Inaugural Address

It is gratifying to know that the Pakistan Society of Development Economists established in 1982 as a forum to discuss economic issues of national and international interest to Pakistan has successfully completed 16 years of fruitful work. Its deliberations have also made a useful contribution to policy formulation in Pakistan. The Society has made possible a meaningful exchange of ideas and experiences amongst academics, researchers, and policy-makers. The current meeting of the society is taking place at a time when the global economy is passing through a crucial stage of its history. The current year is the terminal year of the 20th century and provides a bridge between the last and the next millennium; it is a time to reflect on our past achievements and failures, and against this backdrop, chart out our course for the future

Randomized controlled trial of interferon gamma versus amantadine in combination with interferon alpha and ribavirin for hepatitis C genotype 3 non-responders and relapsers

OBJECTIVES: To evaluate the efficacy and safety of triple combination regimens comprising of interferon alpha-2b (IFN-alpha) and ribavirin plus either IFN-gamma or amantadine in genotype 3 patients, responders or relapsers to interferon plus ribavirin combination. METHODS: Patients were randomized to receive IFN-alpha 3MU thrice a week, ribavirin 800-1200 mg per day with either IFN-gamma 2 MU thrice a week or amantadine 100 mg twice daily. Treatment was continued for 48 weeks in patients showing complete or partial (2 log reduction) early virological response (EVR) at 12 weeks and negative PCR at 24 weeks. RESULTS: Total enrollments were 44; 25 were previously non-responders out of them 12 were in the IFN-gamma arm. Nineteen were relapsers, out of them 10 received IFN-Gamma. Overall EVR with triple regimens was 61.4% (27/44). The EVR for IFN-gamma arm was 72.7% (16/22) and for amantadine arm 50% (11/22) (p=0.089). Sustained virological response (SVR) was 50% (11/22) in the gamma arm and 27.3% (6/22) in the amantadine arm (p=0.122). This figure was 60% (6/10) and 44% (5/9) for relapsers (p=0.845), and 41.6% (5/12) and 7.7% (1/13) for non-responders (p = 0.046).Treatment was well tolerated by most of the patients in both arms. CONCLUSIONS: About one third of patients responded to the triple regimens. However IFN-gamma was a better option. Its combination with pegylated interferon and ribavirin needs further evaluation. (Trial Registration: ClinicalTrials.gov Identifier NCT00538811)

Synthetic approaches to new heterocycles containing two phosphorus atoms

Reactions involving nucleophilic attack of tertiary phosphines and related compounds upon acetylenic systems have been reviewed and the literature has been covered to the end of 1970. In an extension of some of the work outlined in the above review, the bisphosphines 1,2- bis (diphenylphosphino)ethane, bis(diphenylphosphino) methane, o'is 1,2-bis (diphenylphosphino)- ethylene and trans 1,2-bis(diphenylphosphino)- ethylene and the biphosphine derivative tetraphenyibiphosphine were treated with the powerful electrophile dimethyl acetylenedicarboxylate in attempts to synthesize new cyclic phosphonium ylides containing two phosphorus atoms. On reaction with the acetylenic ester, the first three of these bisphosphosphines produced in high yield, cyclic phosphonium ylides character ized as dimethyl 1,1,4,4-tetraphenyl-l,4- diphosphacyclohexa-1,3-diene-2,3-dicarboxylate, dimethyl 1,1,3,3-tetraphenyl-5^-l,3-diphosph(V)ole 4,5-dicarboxylate and dimethyl 1,1,4,4-tetraphenyl 1,4-diphosphorin-2,3-dicarboxylate respectively. The adducts were found to be extremely sensitive to water and they were characterized largely by extensive spectroscopic (mainly NMR) investigations although certain cheinical reactions assisted in the structure determinations« Dimethyl 1,1,4,4- tetraphenyl-1,4-diphosphorin-2,3-dicarboxylate showed some evidence of aromatic character. The fourth of the bisphosphines, trans 1,2- bis(diphenyiphosphino)ethylene, was found to react with dimethyl acetylenedicarboxylate to give a 1:1 adduct. NMR evidence suggests that this adduct has a zwitterionic rather than an ylidic structure while protonation experiments, hydrolyses and deuterolyses are consistent with an ylidic structure. The sum of the evidence suggested that the adduct in solution is an equilibrium of two or more isomers in which a zwitterionic form is the major component while an ylidic form is the most reactive component of the mixture. Hydrolysis of the adduct led to an unusual reaction in which one of the diphenyiphosphino groups was eliminated to give a product identical to the 1:1:1 adduct formed from diphenylvinyIphosphine, dimethyl acetylenedicarboxylate and water. A mechanism has been postulated for this reaction and deuterium labelling studies gave some support to this mechanism. Tetraphenylbiphosphine gave a derivative of the o'ls 1,2-bis (diphenylphosphino) ethylene system on reaction with the acetylenic ester

