The chemokine receptors XCR1, CXCR1 and CXCR2 regulate oral epithelial cell behaviour.

Chemokines are chemoattractant cytokines which act on specific receptors and play an important role in tumour biology. The aim of this project was to determine whether the chemokine receptors XCRl, CXCRl and CXCR2 and their respective ligands lymphotactin, IL-8 (CXCRl&2) and GRO-a regulate the behaviour of normal and malignant oral epithelial cells. XCRl, CXCRl and CXCR2 mRNA and surface protein expression was detected in normal and oral cancer cell lines. Lymphotactin, IL-8 and GRO-a facilitated intracellular activation of ERK1/2 signaling pathway and stimulated migration, invasion and proliferation of all cells. These effects were mediated through XCRl for lymphotactin, CXCRl and CXCR2 for IL-8 and CXCR2 for GRO-a. The cancer cells showed a greater response than normal cells and a direct relationship between receptor expression and migration, invasion and proliferation was observed. XCRl but not lymphotactin was expressed by epithelial cells in normal oral mucosa in vivo and both were expressed and upregulated in inflammation and cancer. Constitutive expression of both XCRl and lymphotactin was found in regional lymph nodes and on metastatic tumours. Lymphotactin mRNA al}d constitutive intracellular protein was detected in normal and cancerous oral cells. Exposure of normal cells to lymphotactin resulted in increased adhesion to fibronectin but not collagen and stimulated MMP-2 and -9 release whereas exposure of cancer cells resulted in increased adhesion to both collagen and fibronectin and stimulated MMP-2, 9 and MMP-7 release. These findings show for the first time that XCRl and its ligand lymphotactin are expressed by epithelial cells in a range of oral conditions and strongly suggest that they play an important role in regulating the behaviour of normal and malignant epithelial cells. Similarly CXCRl and CXCR2 are upregulated on malignant oral cells in vitro and may be important in the biology of oral cancer

Human Capital and Economic Growth: Evidence from Selected Asian Countries

Impact of human capital on economic growth of selected Asian countries was examined, in the context of a visual search task. The main aim of this study is to find the empirical relationships among human capital and economic growth by using panel data technique for the period 1990-2012. In this study Government Expenditure on Health and gross school enrolment at secondary level used as a proxy variables for measuring human capital. The results of econometric estimation and panel least squares estimates indicated, a strong positive association of government expenditure on health and gross fixed capital formation with GDP. Another result of this study is that the gross school enrollment has positive but insignificant impact on gross domestic product. The study recommends that Government should escalate the enrollment of students in primary and secondary level, incentives to the people working abroad and should also facilitate the private sector to develop the labor force. Moreover, government should increase their expenditure on different areas of health sector such as for the development of infrastructure of health sector and provision of better health care facilities to the patients. Keywords: Human capital, Economic growth, Capital, Asian countries

Human Capital and Economic Growth: Evidence from Selected Asian Countries

Impact of human capital on economic growth of selected Asian countries was examined, in the context of a visual search task. The main aim of this study is to find the empirical relationships among human capital and economic growth by using panel data technique for the period 1990-2012. In this study Government Expenditure on Health and gross school enrolment at secondary level used as a proxy variables for measuring human capital. The results of econometric estimation and panel least squares estimates indicated, a strong positive association of government expenditure on health and gross fixed capital formation with GDP. Another result of this study is that the gross school enrollment has positive but insignificant impact on gross domestic product. The study recommends that Government should escalate the enrollment of students in primary and secondary level, incentives to the people working abroad and should also facilitate the private sector to develop the labor force. Moreover, government should increase their expenditure on different areas of health sector such as for the development of infrastructure of health sector and provision of better health care facilities to the patients. Keywords: Human capital, Economic growth, Capital, Asian countries.

The logistics of voucher management: The underreported component in family planning voucher discussions

