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Objectives: To assess the prevalence, pattern, and associated factors of dyslipidemia in patients with coronary artery disease (CAD) in the Northwest region of Pakistan. Method: A cross-sectional secondary data analysis was performed on CAD patients visiting cardiology clinics in selected hospitals from July to December 2019. A total of 362 patients were included via consecutive sampling. Dyslipidemia was operationalized according to the “National Cholesterol Education Program (NCEP ATP III) guidelines”. Results: Mixed dyslipidemia was recorded in 92.26% of the patients, while isolated dyslipidemia was observed in 5.24%. A high prevalence of combined dyslipidemia with increased LDL-C, TG, and low HDL-C was noted. Contrarily, elevated LDL-C was the commonest single lipid disorder (84.25%). Hypercholesterolemia was the least common disorder. Increasing BMI was found to be independently associated with hypercholesterolemia (OR: 1.19). Similarly, age (OR: 0.97) and being a rural resident (OR: 2.61) were independent factors associated with hypertriglyceridemia. Furthermore, being an urban resident (OR: 2.25) and increasing BMI (OR: 1.77) were also significantly associated with high LDL-C. Conclusion: Mixed dyslipidemias were observed in the majority of the patients. Age, BMI, and residence were noted to be independently associated with abnormal lipids. Early screening and proper management should be encouraged to minimize this significant cardiovascular risk. [ABSTRACT FROM AUTHOR]

As a country, Pakistan is mostly dependent on fossil fuels for fulfilling its energy demand, which is expensive, as well as being environmentally unfriendly. It is high time that the country decides to shift from fossil fuels to renewable energy resources like geothermal, wind, solar, etc., to cater for global warming issues. Pakistan has a lot of potential geothermal sites, as the location of Pakistan lies on several fault lines and hot springs, thus making it very easy to extract the temperature from deep inside the earth and harness it for Geothermal Energy. Also, a sound knowledge of ground temperature is essential to use geothermal energy, which is obtained by drilling boreholes and putting in sensors. However it becomes a very expensive and labor intensive procedure. Therefore, to avoid the huge cost for drilling boreholes, particularly for ground temperature analysis, a numerical approach has been considered for determining ground temperature. Furthermore, correlation charts between air and ground temperatures have been developed, as there were no proper studies on the ground temperature of Pakistan. Then, with the help of a boreholes drilled in the National University of Sciences and Technology, Islamabad, Pakistan, the actual ground and numerically calculated temperatures have been compared. The results show a temperature error margin in the range between 0.27% for higher depths of about 5.6 m and 7.3% near the surface of about 2.7 m. Thus, it is shown that the proposed method is easy to implement and better than large scale testing methods for the depths at which geothermal energy is extracted. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the types of Shariah capabilities of Islamic banks, which provide bases for the types of Shariah value propositions, offered by the relationship managers in their front-line service experiences with the customers. Design/methodology/approach: A resource-based view of Shariah capabilities and a service-dominant logic view of value propositions are adopted. Fifteen relationship managers from multiple Islamic banks in Pakistan are interviewed to find a typology of Shariah capabilities and a resultant typology of value propositions for Islamic banks. Findings: The findings suggest that Islamic banks claim to possess five types of Shariah capabilities, namely, Shariah governance capability (SGC), Shariah compliance capability (SCC), Shariah monitoring capability (SMC), Shariah structuring (product) capability (SSC) and Shariah learning capability (SLC). These capabilities lead to four types of values propositions, namely, Shariah identity value (SIV), Riba-free value (RFV), Shariah disclosure value (SDV) and Tangibility value (TV) of the real assets in transactions. Research limitations/implications: The study has relied on the front-line experiences of relationship managers who are connected to the Islamic banks' capabilities inside the banks and the value propositions that they offer to show relationships with customers in front-line service experiences. Other stakeholders may have different perspectives on both capabilities and value propositions. Originality/value: This paper contributes to Islamic finance theory by theoretically and empirically showing two typologies for the Islamic banks' capabilities and value propositions, respectively. [ABSTRACT FROM AUTHOR]

PURPOSE: Cataract surgical rate (CSR) (cataract surgeries performed per million population) is an eye health indicator that helps assess the state of eye care services. A survey in 2002 revealed a CSR of 2254. The current survey aimed to establish a new and sustainable development goal compliant baseline for the volume of cataract surgery performed by different service providers in Pakistan at district, provincial, and national levels. METHODS: The survey was commissioned by the National Committee for Eye Health under the Ministry of National Health Services, Regulations and Coordination. The methodology used for the survey included identification and mapping of all service providers by district and category and data collection from all districts in the country. RESULTS: There were more cataract surgeries performed in women than men with a male-to-female ratio of 0.95. About 98.9% of all cataract surgeries were performed with intraocular lenses, while 63.9% were performed by phacoemulsification. About 17.7% of cataract surgical services were provided in the government sector (including Forces), while nongovernmental organizations and the private sector contributed to 82.3%. Pakistan achieved a national CSR of 5307 which is almost double the CSR determined in 2002. CONCLUSION: In order to achieve a CSR of 7500+ by 2030, there is a need for at least 1,840,000 cataract surgeries to be performed annually. If there is no change in the current annual cataract surgical output, the CSR will drop to 4628 by 2030. [ABSTRACT FROM AUTHOR]

