Is the Physical Infrastructure in Pakistan Enough to Attract Foreign Direct Investment

One suitable way for Pakistan to develop its infrastructure can be attracting FDI in infrastructure development and maintenance. The developing world needs a massive increase in private sector involvement in infrastructure investments. Although after 2000 Pakistan has realized and focused on the opportunity, driven by foreign direct investment, areas that had traditionally been defined as public sector responsibilities benefited from substantial commitments of capital and resources. The World Bank Project Database indicates that an estimated total of 1,707 private infrastructure projects worth US$458.2 billion were concluded from 1990 to end-1998. Foreign direct investment is the engine behind this development, with foreign investors involved in over 80 percent of transactions. During this period developing countries received an estimated US$138.3 billion in foreign direct investment from these infrastructure investments. Supported by a strong policy framework, private sector financing and operation of infrastructure facilities can result in significant efficiency gains while alleviating budgetary pressures. There is a startling gap between, allegedly, globalization-induced changes in international competition for foreign direct investment (FDI) and recent empirical evidence on the relative importance of determinants of FDI in developing countries. Traditional market-related determinants are still dominant factors. This paper analyzes the role of infrastructure availability in determining the attractiveness of countries for FDI inflows for export-orientation of MNE production. We posit that investments by governments in providing efficient physical infrastructural facilities improve the investment climate for FDI. MNEs may be particularly sensitive to infrastructure availability for locating their investments designed to feed the global, regional or home country markets. E.g. Transport infrastructure, telecommunications infrastructure, information infrastructure, energy availability for countries. The role of infrastructure in explaining the attractiveness for foreign production by MNEs, MNEs’ decision making pertaining to location of product mandates for global or regional markets sourcing is significantly influenced from infrastructure availability considerations. These findings suggest that infrastructure development should become an integral part of the strategy to attract FDI inflows in general, and export-oriented production from MNEs in particular

Anosmia in Parkinson’s Disease in Pakistan: A Matched Case – Control Study

Objective:  To assess olfactory dysfunction in Parkinson's disease (PD) patients in Pakistan utilizing an autochthonous smell test. Setting:  Tertiary care center, single-center study. Materials and Methods:  Eighty-seven non-demented patients with PD, who fulfilled Queen Square Brain Bank Criteria were enrolled at the Movement Disorder Clinic, Lahore General Hospital (LGH), Lahore. Fifty-eight controls matched by gender, age, and place of residence were enrolled among patients and visitors attending other hospital clinics. Both groups underwent olfactory testing using the Pakistani Smell Identification test (PKSIT). The participants were required to identify the smell from a set of choices and were scored out of 10. Results:  Among patients in the study group, the mean duration of disease was 4.7 years (range 6 months to 19 years). The PD onset mean age was 52.15 ± 13.02 years among patients. The mean number of smell test items accurately recognized by the PD patients was 4.55 ± 2.4. A multiple linear regression demonstrated that age (P < 0.05) but not disease duration (P = 0.899) was a significant determinant of the smell test result in PD and control groups. The mean number of smell test items appropriately recognized by the controls was 7.33 ± 1.69. Logistic regression showed that the PKSIT had 73.2% sensitivity and 84.3% specificity to distinguish PD from control. Conclusion:  PKSIT being easily available, cheap, and more convenient to use in the Pakistani population, can be used in the evaluation of olfactory dysfunction in PD subjects

crossed cerebellar diaschisis in partial status epilepticus

Crossed cerebellar diaschisis is a phenomena described as decrease in metabolism in the cerebellar hemisphere contralateral to the supratentorial lesion. A 61 year old man presented with status epilepticus. CT Brain showed small acute hemorrhage in left parietal lobe.MRI revealed diffusion restriction in right cerebral and left cerebellar hemispheres with hyperintensities on T2WI and FLAIR. However, CT perfusion was suggestive of increased perfusion in these areas. Periictal EEG showed frequent bursts of higher voltage spike and wave discharges over the right hemisphere. He was treated with IV antiepileptics. But he continued to deteriorate, and expired at 10th day of admission

Expression of a full length Arabidopsis vacuolar H+-pyrophosphatase (AVP1) gene in tobacco (Nicotiana tabbacum) to increase tolerance to drought and salt stresses

