RESOURCE USE AND FARM PRODUCTIVITY UNDER CONJUNCTIVE WATER MANAGEMENT IN PAKISTAN

The paper describes a study of canal and supplemental ground water used by 544 farmers for wheat crop in the Rechna Doab catchment of Pakistan. The main objective was to assess the on-farm financial gains through conjunctive water use. For econometric analysis, a linear relationship between the wheat production and different determinant variables was assumed. The results highlighted the problem of increased use of tubewells water in the saline zones that had resulted in the deterioration of the groundwater quality and led to the problem of permanent upconing of saline groundwater. Conjunctive water management increased the farm income by about Rs. 1000 and 5000 per hectare compared to only using the canal and tubewell water, respectively The results of financial analysis show that the net-gains were 30 percent higher on the farms using conjunctive water management as compared to the farms using only tubewell irrigation.Environmental Economics and Policy, Resource /Energy Economics and Policy,

Dual chamber pacemaker implants--a new opportunity in Pakistan for children with congenital and acquired complete heart block

Implantation of cardiac pacemakers has been practiced for at least five decades with continuous developments of the hardware. The invention of dual chamber pacemakers has initiated a debate concerning its superiority over single chamber ventricular pacemakers. Throughout the world, surgeons have been using dual chambered permanent pacemakers with successful follow ups. However, Pakistan has not yet taken the advantage of such pacemaker devices till now. We report three cases that underwent a dual chamber permanent pacemaker implantation for the first time in children less than 8 kg with successful follow ups

Effects of Inhaled Brevetoxins in Allergic Airways: Toxin–Allergen Interactions and Pharmacologic Intervention

During a Florida red tide, brevetoxins produced by the dinoflagellate Karenia brevis become aerosolized and cause airway symptoms in humans, especially in those with pre-existing airway disease (e.g., asthma). To understand these toxin-induced airway effects, we used sheep with airway hypersensitivity to Ascaris suum antigen as a surrogate for asthmatic patients and studied changes in pulmonary airflow resistance (R(L)) after inhalation challenge with lysed cultures of K. brevis (crude brevetoxins). Studies were done without and with clinically available drugs to determine which might prevent/reverse these effects. Crude brevetoxins (20 breaths at 100 pg/mL; n = 5) increased R (L) 128 ± 6% (mean ± SE) over baseline. This bronchoconstriction was significantly reduced (% inhibition) after pretreatment with the glucocorticosteroid budesonide (49%), the β (2) adrenergic agent albuterol (71%), the anticholinergic agent atropine (58%), and the histamine H(1)-antagonist diphenhydramine (47%). The protection afforded by atropine and diphenhydramine suggests that both cholinergic (vagal) and H(1)-mediated pathways contribute to the bronchoconstriction. The response to cutaneous toxin injection was also histamine mediated. Thus, the airway and skin data support the hypothesis that toxin activates mast cells in vivo. Albuterol given immediately after toxin challenge rapidly reversed the bronchoconstriction. Toxin inhalation increased airway kinins, and the response to inhaled toxin was enhanced after allergen challenge. Both factors could contribute to the increased sensitivity of asthmatic patients to toxin exposure. We conclude that K. brevis aerosols are potent airway constrictors. Clinically available drugs may be used to prevent or provide therapeutic relief for affected individuals

A Data Layout Descriptor Language (LADEL).

To transfer data between devices and main memory, standard C block I/O interfaces use block buffers of type char. C++ programs that perform block I/O commonly use typecasting to move data between structures and block buffers. The subject of this thesis, the layout description language (LADEL), represents a high-level solution to the problem of block buffer management. LADEL provides operators that hide the casting ordinarily required to pack and to unpack buffers and guard against overflow of the virtual fields. LADEL also allows a programmer to dynamically define a structured view of a block buffer\u27s contents. This view includes the use of variable length field specifiers, which supports the development of a general specification for an I/O block that optimizes the use of preset buffers. The need for optimizing buffer use arises in file processing algorithms that perform optimally when I/O buffers are filled to capacity. Packing a buffer to capacity can require reasonably complex C++ code. LADEL can be used to reduce this complexity to considerable extent. C++ programs written using LADEL are less complex, easy to maintain, and easier to read than equivalent programs written LADEL. This increase in maintainability is achieved at a cost of approximately 11 % additional time in comparison to programs that use casting to manipulate block buffer data

