Are Defense Expenditures Pro Poor or Anti Poor in Pakistan? An Empirical Investigation

Recent increase in defense expenditure (Dexp hereinafter) in Pakistan due to increase in internal security and terrorism is an issue of concern to many Pakistani and other stakeholders in the Pakistan economy. Presently, internal security issues especially that of the increasingly violent homegrown terrorism is forcing increasing financial cost on government‘s expenditure towards defense sector. According to Budget documents, defense budget amounts to Rs 700. 2 billion for the 2014-15 fiscal year compared with Rs 627.2 billion allocated in the preceding fiscal year, showing an increase of Rs 73 billion. However, these figures do not include Rs 163.4 billion allocated for pensions of the military personnel.1 In addition to this, military would also be given Rs 165 billion under the contingent liability and Rs 85 billion under the Coalition Support Fund (CSF). This means that in reality Rs 1113 billion has been allocated for the military which is about 28.2 percent of the country‘s total budget [Sheikh and Yousaf (2014)]. This has led to diversion of the money needed for much-needed development projects, as the share of current expenditure in total budgetary outlay for 2014-15 is 80.5 percent.2 This diversion of funds has economic implication since some social sectors are likely to suffer in Pakista

Single Stage Reconstructive Surgery to Treat Anorectal Malformations in Neonates; Ten Years Experience

Objective: To present single surgeon’s ten years’ experience of Single stage reconstructive surgery in 26 neonates born with anorectal malformations (ARMs) and review of literature. Methodology: This is a retrospective study of 26 neonates admitted in NICU with diagnosis of ARMs between period of June 2011 to Oct 2021 and managed by single stage reconstructive surgery with an average follow up of three years. All these patients were full term. The diagnosis was confirmed on clinical examination supported by cross table lateral film in prone position after 24 hours and ultrasound evaluation of level of rectal pouch. Single stage reconstructive surgery was done under general anesthesia within 24 to 48 hours after birth. The outcome of single stage reconstruction of neonates with anorectal malformations is evaluated post operatively during an average regular follow up of 3 years. Results: All the 26 neonates are treated by single stage reconstructive surgery between 24 to 48 hours after birth during the period from June 2011 to Oct 2021 who were admitted with anorectal malformations in NICU after excluding associated congenital anomalies.  All the patients had excellent cosmetic and functional outcome without significant problem of wound infection. Only 3 female patients with recto-vestibular fistula had mild superficial wound infection and were managed conservatively. Conclusion: Single stage reconstructive surgery to treat ARMs in neonates I effective, safe and feasible with good continence. It avoids morbidity and higher cost associated with three stage surgeries and colostomy. This fact may further be confirmed through multi-institutional experience in large number of patients

Association of Vitamin D receptor gene BsmI polymorphism with type 2 diabetes mellitus in Pakistani population

Background: Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder with strong genetic components. The reported association of vitamin D receptor (VDR) gene polymorphisms varies among ethnic groups.Objectives: The present study was conducted to determine association of vitamin D receptor gene BsmI (rs1544410 A>G) polymorphism with type 2 diabetes mellitus in Pakistani population.Methods: Blood samples were collected from 150 T2DM patients and 100 non-diabetic engaged by convenient sampling method. After collection of demographic data, assessment of fasting glucose (FG), vitamin D, HbA1c, renal function tests, liver function tests and lipid profile was done. Candidate gene polymorphism was analyzed by DNA amplification with polymerase chain reaction and endonuclease digestion.Results: Biochemical parameters were significantly different among case and control groups. Associations of BsmI genotype with T2DM, related complications and biochemical variables were not significant.Conclusion: The current study did not provide evidence for the association of VDR gene BsmI polymorphism with T2DM in Pakistani population.Keywords: Vitamin D receptor gene; single nucleotide polymorphism; type 2 diabetes mellitus

Association of Vitamin D receptor gene BsmI polymorphism with type 2 diabetes mellitus in Pakistani population

Background: Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder with strong genetic components. The reported association of vitamin D receptor (VDR) gene polymorphisms varies among ethnic groups. Objectives: The present study was conducted to determine association of vitamin D receptor gene BsmI (rs1544410 A>G) polymorphism with type 2 diabetes mellitus in Pakistani population. Methods: Blood samples were collected from 150 T2DM patients and 100 non-diabetic engaged by convenient sampling method. After collection of demographic data, assessment of fasting glucose (FG), vitamin D, HbA1c, renal function tests, liver function tests and lipid profile was done. Candidate gene polymorphism was analyzed by DNA amplification with polymerase chain reaction and endonuclease digestion. Results: Biochemical parameters were significantly different among case and control groups. Associations of BsmI genotype with T2DM, related complications and biochemical variables were not significant. Conclusion: The current study did not provide evidence for the association of VDR gene BsmI polymorphism with T2DM in Pakistani population. DOI: https://dx.doi.org/10.4314/ahs.v19i2.41 Cite as: Fatma H, Abdul SN. Association of vitamin D receptor gene BsmI polymorphism with type 2 diabetes mellitus in Pakistani population.Afri Health Sci.2019;19(2): 2164-2171. https://dx.doi.org/10.4314/ahs.v19i2.4

