Budget Balance through Revenue or Spending Adjustment: Evidence from Pakistan

Government cannot roll over the debt forever (ponzi game is not allowed). In the long run, inter-temporal budget constraint has to be satisfied, which is possible either through government spending adjustment or increasing government revenues. So current budget deficit calls for adjustment, in the future, in spending or revenues. There are four hypotheses, in the literature, in this regard: the tax-and-spending hypothesis, the spending-and-tax hypothesis, bi-directional causality between government revenues and government expenditures, and independence of taxes and expenditures hypothesis. The last hypothesis, however, have negative implications, in the long run, in terms of debt sustainability and inflatio

Incidence of External Ear Canal Folliculitis

To analyze the incidence of ExternalEar Canal Folliculitis (EECF) in adult population ofdistrict Bannu.Methods: In this descriptive study 100 patientswith ear ache, presented in four quarters of the yearwere included. Complaints, and findings on physicalexamination including otoscopy results, diagnosiswere recorded. Inclusion criteria was adults (18+)with ear pain as a major complaint. We included thecases with another major complaint only when itwas related to the ear pain (e.g. referred pain fromsinusitis, tonsillitis).Exclusion criteria was antibiotictreatment in the last 10 days was marked asexclusion criteria. Both the rates of external ear canalfolliculitis and the rate of Non-external ear canalfolliculitis were compared. We also subdivided thedifferent diagnostics under the title "folliculitischannel of the non-outer ear." The prevalence of theexternal ear canal folliculitis diagnosis wascalculated, including subdivisionby sex and agegroups, by location in the ear canal includingposterior vs. anterior and by the quarters of the year.Results: 35% of cases represented EECF wereincluded. The ratio of male to female was observed3: 2. The condition was maximum in 2nd& 3rd quarterof the year where as it was minimal in 1st and 4thquarters. Earache in adult patients was the mostcommon principal inflammation, which is generallytermed as EECF.Conclusion: Different factors are being involvedin its prevalence including poor hygiene, overcrowding, bath in a contaminated water, hotweather, ear wax and lack of specialized care. Sincetreatment is only possible upon clinical diagnosis,doctors will likely be more reserved about oralantibiotics if EECF can be diagnosed appropriatel

Collection of Departmental Information by Utilizing Computer Technology: Evidence from Schools of Karachi

This paper is an analysis of Collection of Departmental Information (CDI) of Education Department of Karachi, but the concept of the paper is general in nature and applicable to every department of any country for the purpose of computerization of all the related records and CDI. The Paper examines the existing manually run infrastructure of CDI for onward submission to concerned departmental authorities. With the advent of information technology, the transformation and collection of information is analyzed for comparison between traditional source code and computer based working system. Trend of introducing computer in Government Departments has been examined and recorded with positive results. The Governor of Sindh seems to be very serious and has much emphasized the need of using computer technology for easy access, efficient, diligent and versatile functioning of the departments. In the light of results based on interviews, literature review and their analysis, policy implications are made for better Management of CDI for concerned authorities.Manual Information, Computer Technology, Versatile, Diligent, Acceleration, Access and Management

Frequency of poor quality of life and predictors of health related quality of life in cirrhosis at a tertiary care hospital Pakistan

Background Cirrhosis produces variety of symptoms which eventually lead to a negative impact on Health Related Quality of Life (HRQOL). The general aim of this study was to evaluate the magnitude of poor HRQOL and to assess factors related with HRQOL in patients with CLD in Pakistan. Findings This was a cross sectional study conducted in gastroenterology outpatient clinics of Aga Khan University Hospital, Karachi on adult patients with cirrhosis. In this study chronic liver disease questionnaire (CLDQ) was used to assess HRQOL of these patients and CLDQ score was used as an outcome measure to determine factors related with HRQOL. 273 participants were recruited in the study; 155 (57%) were males. Mean age of participants was 49 ± 11 years. The most common cause for cirrhosis was viral infection 247(91.5%). Mean Model for End Stage Liver Disease (MELD) score was 12.6 ± 6.8 and 2/3 of patients 209 (76.6%) had advanced cirrhosis in Child Turcot Pugh (CTP) B or C stage. Poor HRQOL was seen in 187(69%; 95% C.I.: 63%, 74%) of the participants. Mean CLDQ score was 4.36 ±1.1. Amongst all of the domains, fatigue domain had lower CLDQ score. Hemoglobin (β = 0.09 [SE = 0.04]), Albumin (β = 0.32[SE = 0.09]), Diastolic Blood Pressure (DBP) (β = 0.01[0.005) prior history of decompensation (β = 0.98[SE = 0.39] were significant factors associated with HRQOL in patients with liver cirrhosis. Conclusion Frequency of poor health related quality of life determined by CLDQ score is high in patients with liver cirrhosis. Hemoglobin, serum albumen, prior history of decompensation (like encephalopathy and upper gastro intestinal bleed), are associated with health related quality of life

Green finance, renewable energy investment, and environmental protection: empirical evidence from B.R.I.C.S. countries

Environmental degradation has become a severe concern for the globe; therefore, policymakers in emerging economies are trying to meet the environmental standards. Nowadays, economies have shifted their energy pattern from non-renewable to renewable energy (R.E.U.), but its cost is too high. Undoubtedly, the financial sector also performs well in facilitating such green activities. Therefore, the current study investigates the role of R.E.U. and green finance in environmental quality and collects the data for B.R.I.C.S. economies from 2000 to 2018. The study uses quantile regressions and other advanced techniques to deal with the problems of cross-sectional dependence (C.S.D.) and heterogeneity. The estimated outcomes show that green finance, R.E.U. consumption, and technical innovations perform well in securing the environment by reducing carbon emissions. Likewise, the environmental quality in selected economies is deteriorating due to the rise in non-R.E.U. consumption, economic progress, F.D.I., and trade openness. Therefore, it is time to reshape the local, national and regional growth policies concerning a green investment that can secure our environment. Also, this study proposes future pathways for green finance and other factors relevant to a sustainable environment

