Evaluating the effectiveness of foreign capital flows in mitigation of gender inequality in Developing countries

Over the decades, foreign capital inflows (FCIs) have been contributing to the economic growth and development of underdeveloped and developing economies. However, it is imperative to inspect the effect of FCIs on gender inequality (GI). The latter includes SDG 5 which addresses the elimination of GI in all its forms. The existing empirical literature on the relationship between FCI-GI nexus shows mixed results. The current study scrutinized the effects of FCIs on GI in a panel of 71 developing economies for the time period 2001-2019. The study used the system generalized methods of moments (GMM) for model estimation. The positive and significant impact of remittances on G I was explored. It was found that official development assistance (ODA) caused an increase in GI in developing economies. The results showed that gross domestic product (GDP) and trade openness (TOP) increased GI. However, good governance was found to reduce GI in developing economies. The outcomes provide a guideline for the role of FCIs in reducing GI in developing economies

An innovation in flipped class room: A teaching model to facilitate synchronous and asynchronous learning during a pandemic

Objective: To conduct an on line Flipped Class Room (FCR) to facilitate synchronous (in class activity) and asynchronous learning [Virtual Learning Environment (VLE)] and acquire feedback of the learning experience from medical students at Aga Khan University.Methods: This interventional study was conducted with year II students undergoing Endocrine Reproduction Module at the Aga Khan University during April 13 to May 22, 2020. Pre reading material and pretest was shared with the students via Virtual Learning Environment (VLE) one week before the class. Microsoft Teams was used to conduct online session by two facilitators, where student discussion on case studies was encouraged. A WhatsApp group was created with the facilitators to respond to any student queries. The session was recorded and later uploaded on VLE. Posttest and a student satisfaction survey was conducted at the end of the session.Results: The average score for the pretest and posttest was 19.67 ± 1.37 and 24.60 ± 1.34 respectively (p value \u3c0.05). The learner curve showed an increase in the knowledge learned by 4.93 points (p value \u3c0.05). Fifty-five percent students felt that placement of session was appropriate and were satisfied with the instructions and expected outcomes, received constructive feedback for improvement and generated positive attitude towards learning.Conclusions: The innovative model of FCR through facilitation of synchronous and asynchronous learning empowered student\u27s engagement and interactive learning. Students perceived this as a great learning experience which they enjoyed with positive reinforcement from feedback given by the facilitators. They suggested continuation of this model for further learning sessions in other modules of undergraduate medical education at Aga Khan University

Urdu Translation and Validation of Academic Resilience Scale in Pakistani School Students

The present study was conducted to translate and validate the Academic Resilience Scale (Martin & Marsh 2006) in Urdu on Pakistani school students. For this purpose forward and backward translation method (Brislin, 1976) was utilized to translate original English version into Urdu. Urdu version had high test-retest reliability coefficient i.e. r=.903**. For validation, a sample of 340 students was selected conveniently from different schools Multan, Pakistan. Exploratory factor analysis (EFA) was performed to measure the factor structure of scale and it was discovered to be one-dimensional. ARS – Urdu version had significantly good reliability coefficient (α = .843). The scale validity and reliability were found to be satisfactory. Therefore, its findings demonstrated that it is appropriate for measuring academic resilience of school students

Common alternative diagnoses among a pediatric hospital-based cohort evaluated for tuberculosis in karachi, pakistan: The need for facilitated referral in tuberculosis clinics

Background: Children evaluated for tuberculosis (TB) are often diagnosed with miscellaneous conditions that mimic TB. Knowledge of differentials informs policy on service provision through liaison with referral centers offering definitive diagnosis and treatment for common alternative disorders.Methods: We reviewed medical records of children who were offered diagnostic testing for TB (culture or Xpert MTB/RIF) at a tertiary care hospital in Karachi, Pakistan to identify common alternative diagnoses among children who are evaluated for TB.Results: From January 2014 to December 2015, of 126 culture or Xpert MTB/RIF negative children presenting with chronic symptoms, 31 were diagnosed and treated for TB based on clinical criteria (5 of 48 children with pulmonary and 26 of 78 with extrapulmonary presentations; 10.4% and 33.3%, respectively). Among remaining 95 patients, common alternative diagnoses to pulmonary TB (n = 43) were bacterial pneumonia or empyema (60.5%, n = 25) and underlying bronchiectasis (20.9%, n = 9). Among 52 extrapulmonary presentations, the most common alternative diagnoses were lymphoproliferative disorders (n = 11, 21.1%), bacterial infections (n = 11, 21.1%), and autoimmune disorders (n = 9, 17.3%). Of note, five children were diagnosed with underlying primary immunodeficiencies (9.6%). Children with alternative disorders were treated for TB in 25 of 95 cases (26.3%). Although 77.8% (n = 98) children were followed up at the facility, 15.9% (n = 20) were lost to follow-up.Conclusions: Pediatric TB mimics many disorders that primary level centers are not equipped to diagnose or manage, leading to suboptimal outcomes. Knowledge of common alternative diagnoses is essential to inform facilitated referral for common mimicking disorders in children

