Trade Liberalisation Policies, Intra-regional Trade and Opportunities for Sustainable Agricultural Development

Many of the Near East (NE) countries are currently opening their agricultural markets at three distinct but interacting levels: unilateral liberalisation, regional integration schemes and multilateral trade liberalisation. These changes hold important implications for intra- and extra-regional trade, use of agricultural resources and sustainability of agricultural development in the NE countries. Unilaterally, and since the late 1980s, most countries of the region have liberalised their agriculture sectors by eliminating or reducing input subsidies, removing or reducing guaranteed producer prices, reducing the number of subsidised commodities and liberalising the exchange rate and the trade regime. Most of the implicit and explicit subsidies for agricultural inputs and outputs were withdrawn. However, some of the NE countries were able to continue supporting agriculture mainly for food security reasons. Experiences showed that domestic reform is necessary but not sufficient condition for economic growth.

Trade Liberalisation Policies, Intra-regional Trade and Opportunities for Sustainable Agricultural Development

Many of the Near East (NE) countries are currently opening their agricultural markets at three distinct but interacting levels: unilateral liberalisation, regional integration schemes and multilateral trade liberalisation. These changes hold important implications for intra- and extra-regional trade, use of agricultural resources and sustainability of agricultural development in the NE countries. Unilaterally, and since the late 1980s, most countries of the region have liberalised their agriculture sectors by eliminating or reducing input subsidies, removing or reducing guaranteed producer prices, reducing the number of subsidised commodities and liberalising the exchange rate and the trade regime. Most of the implicit and explicit subsidies for agricultural inputs and outputs were withdrawn. However, some of the NE countries were able to continue supporting agriculture mainly for food security reasons. Experiences showed that domestic reform is necessary but not sufficient condition for economic growth

Does obesity affects early infection after total knee arthroplasty. a comparison of obese vs non obese patients

Abstract Surgical site infection (SSI) is a disastrous complication after total knee arthroplasty (TKA) which can cause prosthesis loosening and may end up in septicaemia. The incidence of infection reported to be in the range of 0.3-12.4% for primary TKA. Significantly higher infection rate is found in the morbidly obese patients. The current study compared the immediate rate of post-total knee replacement wound infection in the obese versus non-obese population. The cross-sectional study was conducted at Aga Khan University Hospital (AKUH) and comprised patients undergoing TKA for primary knee osteoarthritis. Surgical outcome was measured by the Southampton wound infection score at 1-month follow-up. Out of 142 enrolled patients with a mean age of 67.8±56 years, infection was confirmed in 3(2.11%) patients who needed surgical management. All the patients who developed SSIs were females

Biometric and Ultrasonographic Evaluation of the Testis of One-humped Camel (Camelus dromedarius)

Twenty four adult clinically healthy one-humped male camels (Camelus dromedarius) were examined three times (beginning, mid and end) in each season (winter, spring, summer and autumn) for establishing the normal ultrasonic appearance and seasonal changes in the testicular parenchyma in the natural ecology of Punjab, Pakistan. The testes of each camel were scanned by using a B-mode real time ultrasound scanner fitted with a 7.5-MHz linear-array transducer. Scrotal biometry was done with the measuring tape during all the seasons of year. The tunics of the testes appeared as hyperechoic lines surrounding the homogenous, moderately echogenic parenchyma of the testis. The mediastinum testis was visualized as hyperechoic central line and a spot, in longitudinal and transverse sections, respectively. During winter season, the parenchyma was hyperechoic and mediastinum testis was seen as thin hyperechoic line. In spring, the echogenicity of parenchyma was moderate and mediastinum appeared relatively thick central hyperechoic line. In summer and autumn, less echoic parenchyma and thick band of mediastinum was recorded. Biometric studies showed significantly (P<0.01) higher scrotal length and width of the testis during winter and spring season as compared to summer and autumn. Present study revealed that the ultrasonic structure of camel testis resembles other mammals and season has an apparent effect on the testicular size and echogenicity of the testicular parenchyma in the one-humped camel