Background: The purpose of health care vouchers or coupons is to receive a health service in exchange which is fully or partially subsidized, such as any treatment offered for communicable disease; for immunization; antenatal care-/postnatal care-related maternal health services; a family planning (FP) service; or to get a health commodity like a medicine. Vouchers are targeted for a group of people who can benefit the most such as on the basis of poverty ranking, marginalized or living in rural areas. According to the World Health Organization, voucher schemes in the area of sexual and reproductive health are considered of high value if they are implemented to address the issues of contraceptive commodity or service unavailability or to address the barriers to access such services through contracting out health services, for example, through social franchising (SF). FP vouchers can substantially expand contraceptive access and choice and empower the underserved populations. Literature cites voucher\u27s effectiveness in better targeting, increasing use, and improving program outcomes in FP programs; however, there is little research or explanation of how voucher management is done in practice.Discussion: The paper attempts to describe various components of voucher management system and its functioning using example of a voucher program in Pakistan. There are challenges such as high upfront cost, targeting the appropriate clients, validation of vouchers, and quality assurance, but these can be managed with better preparation at the planning and design stage. Strong monitoring and evaluation are integral to successful implementation of the voucher program. Also, voucher interventions that are targeted and adopt a pro-poor strategy have been found to improve access to care within poor and marginalized populations. Such programs have the capacity to bridge health inequities in developing nations. Targeted voucher schemes such as those which are designed as pro-poor or pro-rural are known to reduce barriers to access for those living with poverty or for the ones considered as marginalized population. Hence, such interventions have the capacity to fulfill the gaps in health inequities, especially, in low- and/or middle-income countries.Conclusion: Voucher programs should report the voucher logistics and management to build a larger evidence base of best practices. All voucher schemes must be designed, implemented, and evaluated on the basis of set objectives through addressing the local context. But any voucher implementing organization also conducting the in-house voucher management simultaneously may be considered as a weakness in program design, in turn providing rationale for either failure or success of that particular voucher intervention. Therefore, separating implementation and management of a voucher initiative can lead to enhanced transparency, improved accountability, allow for independent validation of services, and facilitate compliance for payments

Triggers of blood transfusion in percutaneous nephrolithotomy

Objective: To determine the triggers of blood transfusion in patients undergoing percutaneous nephrolithotomy (PCNL).Study Design: Observational study.Place and Duration of Study: The Aga Khan University Hospital, Karachi, from 1988 to 2007. Methodology: The percutaneous surgery database was retrospectively reviewed to identify patients with postoperative haemorrhage and need for blood transfusion. Blood loss was estimated by the postoperative drop in haemoglobin factored by the quantity of any blood transfusion. Various patients and procedure-related factors were assessed for association with total blood loss or blood transfusion requirement using stepwise univariate, forward multivariate regression analysis.Results: A total of 326 procedures were performed in 316 patients. Two hundred and thirty two procedures were included in the study. There were 167 males and 65 females. The mean age was 41+14 years. The mean haemoglobin drop was 1.68 +1.3 gm/dL. The overall blood transfusion rate was 14.2%. Stepwise multivariate regression analysis showed that female gender (p = 0.003), staghorn stone (p = 0.023), stone fragmentation with ultrasound (p = 0.054) and chronic renal failure (p = 0.001) were significantly predictive of the need for blood transfusion. Conclusion: Chronic renal failure, female gender, presence of staghorn calculi and stone fragmentation using ultrasonic device were predictive of blood transfusion in this cohort of patients

A study protocol : using demand-side financing to meet the birth spacing needs of the underserved in Punjab Province in Pakistan

Background: High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women's health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan. Methods/Design: This study will use quasi-experimental design with control arm and be implemented in: six government clinics from the Population Welfare Department; 24 social franchise facilities branded as `Suraj' (Sun), led by Marie Stopes Society (a local non-governmental organization); and 12 private sector clinics in Chakwal, Mianwali and Bhakkar districts. The study respondents will be interviewed at baseline and endline subject to voluntary acceptance and medical eligibility. In addition, health service data will record each client visit during the study period. Discussion: The study will examine the impact of vouchers in terms of increasing the uptake of modern contraception by engaging private and public sector service providers (mid-level and medical doctors). If found effective, this approach can be a viable solution to satisfying the current demand and meeting the unmet need for contraception, particularly among the poorest socio-economic group

Integrated Study of Geotechnical and Geophysical Methods to Assess the Soil Corrosion Potential for Construction Site

