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During the current emergency of Pandemic disease of COVID-19, the importance of online learning strategy has much increased due to closure of schools, colleges and universities in most part of the globe. To evaluate the effectiveness of online learning, a statistical study has been conducted on the academic achievements of postgraduate students learned by online versus face-to-face learning modes. The statistical analysis of academic achievements of postgraduate students has been done by SPSS-20 statistical tool. The t-test analysis showed that the t-value was 0.549 and p-value was 0.583. The significance level for t-test analysis was 0.05. As, the p-value was more that 0.05 (p>0.05) so, no significant relation has been found in the academic achievements of the students learned by online and face to face modes of learning. The null hypothesis (Ho) was proved true and the alternative hypothesis (H1) rejected. The reasons for no significant relation were abruptly shifting of learning modes from face to face to online, slow working of LMS accounts due to over burden, login and voice problems during the online classes. Overall, the students performed better in the online modes of learning. Some students performed good in face-to-face learning and performed poor in online modes of learning. So, to generalize, it is necessary to do more research on online modes of learning under regional context.

The aim of this research was to check the effects of teacher's training and teaching methods on academic achievements and interests of students at secondary schools in computer course. The population was divided into four groups; lecture teaching method (control group), discussion teaching method (experimental method), inquiry teaching method (experimental group) and demonstration teaching method (experimental group). Each group has a sample size of 20 students. A pre-test before training of teachers and post-test after training of teachers for academic achievement and interests of students taught by four teaching methods were conducted. The results of pre and post-tests were then analysed by statistical tools of descriptive statistics and ANOVA test. The results of the study indicated that students' academic achievements and interests were increased before and after the training of the teachers taught by lecture, discussion, inquiry and demonstration teaching methods. The demonstration teaching method was ranked 1st and lecture teaching method was ranked last. So, it can be concluded that training of the teacher's plays an important role for choosing the best method for teaching and improves the academic achievements and interests of students.

Carbonate rocks are the most impressive petroleum reservoirs in the world, constrained by depositional and diagenetic processes. With Paleocene Lockhart Limestone (PLL) strata, the Hazara Basin in northwest Pakistan is a growing petroleum basin. It is crucial to evaluate how PLL depositional and diagenetic processes affect reservoir potential. A combination of field observations, petrographic analysis, and Xрray fluorescence is applied to achieve the desired goals. PLL consists mainly of densely fossiliferous nodular limestone that exhibits three main facie associations: low-energy lagoon facies represented by abundant green algae and micritic matrix, foraminifera-rich inner ramp with low-energy conditions, and shallow marine middle ramp with restricted water circulation and abundant non-skeletal allochems. PLL is interpreted to be formed in middle-inner ramp to lagoon depositional setting representing type 3 transgressive-regressive systems tract. The geochemical results show that CaCO3 range (82.20–94.86 wt %) is dominant than other element oxides indicating that calcareous influx is more, which inhibits the clastic rocks influence in the deposition and the influence of magnesium enrichment process is minimal, which ultimately supports the formation of ramp setting. The diagenetic features include compaction, micritization, stylolites, dissolution, cementation, dolomitization, fractures, and recrystallization representing marine, marine-meteoric mixing, and burial diagenetic environments. Dissolution and fracturing can improve the net porosity of the formation, making it a better reservoir for petroleum exploration. PLL is correlated with stratigraphic equivalents involving the Jahrum Formation (Iran) and Zongpu Formation (China) for better understanding the reservoir properties of other carbonate petroleum fields. [ABSTRACT FROM AUTHOR]

This paper attempts to compare the availability, quality, similarities and differences of student support services in Allama Iqbal Open University (AIOU) and United Kingdom Open University (UKOU) and also to identify and enlist the deficiencies that AIOU students are facing in the student support services. The study found out that student support services of AIOU are quantitatively developing rapidly on the lines of UKOU. Though the regional campuses of both the institutions have almost the same status in the provision of student support service yet the UKOU students have better services in the guidance and counseling, modern communication facilities and career guidance. Moreover, there also exists Open University student association in UKOU. The conclusions led to the recommendation that AIOU regional campuses may be made independent like UKOU, counseling and guidance cell might be established at every regional campus, modern communication facilities like toll free, auto answer may be provided at AIOU regional campuses. (Contains 12 tables.)

The present study was undertaken to measure the attitude of the students towards teacher training programs through Distance Education offered by Allama Iqbal Open University (AIOU), Islamabad, Pakistan. To achieve the said end, the descriptive method of research was considered appropriate. The population of the study consisted of the B. Ed. Students of AIOU. Three hundred students from the Sahiwal region were selected as sample for the study. Questionnaire was used as a Research tool to gather the relevant data. Data was analyzed in terms of percentage and mean score. It was found that majority of the students appreciated the overall input of the program though a few eyebrows were raised concerning the assessment of the assignments. (Contains 9 tables.)

The paper addresses a key issue in language planning of the third world countries, specifically Pakistan, a country that remained under the shackles of Colonialism till 1947. But, still the country does not have a clear cut language policy. Being richly multilingual and multicultural, it had to cope with the problem of a second language, the national language and the regional and local languages. The often accepted dictum "choosing to learn a second language affords you unending possibilities" does not hold ground here. Learning a second language is a compulsion. But the second language could be Urdu, English or some powerful local language. This confusion has since long marred the teaching learning situation in some of the third world countries especially Pakistan. The teacher remains affixed with the Grammar Translation Method. The students have to refer to Urdu to learn English. However, Urdu is not the mother language of ninety three percent of the population. Hence, the students have to translate their thoughts twice which more often results in the loss of meaning. The present study was experimental in nature which sought to find answer to the question: Is it possibly to do away with Urdu and refer to the local language of the child while teaching him the English language? The study followed a pre-test, post-test and a single group experimental design. It was found that the students were more enthusiastic in learning the English language through the medium of their local language. It is conceded that Urdu may be taught as a national language but while teaching the foreign language, its middle-man status must be done away with.