Burnout, job dissatisfaction, and mental health outcomes among medical students and health care professionals at a tertiary care hospital in pakistan: Protocol for a multi-center cross-sectional study

Burnout, a state of vital exhaustion, has frequently been related to work-related stress and job dissatisfaction. Given the emotionally and physically challenging nature of their work, high rates of burnout have been reported among health care professionals. This may put them at a higher risk for of suffering from adverse mental health outcomes, including depression, anxiety and stress. In our study, we aim to assess the prevalence i of and associations among burnout and job dissatisfaction and adverse mental health outcomes in a developing country, where the challenges faced by the health care system are unique. Facilities are over-burdened and there is a sharp contrast between doctor to patient ratios in developing and developed countries. We plan to conduct a cross sectional study at the largest tertiary care hospital in Pakistan and its peripheral affiliated health centers. A proportionate sampling technique will be employed to include medical and nursing students, interns, residents and consultants. Previously validated questionnaires, including the Maslach Burnout tool, DASS 21, and Job Satisfaction Survey will be disseminated through Survey Monkey. Statistical analysis will be conducted using IBM SPSS Statistics Version 23 to study the association among burnout, job dissatisfaction, adverse health outcomes and demographic and work-related factors This study may begin laying the foundation for prioritizing the novel concept of physician mental health in the developing world. Further research building on to the results of this study will generate evidence to make recommendations about routine screening for mental illness and policy changes in the health care system

Success Rate of Endoscopic Third Ventriculostomy (ETV) in Non-Communicating Hydrocephalus in Pediatric Age Group

Objective:&nbsp;&nbsp;To evaluate success rate of the endoscopic third Ventriculostomy (ETV) in non-communicating type of hydrocephalus in pediatric age group. Material and Methods:&nbsp;&nbsp;This study was carried in the department of neurosurgery at Liaquat university hospital, Jamshoro in which an endoscopic third Ventriculostomy procedure was performed in patients (n = 55) with non-communicating hydrocephalus from October 2016 to April 2017. Post-operative follow-up was done on the 15th day post-operative to assess clinical and radiological improvement. Results:&nbsp;&nbsp;55 patients were included in this study, 26 (47.27%) males and 29 (52.73%) females. The mean age was 3.96 years. The most common etiology was aqueductal stenosis 28 (50.90%) patients followed by posterior fossa tumors in 18 (32.72%) patients. The operative technique was successful in 41 (74.55%) patients. Out of 41 successful patients, 34 (82.92%) patients had clinical as well as radiological improvement whereas 7 (17.07%) patients had clinical improvement only. Conclusion:&nbsp;&nbsp;The success&nbsp;rate of ETV was 74.55% in the non-communicating hydrocephalus in the pediatric age group in our study. Endoscopic third Ventriculostomy is an effective treatment for non-Communicating hydrocephalus in pediatric age groups by diversion of CSF intracranially. This procedure provides shunt freedom and can be used alternative to shunts in pediatric age groups with non-communicating hydrocephalus

Histomorphometrical Investigations on the Heart, Kidneys and Adrenal Glands in Normal Teddy Goats (Capra hircus) Using Image Analysis System

This study was conducted to elucidate the effects of age and sex on the histometrical values of blood pressure related organs including heart, kidneys and adrenal glands in teddy goats. The hearts, kidneys and the adrenal glands of 36 teddy goats, divided in three age-groups; kids (6-12 months), adults (13-21 months) and adults (22-24 months), were processed for histometrical studies. Mean diameters, volumes and Intramural connective tissue contents of right atrium, left atrium, right ventricle and left ventricle were recorded from cardiac specimens. Age affected none of the parameters of the heart significantly. Mean diameters and volumes of subcapsular and juxtamedullary glomeruli were recorded from kidney specimens. All parameters of the kidney invariably showed a consistent rise with advancing age. Thicknesses of the zona glomerulosa, zona fasciculata and zona reticularis of the right adrenal gland were measured. Thickness of different zones of the adrenal cortex showed significant (P<0.05) changes with age. It is conceivable from these findings that the development of heart, kidneys and adrenal showed an increase parallel to the advancing age to adjust with the increasing blood pressure due to physiological development process. Sex, however, played a secondary role

