 97 patients were included in this review. Solitary thyroid nodule was the initial presentation in three. Majority (58.7%) presented with neck swelling or enlarging goiter. One out of every 3 patients showed evidence of lymph node involvement and 20% had distant metastases. The aggressiveness of the disease did not correlate with age, sex or histological subtype. There was no correlation between the size of the tumor and presence of local or distant metastases. CONCLUSION: Thyroid cancer is a more aggressive disease in Pakistan, with majority of patients presenting with multinodular goiters, and a significant number have lymph node metastases. A higher degree of vigilance and a lower threshold for fine needle aspiration (FNA) is needed while evaluating patients with thyroid goiter

Effect of prepregnancy body mass index and gestational weight gain on birth weight

Objective: Nutritional status of women has been considered an important prognostic indicator of birth outcome. The study aims to show the effect of various prepregnancy Body Mass Index (BMI) categories and corresponding gestational weight gain on newborn birth weight.Methods: Two hundred women were included in the study. These women had regular antenatal visits and later delivered at The Aga Khan University Hospital (AKUH) between the period January 1, 1996 to December 31, 1997.Results: For women with prepregnancy BMI \u3c 19., mean birth weight of newborns was lower for those gaining \u3c 12.5 kg than those gaining \u3e 12.5 kg (P \u3c 0.001). Women who started their pregnancy with BMI 19.8-26 and gained weight above expected range gave birth to high birth weight babies (P = 0.009). Gestational weight gain did not have a significant association with birth weight for women having prepregnancy BMI \u3e 26.Conclusion: Efforts should be made to attain adequate prepregnancy weight to reduce the likelihood of low birth weight babies. Hence, special attention should be paid to women with low prepregnancy BMI

Uterine atony at a tertiary care hospital in Pakistan: A risk factor analysis

Objectives: To identify risk factors for uterine atony following assisted or unassisted vaginal delivery.Design: This hospital based case control study was done at The Aga Khan University Karachi, Pakistan. Cases were defined as all women with uterine atony within 24 hours of an assisted or unassisted vaginal delivery. Controls were based on women with normal assisted or unassisted vaginal delivery without uterine atony. Data abstracted form the medical records; adjusted odds ratios were estimated by multiple logistic regression.Results: Factors having a significant association with uterine atony were gestational diabetes mellitus (odds ratio 7.6, 95% CI 6.9-9.0, p = 0.003) and a prolonged second stage of labour in multiparas (odds ratio 4.0, 95% CI 3.1-5.0, p = 0.002). No associations were found with high parity, age, preeclampsia, augmentation of labour, antenatal anemia and a history of poor maternal or perinatal outcomes.Conclusions: Among previously documented risk factors for uterine atony, only a prolonged second stage of labour in multiparas was found to be significant in this study. Gestational diabetes mellitus, a previously undocumented factor, has also been identified as an independent risk factor. Multiparity and age were not found to be significant risk factors. The study underlines the importance of confirming these findings for better prevention and management of uterine atony

A comparison of severe pre-eclampsia/eclampsia in patients with and without HELLP syndrome

Background: The relationship of Haemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) syndrome with maternal and perinatal health and its presentation in Pakistani population is not known.Purpose: To determine the mode of presentation along with maternal and perinatal outcome of patients with HELLP syndrome.Methods: Case records of patients with severe hypertension in pregnancy who delivered between January 1, 1989 and December 31, 1994 at The Aga Khan University Hospital, Karachi. Out of 120 cases of severe pre-eclampsia/eclampsia, there were 36 cases of HELLP syndrome (Group-A). These were then compared with cases without HELLP syndrome (Group B) for their mode of presentation along with maternal and perinatal morbidity and mortality.Results: The overall incidence of HELLP syndrome was 0.4%. In the antepartum factors; unbooked status (66% vs 30%; p \u3c 0.05), diastolic B.P. \u3e 120 mmHg (61% vs 16%; p \u3c 0.05) DIC (13% vs 2%; p = 0.03), seizures (40% vs 16%, p = 0.01) and ARF (11% vs 1%, p = 0.07) were significantly raised. In the intrapartum factors there were no significant differences between the two groups in mode of delivery and complications of delivery. Neonatal outcomes did not differ significantly in the two groups.Conclusions: Women with severe hypertension in pregnancy manifesting with HELLP syndrome show a significantly greater frequency of developing DIC, seizures and acute renal failure. Therefore, their care necessitates intensive monitoring to preclude development of these complications

Behind the counter: pharmacies and dispensing patterns of pharmacy attendants in Karachi.