Phloroglucinol in Irritable Bowel Syndrome

Objective: To determine the efficacy and tolerability of phloroglucinol, an antispasmodic agent in the treatment of Irritable Bowel Syndrome (IBS). Methods: It was an open label (quasi interventional) study. One hundred patients coming to the gastroenterology clinics of Aga Khan University Hospital with IBS as defined by the Rome II criteria were enrolled between February 2004 and September 2004 to participate in the trial and were treated as outpatients. Phloroglucinol (Himont) 50mg orally three times daily was given for two months. Symptoms were assessed before and during treatment using a questionnaire. Results: One hundred patients were enrolled in the study. Of them 61% (61/100) were males and 39% (39/100) were females. Their mean age was 41±14 years. Sixty-eight patients completed the study and 28 dropped out. On Phloroglucinol treatment there was an overall statistically significant improvement in abdominal pain (p\u3c0.001), frequency of stools per day (p\u3c0.001), urgency (p\u3c0.001), passage of mucus per rectum (p\u3c0.001),sense of incomplete defecation (p=0.001) and bloating (p=0.001). However, no response was seen in the feature of straining in both genders (p=0.676). The difference in response to treatment according to gender separately showed statistically significant improvement in the sense of incomplete defecation in females alone(p=0.003). Conclusion: Phloroglucinol in a dose of 50mg three times daily is effective and well tolerated by the IBS patients. It relieves most of the symptoms of IBS (JPMA 56:5;2006

Spontaneous uterine rupture secondary to morbidly adherent placenta in an unscarred uterus

We report a case of spontaneous uterine rupture in a primigravida with an unscarred uterus, which was secondary to morbidly adherent placenta proven on surgery and histology. Although rare, uterine rupture should be considered as a differential diagnosis of acute abdominal pain in pregnancies, especially when associated with free fluid, even with the absence of vaginal bleeding. Abnormal placentation is associated with spontaneous antepartum uterine rupture even in early pregnancy. Most cases in the literature have advocated emergency hysterectomy to arrest life-threatening hemorrhage

The Edge Version of Degree Based Topological Indices of HAC5C6C7[p, q] Nanotube

Let G be a simple molecular graph with vertex set V (G) and edge set E(G) respectively. The degree deg(v) of the vertex v 2 V (G) is the number of vertices adjacent with vertex v. A graph can be recognized by a numeric number, a polynomial, a sequence of numbers or a matrix. A topological index is a numeric quantity associated with a graph which characterize the topology of graph and is invariant under graph automorphism. Topological indices play important role in mathematical chemistry especially in the quantitative structurepropertyrelationship (QSPR) and quantitative structure-activity relationship (QSAR) studies. In this paper we compute the edge version of some important degree based topological indices like Augmented Zagreb Index, Hyper-Zagreb Index, Harmonic Index and Sum-Connectivity Index of HAC5C6C7[p, q] Nanotube

Assessment and feedback for large classes in transnational engineering education: student–staff partnership-based innovative approach

Assessment and feedback (A&F) are two major components of any educational program and must be properly in place to ensure student learning and quality of experience. However, these important components come under severe challenges of meeting student expectations in the large class size context. When the program delivery relates to a transnational educational (TNE) scenario, the additional constraints on staff–student physical interaction, regional time differences and cultural background gaps introduce additional challenges: Conducting proper assessments and provide timely and constructive feedback to the students. In this paper, the authors propose a novel assessment and feedback framework which exploits having a large student number as a positive factor by introducing staff–student partnership to implement efficient assessment and feedback strategies. Authors propose to use students for peer-review, assessment design, evaluation rubric design and tutorial-based feedback. The students also take part in preparing feedback clusters based on which the instructor provides pseudo-personalised video feedback. Through feedback clusters, authors introduce the trade-off between individual feedback and generic feedback. The results of the study are particularly promising in terms of student satisfaction and learning enhancement