Pakistan: State Autonomy, Extraction, and Elite Capture—A Theoretical Configuration

―When groups are adequately stated, everything is stated!‖1 Management of actions and interest groups has historically been sovereign‘s existentialist imperative. The paper revitalizes philosophical state autonomy debate and then narrows down its focus to capture extractive antics of as erratic a state as Pakistan. A typology of factions – captioned as Elites – operative in extractive realm of Pakistan is developed to round them in theory, identify their properties, and lay bare mechanics of intra-elite and elite-non-elite transactions. The paper seminally develops the rational actor dilemma confronting Pakistani elites and identifies the modes through which the dilemma plausibly resolves itself. The transactional engagement between Pakistan‘s internal and external rational actors is dissected to theorize that Pakistan essentially is an equilibrium consensus subsistence state thereby opening up vast vistas for future research. The paper concludes with the glum finding that Pakistan in its current essence and manifestation is fundamentally a captive state – beholden to elites of Pakistan. JEL Classification: H1 Keywords: State Autonomy; Elite Capture; Pakistan‘s Tax System; Pakistani Elites; Elites‘ Rational Actor Dilemma; Equilibrium Consensus Subsistence State; Captive Stat

Pakistan‟s Governance Goliath: The Case of Non-Professional Chairman, FBR

The governance crisis of Pakistan‘s public sector is wide, deep and historically imbedded. There are a host of factors which contribute at varying degrees towards the extant of governance mess. The body of scholarship created to analyse the underlying factors of public sector management mess of Pakistan is not only scant but also deficient in quality, coverage and construct validity. In the entire administrative morass of Pakistan, the quagmire of Federal Board of Revenue (FBR)—house of the state‘s extractive function—is by far the most sombre and serious one. The paper picks up FBR as the unit of analysis and there too, only one variable, that is, appointment of a non-professional generalist as its Chairman to analyse below par performance of Pakistan‘s revenue function—by far the lowest in the world. It posits that appointment of non-professional Chairman, FBR, is a compelling exposition of a collusive duopoly arrangement between elites and generalist cadres of Pakistan civil services—both symbiotically pursuing their perverse particularistic interests at the expense of citizenry at large. The paper develops a theoretical framework within which it attempts to analyse domination of Pakistan‘s extractive function over history from various dimensions. It argues that, since the entire institutional infrastructure of the state has fallen hostage to elitesgeneralist duopoly paradigm, the control of its extractive function is only a logical consequence thereof, and that a non-professional generalist chairman is imposed on the revenue function only to precisely, and fully control the extractive policy formulation process as well as the extractive operations on the ground—to the ultimate advantage of the duopoly. JEL Classification: H1 Keywords: Public Sector Management, Federal Board of Revenue, Civil Service of Pakistan, Inland Revenue Service, Chairman, FBR, Institutionalis

Pakistan: Withholdingisation of the Economic System—A Source of Revenue, Civil Strife, or Dutch Disease+?

The paper takes an incisive shot at the systemic inadequacies that have tiptoed into the economic order of the state over time via the apparently innocuous mechanism of withholding taxes. Withholding tax—a legitimate instrument of preponing the state revenues on clearly identifiable chunks of incomes—has historically been resorted to by most states, and to that extent it should be normal with Pakistan, too. However, what has happened in Pakistan is that the tool of withholding taxation has been used as a source of revenues way too large in scale, size, scope and intensity. In addition to the pulling forward of tax collection on clearly demarcated chunks of incomes, a large number of transactions have also been roped into its nexus and then charged to tax by presumptivising gross receipts as income—a withholdingisation of the sorts not only of the tax system but of the entire economic system as a weighty portion of ubiquitous withholding taxes gets stuck into the pricing structure of the final goods and services produced in the economy rendering them price-incompetitive in the international market. This overwhelming withholdingisation of the economic system, it is argued, has been brought about by a numb state continually operating under, using a Freudian framework, the “pleasure principle” instead of the “reality principle” with political governments complacently choosing to continue harvesting quick bucks into the exchequer, pushing the extractive system into a total disarray, the society into burgeoning civil strife, and the economy to the Dutch Disease effect. JEL Classification: H1 Keywords: Withholdingisation; Withholding Taxes, Pakistan Tax System; Federal Board of Revenue; Civil Strife; Dutch Disease Effect; Cost of Collection; Tax Refor

