Assessing the Judicial Efficiency of District Courts in Pakistan: An Empirical Evidence Using Extended Linear Programming Technique

Objective: The present study focuses on measuring efficiency of district courts of Punjab, Pakistan taking into consideration various measures of productivity. Research Gap: To our knowledge, quantitatively analysis of these issues is not done so far dealing the efficiency issue of the Justice System both at higher and lower level of Judiciary in Pakistan. Therefore, this study embraces this novelty in itself by measuring the efficiency of lower courts in Punjab’ judiciary system considering the judges’ caseloads, administrative staff, and court expenses. Design/Methodology/Approach: The study adopted frontier approach i.e., Data Envelopment Analysis for the calculation of efficiency estimates for 36 Districts of Punjab using the dataset of the year 2020-21. The Main Findings: Registration (Filing) of new cases in civil courts is found to be the most restrictive exogenous factors causing delays in the case disposition. Theoretical / Practical Implications of the Findings: The most important implication of this study is to highlight the existing bottlenecks in the courts at district level. By calculating pure, overall and scale efficiency of courts, the judicial bodies can have better understanding whether it’s the issue of human and physical resources or the size of courts itself causing high rate of pendency of cases in district courts of Punjab. Originality/Value: This study is innovative in its issue and approach to discuss the quality of judicial services. So far there is no empirical estimation of efficiency of courts of Pakistan at District level. Hence this shows a significant contribution of this study in existing literature

Bronchogenic Cyst in a 13 month Old Child

Background Persistent cough ,stridor and respiratory distress are most common symptoms encountered by paediatrician in their daily practices.Although bronchogenic cyst is rare cause of persistent cough but should always be kept in differential diagnosis of respiratory sypmptoms nonresponding to antibiotics and bronchodilators. Case presentation 13 month old baby had history of frequent visits at hospital and treated as case of pneumonia and hyperreactive airway disease.Chest X-ray revealed cystic mass in mediastinum with CT chest confirmed bronchogenic cyst for which patient underwent surgical excision.Histopathology report revealed bronchogenic cyst .After surgical excision patient got stable with stridor got settled. Conclusion Case is being reported to create awareness related to bronchogenic cyst as cause of persistent cough and respiratory distres

Bronchogenic Cyst in a 13 month Old Child

Background Persistent cough ,stridor and respiratory distress are most common symptoms encountered by paediatrician in their daily practices.Although bronchogenic cyst is rare cause of persistent cough but should always be kept in differential diagnosis of respiratory sypmptoms nonresponding to antibiotics and bronchodilators. Case presentation 13 month old baby had history of frequent visits at hospital and treated as case of pneumonia and hyperreactive airway disease.Chest X-ray revealed cystic mass in mediastinum with CT chest confirmed bronchogenic cyst for which patient underwent surgical excision.Histopathology report revealed bronchogenic cyst .After surgical excision patient got stable with stridor got settled. Conclusion Case is being reported to create awareness related to bronchogenic cyst as cause of persistent cough and respiratory distres

Latent iron deficiency in non-anemic children under five years of age

Background: The most common nutritional deficiency in world is iron deficiency. The iron deficiency is the most common cause of anemia due to nutritional deficiency and is seen most commonly in children under five years of age. Objective: To determine the frequency of iron deficiency in non-anemic children under five years of age. Methods: A descriptive cross-sectional survey was conducted in pediatrics department of –removed for blind review---from August 2020 to February 2021. A total of 145 non-anemic children, ages 2-59 months were enrolled through non-probability consecutive sampling in this study. The complete blood count and C-reactive protein were sent for laboratory tests to rule out infection/inflammation. In children with normal hematocrit (30-40%) and CRP (≤ 6), serum ferritin levels were sent. Those children in whom serum ferritin levels were ≤12ng/ml was regarded as cases of latent iron deficiency. SPSS version 23 was used for data entry and analysis. Age and gender for effect modifiers were controlled by stratification. The chi square test was used for post stratification. The value of p ≤ 0.05 was considered significant. Results: The mean age of the patients was 3.20±5.41 years. Among all children, 69 (47.6%) were boys and remaining 76 (52.4%) were girls. Out of 145 children, 62 (42.8%) were iron deficient whereas 83 (57.2%) were non-iron deficient. The male to female ratio of iron deficiency was 1:1.3. The prevalence of iron deficiency among infants was 46%, followed by toddlers 42% and preschoolers 41%. The mean serum ferritin level was 22.96±2.21 ng/ml. The mean hematocrit was 33.84±2.68. The statistical analysis showed that there was an insignificant association between iron deficiency and age groups of children (p ≥ 0.5). Conclusion: The study concluded that the iron deficiency in children is very common, especially in infants. Screening of iron deficiency in children under five years of age seems to be a very important task for better child care. Key words: Anemia, Iron-Deficiency; Child, Preschool; Malnutrition

