Impact of Political Instability on International Investment and Trade in Pakistan

This paper focuses on the effect of political instability on international investment and trade in Pakistan. The sample comprised of annual data for a period of 41 years (from 1976 to 2016). To test the long and short run relationships among the variables, ARDL model is applied and particularly Error Correction Model is used for short run analysis. To check the serial correlation in the ECM models, LM serial correlation test is applied. Cumulative sum (CUSUM) is also utilized to test the stability of the ARDL models. The unit root of all the variables is also tested and it is found that all the variables are stationary either at level or at first difference. Findings conclude that political instability badly hampers both the international investment and trade in the long-run. Moreover, in short-run, the political instability significantly hinders the foreign portfolio investment and exports. No significant impact of political instability is found on foreign direct investment and imports in the long run

Impact of Political Instability on International Investment and Trade in Pakistan

This paper focuses on the effect of political instability on international investment and trade in Pakistan. The sample comprised of annual data for a period of 41 years (from 1976 to 2016). To test the long and short run relationships among the variables, ARDL model is applied and particularly Error Correction Model is used for short run analysis. To check the serial correlation in the ECM models, LM serial correlation test is applied. Cumulative sum (CUSUM) is also utilized to test the stability of the ARDL models. The unit root of all the variables is also tested and it is found that all the variables are stationary either at level or at first difference. Findings conclude that political instability badly hampers both the international investment and trade in the long-run. Moreover, in short-run, the political instability significantly hinders the foreign portfolio investment and exports. No significant impact of political instability is found on foreign direct investment and imports in the long run

Maternal genital tract colonisation by Group-B Streptococcus: A hospital based study

Objectives: To determine the prevalence of Group B Streptococcus genital tract infection in pregnant women and to determine the risk factors for its colonisation.Methods: The cross-sectional study was conducted at the Aga Khan University Hospital, Karachi and Sobhraj Hospital, Karachi, from May to August 2007. Pregnant women at 35-37 weeks gestation attending antenatal clinic at these hospitals constituted the study population. Based on stratified sampling, 405 patients were recruited. High vaginal swabs of these patients were taken in order to calculate the prevalence of infection at each hospital. Logistic regression was used to evaluate the risk factor association. SPSS 11.5 was used for statistical analysis.Results: The overall prevalence of colonisation was 17% (n=69) (95% CI: 13.4-20.7). Of the 155(38.27%) women at the Aga Khan Hospital, 35(22.6%) were positive, while among the 250 (61.72%) women at Sobhraj Hospital, the prevalence was 13.6% (n=34). The colonisation was found to be significantly associated inversely with the body mass index of the patient (OR 0.91; 95% CI: 0.08-1.0).Conclusion: Group B Streptococcus screening should be an integral part of antenatal care and should be offered to all pregnant women

Comparison of Vitamin D Levels in Patients with Dengue Haemorrhagic Fever and Dengue Fever

Background: To compare vitamin D levels in patients of dengue hemorrhagic fever with dengue feverMethods: A total of 50 patients with diagnosed dengue fever, who fulfilled the inclusion criteria were enrolled in the study. Patients were divided into two groups having 25 participants each; one group had Dengue fever (DF) while the other was suffering from dengue hemorrhagic fever (DHF). Vitamin D was estimated by the chemiluminescence method. Pearson’s Chi-square was applied to compare the proportion of patients in each study group. Relative Risk was measured along with 95% confidence interval. Significant p-value was < 0.05.Results: Mean age of patients was 37.79 ± 15.2 years (range: 16-90 years). There were 74% males and 26% females. Mean vitamin D levels in dengue fever patients were higher (21.5 ± 13.6 ng/ml) as compared to Dengue hemorrhagic fever (12.4 ± 5.6 ng/ml). The difference was statistically significant (p=0.003).Conclusions: Vitamin D may have a role in the management of dengue fever. Low levels of vitamin D might be associated with dengue hemorrhagic fever

Association of 25 Hydroxy Vitamin D Levels with Age in Community Acquired Pneumonia

Background : To determine association of 25 hydroxy vitamin D deficiency with age in patients with community acquired pneumonia (CAP). Methods: In this descriptive study 150 diagnosed patients of community-acquired pneumonia based on the CURB-65 scoring criteria were enrolled. The 25 hydroxy vitamin D levels were recorded in all patients. Patients were divided into three groups according to their age. Effect modifiers like gender were controlled by stratification. Post stratification chi square test was applied. A p value of 0.05 was considered significant. Results: Mean age of the patients was 40.05 ± 14.33 years (mean ± SD). Out of 150 patients 54.7% (n=82) were males while the 45.3% (n=68) were females. The mean level of vitamin D was 18.43 ± 5.005 (mean ± SD) ng/ml. When the cut off value for deficiency was applied i.e. 20 ng/ml, the 60% (n=90) patients were found deficient while 40% (n=60) patients had normal values. The p value was significant only for the age group to 35 to 50 years. Independent sample t test showed that the difference is statistically significant (p=0.003) in age groups between 35 to 50 years. Conclusions: Lower concentrations of vitamin D might be associated with CAP particularly in age group between 35 to 50 years

Effect of α-lipoic acid and exercise training on cardiovascular disease risk in obesity with impaired glucose tolerance

Obese subjects with impaired glucose tolerance (IGT) are more susceptible than healthy individuals to oxidative stress and cardiovascular disease. This randomised controlled investigation was designed to test the hypothesis that α-lipoic acid supplementation and exercise training may elicit favourable clinical changes in obese subjects with IGT. All data were collected from 24 obese (BMI ≥ 30 kg/m2) IGT patients. Following participant randomisation into two groups, fasting venous blood samples were obtained at baseline, and before and following intervention. The first group consisted of 12 participants who completed a 12 week control phase followed by 12 weeks of chronic exercise at 65% HRmax for 30 minutes a day, 5 days per week, while ingesting 1 gram per day of α-lipoic acid for 12 weeks. The second group consisted of 12 participants who completed the same 12 week control phase, but this was followed by 12 weeks of 1 gram per day of α-lipoic acid supplementation only (no exercise). The main findings show a comparatively greater rate of low density lipoprotein (LDL) oxidation in the group consisting of α-lipoic acid only (p < 0.05 vs. pre intervention), although total oxidant status was lower post intervention (p < 0.05 vs. baseline) in this group. However, exercise and α-lipoic acid in combination attenuates LDL oxidation. Furthermore, in the α-lipoic acid supplement plus exercise training group, total antioxidant capacity was significantly increased (p < 0.05 vs. baseline and pre intervention). Body fat percentage and waist and hip circumference decreased following exercise training (p < 0.05 vs. post intervention). There were no selective treatment differences for a range of other clinical outcomes including glycaemic regulation (p > 0.05). These findings report that α-lipoic acid ingestion may increase the atherogenicity of LDL when ingested in isolation of exercise, suggesting that in IGT the use of this antioxidant treatment does not ameliorate metabolic disturbances, but instead may detrimentally contribute to the pathogenesis of atherosclerosis and development of CVD. However, when α-lipoic acid is combined with exercise, this atherogenic effect is abolished

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Oxidative stress and the role of antioxidants in the reduction of cardiovascular risk

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