Fighting Governmental Corruption in Pakistan: An Evaluation of Anti-Corruption Strategies

Corruption remains a persistent problem in both developed and developing countries. Statistics provide evidence that Pakistan faces the menace of corruption. The recently released Corruption Perception Index (CPI) for 2019 by Transparency International (TI) ranks Pakistan as the 120th country out of a total of 180. In 1995 Pakistan used to be the second most corrupt country in the world. Moreover, TI’s Global Corruption Barometer for 2017 shows that 40–50 per cent of the respondents have given a bribe to get a public service in Pakistan. The Global Competitiveness Reports (2016, 2017, and 2018) released by the World Economic Forum in Switzerland have declared corruption to be the topmost problematic factor when doing business in Pakistan. Corruption is a public problem and relevant academic literature holds the dominant view that it obstructs economic development. It increases the direct costs of firms through bribery. It encourages bureaucratic red tape and corrupts the institutions of contract enforcement and property rights protection. Although corruption and anti-corruption have long been research topics in the social sciences, little has been done about the evaluation of anti-corruption strategies. Anti-corruption efforts are required where corruption prevails. With this in view, the study aims to ascertain the opinion of policy professionals regarding different anti-corruption strategies. Data on 26 anti-corruption strategies were collected through a self-administered questionnaire from 100 policy professionals working in 12 different policy institutes. The results have found slight differences between the mean scores for anti-corruption strategies, depicting a certain level of effectiveness for each strategy. Harsher punishments for corrupt persons and legal protection for whistleblowers informing about persons involved in corruption are the strategies that had the highest mean scores of 4.07 and 4.04 respectively. Policy professionals rated the category of “Political, legal and judicial strategies” with the highest mean value of 3.90 as the most effective anti-corruption typology. A holistic approach is required in Pakistan to eradicate corruption from governmental offices

Improving diagnosis of tuberculous lymphadenitis by combination of cytomorphology and MPT64 immunostaining on cell blocks from the fine needle aspirates

Background: Extra pulmonary tuberculosis (EPTB) constitutes 18% of all tuberculosis (TB) cases and tuberculous lymphadenitis (TBL) constitutes 20–40% of EPTB. Diagnosis of TBL is challenging because of the paucibacillary nature of the disease. Objective: To investigate the diagnostic potential of a new antigen detection test based on the detection of M. tuberculosis complex specific antigen MPT64 from fine needle aspirate (FNA) cytology smears and biopsies obtained from patients with clinically suspected TBL using immunohistochemistry (IHC). Materials and methods: This study was conducted at Khyber Teaching Hospital and Rehman Medical Institute, Peshawar, Pakistan, from January 2018 to April 2019. Samples, including FNA (n = 100) and biopsies (n = 8), were collected from 100 patients with presumptive TBL. Direct smears and cell blocks were prepared from the FNA samples. All samples were subjected to hematoxylin–eosin (H&E) staining, Ziehl-Neelsen (ZN) staining, and immunostaining with polyclonal anti-MPT64 antibody. The culture was performed only for biopsy specimens. All patients were followed until the completion of anti-TB treatment. The response to treatment was included in the composite reference standard (CRS) and used as the gold standard to validate the diagnostic tests. Results: The sensitivity, specificity, positive and negative predictive values for ZN staining were 4.4%,100%,100%,56%, for culture were 66%,100%,100%,50%, for cytomorphology were 100%,90.91%,90%,100%, and for immunostaining with anti-MPT64 were all 100%,respectively. The morphology and performance of immunohistochemistry were better with cell blocks than with smears. Conclusion: MPT64 antigen detection test performed better than ZN and cytomorphology in diagnosing TBL. This test applied to cell blocks from FNA is robust, simple, and relatively rapid, and improves the diagnosis of TBL