Prevalence of Hepatitis D in HBsAg positive patients visiting liver clinics

Objective: To estimate the prevalence of hepatitis D in HBsAg (hepatitis B surface antigen) positive patients visiting liver clinics. Methodology: All HbsAg positive patients who had visited two liver clinics; in Karachi and in Jacobabad, from October 2007 to March 2008, were included in this study. These patients were tested for HBV DNA and HDV RNA by PCR technique, HBeAg and anti-HDV. Clinical status of the patients was evaluated by examination, routine biochemical tests and ultrasound. Results: Total numbers of patients included in the study were 362 comprising of 151 patients from the clinic in Jacobabad and 211 from Karachi. The patients ranged from 4 to 70 years age (mean age 29.75 ±11.27). Out of the total patients 297 (82%) were males. All the patients were screened for HDV antibody out of which 212 (58.6%) tested positive. Total 65 anti-HDV positive patients were tested for the HDV RNA by PCR, out of which 30 (46.2%) tested positive for the virus. Three hundred and forty (340) patients were screened for HBeAg, out of which 71 (20.9%) tested positive. Three hundred and seven patients were screened for HBV DNA by PCR, out of which 88 (28.7%) were positive for the virus. HBV DNA was positive in 16.2% of HbeAg negative patients (pre-core mutants). The frequency of positive HDV antibody was 69.23% in patients from Kashmore, 67% in Jacobabad, 65.4% in Jaffarabad, 65.21% in Quetta, 60% in Naseerabad, 36.58% in Karachi, 58.33% in other areas of Balochistan and 60.71% in other areas of Sindh. Positive HDV antibody status was associated with more severe and advanced disease (p\u3c0.0001) Conclusion: This data shows extremely high prevalence of hepatitis D in the referred patients from some areas of Southern Pakistan. Effective preventive measures are the need of the hour and Pakistan may be considered as one of the areas of highest HDV prevalence around the globe (JPMA 59:434; 2009)

Bioleaching of copper- and zinc-bearing ore using consortia of indigenous iron-oxidizing bacteria

Indigenous iron-oxidizing bacteria were isolated on modified selective 9KFe(2+) medium from Baiyin copper mine stope, China. Three distinct acidophilic bacteria were isolated and identified by analyzing the sequences of 16S rRNA gene. Based on published sequences of 16S rRNA gene in the GenBank, a phylogenetic tree was constructed. The sequence of isolate WG101 showed 99% homology with Acidithiobacillus ferrooxidans strain AS2. Isolate WG102 exhibited 98% similarity with Leptospirillum ferriphilum strain YSK. Similarly, isolate WG103 showed 98% similarity with Leptospirillum ferrooxidans strain L15. Furthermore, the biotechnological potential of these isolates in consortia form was evaluated to recover copper and zinc from their ore. Under optimized conditions, 77.68 +/- 3.55% of copper and 70.58 +/- 3.77% of zinc were dissolved. During the bioleaching process, analytical study of pH and oxidation-reduction potential fluctuations were monitored that reflected efficient activity of the bacterial consortia. The FTIR analysis confirmed the variation in bands after treatment with consortia. The impact of consortia on iron speciation within bioleached ore was analyzed using Mossbauer spectroscopy and clear changes in iron speciation was reported. The use of indigenous bacterial consortia is more efficient compared to pure inoculum. This study provided the basic essential conditions for further upscaling bioleaching application for metal extraction.</p

Stiff person syndrome: a diagnostic and management challenge

Stiff person syndrome (SPS) is a rare neurological disorder characterized by progressive muscle stiffness and rigidity, mostly involving axial muscles, resulting in functional disability. It is associated with elevated anti- Glutamic acid decarboxylase (GAD) antibody levels. Electromyography findings are often diagnostic. We present a case of a 48 years old male, who presented with progressive stiffness and rigidity of axial muscles and limbs. His EMG was consistent with SPS. Anti GAD antibodies were markedly elevated. He was treated with rituximab and has improved significantly. SPS is a difficult diagnosis, usually under diagnosed due to lack of awareness among medical community. There is a dire need to further study the disease and invent better treatment options for patients suffering from SPS