The social networking sites (SNS) usage has received popularity in recent years, particularly for students' academic purposes and communication. This article analyzes the experience of university students with using SNS and the strategies they employ to strengthen sociability and learning activities through social media such as Facebook, TikTok, Messenger, YouTube, and WhatsApp. This study was conducted by collecting data from a qualitative research design by adopting a semi-structured face-to-face interview with 22 graduate university students studying in the Department of Education, Benazir Bhutto Shaheed University, Lyari, Karachi who reported experiences and strategies in learning activities with SNS. The randomly sampled data were transcribed and thematically analyzed. The results of the qualitatively designed study shown that despite a few constraints, university graduate students utilize SNS for academic and social reasons. The students acknowledged social media as a significant, effective academic and communication plate form. The study recommends that dependency on SNS seems to expand for endangering students' academic, social, and physical well-being. [ABSTRACT FROM AUTHOR]

In Western countries, university students adopt various approaches to studying depending on how they perceive their learning environment. Their perceptions and approaches are related to demographic and contextual factors such as age, subject of study, gender, and year of study. This study looked for similar relationships in Pakistani students. A survey, administered to 494 male and 418 female undergraduates in four subject areas across four years of study at two universities in Pakistan, addressed their perceptions of the learning environment, learning preferences, motivation, and approaches to studying. Consistent with Western research, students in the arts and social sciences perceived their programmes more positively and were more likely to adopt a deep approach to studying, compared to students in science and technology or business and management. Contrary to Western research, students' perceptions of their learning environment varied with age and year of study, but their approaches to studying did not. Gender differences were found in their perceptions and motivation. These variations appear to be specific to the context of Pakistan.

Moringa oleifera is gaining popularity as multi-cut quality fodder in Pakistan because of its great nutritional value and biomass production. For successful quality biomass production, proper crop nutrition is vital especially during dry season. Therefore, the present study was conducted with the objective to explore the impact of variable doses of "nitrogen, phosphorus, and potassium (NPK)" fertilizer for maximum foliage production and improve the quality of moringa under field conditions. Three levels of NPK (No fertilizer, 25:25:50, and 50:50:100 kg ha−1) were applied in already established two years old moringa plants on 15 September 2016, at research area of University of Agriculture, Faisalabad-Pakistan. Dimension of each experimental unit was 3.5 × 5.5 m. After thirty days of fertilizer treatments, two cuttings were taken with the interval of 30 days. The experimental design was RCBD with factorial arrangements having three replications. Significant differences were observed in growth, biomass production, and quality of produce. The moringa plants treated with application of 50:50:100 kg NPK ha−1 produced maximum dry biomass with good quality (crude protein, fiber, fat, and ash%) during both cuttings. Nonetheless, first cutting produced more growth and biomass as compared to second cutting. While NPK supplementation increased 50% more biomass production and better quality compared to control in second cutting. Increased biomass production of moringa was associated with high chlorophyll contents, better antioxidant, and quality (crude protein, fiber, fat, and ash%) status with NPK supplementation. [ABSTRACT FROM AUTHOR]

There has been a paucity of research on the experiences of students at Pakistani universities. A survey of over 900 students at two universities examined their approaches to studying and perceptions of their courses. Evidence was obtained for a deep approach, a surface approach and two aspects of a strategic approach. Their perceptions were based upon the instructional practices, the acquisition of generic skills, the appropriateness of the assessment and of their workload, and the available learning resources. A higher-order analysis revealed two broad dimensions of the student experience in Pakistan. Students who had positive perceptions tended to adopt a deep approach, to prefer courses, teaching and assessment that supported their understanding and to be engaged and reliable in their studies. However, students who had negative perceptions tended to adopt a surface approach and to prefer courses, teaching and assessment that reinforced this approach through the bare transmission of information. (Contains 7 tables.)

The current study investigates the water quality parameters of drinking water resources in District Neelam (DNLM), Azad Jammu & Kashmir (AJK), Northwestern Pakistan. The studied area has been recently reported with many waterborne diseases, which probed this analytical study. The samples were aseptically collected from springs, taps, and surface water bodies. The water quality parameters, such as physical, microbiological, anions, and heavy metals, were tested. Results showed that the electrical conductance (EC) and total dissolved solids (TDS), were 974.60 µS/cm and 912.10 mg/L, respectively, exacerbating the quality of drinking water in DNLM. For microbial water testing, we used 3M-Petrifilms as a detection source, which could separate coliform bacteria from E. coli by creating unique surface chromophores. Out of sixty collected samples, 76% had bacterial contamination. Nitrite, nitrate, and phosphate (9.8, 15.0, and 15.1 mg/L), were also surpassing the safe limits of the World Health Organization (WHO) standards for water quality measurement. The heavy metals, i.e., As, Cr, Cu, and Pb were also tested in current analysis. Pb and Cr (0.04 mg/L and 0.06 mg/L) exceeded from safe drinking water guidelines of the WHO and more than 50% of the collected samples had Pb as a major water pollutant in DNLM. Poor waste management, open sludge discharge, lack of municipality measures, and mineral leaching into the freshwaters of DNLM due to mining and metal extraction processes were the main sources of water pollution in the region. The inorganic pollutants were responsible for the sudden rise of different malignancies and other fatal diseases (vital organ failures and reproductive disorders) in the region, which has not been reported in the past. The current investigation yielded useful baseline data of the drinking water reserves of NW Pakistan that could help to develop techniques for the mitigation of water pollutants present in the region. [ABSTRACT FROM AUTHOR]

Objective: To determine the factors of iron deficiency anaemia among the post-menopausal women in our population. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Aug 2019 to Jan 2020. Methodology: A total of 300 post-menopausal women were included in this study. Menopausal status was taken as one year after the last menstrual period. Iron deficiency anaemia was diagnosed, based on haemoglobin and ferritin levels. In addition, the relationship of age, age at menopause, comorbid medical illnesses and duration of menopause was assessed with the presence of iron deficiency anaemia among the post-menopausal women participating in this study. Results: Out of 300 post-menopausal women studied in the given period, 124(41.3%) had no anaemia, while 176(58.7%) had the iron deficiency anaemia. Furthermore, 225(75.0%) had menopause after the age of forty, while 75(25.0%) had menopause after the age of forty. After applying the binary logistic regression analysis, we found that advancing age, longer duration since menopause and presence of medical comorbidities had a statistically significant association with anaemia in the target population. Conclusion: This study showed a high frequency of iron deficiency anaemia among post-menopausal women. In addition, women with longer duration since menopause, advanced age and other medical illnesses were more at risk of having iron deficiency anaemia s compared to other women. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of lifestyle on the optimization of blood pressure in adult hypertensive patients Study Design: Quasi-experimental study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, Aug 2019 to Jan 2020 Methodology: The study population comprised of 200 hypertension patients reporting for routine follow-up. Patients were divided into two groups. Group-A (controls) had the patients with the continuation of the routine anti-hypertensive medication. At the same time, Group-B (cases) received lifestyle modifications (salt restriction, quitting smoking and daily step count by using a pedometer) in addition to the routine anti-hypertension medication. Control of blood pressure among the groups was compared three months after the start of the study. Results: Mean age of the patients was 46.50±3.56 years. The mean duration of hypertension in the study participants was 5.12±3.24 years. Optimal blood pressure was achieved in 103(51.5%), while this was not achieved in 97(48.5%). With the help of binary logistic regression analysis, we found a statistically significant difference in achieving optimal blood pressure control among the cases and controls. Gender was also statistically significant in achieving control of blood pressure (p- value<0.001). Conclusion: This study showed a significant difference in optimizing the blood pressure of patients who received lifestyle modification in addition to conventional biological treatment than those who only received the routine anti-hypertensive medication. Females also had better control as compared to males. [ABSTRACT FROM AUTHOR]