Erythema annulare centrifugum: A rare skin manifestation of hashimoto thyroiditis

Erythema annulare centrifugum (EAC) is an unusual skin condition appearing as recurrent erythematous annular eruptions associated with autoimmune disorders, infections, and various neoplastic conditions. We present a very rarely reported association of EAC with Hashimoto thyroiditis (HT) in a young male. A 26-year-old male recently diagnosed as case of HT presented in the dermatology clinic with nine-month history of non-itchy persistent annular lesions on the body. The morphology and biopsy of lesions confirmed the diagnosis of EAC. HT is a part of the spectrum of autoimmune thyroid diseases with its own specific cutaneous manifestations. Our case also depicts the impact of antigen-antibody related immunological reaction, which might be involved in the development of both HT and EAC, and it could be the stages of the same pathological condition of two different clinical presentations

Diff erential genotypic response of two varieties of Hordeum vulgare L. in response to hydrazine hydrate alone and in combination with dimethyl sulfoxide

Induced mutation has been an important tool for a man in bringing desirable changes in plants since times immemorial. Cereals form an integral part of human diet along with pulses, especially in India. Cereals contain a high percentage of carbohydrates along with the considerable amount of proteins. The present experiment was carried out to induce the variability in Hordeum vulgare L. variety RD-2035 and BH-393. The mutagen used in this experiment was hydrazine hydrate (Hz). The mutagen was used singly and in combination with dimethyl sulfoxide (DMSO). Usually, the DMSO is considered as a carrier for a mutagen to enhance the mutagenic activity of that particular mutagen used in combination. The two varieties of seeds were treated with individual concentrations of Hz along with combination treatments with DMSO. The seeds were sown to raise the M1 generation. Cytology of both control and treated plants was observed in the M1 generation. The control plants showed normal meiosis, whereas the treated plants showed different chromosomal abnormalities. The different chromosomal abnormalities were laggard, bridge, micronucleus, and univalents. The meiotic abnormalities were low at lower concentrations of both individual and combination treatments while as the percentage abnormalities increased with increasing concentrations of both individual and combination treatments. M1 seeds were sown to raise the M2 generation. Quantitative characters of both control and treated plants were observed. The lower concentrations of both individual and combination treatments induced desirable changes in quantitative characters while as the higher ones induced negative effects

High energy density nutritional supplements; impact on appetite, appetite regulation and energy intake in underweight and malnourished individuals