Perception and knowledge about dietary intake in patients with liver cirrhosis and its relationship with the level of education

Objective: To determine patients perception and knowledge regarding diet in cirrhosis and its relationship with the level of patients education. Study Design: Cross-sectional observational study. Place and Duration of Study: This study was conducted at Gastroenterology Outpatient Clinics at the Aga Khan University Hospital, Karachi, the Aga Khan Health Services, Malir, Karachi and Hamdard University, Karachi, from January to December 2010. Methodology: Consecutive adult patients with compensated cirrhosis were enrolled. Demographic data, level of education, type and reason of food restriction as well as the source of dietary information was asked. Baseline laboratory test were performed, and nutritional status was assessed by BMI normogram. Results: Ninety patients, 58% male were enrolled. Mean age of the patient was 49 11 years. Overall 73% of the patients were restricting fat, meat, fish and eggs in their diet; 53% were in uneducated group and 47% were in educated group (CI, 0.24-1.62, p-0.34). Twenty two patients (62.8%) in uneducated and 21 in educated group (68%) were restricting diet on the advice of their doctors, whereas 13 in uneducated group (37%) and 11 in educated group (32%) believed these dietary components to be harmful for the liver. Thirty two of uneducated patient (71.1%) and 28 of educated patients (62.2%) believed that vegetables, fruits and sugarcane had a beneficial effect on the liver. Main source of dietary information to the patients was the doctor. On sub-group analysis those who restricted diet irrespective of their educational level, had more patients with BMI less than 18.5 kg/m2, (CI 0.01-0.94, p-0.001), haemoglobin less than 12 g/dl (CI 0- 0.03, p-0.001) and serum albumin less than 3 g/dl (CI 0.1- 03, p-0.001). Conclusion: Both educated and uneducated classes of the patients have improper knowledge and perception of diet in cirrhosis. Patients with cirrhosis who restricted diet, had relatively low BMI, haemoglobin and albumin as compared to those who did not restrict. Main source of dietary information to cirrhotic patients were health care personnels

DEVELOPMENT AND CHARACTERIZATION OF IN SITU GEL OF XANTHAN GUM FOR OPHTHALMIC FORMULATION CONTAINING BRIMONIDINE TARTRATE

Objective: The goal of this study was to develop and characterize an ion-activated in situ gel-forming brimonidine tartrate, solution eye drops containing xanthan gum as a mucoadhesive polymer.Method: Sol-gel formulation was prepared using gellan gum as an ion-activated gel-forming polymer, xanthan gum as mucoadhesive agent, and hydroxypropyl methyl cellulose (HPMC E50LV) as release retardant polymer. Phenylethyl alcohol is used as preservatives in borate buffer. The 23 factorial design was employed to optimize the formulation considering the concentration of gelrite, xanthan gum and HPMC as independent variables, gelation time, gel strength, and mucoadhesive force (N). Gelation time , gel strength, mucoadhesive force (N), viscosity (cP) and in vitro percentage drug release were chosen as dependent variables. The formulation was characteristics for pH, clarity, isotonicity, sterility, rheological behavior, and in vitro drug release, ocular irritation, and ocular visualization.Result: Based on desirability index of responses, the formulation containing a concentration of gelrite (0.4%), xanthan gum (0.21%), and HPMC (HPMC E50 (0.24%) was found to be the optimized formulation concentration developed by 23 factorial design. The solution eye drops resulted in an in situ phase change to gel-state when mixed with simulated tear fluid. The gel formation was also confirmed by viscoelastic measurements. Drug release from the gel followed non-fickian mechanism with 88% of drug released in 10 h, thus increased the residence time of the drug.Conclusion: An in situ gelling system is a valuable alternative to the conventional system with added benefits of sustained drug release which may ultimately result in improved patient compliance