In this era, the learning process has become more complex. Students from lower grade to higher education have to require powerful tools to understand difficult ideas. Concept maps can be successfully implemented in higher and professional education. The present research was designed to assess the usefulness of concept maps learning strategy for higher education in Pakistan.The Concept Maps are graphical or view devices for assembling and linking information. These are utilized for creating connections between concepts in the form of connected boxes. Quasi-experimental designed of study was used for the current research. The marks obtained in pre- and post- tests of students were analyzed by SPSS for three types of items (Knowledge, Comprehension and Application). The results of the research indicated a significant influence of concept maps learning strategy on the student’s knowledge, comprehension and application. [ABSTRACT FROM AUTHOR]

In the modern era, the organized retailers are growing and replacing unorganized retailers due to the competitive business environment around the globe. Although, the unorganized retailers have more market share than organized retailers regarding the 70% world population geographically residing. The literature lacks empirical evidence on customers' perception of retailers in the context of Pakistani retail industry. Hence, objective of this study is to understand the customers' perception of unorganized retailers for local and international organizations. This research work is an effort to investigate the moderating role of attitude on customers' perception regarding Pakistan's unorganized retailers. Based on the five-Likert scale, the sample-set has been collected through a survey from the customers by convenience sampling techniques. Structure equation modelling (SEM) model is performed in SMART PLS 3.3 for data analysis. The estimated result reveals that services, promotion advertising, positive attitude, and brand have a strong and significant relation with customers' perception, it can modify customer's perception. According to the results, it's a serious issue to divert the customer's attention towards Pakistan's unorganized retailers. It also infers that attitude can divert the customer's perception as a moderator role. [ABSTRACT FROM AUTHOR]

Introduction. This study aims to explore the impact of tourism along with some other regressors, namely labor force, official development assistance, local investment, and inflation rate on the economic growth rate of the developing country of Pakistan. Material and Methods. We used annual time series data over the period from 1980 to 2018 for empirical analysis. Based on the order of integration of data, we employed an Autoregressive Distributed Lag (ARDL) approach. Results. Empirical results vindicated a positive relationship between tourism and growth. The official development assistance and inflation rate have shown significantly negative impacts on the economic growth of Pakistan, whereas domestic investment has shown an insignificantly positive impact on the economic growth. Conclusions. The empirical findings exhibit that tourism plays a key role in the process of economic growth and development of Pakistan. The study recommends that the management authorities should implement appropriate policies to attract more tourists to improve economic growth of Pakistan. Furthermore, sincere efforts are required to ensure macroeconomic stability through controlling inflation, avoiding reception of foreign aid, and encouraging global investment. [ABSTRACT FROM AUTHOR]

Objective: To assess the association of fatty liver with type 2 diabetes and other socio-demographic factors among the patients at Pak Emirates military hospital Rawalpindi. Study Design: Cross-sectional analytical Study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan from Aug 2019 to Jan 2020. Methodology: This study was conducted on 300 patients of type 2 diabetes mellitus reporting for a routine checkup at the medical Outpatient department. Fatty liver was diagnosed on ultrasound by a consultant radiologist. Results: Out of three hundred patients with diabetes mellitus included in the final analysis, 225(75.0%) were males, and 75(25.0%) were females. 176(58.6%) had fatty liver on ultrasound, while 124(41.4%) had no fatty liver on ultrasound examination at the time of the study. we found that increasing age, long duration of diabetes and poor control of illness had a statistically significant relationship with the presence of fatty liver among the target population (p<0.05). Conclusion: Patients with type 2 diabetes had a high frequency of fatty liver on routine ultrasound examinations. In addition, patients with more age, long duration of diabetes mellitus and poor control of illness were at a high risk of developing fatty liver among the study participants. [ABSTRACT FROM AUTHOR]

Cadmium (Cd+2) is a potential and widespread toxic environmental pollutant, mainly derived from a rapid industrial process that has inhibitory effects on growth, physiological, and biochemical attributes of various plant species, including medicinal plants such as Silybum marianum L. Gaertn commonly known as milk thistle. Plant signaling molecules, when applied exogenously, help to enhance/activate endogenous biosynthesis of potentially important signaling molecules and antioxidants that boost tolerance against various abiotic stresses, e.g., heavy metal stress. The present study documented the protective role of salicylic acid (SA;0.25 μM) and hydrogen peroxide (H2O2; 10 μM) priming, foliar spray, and combinational treatments in reducing Cd+2 toxicity (500 μM) in milk thistle grown at two diverse ecological zones of Balochistan Province of Pakistan i.e., Quetta (Qta) and Turbat (Tbt). The morpho-physiological and biochemical attributes of milk thistle were significantly affected by Cd+2 toxicity; however, priming and foliar spray of SA and H2O2 significantly improved the growth attributes (root/shoot length, leaf area, and root/shoot fresh and dry weight), photosynthetic pigments (Chl a , b , and carotenoids) and secondary metabolites (Anthocyanin, Soluble phenolics, and Tannins) at both altitudes by suppressing the negative impact of Cd+2. However, the oxidative damage parameters, i.e., MDA and H2O2, decreased astonishingly under the treatment of signaling molecules, thereby protecting membrane integrity under Cd+2 stress. The morphological variations were profound at the low altitude (Tbt) as compared to the high altitude (Qta). Interestingly, the physiological and biochemical attributes at both altitudes improved under SA and H2O2 treatments, thus hampered the toxic effect of Cd+2. These signaling compounds enhanced tolerance of plants under heavy metal stress conditions with the consideration of altitudinal, and ambient temperature variations remain to be the key concerns. [ABSTRACT FROM AUTHOR]