Banking industries are blamed to be among the major factors that affect global climate change both directly and indirectly. The green banking concept has emerged in the last decade to trigger the adverse impact the banks put on a healthy environment. However, research regarding the adoption of green banking practices in developing economies, especially in Pakistan, is scarce. While environment friendly businesses are promoted by the government including in the banking industry. Green banking practices not only adopted by the business operations but also to practice it at policy-making level. It also encourages green project financing to ascertain environmental efficiency. Based on SRI theory, this study investigates the relationship between green banking practices and their direct and indirect impact on environmental performance. Structural equation modelling approach has been adopted to test the relationships of variables of the study. The impact of the green practices has been recognized much greater and influential in promoting green environment regarding policy-making and investments in green projects. Results reveal that there is a significant influence of policy, daily operations, and investments on the adoption of green banking practices. Interested parties can adopt the study proposed framework to access and identify the factors which can promote justified level of green banking practices in the country. Moreover, this study may help in providing rich updated literature in green banking to speed up future research in the same area. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to spotlight and explore various determinants of Islamic social reporting (ISR) in Islamic banks of Pakistan. Design/methodology/approach: The authors have used firm size, firm profitability, firm age, board size and board independence as determinants of ISR. The authors collected data from Islamic banks listed on Pakistan Stock Exchange for the period 2012–2019. Multiple estimation techniques, i.e. fixed effect model, random effect model and one-step difference generalized method of moment (GMM), have been applied. Findings: Random effect model was found to be more robust as compared to fixed effect model and one-step difference GMM. The results reported by the random effect model, preferred among the three, show that firm size, firm profitability, firm age and board size are important determinants of ISR in Islamic banks of Pakistan, while board independence does not determine social reporting for Islamic banks in Pakistan. Although social reporting in annual reports of Islamic banks in Pakistan is increasing, further improvement and compliance is required to ensure accountability and transparency in financial reporting as recommended by Islamic teachings. The study has certain managerial implications, especially for top management of Islamic banks. Originality/value: To the best of the authors' knowledge, this study is the first to discuss determinants of ISR in Islamic banks of Pakistan. The developed framework herein provides a precise guideline for Islamic banking to enhance their performance, which has never been discussed before. [ABSTRACT FROM AUTHOR]

The behavioural biases impact the decision-making of individual investor in the stock market, hence, modern finance theories presumed that investor does not make a rational decision. This research paper aims to examine the impact of behavioral factors on environmental issues regarding individual investor's decision-making in the Stock Market of Pakistan. The data was collected from five provinces of Pakistan through adapted questionnaires; a sample size of 421 individual investors of the Pakistan stock market. This study applied the Structural Equation Model (SEM) using SmartPLS to analyze the influence of individual investor's behavioural factors on environmental issues. This study finding showed that overconfidence, loss aversion, mental accounting, and herding biases of individual investors positively affect investment decisions on environmental issues. This study attempts to fulfil the gap by analyzing behavioral factors and environmental issues in the Pakistan stock market. However, the current study contributes to the existing literature on behavioral finance and environmental issues in the Pakistan stock market. Furthermore, the current study will be useful for financial professionals, regulatory authorities, or investment advisors, academia as well as practitioners. [ABSTRACT FROM AUTHOR]

Purpose: Previous phases of trachoma mapping in Pakistan completed baseline surveys in 38 districts. To help guide national trachoma elimination planning, we set out to estimate trachoma prevalence in 43 suspected-endemic evaluation units (EUs) of 15 further districts. Methods: We planned a population-based trachoma prevalence survey in each EU. Two-stage cluster sampling was employed, using the systems and approaches of the Global Trachoma Mapping Project. In each EU, residents aged ≥1 year living in 30 households in each of 26 villages were invited to be examined by trained, certified trachoma graders. Questionnaires and direct observation were used to evaluate household-level access to water and sanitation. Results: One EU was not completed due to insecurity. Of the remaining 42, three EUs had trichiasis prevalence estimates in ≥15-year-olds ≥0.2%, and six (different) EUs had prevalence estimates of trachomatous inflammation—follicular (TF) in 1–9-year-olds ≥5%; each EU requires trichiasis and TF prevalence estimates below these thresholds to achieve elimination of trachoma as a public health problem. All six EUs with TF prevalences ≥5% were in Khyber Pakhtunkhwa Province. Household-level access to improved sanitation ranged by EU from 6% to 100%. Household-level access to an improved source of water for face and hand washing ranged by EU from 37% to 100%. Conclusion: Trachoma was a public health problem in 21% (9/42) of the EUs. Because the current outbreak of extremely drug-resistant typhoid in Pakistan limits domestic use of azithromycin mass drug administration, other interventions against active trachoma should be considered here. [ABSTRACT FROM AUTHOR]