Abstract This thesis describes the impact of high energy density nutritional supplement drinks (HENSDs) on appetite regulation, energy intake and cardiovascular risk factors in lean healthy females. It also explores the impact of Solid Ready-To-Use Foods (RTUF) and a milk based Liquid Ready-To-Use proprietary Supplement (LRUS) on weight gain and appetite in mild to moderate underweight children from Pakistan. The thesis consists of a literature review (Chapter 1), general methods (Chapter 2), three experimental chapters (Chapter 3- Chapter 5), each describing an independent research study, and a general discussion and conclusion chapter (Chapter 6). Accumulating evidence suggests that oral HENSDs increases energy intake and are beneficial for the treatment of malnutrition. Their effectiveness however, may be diminished by acute suppression of appetite. Therefore, the first experimental study aimed to investigate the extent to which the consumption of the HENSD in the fasted state reduces energy intake during a consecutive breakfast and lunch and whether this reduction relates to changes in appetite and metabolic appetite regulators. Twenty three young females with BMI of 18.2 ± 0.8 kg/m2 consumed either a HENSD or a low energy drink (PLACEBO) after fasting, in a single blind randomized cross-over study. Appetite was tracked, and blood taken, prior to the intake of the supplement and 240 minutes afterwards. Energy intake was recorded during an ad libitum buffet breakfast served 60 minutes and an ad libitum buffet lunch served 240 minutes post supplementation. Energy intake during the breakfast was significantly higher in the PLACEBO than in the HENSD trial. No significant difference was found in energy intake during the lunch between the two trials. When energy provided by supplements was added to energy intake during breakfast and lunch, the energy intake in the HENSD trial was significantly higher. The net effect was that total energy intake was increased by 1.07 ± 0.34 MJ in the HENSD trial. During the pre-breakfast, feelings of hunger and a desire to eat were significantly lower; satiety and fullness were significantly higher in the HENSD trial. After breakfast, none of the appetite measures differed between the trials regardless of plasma PYY, CCK, and insulin concentrations being significantly higher in the HENSD trial. The second experimental study investigated the time scale of compensation after HENSD supplementation. Over a five day period, energy intake was measured after the supplementation during the evening meal, and during the ad libitum breakfast, lunch and dinner consumed on the consecutive day. Since, consumption of HENSD due to the promotion of energy was expected to promote positive energy balance, this study also aimed to investigate the impact of HENSD supplementation on cardio-metabolic risk factors. Twenty-three young healthy females with a BMI of 18.7 ± 1.2 kg/m2 participated in a single blind randomised, controlled, crossover study. Participants consumed either HENSD or a PLACEBO for five days in the evening. Participants were asked to record their dietary intake during the days of supplementation. On the sixth day plasma lipids, insulin and glucose concentrations were measured in the fasted state and at 30, 60, 90 and 120 minutes after the ad libitum buffet breakfast and lunch. The findings showed that the average daily energy intake was significantly higher in HENSD trial and that consumption of HENSDs in the evening induced immediate and short-lasting reduction in energy intake. Fasting plasma concentrations of insulin and HOMA (IR) were significantly higher in the HENSD as compared to the PLACEBO trial. No significant differences were detected in fasting plasma concentrations of TAG, total-, HDL- and LDL-cholesterol between the HENSD and the PLACEBO trials. The third experimental study explored the efficacy of RTUFs and LRUS in promoting weight gain and their effect on appetite regulation in mild to moderate malnourished children. An open labelled randomized controlled trial was conducted in primary schools of Pakistan. Sixty eight mild to moderate underweight children aged 8.2 ± 1.2 years were randomly allocated to receive either RTUF or LRUS providing 500 kcal/ day in addition to regular diet in their school for four weeks. The children’s height, weight, and skinfolds were measured before supplementation and at the end of the supplementation. The children marked visual analogue scale questionnaires before the provision of the first and the last supplement. The findings from this study indicated that after four weeks of supplementation the average weight gain, change from the baseline in weight-for-age Z score (WAZ), height-for-age Z score (HAZ) in the RTUF and LRUS were not significantly different between the two groups. The difference in the appetite measures before the provision of the first and the last supplement between the two groups were also not significantly different. The total extra energy supplied for 4 weeks would have been expected to lead to an excess gain of 2kg. Thus, at least 2/3 of the energy ingested appeared to have been compensated by less intake at other times. Based on the data obtained the following conclusions have been drawn: • Following oral intake of HENSDs, the appetite suppressive action of the metabolic and hormonal appetite modulators is short lived. • HENSDs consumption for five consecutive days in the evening induced compensation, which happens immediately, disappears quickly and is short-lived which allows only partial compensation for the energy provided by HENSD. • Short-term supplementation with HENSD is safe in relation to the impact on cardiometabolic risk factors such as plasma concentration of fasting and postprandial lipids but can be expected to reduce insulin sensitivity. • RTUF and LRUS given to the community has similar impact on improving the nutritional status in mild of moderate underweight children but the overall rate of weight gain was lower than expected

Abdominal Lymphonodular Cryptococcosis in an Immunocompetent Child

We describe our experience with an apparently immunocompetent child presenting with pyrexia of unknown origin without focal signs. Investigations revealed lymphadenopathy at lung hila, mesentery, and porta hepatis. The child had received at least two months of empiric antituberculous therapy (ATT) before she came to us. A CT-guided biopsy revealed granulomatous inflammation. PAS stain showed yeasts which stained blue with Alcian blue, suggesting C. neoformans

A take on social wellbeing attributes by first year medical students

Objective: To compare awareness about concept of social wellness in male and female first year medical students. Methods: It was a cross sectional, questionnaire based study conducted from February till December 2010. Responses on aspects of social wellness were rated never, sometimes, mostly and always from lowest to highest (1-4); evaluated as frequency, proportion and percentages by PASW (Predictive analysis software) version 18. Chisquare test was applied for comparison of social wellness in both genders; results to be declared significant with pvalue \u3c0.05. Results: Overall score for social well being of females (20.24±4.50) was higher than male medical students (18.66±4.76; p\u3c0.0001). Majority of the female respondents believed that they exhibit fairness and justice in public dealing (p\u3c0.004), had a good network of close friends and family (p\u3c0 001), were prompt at helping batch fellows (p \u3c0.004), participated in group discussions (p \u3c0.004), followed dynamics of communication (p\u3c0.05) and were better at solving problems (p\u3c0.01) as compared to the male respondents. Conclusion: The scores highlighted a better interaction of females with the social environment