Environmental problems caused by global warming are becoming alarming with every passing day. To curb greenhouse gas (GhG) emissions, promoting alternative fuel vehicles (AFVs) and sustainable transport mode choices is critical. This study explores the predictors of eco-social purchase, use, and conservation intentions in a developing country by employing an extended model of the theory of planned behaviour (TPB). Using a self-administered survey technique, data were collected from a nationally representative sample of 1372 customers of three leading automobile manufacturers from eight big cities of Pakistan. Partial Least Squares Structural Equation Modelling (PLS-SEM) was applied to test the measurement and structural models. Results showed that the extended model of TPB received support in the context of Pakistani culture and for the targeted behaviours related to eco-social purchase, use, and conservation intentions concerning AFVs. Implications for marketers and theoretical contribution are discussed at the end. [ABSTRACT FROM AUTHOR]

Migration Literature endeavours to recount the struggles and sufferings of the migrants in literary studies and has specifically become an area of growing interest since 1980s alike for researchers and chroniclers who focus on hostility, identity crisis, racism, violence, exploitation and cultural diversity witnessed by them or experienced by the migrants. The blood-spattered partition of 1947 was defining moment in the history of India and Pakistan and its repercussions are horrific to count be it massive migration or blind massacre, communal violence or religious fanaticism. However, the women bore the greatest brunt of the frenzy in wake of partition of 1947. This study brings forth the representation of women in the selected works of Khushwant Singh's Train to Pakistan and Bepsi Sidhwa's Cracking India These narratives have the tinge of personal loss and first-hand observations as the authors themselves were victim of the unjustified sorrows and trauma of Partition of 1947. The textual analysis of the selected works signifies the abduction, humiliation, and exploitation of women in the name of honour killing, manliness and reparation as well as the endurance, empowerment and audacity of women as they fought back in those adverse circumstances being marginalized and victims. The study emphasizes that women also deserve to be discussed as more than sufferers and victims of engendered ferocity. [ABSTRACT FROM AUTHOR]

This study aims to investigate the asymmetric fiscal decentralization effect on economic growth and environmental quality by using Pakistan data from 1984 to 2018. Our findings demonstrate that expenditure decentralization has asymmetric effects on economic growth and CO2 emissions in short- and long-run in Pakistan. Therefore, positive and negative fluctuations in expenditure decentralization affect economic growth and CO2 emissions differently in Pakistan. The results of asymmetric ARDL suggested that negative shock of revenue decentralization is reduced the economic growth and CO2 emissions in the short and long-run, while positive shock of revenue decentralization is reduced the economic growth and CO2 emissions. Our asymmetric results are country-specific and more effective in policy analysis in Pakistan. The outcomes of this study may also help Pakistan's local governments and the central government in addressing the problem of economic growth and environmental pollution. [ABSTRACT FROM AUTHOR]

Moringa (Moringa oleifera L.) tree is being used for animal feed and human food as its leaves are an excellent source of amino acids and proteins. Moringa is indigenous plant of Pakistan, but its adaptation and production as agroforestry and fodder crop in smallholder farming sector is very low. Inorganic fertilization has been identified as a major limiting factor for moringa growth and quality of produce. A field experiment was conducted at the Directorate of Farms, University of Agriculture, Faisalabad, Pakistan, to optimize NPK dose for healthy and quality produce of moringa. The experiment was comprised of four treatments—control (no fertilizer), 125:75:75 NPK, 100:50:50 NPK and 75:25:25 NPK kg ha−1—under randomized complete block design with factorial arrangements having four replicates. First harvest was taken in May and then applied with fertilizers. Results revealed that different harvesting time (months) significantly affected the number of branches, shoot dry weight, chlorophyll a and b contents, carotenoid contents, total phenolic contents, K contents and total soluble protein except shoot fresh weight. Regarding the fertilizer treatments, application of 125:75:75 kg NPK ha−1 produced total phenolic contents, K concentration and soluble proteins as compared to control and other treatments. Maximum growth, nutrient and biochemical attributes were observed in the month of August. In crux, for the maximum growth, nutrient and biochemical attributes, August is the best harvesting time using the 125:75:75 kg of NPK ha−1 as fertilizer dose. [ABSTRACT FROM AUTHOR]

Introduction: Most of the antibiotics currently used in pediatrics are either unlicensed or being prescribed outside the specifications of product label (off-label prescribing). The aim of this study was to assess the extent of off-label antibiotic use in pediatrics. Methodology: A six month longitudinal off-label antibiotic utilization survey was carried out from January to June, 2018. A structured questionnaire was designed to collect detailed information for each pediatric patient admitted to participating health center. The data included basic demographic and clinical diagnosis with details of prescribed antibiotics (formulation, dose, dosage, route of administration and indication for use). Data were analyzed using Social packages for Statistical Sciences (SPSS) version 21.0. Results: Of 1,810 admissions, 1,795 (99.2%) patients received antibiotics. Out of these, a total of 451 (25.1%) patients (326 patients admitted in the medical ward and 125 patients in ICUs) received at least one unlicensed/off-label antibiotic. Antibiotics were predominantly prescribed for the treatment of infections (n = 311, 69.0%). The majority of the pediatric patients who received off-label antibiotic suffered from respiratory tract infections (n = 223, 49.4%), skin and soft tissue infections (n = 53, 11.8%), gastrointestinal tract infections (n = 56, 12.4%) and other infections (n = 46, 10.2%). Co-amoxiclav (n = 190, 42.1%) was the most frequently off-label prescribed antibiotic to pediatric patients. An inappropriate dose for patients (n = 430, 95.3%) was the most frequent cause of prescribing off-label antibiotics. Conclusions: Further evaluation of health and economic outcomes of off-label prescribing and determinants influencing the drug choice is required. [ABSTRACT FROM AUTHOR]

This paper aims to find out relationships among the energy, environment, and the industrial production for a developing country which is in earlier stages of development. It also tests a few contradicting hypotheses to find the possible shape of an environmental Kuznets curve. Using the time series data, the study finds robust long-run relationships between energy, environment, and industrial production for Pakistan. The scale economy is also assumed. It is also found that the capital and labor elasticities of income show increasing returns in the presence of energy and emission variables. It finds evidence of EKC in a quadratic restricted model but not in a cubic function. This analysis implies that the focus of policy authorities should be to persuade environment-friendly energy resources. After an initial stage of economic development, society has to take serious measure to tackle the issues of environmental degradation. [ABSTRACT FROM AUTHOR]