Credit risk evaluation is getting importance due to competition and also the Basel requirements. This study is based on the evaluation of credit scoring models for retail bank loan customers of Askari Bank Limited in Pakistan. Credit risk models further brings efficiency in the evaluation of a loan application which ultimately reduces the overall risk of bank and also reduces the probability of default on loans. This study has used three credit scoring models of logistic regression, discriminant analysis and probit analysis for the evaluation of credit applicants. The ranking criteria for ranking among the various models is based on the average correct classification rate. Therefore, the ranking shows that probit analysis techniques has the highest average correct classification rate while Logistic regression technique has the lowest average correct classification rate. These statistical credit scoring approach further augments the judgmental approach of credit application evaluation procedure. Further studies can be carried out on an extended data sample of retail loans. Other important variables can be included in the model to further improve the validity of the credit evaluation procedure according to the regulatory requirements. The statistical procedures of decision trees and neural networks can also be applied in credit scoring procedures to further make it more authentic and reliable. [ABSTRACT FROM AUTHOR]

Introduction: At the time of independence, eye care services were provided by a few Christian missionary hospitals, Government hospitals and a few family owned Cottage hospitals. In 1950s and 60s, new eye departments were established in Karachi, Multan & Peshawar and also at Armed Forces' hospitals. In spite of this, no organized eye care services were available to 80% of the population. Prof Hugh Taylor, a WHO Consultant, conducted a survey in 1980 only to find out that there was a gross human resource mismatch in Pakistan. Another survey and situational analysis carried out in 1998 showed a lack of trained manpower at all levels with poorly organized services and infrastructure at district level and a total lack of eye care services at THQ hospitals, Rural Health Centres and Basic Health Units. There was no referral pathway from primary level onwards. Methodology: The results of the situational analysis led to development of a new National Plan. The guiding document in this regard was Vision 2020 - "The Right to Sight" initiative. The main objectives were provision of latest technology for eye care, development of infrastructure, training and deployment of Human Resource (HR) at different levels of health careto provide eye care services to poor, at their door step. Provision of equipment and up gradation of infrastructure was planned for 7 centers of excellence, 20 tertiary teaching eye departments, 63 DHQ Hospitals and 147 THQ Hospitals across the country with creation of posts of ophthalmologists, subspecialists and allied vision sciences personnel at different levels of health care. Results: The results of these interventions show that 37 medical institutions for eye care have produced more than 2300 ophthalmologists with 46 vitreo-retina (VR) specialists, 30 paediatric ophthalmologists and 92 community ophthalmologists. There are also 20 institutions training allied vision personnel that have trained 1568 optometrists, 50 orthoptists, 84 investigative oculists, 56 refractionists, 150 ophthalmic nurses & 1568 ophthalmic technicians. Eye units at 33 out of 47 tertiary hospitals and 94 out of 131 DHQ Hospitals have been upgraded while 96 out of 147 THQ Hospitals have new eye departments. Posts of ophthalmologists, and allied vision personnel have been created at different tiers of eye care. The impact has been 97% increase in OPD attendance, 94% more access by females, 82 % increase in surgeries and 78% increase in intraocular lens implants. At the present time, cataract surgeries are being done with no or minimal cost to the patients, trachoma is near eradication, blindness due to glaucoma and diabetes is being prevented due to early screening and low vision devices are being provided to people with vision impairment. Similarly, people with complicated vitreo-retinal disorders and children with eye disorders are being treated at sub specialty centres. In the next 5 years, it is planned to establish eye screening and service delivery centres at rural health centres (RHCs) with creation of posts and provision of equipment, training of nutrition supervisors and school teachers in vision screening & provision of portable eye examination kit (PEEK) to LHWs with referral to RHCs/THQs. [ABSTRACT FROM AUTHOR]