Corrosion of subsurface steel structures is very critical issue especially in moisture subsoil. The use ofphysiochemical properties such as pH, salts concentration, electrical resistivity is very common to quantify corrosivenature of subsoil. However, the laboratory measurements of these parameters are quite difficult due to time and budgetconstraints. In this work soil corrosion potential of a power plant site was evaluated using geophysical and geotechnicalinvestigations. Soil samples were collected from 15 boreholes drilled up-to 50 m depth for laboratory testing whereas 3probes of four electrodes vertical electrical sounding (VES) using Wenner configuration were also performed tomeasure the electrical resistivity of the subsurface soil up to 50 m depth. According to the USCS soil system silty clay(CL-ML) was interpreted as dominant material in all boreholes as shallow depth. Poorly graded sand (SP) including silt(SM) was found of variable depth in almost each borehole. The true resistivity values at the depth of 30 meters liesbetween the 19.9 ohm- meters to 59.8 ohm meters. All observation points of electrical resistivity survey VES-I, VES-IIand VES-III near-surface material show moderate soil corrosion potential which is favorable for design of earthing. Upto depth of 4 m, the values of resistivity 52.6 to 59.8 ohm-meters shows adequate estimation of corrosion. According tothe International standard these curves belong to bell type or K type curve of resistivity model. Their resistivity valueswith respect to depth show low to moderate corrosion potential which is satisfactory for construction at this depth afterapplying the nominal cathodic protections. Thus, electric pipe lines may be installed at this depth

Is laparoscopic pyeloplasty a comparable option to treat ureteropelvic junction obstruction (UPJO)? a comparative study

Abstract OBJECTIVE: To compare laparoscopic with open pyeloplasty. METHODS: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of patients who underwent surgical correction of ureteropelvic junction obstruction between during January 2008 and December 2012. Patients with laparoscopic pyeloplasty were placed in group 1 and those with open pyeloplasty in group 2.The groups were compared for operative time, hospital stay, perioperative complications, blood loss, duration of surgery, outcome and follow-up. Data was analysed using SPSS 19. RESULTS: Of the 73 patients, 29(40%) were in group 1, and 44(60%) in group 2. A crossing vessel could be identified in 25(86.2%) in group 1 and in 33(75 %) in group 2. Laparoscopic procedures were associated with a longer mean operating time (p=0.04), median estimated blood loss (p\u3c0.001) and a shorter mean hospital stay (p\u3c0.001). Follow-up mercaptoacetyltriglycinescan was done in 21(74.5%) patients in group 1 and 23(52.2%) in group 2. Only 2(7%) patients in group 1 and 2(4.5%) in group 2 had poor response on mercaptoacetyltriglycine scan. Mean follow-up was 2.71±1.2 months. Postoperative complications were 5(13%) in group 1 and 9(20%) in group 2(p=0.141). CONCLUSIONS: Laparoscopic pyeloplasty was associated with shorter hospital stay, less pain and less blood loss. The efficacy in term of success rate and perioperative complications of laparoscopic pyeloplasty was comparable to that of open pyeloplasty

Barriers and perceptions regarding different contraceptives and family planning practices amongst men and women of reproductive age in rural Pakistan: A qualitative study

Background: Pakistan ranks as one of the most poorest and most populous in the world with poor reproductive health indicators. This study helps in understanding barriers and perceptions regarding Family Planning (FP), modern contraception, quality of care and free of charge FP services amongst men and women in rural Pakistan.Methods: Employing purposive sampling and Focus Group Discussion (FGD) technique, this qualitative study was conducted with men and women of reproductive age in Pakistan. A total of eight FGDs were conducted in Sindh and Punjab provinces. Being descriptive in nature, the study provided a thematic analysis of the relevant health issues by using an adapted constant comparison analysis process.Results: The contraceptive knowledge and uptake was low and misinformation was prevalent. Men thought of vasectomy as against men\u27 pride and both males and females viewed removal of uterus as a permanent method. The women claimed neighbors, mother-in-law, friends and sister in-law and husband as main sources of information. Women seemed to have a greater exposure since they regularly come into contact with lady health workers and lady doctors but that information is not passed on to their husbands or discussed openly. There were many misconceptions prevalent among the participants, most of which were spread by untrained providers, such as the undesirable impact contraception can have on a woman\u27s ability to conceive children. In addition, restrictions on female mobility and side effects were seen as barriers to contraception by majority of women whereas, most of the men perceived religio-cultural factors as barriers and considered FP as an additional expenditure.Conclusions: Though importance of family planning was recognized by the participants for the well being of the children and financial benefits of raising fewer children but the wellbeing of the woman was not considered a meaningful goal to pursue FP. Besides access, barriers towards use included money, where frequency of use and choice of method was affected by financial limitation. A gendered perspective also prevailed with reference to provider seeking behavior. Spousal communication is a topic mostly neglected by family planning programs, yet many of the barriers are linked to it. There is a need to design health interventions that devise counseling techniques to improve spousal communication, debunk the myths and misinformation in the community, and link the health of the child and mother with birth spacing and smaller family size