The prime objective of the current study is to examine the relationship between corporate entrepreneurship and FP of manufacturing firms listed in PSX. In addition to that, the mediating role of alliance formation orientation and total quality management in the relationship between corporate entrepreneurship and FP of manufacturing firms listed in PSX is also examined. Using random sampling, the final sample appeared as 347. To answer the research questions, we have used PLS-SEM statistical technique. The reason behind using this technique primarily that the aim of current study is to check the weather there is any mediating effect on relations. The second foremost reason of using this technique is that there is no issue if the data is normally distributed or not. Mostly reaches of social science indicates the normality issue in data. So, for such studies PLS is the more appropriate technique, because it can easily handle the abnormal data. The response rate of present study is 63.2% which is significantly high. The survey results have supported the hypothesized results. This study is among the pioneer studies on the issue and will be beneficial for researchers and policy makers. [ABSTRACT FROM AUTHOR]

Objective: To determine the demographic variance in location and histopathological findings of esophageal carcinoma in Punjab-Pakistan. Study Design: Observational cross sectional study. Place and Duration of Study: This study was conducted in Multicentre Tertiary Care Hospitals of Combined Military Hospital/Pak Emirates Military Hospital/Army Medical College Rawalpindi, Combined Military Hospital Kharian and Combined Military Hospital Multan from 2010 to 2017. Methodology: Patients with dysphagia and histopathology proven malignancy were included in this study. All patients had undergone flexible upper gastrointestinal endoscopy. Patients with lesions other than carcinoma, causing dysphagia and those with inconclusive histopathology were excluded from our study. The morphological site of the carcinoma were divided into upper, middle, lower and at gastro-esophageal junction. Histo pathologically proven carcinoma of esophagus was reviewed for subtype of grading differentiation. Statistical analysis was done using IBM version SPSS 22. Results: Out of 150 patients, 85 (57%) were males and 65 (43%) were females. Their age ranged between 30 to 85 ± 12.33. Among one hundred and fifty patients 107 (71.33%) had Squamous Cell Carcinoma, 42 (28%), Adenocarcinoma and metastasis in two cases. Frequency of distribution of esophageal carcinoma in North, East and South Districts of Punjab was 73%, 18% and 9% respectively. Esophageal Carcinoma in upper, middle, lower and Gastroesophageal junction was 22.5%, 35%, 15% and 27.5% respectively. Frequency of well differentiated SCC was 46 (30.6%) and well differentiated AC 31 (20.7%) respectively. Conclusion: SCC with male preponderance is more common in North of Punjab. Lower 1/3rd and GE junction esophageal tumor are the commonest sites in all North, East and South Punjab. Histopathological differentiation revealed Well Differentiated SCC along with significant rise in Adeno-carcinomas compared to previous national studies. [ABSTRACT FROM AUTHOR]

In modern era of industrialization, firm survival is widely acknowledged and geared through industrial cluster in developing countries. The present study unfolds the impact of education, experience and social network on firm death by using two rounds of electrical fittings cluster survey from 2008 to 2017. The empirical outcomes from Cox PH model spotlight that entrepreneurs are relatively more educated, rich in experience of production and marketing, have low hazard rate in their business. The empirical analysis also revealed that firm survival can be achieved through strong social network of entrepreneur. The study findings infer that Small and Medium Enterprises Development Authority and United Nations Industrial Development Organization training programs are needed to focus on cluster entrepreneurs and sustained firm survival. [ABSTRACT FROM AUTHOR]

Objective: To find out presenting complaints of mucormycosis in the nose and paranasal sinuses and its treatment Material and Methods: This case series was conducted in the Department of ENT, Khyber Teaching Hospital, Peshawar, and Abaseen Medical Centre Peshawar, Pakistan, from May 2020 to March 2021. A total of 12 patients were included. Among them, 08 patients were admitted in Khyber Teaching Hospital, and 04 patients were treated at Abaseen Hospital, Peshawar. In addition, literature was reviewed, and results compiled. Results: Among 12 cases, 3 (25%) were females, and 9 (75%) were males. The age range was 55 to 80 years. All patients were diabetic Type 2. At the time of presentation, 35% of patients presented with uncontrolled diabetes mellitus in whom immediate medical opinion was sought. Before doing surgery, their blood glucose levels was within normal limits. In 83.3 % of cases, there was complete nasal obstruction, while in 17%, there was partial nasal obstruction. There were right maxillary sinusitis in 8 (66.6%) cases, and in 4 (33.33%) patients, there was left maxillary sinusitis. In 2 Patients, all of the paranasal sinuses were involved except frontal sinuses. Nearly all the patients had severe headache as well. Conclusion: Mucormycosis was commonly seen in elderly diabetic patients, mostly involving the nose and paranasal sinuses. [ABSTRACT FROM AUTHOR]

The purpose of this study is to determine the influence of HR competencies on HR professionals' effectiveness in the banking sector of Pakistan. The impact of HR professionals' social competencies (HRPSC) on HR professionals' effectiveness (HRPE) were examined. The results suggest that the HRPC had a positive and significant relationship and impact with HRPE. However, this relationship is stronger for HRPSC. Within the sub constructs of HRPSC 'credible activist' is the most highly correlated with HRPE. Finally, the results confirm that HRPSC are found to be more significantly associated with HRPE. It is recommended in the study that the HR professionals need to enhance further their competencies in the area of credible activist, talent manager/organization designer and culture change steward and HR professionals' effectiveness in the banking sector of Pakistan. [ABSTRACT FROM AUTHOR]

This research study examined the association between breach of psychological contract & job involvement of nurses working in public health care sector of Pakistan. Specifically, this study has introduced organizational cynicism as a mediator between breach of psychological contact and job involvement. By using self-administered survey, we collected data from 162 nurses employed in various public sector hospitals in Pakistan. Findings of this study highlighted that breach of psychological contract causes decrease in job involvement of nurses among public sector hospitals and this association is partially mediated through organizational cynicism. Implications for practice and future research directions are highlighted. [ABSTRACT FROM AUTHOR]

This article pinpoints the essential factors influencing hospital information system (HIS) acceptance. The principal HIS users are physicians, who play a preeminent role in healthcare services. Gleaned from hospital physicians in Pakistan, questionnaire data help evaluate HIS acceptance. The critical factors affecting it are assessed through structural equation modeling (SEM), using a partial least squares (PLS) software. The results show that human compatibility, organizational support and HIS quality positively affect both HIS perceived usefulness and HIS perceived ease of use. Subsequently, these two intermediate factors positively affect hospital information system acceptance. Despite its limitations, the study not only contributes theoretically, but also yields both future-research directions and practical policymaking guidelines, so that healthcare providers deliver what HIS users need. [ABSTRACT FROM AUTHOR]

