Macroeconomic Determinants of Urbanization in Pakistan

Urbanization refers to the migration of rural people to urban centers in search of better jobs. Urbanization and growth go together; no country has ever reached middle-income status without a significant population shift into cities. Urbanization has strong association with unemployment, economic growth, poverty, infrastructure, crimes, health, socio-economic conditions and education. In 2050, most of the urban population of the world will be concentrated in Asia (52%) and in Africa (21%). A simple and modest model provided reasonable results. Increase in literacy is a decisive factor that has significant impact on increasing urban population. Per capita GDP growth also positively influences the urban population. Age-structure is too an important determinant of migration and urbanization. It is an open secret that generally young persons have gone abroad. Specification and diagnostics test supported the model which reveals appropriateness and statistical soundness of the model. Serious heed is paid to delimitation of cities to make them manageable and governable. Agriculture is provided sufficient resources to discourage migration to cities

Congenital Pouch Colon: A Preliminary Report from Pakistan

Background: Congenital pouch colon (CPC) is a rare entity in patients of anorectal malformations (ARM) requiring special consideration as to the management. This study is aimed at evaluating the presentation, management, and the outcome of initial surgery in patients with CPC. Materials & Methods: This retrospective study was conducted in the department of Pediatric Surgery of our institute during May 2007- May 2010. The Information about the demography, clinical features, investigations, management, and the outcome of initial surgery was retrieved and analyzed. Results: There were 21 patients of CPC managed during the study period. Sixteen (76%) were males and five (24%) females (M:F 3.2:1). Mean age of presentation was 4.8 days with a range of 12 hours to 45 days. In 18 (85.7%) patients, CPC was found with high ARMs, whereas, in 3 (14.3%) patients it was associated with low ARMs. Imperforate anus with moderate to massive abdominal distension was the presentation in 16 (76%) patients. Abdominal radiographs helped in preoperative diagnosis in 8 patients. Two patients had pneumoperitoneum on abdominal radiographs. At operation, type I CPC was found in 9 (42.8%) patients, type II in 5 (23.8%), type III in 2 (9.5%) patients, and type IV CPC in 5 (23.8%) patients. In 11 (52.4%) patients, pouch was emptied and retained with proximal enterostomy. In 7 (33.3%) patients, end enterostomy with pouch excision was done. In two patients, a window colostomy was formed. In one patient, pouch was disconnected from the normal bowel and Hartmann’s pouch with end ileostomy was formed. There were 2 (9.5%) deaths in our series.Conclusion: CPC is a rare malformation. Massive abdominal distension with imperforate anus is the common presentation. Optimum management can reduce the morbidity and mortality

Occipital Encephalocele and Review of Literature

Encephalocele is a rare congenital malformation of the central nervous system. It is defined as a congenital herniation of the intracranial compartments through a long defect and contains various rudimentary cerebral tissue components or sometimes only cerebrospinal fluid. They are located at midline of parietal or occipital region when the defect is small. Usually only the meninges herniate and the anomaly is cranial Meningocele or cranium bifidum with Meningocele. We present 47 cases of encephalocele, mostly occipital encephalocele, operated during last 5 years in our hospital at the department of Neurosurgery SZH, RYK. This is a retrospective study.Material and Methods: Between January 2008 and December 2013. Forty seven cases of encephalocele have been treated at our department. They were diagnosed on the basis of clinical findings and CT scan was done in all patients. All patients were operated and diagnosis was confirmed at peroperatively. Demographic, clinical, radiological and operative data were reviewed from hospital charts.Results: The total number of patients was 47, out of which 23 were male and 24 were female. Neurosurgical data of patients with encephalocele over the five years and three months from January 2008 to April 2014 were retrospectively studied. The average age of the patients at the time presentation was 10 months and seven days.Conclusion: Encephalocele is a relatively uncommon neurosurgical entity largely seen in the pediatric population. Treatment of this condition can be rewarding if properly managed early. Occipital, parietal, frontal, and frontonasal types may be approached without opening the cranium, while sincipital and basal encephalocele usually require craniotomy. In this series we present our experience in the operative management of encepha-locele with good outcome and also share our recommendation in technical consideration for surgical approaches