Among various abiotic stresses salinity and drought are the two major factors limiting the crop productivity. Genetically engineered salt and drought tolerant plants could provide an avenue to the reclamation of farmlands lost to agriculture because of salinity and a lack of rainfall. The Arabidopsis gene AVP1 encodes a vacuolar pyrophosphatase that functions as a proton pump and generates an electrochemical gradient in vacuole, thereby activating vacuolar membrane-antiporters including Na+/H+ antiporter, which helps in sequestration of Na+ into vacuole. In addition, over-expression of AVP1 gene increase vegetative growth by auxin transport and enhances auxin mediated root development, consequently achieving higher water absorption and retention capacities. The goal of present work is amplification of full length AVP1 (3.2kb) gene, from Arabidopsis thaliana genomic DNA through PCR, its cloning into a suitable plant expression vector and transformation in tobacco through Agrobacterium mediated transformation method for its characterization. PCR analysis showed the successful transformation of this gene in Nicotiana tabaccum. Screening of these putative transgenic plants against different salinity levels (50-250mM NaCl) showed that transgenic plants were tolerant to 250mM NaCl whereas the control plants showed wilting within 36-48 hours of salt treatment. Under periodic drought stress treatment transgenic (AVP1) plants were significantly more tolerant than wild type plants. Similarly the results of salinity and drought tolerance experiment in sand under saline and water regime conditions confirmed that introns play a key role in gene expression and regulations and improve the growth of plants. These resistant phenotypes are associated with increased internal stores of solutes

Challenges and pitfalls in diagnosis of parosteal Osteosarcoma: a clinicopathologic study of 23 cases

Objective: Parosteal Osteosarcoma (PO) is an uncommon variant of osteosarcoma. Diagnosing PO is important due to its malignant nature but the diversity of histologic features makes it challenging by adding a number of soft tissue, bony and cartilaginous lesions into the list of differential diagnosis. Our aim was to study the clinicopathologic and histological features of PO with emphasis on features helpful in its discrimination from other mimicking lesions. Methods: We reviewed 23 cases of PO diagnosed in our institution between January 2001 and August 2015. Results: Femur was the most commonly involved bone (68.2%) along with other long bones and rib in a single case. Soft tissue component was graded as Grade1 in 9(39%), Grade2 in 8(34.7%) and Grade3 in 4(17.3%) cases. Bony component was seen either in combination of or exclusively as parallel streams and interconnected trabeculae (mosaic-pattern). Out of 9 cases with cartilage component, 3 showed a cartilage cap. 2(8.6%) cases showed dedifferentiation into osteosarcoma. Conclusion: PO should always be considered in the differential diagnosis of every lesion arising from the bone surface. Knowledge of the variations in histologic features helps to reach the correct diagnosis which should never be made without radiological correlation

Comparison of Recurrence Rate of Wrist Ganglion Between Seton and Open Surgical Excision in Military Hospitals of Pakistan

Objective: To evaluate the recurrence following open surgical excision and Seton placement in treating symptomatic wrist ganglions in Military Hospitals in a six-month follow-up study. Study Design: Quasi-experimental study Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Bahawalpur Pakistan, Combined Military Hospital, Dera Nawab Sahib Pakistan and Pakistan Airforce Force Hospital, Shorkot Pakistan, from Jun 2015 to Dec 2020. Methodology: The patients were divided into two groups after informed consent. A consultant general surgeon carried out every procedure. The findings were recorded on a uniform proforma, and recurrence was recorded at ten days, six weeks and six months for both groups. Results: The mean age of the patients was 29.45±8.13 years in Group-A (Seton-Group) and 28.56±8.32 years in Group-B (OpenSurgery). There was no difference in the recurrence rates between the Seton-Group (n=7, 4.35%) and Open Surgery-Group (n=2, 4.65%, p=0.931). Conclusion: Seton insertion for treating Ganglions of the wrist is a simple, economical and cosmetic procedure which can be done in the outpatient department. It is a safe alternative to open resection for successful treatment of the wrist Ganglion. Keywords: Ganglion, Open surgery, Recurrence, Seton, Wrist

Commonest cancers in Pakistan - findings and histopathological perspective from a premier surgical pathology center in Pakistan.

Abstract CONTEXT: There are no recent authoritative data about incidence and prevalence of various types of cancers in Pakistan. AIM: To determine the frequency of malignant tumors seen in our practice and provide a foundation for building a comprehensive cancer care strategy. MATERIALS AND METHODS: 10,000 successive cases of solid malignant tumors reported in 2014 were included. All cases had formalin fixed, paraffin embedded specimens available and diagnosis was based on histological examination of H and E stained slides plus ancillary studies at the Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi. The latest WHO classifications were used along with the latest CAP protocols for reporting and the most updated TNM staging. RESULTS: There were 9,492 (94.9%) primary tumors while 508 (5.1%) were metastatic. Some 5,153 (51.5%) were diagnosed in females and 4,847 (48.5%) in males. The commonest malignant tumors in females were breast (32%), esophagus (7%), lymphomas (6.8%), oral cavity (6.7%) and ovary (4.8%), while in males they were oral cavity (13.9%), lymphomas (12.8%), colorectum (7.9%), stomach (6.9%) and esophagus (6.6%). Malignant tumors were most common in the 5th, 6th and 7th decades. About 8% were seen under 20 years of age. CONCLUSIONS: Oral cavity and gastrointestinal cancers continue to be extremely common in both genders. Breast and esophageal cancers are prevalent in females. Lung and prostate cancer are less common than in the west. Ovarian cancer was very common but cervix cancer was less so