Quinoa is recently introduced to Pakistan as a salt‐tolerant crop of high nutritional value. Open field trials were conducted to evaluate its performance on normal and salinity/sodicity‐degraded lands at two locations of different salinity/sodicity levels, S1 (UAF Farm, Normal Soil), S2 (Paroka Farm UAF, saline sodic), S3 (SSRI Farm, normal) and S4 (SSRI Farm, saline sodic) during 2013–2014. Two genotypes (Q‐2 and Q‐7) were grown in lines and were allowed to grow till maturity under RCBD split‐plot arrangement. Maximum seed yield (3,062 kg/ha) was achieved by Q‐7 at normal field (S1) soil which was statistically similar with yield of same genotype obtained from salt‐affected field S2 (2,870 kg/ha). Furthermore, low yield was seen from both genotypes from both S3 and S4 as compared to S1 and S2. Q‐7 was best under all four conditions. Minimum yield was recorded from Q‐2 (1,587 kg/ha) at S4. Q‐7 had higher SOD, proline, phenolic and K+ contents, and lower Na+ content in leaves as compared to Q‐2. High levels of antioxidants and K+/Na+ of Q‐7 helped to withstand salt stress and might be the cause of higher yields under both normal and salt‐affected soils. Seed quality (mineral and protein) did not decrease considerably under salt‐affected soils even improved seed K+, Mg2+ and Mn2+. [ABSTRACT FROM AUTHOR]

Objectives: To compare the operative time and postoperative outcomes in thyroid surgeries using ultrasonic cutting with conventional diathermy dissection. Material and Methods: This prospective study was conducted in Abaseen Hospital, Peshawar, Pakistan from April 2018 to December 2018. Ethical approval was taken from the hospital administration. After taking informed consents from the patients, these were divided into two groups by lottery system. The patients operated with Ultrasonic Cutting device (UCD) were labelled as Group A and Conventional Diathermy dissection (CDD) as Group B. The operative time and outcome of thyroid surgeries were assessed and compared between the two groups. Results: Total of 4 males and 15 females underwent thyroid surgeries during the study period with age ranging from 25 to 70 years, the operative time in Ultrasonic Cutting device (UCD)was less than Conventional Diathermy dissection (CDD) group (100.15 minutes vs 150 minutes p=0.06).The cumulative mean amount of drain was found to be less in UCD group, the difference was statistically significant (80.5 ml vs 133.05 ml p=0.00018).The drain was removed earlier in UCD group, this comparison was also statistically significant (2.5 days in UCD group vs 3.02 days in CDD group, p=0.00007).The mean pain score was fond to be statistically significant on all the postoperative days in UCD group. Conclusion: Less operative time, reduce postoperative pain and minimal complications were recorded in patients who undergone thyroid surgery by Ultrasonic Cutting Scalpel than Conventional method. [ABSTRACT FROM AUTHOR]

The terms of trade (TOT) have an important role in determining direction of the trade which finally transmits into trade balance. The current study is an effort to seek the effect of TOT on the trade balance. The short and long-estimates are computed through Autoregressive Distributed Lag (ARDL) methodology; the results reveal that in the case of Pakistan, there is no significant relationship between TOT and trade balance. Furthermore, the estimated Marshall Lerner (ML) condition is calculated by addition of the absolute values of import and export demand elasticities. The study shows that it does not hold for Pakistan, neither in the short-run, nor in the long-run. The computed ML condition, evidently infers that price have negative impact on trade balance. The demand for exports and imports are price inelastic; thus, to curtail trade balance the government should take measures to increase exports and limit the unnecessary imports. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the presentation and types of foreign bodies in tracheobronchial tree and difficulties encountered in their removal at a Tertiary Care Hospital. Material and methods: This retrospective, descriptive study was carried out at the department of ENT and Head & Neck surgery Khyber Teaching Hospital Peshawar-Pakistan from July 2015 to June 2017. A total of 142 confirmed or suspected cases of foreign body tracheobronchial tree were included in the study from OPD, accident & emergency department (A&E) and referred from pediatric department. Detailed history and clinical examination was performed, X-Ray chest and base line investigation were done in all cases. Rigid bronchoscopy was done under general anesthesia in all cases, and different types of foreign bodies were removed. Difficulties encountered during bronchoscopy were bleeding, slip of foreign body and difficult to remove foreign body. Results: Out of 142 cases 94 (66.2%) were males and 48 (33.8%) were female in the age range of 01 year to 10 years. The duration between inhalation and hospital arrival was 12 hours to 2 weeks. In 90 (63.3%) cases vegetative foreign bodies were retrieved followed by plastic 30 (21.12%) and metallic 20 (14%). In 4 cases removal was difficult due to bleeding and oedema and were refered to thoracic department after tracheotomy. Conclusion: Early diagnosis and proper management along with awareness regarding pediatric home care is stressed upon to reduce morbidity and mortality. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To determine the association of malabsorption in celiac disease with anaemia and other sociodemographic factors at a tertiary care hospital in Pakistan. Study Design: Cross sectional study Place and Duration of Study: Department of General Medicine Military Hospital Rawalpindi from Jul to Dec 2019. Methodology: A total of 300 adults were included in the study, 150 cases were patients with the diagnosis of celiac disease, and the other 150 were controls without celiac disease. Celiac disease was diagnosed based on biopsy findings by a consultant gastroenterologist. Defined was defined based on haemoglobin levels. In addition, the relationship between age, gender, anaemia, and the presence of comorbidities was assessed with the presence of celiac disease among the adults included in the study. Results: Out of 300 cases and controls, 116 (38.7%) patients were males, and 184 (61.3%) were females. One hundred and forty-eight (49.3%) did not show the presence of anaemia, while one hundred and fifty-two (50.7%) showed the presence of anaemia. we found a statistically significant difference in cases and controls regarding the presence of comorbidities and the presence of anaemia (p<0.05). Conclusion: Patients with celiac disease showed a greater frequency of anaemia as compared to those who were not having celiac disease. Therefore, patients with celiac disease are at high risk for developing anaemia, or patients with anaemia should be screened for malabsorption problems. In addition, patients with celiac disease were also at high risk for acquiring other systemic disorders. [ABSTRACT FROM AUTHOR]