PSYCHOSOCIAL ILLNESS IN CHILDREN WITH THALASSEMIA: A CASE-CONTROL STUDY

INTRODUCTION: Thalassemia is the most common hemolytic autosomal recessive disorder. Pakistan has significant number of thalassemic children .The children with chronic disorders like thalassemia are prone to develop psychosocial illness including depression, anxiety, intellectual and behavioral issues.  OBJECTIVE: To assess the psychosocial illness in children with thalassemia and to compare these problems in children with and without Thalassemia   PLACE & DURATION: The Children’s Hospital and the institute of child health, Multan. From January to September 2021.  STUDY DESIGN: Case-control  MATERIAL AND METHOD:   In this study 50 children with Thalassemia and 50 normal children were enrolled as case & control according to inclusion and exclusion criteria. After approval from institutional ethical committee, detailed history ,Socioeconomic status, educational status of parent and child, age of diagnosis of disease, and whether thalassemia is well controlled or not and complications were noted. A Pediatric Symptom Checklist was used for psychosocial problems in all children. Data was analyzed by using SPSS version 22. Mean and standard deviation for quantitative data, while frequencies and percent for qualitative data was calculated. P-value was calculated by Chi square test. Prevalence ratio (ODDS ratio) with 95%confidence interval of all variables were calculated.  RESULTS: Out of 100 patients 50 were in case group (Thalassemia) and 50 control (non-thalassemic.Male female ratio was 1.2:1. 60 %( n=30) cases, 78 %( n=39) control patients were age ranges between 5 to 10 years. Educational level of parents of 40%(n=20),and 56%(n=28) was below matric,42%(n=21) and 90%(n=45) patients were going to school in case and control group respectively.82%(n=41) patients belonged to low socioeconomical status in each group. Regarding characteristics of thalassemia 74 %( n=37) patients were diagnosed within 1st year of life, while 26 %( n=13) after 1st year.64 %( n=32) had well controlled and 36 %( n=18) poor controlled disease. 20%(n=10) had developed Diabetes mellitus,2%(n=1) heart failure,74%(37) growth failure,76%(n=38) hemolytic facial features and 72%(n=36)skin discoloration. Psychosocial problems were statistically significant in children with Thalassemia as compared to healthy ones (p-value<0.001).Poorly controlled thalassemia and complications of heart and growth failure were found statistically significant risk factors.  CONCLUSION: Psychosocial problems are common in children with thalassemia as compared to healthy ones. So these patients must be referred for detailed psychological evaluation and management along with medical treatment.

A social norms approach to changing school children’s perceptions of tobacco usage

Purpose: Over 200,000 young people in the UK embark on a smoking career annually, thus continued effort is required to understand the types of interventions that are most effective in changing perceptions about smoking amongst teenagers. Several authors have proposed the use of Social Norms programmes, where correcting misconceptions of what is considered normal behaviour lead to improved behaviours. There are a limited number of studies showing the effectiveness of such programmes for changing teenagers’ perception of smoking habits, and hence this paper reports on the results from one of the largest Social Norms programmes that used a variety of interventions aimed at improving teenagers’ perceptions of smoking. Design/methodology/approach: A range of interventions was adopted for 57 programmes in Year 9 students, ranging from more passive interventions such as posters and banners to more active interventions such as student apps and enterprise days. Each programme consisted of a baseline survey followed by interventions and a repeat survey to calculate changes in perception. A clustering algorithm was also used to reveal the impact of combinations of interventions. Findings: The study reveals three main findings: (i) the use of social norms is an effective means of changing perceptions (ii) the level of interventions and change in perceptions are positively correlated and (iii) that the most effective combinations of interventions include the use of interactive feedback assemblies, enterprise days, parent and student apps and newsletters to parents. Originality/value: The paper presents results from one of the largest social norm programmes aimed at improving young people’s perceptions and is the first to use clustering methods to reveal the impact of combinations of intervention

Pharmacological evaluation of the hypoglycemic and anti- Alzheimer’s activities of aerial parts of Breynia distachia (Phyllanthaceae)