Demonstration of Normal Development of Corpus Callosum in Infancy by Magnetic Resonance Imaging

Introduction: Corpus Callosum (CC) is the major anatomical and functional commissure which transmits information across two cerebral hemispheres. It is assessed by looking at its morphology on midsagittal sequence of Magnetic Resonance Imaging (MRI). Physiological variations and diseases alter the structure of CC. It undergoes structural changes throughout the infancy which should be taken into account for better evaluation. Hence, the normal reference biometric data of CC on MRI in infants is needed. There are very limited data of normal reference range of thickness of CC especially in infants. Aim: To establish the normal standards for the CC in first year of life using MRI. Materials and Methods: It was a retrospective observational study conducted in the year 2019-2020 in which the MRI images of 100 patients aged 4 days to 12 months with seizures and trauma were reviewed to evaluate CC. Children with abnormalities on MRI were excluded from the study. The thickness of subregions of the CC (genu, body, splenium) and the length were measured. Age related changes in the size of the subregions of the CC was assessed. Data was entered in Microsoft Excel sheet and statistical analysis was done using SPSS software. Results: In the age group of less than two months, the width of genu, body, isthmus and splenium was 5 mm, 2 mm, 1.52 and 3.45 mm, respectively. The length of CC was 47.24 mm. As the age of children increased, there was increase in width of genu, body, splenium, isthmus and length of CC. At the age group of 11-12 months the width of genu, body, isthmus and splenium was 9.10 mm, 4.90 mm, 2.29 mm and 8.64 mm respectively. The length of CC was 60.57 mm. The study reveals that there is a progressive change in dimension of CC with advancement of age. Conclusion: There is a considerable change in the appearance of CC during infancy, knowledge of which is useful in differentiating between normal and abnormal brain.</jats:p

Ideal guidance and procedures for donning and doffing personal protective equipment to be used by health workers during management of patients confirmed with COVID-19 or person under investigation

Highly infectious disease epidemics such as COVID-19 put healthcare workers at higher risk of infection than regular people as they come into more potential contact with contaminated respiratory droplets and so caution is warranted in the use of personal protective equipment (PPE) to lessen risk. It is not clear what kind of PPE best offers protection and the best way to remove PPE. PPE is used by Healthcare workers in the COVID-19 virus disease situation. Its use is an integral part of the strategy to combat COVID-19 and prevent its spread. Optimal PPE use is hard and thus healthcare workers may alter the delivery of care because of improper PPE use. Preventing contamination of PPE during donning and doffing therefore becomes crucial and requires improvisation. Donning and doffing of PPE should include adherence to protocols as well as COVID- 19 specific design of PPE and further research into the risks, benefits, and best practices of PPE use. Lastly, training of users must be stressed to minimize protocol deviations and in turn guarantee the best protection to HCWs. While ranked as the lowest in infection control hierarchy due to its effectiveness as compared to other measures and high cost, PPE is nonetheless extremely important and often overlooked aspect during early outbreak stages of a pandemic where neither drugs nor vaccines are available and access to them is limited. This paper sheds light on the donning and doffing protocols that should be used as well as discusses this often-overlooked aspect of the virus control measure.</jats:p