The current study was focused on the water quality assessment of the District Muzaffarabad (DMZD) Azad Jammu and Kashmir (AJK), the northern part of Pakistan. The qualitative assessment was done on the surface water bodies, spring waters and tap water sources of DMZD. A total of eight parameters were assessed in this exploration including physical parameters, microbiological analysis, anion detection, and heavy metal exploration. Some physical parameters i.e., Electrical Conductance and Total Dissolved Solid showed higher variance than WHO allowed limits having a positive correlation within themselves that has indirectly affected the water quality of the region. Microbiological analysis was also performed using 3M-petrifilms with a capacity to quantify and distinguish between coliforms and E. coli by producing different stains on the surface chromophore of the petrifilm. Amongst eighty collected samples, more than 90% were contaminated with bacteria i.e., coliforms or E. coli. Poor water management and open disposal of sewage, sludge and other waste products were the main causatives of bacterial pollution. The significant anions which were crossing the maximum concentration limits (MCL) were fluoride, nitrite and nitrate (2.981 mg/L, 0.418 mg/L and >30 mg/L). Amongst anions especially, nitrite and nitrate were the real culprits of many health-related issues in humans' i.e., cancers , etc. and fluorides were responsible for diseases such as dental fluorosis, skeletal fluorosis etc. Water quality was generally poor and unsafe in the studied areas. We have also analyzed heavy metal content in the water samples collected from DMZD, AJK. Heavy metals ions detected in the collected water samples were; Arsenic (As 3+ ), Copper (Cu 2+ ), Iron (Fe 2+ ), Lead (Pb 2+ ) and Nickel (Ni 2+ ). We used robust Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES) for heavy metal detection having broader LoD for a variety of turbid samples especially. Along with some fluctuations in the concentrations of other heavy metals, a significant spike was observed for Pb2+ (0.01818 mg/L) in ICP-OES experiments exceeding from MCL (0.01 mg/L) of lead setup by WHO. A higher concentration of Pb2+ was due to anthropogenic sources and natural sources in District Muzaffarabad. The study was aimed to find out the cause of the recent upsurge of different lethal diseases (gastrointestinal, cardiovascular, cancers etc.) in the region relative to water contamination. From this study and application of analytical methods we have revealed meaningful information about the unexplored water quality data of the studied area. [Display omitted] • A Total of eighty water samples have been analyzed for their quality parameters. • Among physicochemical parameters significant fluctuations were observed. • More than 90% of samples were contaminated with microbial contaminants. • Heavy analysis showed high Pb concentration in the studied area. [ABSTRACT FROM AUTHOR]

Suicidal ideation is an indicator of psychological distress and a proportion of people reporting suicidal ideation attempt or commits suicide. Mental illness of any type is strongly associated with suicidal ideation. Furthermore, the links between exposure to domestic violence and mental health problems are well established. Furthermore, a number of studies have reported an association between domestic violence and suicidal ideation. To study the link between domestic violence, mental health and suicidal ideation. Using data from a group of 650 Pakistani women, we explored the putative predictors of suicidal ideation using univariate and multiple logistic regression. Significant predictors were then entered into a path analysis in order to evaluate both the direct and indirect effects of domestic violence on the odds of a study participant reporting suicidal ideation. Mental disorders were observed to significantly predict suicidal ideation. Ability to negotiate conflict between couples appeared to both directly and indirectly, via mitigation against mental disorder, protect against suicidal ideation. The effect of verbal aggression on suicidal ideation appeared to be mostly mediated via its impact on mental health. [ABSTRACT FROM AUTHOR]

In Western countries, university students adopt various approaches to studying depending on how they perceive their learning environment. Their perceptions and approaches are related to demographic and contextual factors such as age, subject of study, gender, and year of study. This study looked for similar relationships in Pakistani students. A survey, administered to 494 male and 418 female undergraduates in four subject areas across four years of study at two universities in Pakistan, addressed their perceptions of the learning environment, learning preferences, motivation, and approaches to studying. Consistent with Western research, students in the arts and social sciences perceived their programmes more positively and were more likely to adopt a deep approach to studying, compared to students in science and technology or business and management. Contrary to Western research, students' perceptions of their learning environment varied with age and year of study, but their approaches to studying did not. Gender differences were found in their perceptions and motivation. These variations appear to be specific to the context of Pakistan. [ABSTRACT FROM AUTHOR]

Objectives: To determine the patient management factors and patient outcomes in pediatric patients of foreign bodies in nose. Methodology: This descriptive study was performed in ENT Department, Khyber Teaching Hospital, Peshawar from February, 2006 to January, 2007. Two hundred fifty seven cases of foreign bodies in nose in patients upto 12 years of age were included. Personal data, clinical features, investigations, management details and complications were recorded on a pre-designed proforma. In younger non cooperative cases foreign bodies were removed under general anesthesia, while in cooperative children it was removed without anesthesia by using suction, use of forceps and foreign body hook. Results: Among 257 cases of foreign bodies in nose 48.46% were between 4 to 8 years, with male preponderance i.e. 63%. Unilateral and bilateral presentations were seen in 95% and 5% cases respectively. Most common foreign body types were plastic beads, pearls, pieces of sponge and small round objects. There were two cases of alkaline battery lodged in the nose. General anesthesia had high success rate. Conclusion: Round shape foreign bodies and younger children are associated with poor outcome with removal attempts made under direct visualization. These cases should be referred directly to otolaryngologists for removal under general anesthesia. [ABSTRACT FROM AUTHOR]

There has been a paucity of research on the experiences of students at Pakistani universities. A survey of over 900 students at two universities examined their approaches to studying and perceptions of their courses. Evidence was obtained for a deep approach, a surface approach and two aspects of a strategic approach. Their perceptions were based upon the instructional practices, the acquisition of generic skills, the appropriateness of the assessment and of their workload, and the available learning resources. A higher-order analysis revealed two broad dimensions of the student experience in Pakistan. Students who had positive perceptions tended to adopt a deep approach, to prefer courses, teaching and assessment that supported their understanding and to be engaged and reliable in their studies. However, students who had negative perceptions tended to adopt a surface approach and to prefer courses, teaching and assessment that reinforced this approach through the bare transmission of information. [ABSTRACT FROM AUTHOR]

Teachers' perceptions and attitudes play an important role in teaching learning process. The present descriptive study, part of a PhD thesis, attempts to measure the attitudes, experiences and perceptions of the English language teachers at secondary level in Pakistan. The study is significant in that it helps to compare the teachers' perception of how language learning takes place with their reported classroom practice. To accomplish the desired goal, the study employed a survey instrument i.e. a questionnaire, to collect data from 100 English language teachers at the secondary level. The sample was equally divided among the male-female and urban-rural demographic variables. The questionnaire was pilot tested before administration to the sample. The Cronbach's alpha was found to be 0.82. The findings of the study revealed that there was a great difference between the teachers' perception of how the English language should be taught and their actual practices in the classroom. [ABSTRACT FROM AUTHOR]