Purpose: To determine the cytotoxic, bronchorelaxant, spasmolytic, antidiabetic, α-glucosidase, acetylcholinesterase, butyrylcholinesterase, α-chymotrypsin and lipoxygenase inhibitory attributes of methanol and dichloromethane extracts of the aerial parts of Breynia distachia.Methods: The dichloromethane and methanol extracts of the aerial parts of the plant were prepared by maceration. Various ex vivo assays were employed, such as the brine shrimp lethality assay, lipoxygenase inhibitory activity assay, α-glucosidase inhibitory assay and α-chymotrypsin assay, as well as assays to assess the spasmolytic and bronchorelaxant activity. Meanwhile, the hypoglycaemic effect were analysed using an alloxan-induced diabetic model in Wistar albino rats.Results: The methanol extract (aerial) showed significant (p ≤ 0.05) cytotoxicity towards brine shrimp larvae at concentrations of 10, 100 and 1,000 μg/mL, respectively, whereas the dichloromethane extract (aerial) of the plant showed non-significant (p ≥ 0.05) results. The methanol extract (aerial parts) also demonstrated significant (p ≤ 0.05) α-glucosidase inhibitory activity and lipoxygenase inhibitory activity, with IC50 (half-maximal inhibitory concentration) values of 40.37 ± 5.29 μg/mL and 132.9 ± 0.33 μg/mL, respectively, while the dichloromethane extract exhibited significant (p ≤ 0.05) α-glucosidase inhibitory activity, with an IC50 value of 135.43 ± 8.29 μg/mL. An in vivo antidiabetic model showed that the administration of 150 and 300 mg/kg methanol extract of the aerial parts significantly (p ≤ 0.05) lowered the blood glucose level in alloxan-induced diabetic rats compared to control (treated with water).Conclusion: Data from different in vitro and in vivo models suggest that the methanol extract (aerial parts) of B. distachia shows significant cytotoxic, bronchorelaxant, spasmolytic, antidiabetic and anti-Alzheimer’s activity Hence, these findings validate the folkloric use of B. distachia and highlight the need to further explore its medicinal potential and the phytoconstituents responsible for its pharmacological actions

Functional Role of MicroRNAs in Embryogenesis

This book chapter will provide an overview of the functional role of microRNAs (miRNAs) in embryogenesis. A brief introduction to embryogenesis and emphasis on the importance of miRNAs in gene regulation will be provided. The biogenesis and mechanism of action of miRNAs will be discussed in detail with a focus on the importance of miRNA-mRNA interaction in gene regulation. The chapter will then delve into the role of miRNAs in early embryonic development, including their importance in the establishment of the three germ layers, cell proliferation, differentiation, and apoptosis during embryogenesis. The role of miRNAs in organogenesis and tissue differentiation, specifically the formation of specific organs such as the heart, lung, liver, and brain, will also be discussed. The chapter will conclude by examining the dysregulation of miRNAs in embryonic development and disease, including teratogenicity, developmental disorders, and developmental cancer. The chapter will summarize the functional roles of miRNAs in embryogenesis and will offer future perspectives and potential therapeutic applications of miRNAs in embryonic development and disease

Surgical Management of Tuberous Sclerosis

Tuberous sclerosis is a genetic disorder with incidence of 1 into 6000 birth. It is a multi-systemic disorder. Seizures associated with tuberous sclerosis (TS) can be difficult to control with medical therapy.Objective: To determine the role of surgery for the management of seizures and other symptoms in Tuberous Sclerosis.Material and Method: Four patients with TSC who underwent surgery were admitted in the Department of Neurosurgery Sheikh Zayed Hospital, Rahim Yar Khan and Department of Neurosurgery, PGMI / Lahore General Hospital, Lahore.Results: We admitted 5 cases, 3 males and 2 females. All presenters with seizers other presenting feature were headache and vomiting in all 5 cases, vomiting in 5 cases. All cases were operated were craniotomy and removal of tumour. Surgery were V.P. Shunt was performed in 3 cases. All 5 cases revealed excellent outcome and seizures well controlled with anticonvulsant postoperatively which were poorly controlled preoperatively. All 5 cases were discharged in satisfactory condition within 2 – 3 weeks. Histopathology the histopathology of all 5 cases were subependymal giant cell astrocytoma (SEGA).Outcome: All 5 cases revealed excellent outcome and the seizures were well controlled post-operatively with anticonvulsants. While pre-operative fits, were poorly controlled. All 5 cases were discharged in satisfactory condition with 2 – 3 weeks.Conclusion: The surgery had excellent outcome for tuberous sclerosis provided timely decision is taken to treat the tumor and associated hydrocephalus. Most of these patients will lead ventriculoperitoneal shunt or EVD as an emergency step to save the life