Determination of in vitro antidiabetic effects of Zingiber officinale Roscoe

Aqueous extracts of Zingiber officinale rhizomes were studied to evaluate their antidiabetic effects on protein glycation and on the diffusion of glucose in vitro in the present study. Zingiber officinale rhizome aqueous extract were examined at concentrations of 5, 10, 20 and 40 g/L. The antidiabetic effects were found to be dose-dependent. Antidiabetic potential of Zingiber officinale was mainly through inhibition of the glucose diffusion and to a limited extent by reducing the glycation. However, further studies are needed to determine in vitro effects of therapeutic potential by restraining postprandial glucose absorptions and plasma protein glycations in diabetic subjects.Extratos aquosos de rizomas Zingiber officinale foram estudados para avaliar os seus efeitos antidiabéticos em glicação de proteínas e sobre a difusão de glicose in vitro, no presente estudo. Extratos aquosos de Zingiber officinale foram examinados nas concentrações de 5, 10, 20 e 40 g extrato de planta/L. Os efeitos antidiabéticos observados eram dependentes da dose. O potencial antidiabético de Zingiber officinale se verificou, principalmente, através da inibição da difusão de glicose e, em menor extensão, através da redução da glicação. Estudos adicionais são necessários para elucidar se efeitos in vitro representam potencial terapêutico, restringindo a absorção de glicose pós-prandial e a glicação de proteínas plasmáticas em indivíduos diabéticos

Antibiotic Susceptibility Pattern of Gram Negative Bacilli Isolated from Different Clinical Specimens in a Tertiary Care Hospital

Objective: To find out the antibiotic susceptibility pattern of gram-negative bacilli isolated from different clinical specimens received in a tertiary care hospital at Wah.Material and Methods: This cross-sectional study was carried out to determine antibiotic susceptibility pattern of gram-negative bacilli, cultured from different clinical specimens received in POF Hospital laboratory at Wah. One hundred and forty-four clinical isolates of gram-negative rods from different clinical specimens from April 2015 to March 2016 were included in the study. All the isolates were processed by standard microbiological methods. The antibiotic susceptibility pattern was carried out by disk diffusion method as recommended by Clinical Laboratory Standard Institute guidelines (CLSI).Results: Out of one hundred and forty-four Gram-negative bacilli, one hundred (69.44%) were from Enterobacteriaceae family and forty-four (30.56%) were from non-Enterobacteriaceae group. The commonest isolated organism was Escherichia coli (47.3%), followed by Pseudomonas aeruginosa (17.36%) and Acinetobacter baumannii (13.19%). These isolates were highly resistant to the most of the commonly prescribed antibiotics. The members of the family Enterobacteriaceae showed better sensitivity for amikacin and cefoperazone-sulbactam. Resistance rate for carbapenems was significantly high for K.pneumoniae and Proteus mirabilis. Among non-Enterobacteriaceae, P.aeruginosa showed better susceptibility for cefoperazone-sulbactam, amikacin, imipenem and meropenem. The multi-drug resistant pattern was observed for Acinetobacter.baumannii.Conclusion: The isolates depict highly resistant patterns to available oral antibiotics as well as commonly prescribed injectable third generation cephalosporins and carbapenems. Establishment and implementation of infection control practices are required to combat this grave situation

AN ANALYSIS OF EXTERNAL DEBT,URBANIZATION AND GOVERNMENT SIZE NEXUS: EVIDENCE FROM PAKISTAN

This study aims to analyze the nexus of external debt, urbanization and government size for Pakistan from 1972 to 2018. The study estimates two different models and employs four proxies of external debts such as (1) debt services to revenue ratio, (2) debt to revenue ratio, (3) debt services to exports ratio and (4) debt to exports ratio in addition to trade openness, per capita GDP, urbanization and inflation as control variables. The bound testing technique of autoregressive distributive lag (ARDL) has been employed. Data is sourced from the World Development Indicators (WDIs) and the International Financial Statistics released by the World Bank and the International Monetary Fund respectively. The study finds that the Law of Wagner is valid for Pakistan’s data which states that the increase in per capita income leads to more government expenditures. Results further show that all four proxies of external debt are statistically significant in reducing government expenditures; and the association between government size and urbanization is positive owing to the fact that urbanization leads to the high government expenditure for social and economic development of its people. The study has generated some policy implications. The government should efficiently utilize resources vis-à-vis reducing reliance on external debt to finance public expenditures. Likewise, the development of rural areas should be considered seriously to reduce the pressure of population in some specific cities of Pakistan

Association analysis of vitamin D receptor gene polymorphisms in North England population with Type 2 diabetes mellitus

Background: Numerous diabetes susceptibility loci, include a region consisting vitamin D receptor gene found in chromosome 12q, have been known using genome wide screens. Aim: The aim of present study is to probe the relationship between polymorphism of vitamin D receptor gene (single nucleotide polymorphisms) and type 2 diabetes mellitus (T2DM). Five hundred T2DM patients and 200 healthy subjects with normal HbA1c( 64 5.0 %), fasting blood sugar ( 64 120 mg/dL) and random blood sugar ( 64 140 mg/dL) were enrolled. Metholodgy: The genotypes were found by polymerase chain reaction restriction fragment length polymorphism and DNA sequencing. Results: revealed that no considerable differences in frequencies of genotype and allele of the Bsm I and Fok I polymorphisms between healthy and patients in the North England (For Fok I: OR = 1.11, 95% CI: 0.72\u20131.12; for Bsm I: OR = 1.35, 95% CI: 0.79\u20131.98). Conclusion: It is recommended that both following polymorphisms of vitamin D receptor gene may not considerably add to the progression of T2DM in the North England