With many advantages over well-established methods, laser induced breakdown spectroscopy (LIBS) has emerged as a useful analytical technique for the compositional analysis of multi-elemental geological materials. In this study, LIBS was employed for qualitative and quantitative analysis of a rare mineral, astrophyllite, bearing precious elements of industrial and technological interest. The experiment was carried out using second harmonic generation of Nd:YAG laser of pulse width 5 ns and repetition rate of 10 Hz. Microplasma was produced by focusing laser beam on an astrophyllite target, and optical emissions from the generated plasma were recorded in the spectral range of 200–720 nm with the help of a LIBS2000+ detection system. On analyzing the optical spectra, existence of 15 elements in astrophyllite target were revealed. These elements include: Ti, W, Ag, Al, Ba, Ca, Cr, Cu, Fe, Li, Mg, Na, Ni, Si and H. For quantification, calibration-free method was used. Only ten elements, namely Ti, W, Fe, Cr, Cu, Ca, Mg, Ni, Si and Al, were quantified with relative weight concentrations of 55.39%, 18.79%, 18.30%, 4.05%, 2.66, 0.43%, 0.18%, 0.12%, 0.06% and 0.02%, respectively. To benchmark these results, XRF analysis was performed, which confirmed the presence of all the elements detected in the optical spectrum of the sample, except for Na, Li, and H. The concentrations of these ten elements as measured by XRF were in reasonable agreement, especially for the major elements. The presence of a significant amount of Ti and W in an astrophyllite sample, found in Pakistan, highlights the economic value of this mineral. This study may be of further interest in commissioning LIBS technology for exploration of minerals in the region. [ABSTRACT FROM AUTHOR]

In this study, we developed a new hybrid mathematical model that combines wind-speed range with the log law to derive the wind energy potential for wind-generated hydrogen production in Pakistan. In addition, we electrolyzed wind-generated power in order to assess the generation capacity of wind-generated renewable hydrogen. The advantage of the Weibull model is that it more accurately reflects power generation potential (i.e., the capacity factor). When applied to selected sites, we have found commercially viable hydrogen production capacity in all locations. All sites considered had the potential to produce an excess amount of wind-generated renewable hydrogen. If the total national capacity of wind-generated was used, Pakistan could conceivably produce 51,917,000.39 kg per day of renewable hydrogen. Based on our results, we suggest that cars and other forms of transport could be fueled with hydrogen to conserve oil and gas resources, which can reduce the energy shortfall and contribute to the fight against climate change and global warming. Also, hydrogen could be used to supplement urban energy needs (e.g., for Sindh province Pakistan), again reducing energy shortage effects and supporting green city programs. [ABSTRACT FROM AUTHOR]

A new species, Subancistrocerus pakistanensis Qasim, Carpenter et Rafique sp. nov. is described and illustrated from Pakistan, based on several specimens collected in the Multan Region. Genus Subancistrocerus is recorded for the first time from Pakistan. [ABSTRACT FROM AUTHOR]

This paper spotlights whether gross domestic product (GDP), energy consumption and urbanization affect Carbon dioxide (CO2) emissions covering the time span 1972-2014 in Pakistan. The empirical estimates of autoregressive distributed lag (ARDL) affirmed that energy consumption and GDP are the main drivers of the pollutant environment in Pakistan, and also quantitatively determine the definite impact percentage of each dynamic force in Pakistan. Specifically, the empirical findings determine that in the long run, energy consumption and GDP intensify CO2 emissions showing significant impact; however, industrialization and urbanization are found to be insignificant. Based on empirical findings, this suggests that the constricting economic gap implementation between urban and rural areas, amendments to the energy erection and mechanical novelty will offer a treasured reference for Pakistan in exertions to diminish carbon emissions. [ABSTRACT FROM AUTHOR]

Background: Dysphagia results from impeded transport of liquids, solids, or both from the pharynx to the stomach. Among the malignant lesions, carcinoma of oesophagus is the commonest cause. Our objective was to find out the frequency of different endoscopic lesions and outcome of the endoscopic therapeutic interventions in patients presenting with dysphagia., Methods: This descriptive study was conducted at Department of Gastroenterology, Military Hospital Rawalpindi from June 2008 to May 2009. Patients of dysphagia after their consent were interviewed about the symptoms. Relevant biochemical investigations were done. Barium swallow and upper Gastrointestinal (GI) Endoscopy were carried out. Benign strictures were dilated with Savary Gilliard Dilators. Malignant strictures were further evaluated to decide treatment plan. In patients considered to have oesophageal dysmotility, pressure manometery was done before specific therapy., Results: Seventy nine patients were enrolled. Twenty-five had malignant strictures, out of those commonest was adenocarcinoma 14 (56%). Twenty-nine had benign strictures the commonest being Gastro-oesophageal Reflux Disease (GERD) related peptic stricture 9 (31%). Fifteen had oesophageal dysmotility, and achalasia was present in 10 out of them. After evaluation 12 out of 25 patients with malignant strictures were considered fit for surgery. Self-expanding metal stents (SEMS) were passed in 5. All benign strictures were dilated with Savary-Gillard dilators. Pneumatic balloon dilation was done in patients of achalasia., Conclusion: The commonest malignant lesion resulting in dysphagia was adenocarcinoma while in benign it was GERD related peptic stricture. Achalasia was most frequent in oesophageal motility disorders. Standard of treatment for early oesophageal malignancy is surgical resection. SEMS is a reliable way to allay dysphagia in inoperable cases. Savary Gillard dilatation in benign, and pneumatic balloon achalasia dilatations are effective ways of treatment.

Introduction: The healthcare systems of developing countries are complex in that they often accommodate a range of disparate and often competing paradigms of care. This is the case in Pakistan where Indigenous traditional medicine (TM) co-exists with Western allopathic medicine and, in theory at least, with 'globalised' complementary and alternative medicines (CAM). To date we know little about what treatments are being chosen and why in this still predominantly rural country., Aim: To gain a preliminary understanding of patterns of usage of traditional medicine and globalised complementary and alternative medicine by cancer patients in Pakistan., Method: Structured survey of 362 cancer patients, from diverse regions in the Punjab and North-west Frontier Province provinces, who were being treated in four different hospitals in Lahore, Pakistan., Results: Use of traditional medicine is high amongst cancer patients, with many patients using a combination of different therapeutic modalities. Unlike studies in Western contexts, this study indicated no relationship between cancer type or sex and use of CAM/TM. However level of education was influential in determining usage of particular TM. There is, however, no uniformity in patterns of use of different TM., Conclusion: There is less differentiation between social groups in usage of CAM and TM in Pakistan than has been reported in studies of western cancer patients. Differing levels of use for specific TM highlight the need to get beyond monolithic categorizations (such as TM) to understand use patterns for specific indigenous practices (in their social and cultural context).