Role of Flavonoids as Wound Healing Agent

Flavonoids are found as the most abundant bioactive compounds all around the world. It is found in a number of medicinal plants that are used as wound healing agents in traditional medicinal uses such as Buddleja globosa, Moringa oleifera, Lam, Butea monosperma, Parapiptadenia rigida and Ononis spinosa. Flavonoids nowadays are being used in different formulation and wound healing dressings. Inflammation, proliferation and reepithelialization are involved in wound healing. Most of the wound healing medicinal plants possess multiple flavonoids that act as synergistic effect or combined effect. This chapter briefly reviews the role of flavonoids as wound healing agent in traditional and modern medicine

Addition of nintedanib or placebo to neoadjuvant gemcitabine and cisplatin in locally advanced muscle-invasive bladder cancer (NEOBLADE) : a double-blind, randomised, phase 2 trial

Background Recurrence is common after neoadjuvant chemotherapy and radical treatment for muscle-invasive bladder cancer. We investigated the effect of adding nintedanib to neoadjuvant chemotherapy on response and survival in muscle-invasive bladder cancer. Methods NEOBLADE was a parallel-arm, double-blind, randomised, placebo-controlled, phase 2 trial of neoadjuvant gemcitabine and cisplatin chemotherapy with nintedanib or placebo in locally advanced muscle-invasive bladder cancer. Patients aged 18 years or older, with an Eastern Cooperative Oncology Group performance status of 0–1, were recruited from 15 hospitals in the UK. Patients were randomly assigned (1:1) to nintedanib or placebo using permuted blocks with random block sizes of two or four, stratified by centre and glomerular filtration rate. Treatments were allocated using an interactive web-based system, and patients and investigators were masked to treatment allocation throughout the study. Patients received oral nintedanib (150 mg or 200 mg twice daily for 12 weeks) or placebo, in addition to usual neoadjuvant chemotherapy with intravenous gemcitabine 1000 mg/m2 on days 1 and 8 and intravenous cisplatin 70 mg/m2 on day 1 of a 3-weekly cycle. The primary endpoint was pathological complete response rate, assessed at cystectomy or at day 8 of cycle 3 (plus or minus 7 days) if cystectomy did not occur. Primary analyses were done in the intention-to-treat population. The trial is registered with EudraCT, 2012-004895-01, and ISRCTN, 56349930, and has completed planned recruitment. Findings Between Dec 4, 2014, and Sept 3, 2018, 120 patients were recruited and were randomly allocated to receive nintedanib (n=57) or placebo (n=63). The median follow-up for the study was 33·5 months (IQR 14·0–44·0). Pathological complete response in the intention-to-treat population was reached in 21 (37%) of 57 patients in the nintedanib group and 20 (32%) of 63 in the placebo group (odds ratio [OR] 1·25, 70% CI 0·84–1·87; p=0·28). Grade 3 or worse toxicities were observed in 53 (93%) of 57 participants who received nintedanib and 50 (79%) of 63 patients in the placebo group (OR 1·65, 95% CI 0·74–3·65; p=0·24). The most common grade 3 or worse adverse events were thromboembolic events (17 [30%] of 57 patients in the nintedanib group vs 13 [21%] of 63 patients in the placebo group [OR 1·63, 95% CI 0·71–3·76; p=0·29]) and decreased neutrophil count (22 [39%] in the nintedanib group vs seven [11%] in the placebo group [5·03, 1·95–13·00; p=0·0006]). 45 treatment-related serious adverse events occurred in the nintedanib group and 43 occurred in the placebo group. One treatment-related death occurred in the placebo group, which was due to myocardial infarction. Interpretation The addition of nintedanib to chemotherapy was safe but did not improve the rate of pathological complete response in muscle-invasive bladder cancer