BACKGROUND: There is little literature available on dispensing patterns and unsupervised sale of medicines from pharmacies in developing countries. OBJECTIVE: This study obtained background information on pharmacies assessed the level of training, knowledge and dispensing patterns of pharmacy attendants in Karachi. METHODOLOGY: This is a descriptive cross sectional study with convenient sampling. A structured questionnaire was used to interview pharmacy attendants. RESULTS: Of the 219 pharmacies surveyed, 62% reported more than 50 customers daily and 20% also sold items of general provision. Mean operating hours were 13. Only 24 (11%) had a visible license. On an average 3 attendants were employed per pharmacy. We interviewed one in each. Amongst the 219 interviewed, 77 (35%) were intermediate qualified and only 26 (12%) pharmacologically trained. Correct frequency of ORS administration was not known by 167 (76%) and 21% incorrectly suggested an anti-diarrhoeal preparation for viral diarrhoea in children. The knowledge of those with pharmacological training was significantly better. For respiratory tract infection in children approximately 60% did not know the correct dose of Paracetamol and Amoxicillin. Only 13 (6%) knew that Propanalol was contraindicated in hypertensive asthamatics. For Cotrimoxazole, metronidazole and lomotil only 40%, 21% and 15% respectively, were aware that these could not be dispensed without prescription. CONCLUSION: In the absence of trained pharmacists existing pharmacy attendants should be trained to improve drug-dispensing patterns

An integrated systems-level model of ochratoxin A toxicity in the zebrafish (Danio rerio) embryo based on NMR metabolic profiling

Ochratoxin A (OTA) is one of the most widespread mycotoxin contaminants of agricultural crops. Despite being associated with a range of adverse health effects, a comprehensive systems-level mechanistic understanding of the toxicity of OTA remains elusive. In the present study, metabolic profiling by high-resolution magic angle spinning (HRMAS) NMR, coupled to intact zebrafish embryos, was employed to identify metabolic pathways in relation to a systems-level model of OTA toxicity. Embryotoxicity was observed at sub-micromolar exposure concentrations of OTA. Localization of OTA, based on intrinsic fluorescence, as well as a co-localization of increased reactive oxygen species production, was observed in the liver kidney, brain and intestine of embryos. Moreover, HRMAS NMR showed significant alteration of metabolites related to targeting of the liver (i.e., hepatotoxicity), and pathways associated with detoxification and oxidative stress, and mitochondrial energy metabolism. Based on metabolic profiles, and complementary assays, an integrated model of OTA toxicity is, thus, proposed. Our model suggests that OTA hepatotoxicity compromises detoxification and antioxidant pathways, leading to mitochondrial membrane dysfunction manifested by crosstalk between pathways of energy metabolism. Interestingly, our data additionally aligns with a possible role of mitochondrial fusion as a "passive mechanism" to rescue mitochondrial integrity during OTA toxicity.Solid state NMR/Biophysical Organic Chemistr

Measurements of Black Carbon Specific Absorption in the Mexico City Metropolitan Area during the MCMA 2003 Field Campaign

International audienceDuring the Mexico City Metropolitan Area (MCMA) field campaign of 2003, measurements of the shortwave radiation field, lidar backscatter, and atmospheric concentrations of black carbon (BC) permitted the inference of the BC carbon specific absorption, ??, defined as the absorption cross section per unit mass (with units of m2/g). This diverse set of measurements allowed us to determine ?? in two ways. These methods ? labeled I and II ? are distinguished from one another in the manner that the columnar concentration of BC (with units of mg/m2 is determined. This concentration is found by using either surface measurements of BC concentration and lidar estimates of aerosol mixing heights, or a more rigorous method that relies on the columnar aerosol size distribution. The averaged values of ?? derived from these methods agree to about 20%, although we expect that the values obtained from method I are underestimated. These results, along with those of Schuster et al. (2005), suggest that in the MCMA, ?? is in a range of 8 to 10 m2/g at a wavelength of 550 nm. This range is somewhat lower than the commonly accepted value of 10 m2/g for a wavelength of 550 nm, but is consistent with the calculations of Fuller et al. (1999), who suggest that this value is too high