Assessment of malnutrition in patients with liver cirrhosis using protein calorie malnutrition (PCM) score verses bio-electrical impedance analysis (BIA)

Objective: Malnutrition is a common problem in patients with liver cirrhosis and tools for nutritional assessment are under debate. We conducted this study to assess prevalence of malnutrition in cirrhotic patients using PCM score and BIA. Additionally we compared BIA to PCM score for detecting malnutrition in this patient population. Results: This was a cross sectional study conducted in two tertiary care hospitals of Karachi Pakistan on adults with liver cirrhosis. Malnutrition was assessed by PCM score using anthropometric measurements and biological specimens and (ii) Body cell mass was assessed using BIA. Malnutrition as estimated by the PCM score was present in 122 (73%) of patients in which most patients had mild malnutrition (n = 72 (45%)), followed by 34 (21%) with moderate malnutrition and 3 (1.9%) with severe malnutrition. Malnutrition according to BIA estimated through body cell mass could detect it in 98 (61%) of patients. There was optimal correlation of PCM score with body call mass (Pearson correlation coefficient = 0.3 (p value 0.001)). We conclude that majority of the patients with liver cirrhosis had malnutrition as determined by PCM score. BIA underscored the malnutrition in this patient population

Smart Energy Management System for Minimizing Electricity Cost and Peak to Average Ratio in Residential Areas with Hybrid Genetic Flower Pollination Algorithm

Demand Side Management (DSM) plays a significant role in the smart grid to minimize Electricity Cost (EC). Home Energy Management Systems (HEMSs) have recently been studied and proposed explicitly for HEM. In this paper, we propose a novel nature-inspired hybrid Genetic Flower Pollination Algorithm (GFPA) to minimize cost with an affordable delay in appliance scheduling. Our proposed GFPA algorithm combines elements of the Genetic Algorithm (GA) and Flower Pollination Algorithm (FPA) to create a hybrid approach. To assess the effectiveness of the proposed algorithm, we consider a scalable town consisting of 1, 10, 30, and 50 homes, respectively. The proposed solution finds an optimal scheduling pattern that simultaneously minimizes EC and Peak to Average Ratio (PAR) while maximizing User Comfort (UC). We assume that all homes are homogeneous regarding appliances and power consumption patterns. Simulation results show that our proposed scheme GFPA performs better when applying Critical Peak Pricing (CPP) signal using different Operational Time Intervals (OTIs) and compared with unscheduled, GA, and FPA-based solutions in terms of reducing cost since they achieve on average 98%, 36%, 23%, and 22%, respectively. Similarly, PAR averages 98%, 36%, 59%, and 55%, respectively. While, UC comparing to GA and FPA, are around 88%, 48%, and 63%, respectively. Our proposed scheme achieves better results by applying Real Time Pricing (RTP) signals and different OTIs. As these schemes, i.e., unscheduled, GA, FPA, and GFPA, achieve cost on average 92%, 50%, 29%, and 28%, respectively. While PAR on average 94%, 39%, 62%, and 56%, and UC for GA, FPA, and GFPA on average 98%, 52%, and 49%, respectively. Overall, ourproposed GFPA algorithm offers a more effective solution for minimizing EC with an affordable delay in appliance scheduling while considering PAR and UC

Helicobacter Pylori Gastritis and risk of Ischaemic Stroke

OBJECTIVE: To identify the association between H. Pylori gastritis and stroke. METHOD: Patients with biopsy proven H. Pylori gastritis and non H. Pylori gastritis were enrolled. Patients were followed for a period of two years. RESULTS: A total of 326 patients were included in the study. 162 patients were with H. Pylori gastritis. There was no significance difference in age, sex and duration of symptoms in the two groups. Three patients in H. Pylori group had stroke or TIA as compared to one in non H. Pylori group. Patients with H. Pylori gastritis were more likely to die or have cardiac and or neurological event as compared to Non H. pylori gastritis (OR 1.23, 95% CI 0.89-1.67). This relationship was not significant after adjusting for cardiovascular risk factors (AOR 0.85, 95% CI 0.45-1.31). CONCLUSION: H. Pylori gastritis is not independently associated with increased risk for stroke. Larger, randomized studies are needed to confirm our findings

Accelerated Proximal Algorithm for Finding the Dantzig Selector and Source Separation Using Dictionary Learning

In most of the applications, signals acquired from different sensors are composite and are corrupted by some noise. In the presence of noise, separation of composite signals into its components without losing information is quite challenging. Separation of signals becomes more difficult when only a few samples of the noisy undersampled composite signals are given. In this paper, we aim to find Dantzig selector with overcomplete dictionaries using Accelerated Proximal Gradient Algorithm (APGA) for recovery and separation of undersampled composite signals. We have successfully diagnosed leukemia disease using our model and compared it with Alternating Direction Method of Multipliers (ADMM). As a test case, we have also recovered Electrocardiogram (ECG) signal with great accuracy from its noisy version using this model along with Proximity Operator based Algorithm (POA) for comparison. With less computational complexity compared with ADMM and POA, APGA has a good clustering capability depicted from the leukemia diagnosis