This study was aimed at assessing the extent of disclosure in commercial banks of Pakistan and making comparison between the information disclosure of large commercial banks and small commercial banks. The study used five large commercial banks and five small commercial banks for comparison purposes. Data was collected from their published annual reports using content analysis technique for thirty seven items disclosure index. This disclosure index included thirteen items for financial disclosure and twenty four items for non financial disclosure. The findings of this study reveal that small banks in Pakistan are more efficient in disclosing information than large commercial banks. Among the ten commercial banks selected for this study Faysal Bank Ltd has the highest disclosure compliance level of 82.7% while Habib Bank Ltd has lowest level of disclosure compliance level of 54.3 %. The independent sample T-Test also suggest that there is difference in means of disclosure between small banks and large banks in Pakistan, the mean of corporate information disclosure of small banks is 0.047 (4.7%) more than large banks sample. This study provides an insight to investors, policy makers and regulatory bodies in Pakistan like Securities and Exchange Commission of Pakistan (SECP) and State Bank of Pakistan (SBP) with respect to extent of corporate information disclosure level of commercial banks in Pakistan. [ABSTRACT FROM AUTHOR]

A pot study was carried out at the Institute of Soiland Environmental Sciences,. University of Agriculture, Faisalabad, Pakistan during the year 2008 to evaluate the effect of phosphorus with and without rhizobium inoculation on mungbean crop. Four levels of P fertilizers (50% of recommended dose, recommended dose, 150% of recommended dose) were applied by using SSP @1.2, 2.4 and 3.6 g per 14 kg of soil, respectively. Layout system was 2 factorial completely randomized design with six repeats. The results revealed that 150 percent of recommended P dose with rhizobium inoculation increased P concentration significantly in roots (0.113), shoots (0.223), grains (0.300) and P uptake (25.19 mg/plant). The same treatment also significantly increased nitrogen concentration in roots (1.74), shoots (1.79), grains (4.14) and N uptake (290.06 mg/plant). The results further showed that inoculation with rhizobium increased nitrogen fixation in mungbean crop. The combination of phosphorus and inoculation showed maximum positive effect on nitrogen and phosphorus concentration and their uptake by plants. [ABSTRACT FROM AUTHOR]

purpose To determine the prevalence of non-vision-impairing ocular conditions (NVIC) and estimate the number of primary eye care treatments per 1000 population per month. methods A cross-sectional study in a random sample of 1670 people was done to determine the load of NVIC in a village in Chakwal district. results The prevalence of NVIC was 30.6% (306 per 1000 population). NVIC with the exclusion of presbyopia accounted for 14.6%. The main NVIC were allergic conjunctivitis (3.7%), bacterial conjunctivitis (3.5%), pterygium/pinguicula (2.6%) and acute/chronic dacryocystitis (1%). The average Complaint Frequency (CF) per month/1000 population was 55, excluding complaints of near vision and watery eyes. conclusions The foundation of a comprehensive district eye care strategy in the light of VISION 2020 - the Right to Sight - remains an effective primary eye care service whose elements are treatment of NVIC, detection and referral of cataracts and refractive errors, and promotion of eye health. [ABSTRACT FROM AUTHOR]

AIM To present the results of a rapid assessment of cataract surgical services in Chakwal District, Pakistan. METHODS 40 clusters of 40 persons of 50 years and older (1600 eligible persons) were selected by systematic random sampling from the entire Chakwal district. A total of 1505 persons were examined (coverage 94%). RESULTS Cataract is the major cause of bilateral blindness (46.5%). The age and sex adjusted prevalence of bilateral cataract blindness (VA < 3/60) in people of 50 years and older was 2.0% (95% CI: 1.2-3.2%), with a cataract surgical coverage of 92% for males and 73% for females, a significant difference. The prevalence of bilateral cataract and VA < 6/60 in persons of 50 years and older was 5.1% (95% CI: 3.6-6.9), an estimated total of 8833 persons. In this last group, the surgical coverage was 66% (persons) and 50% (eyes). Of the patients operated with IOL implantation, 12% could not see 6/60, while 36% of those operated without IOL could not see 6/60. 'No services' (18%) and 'cannot afford' (18%) were mentioned most as reasons why surgery had not been done, followed by 'no information' (13%), 'waiting for maturity' (12%) and 'old age, no need for surgery' (12%). CONCLUSION The number of cataract operations in Chakwal District can be increased by reducing the threshold for cataract surgery to VA < 6/60 or less. A special approach to operate more females may be required. Results from this survey can be used for a planning exercise to optimize eye care services in the district. Sustained efforts have to be made to increase the number of IOL surgeries, through making IOL surgery available locally at an affordable cost. [ABSTRACT FROM AUTHOR]

The long-term power planning at the regional level has recently gained significance due to the economic and efficiency competitiveness of a decentralized energy system. In Pakistan, the power sector faces the challenge of exceptionally increasing electricity demand in metropolitan areas and the urgency of reliable power access in rural areas. In this paper, a regional power-generation system of GB is developed using the LEAP (Long-range Energy Alternative Planning) model from 2016 to 2050, to explore future clean pathways to understand the planning and operational implications of futuristic variable renewables (VRE) and best available technologies (BAT). The regional power system model is further expanded by using the end-user and econometric approaches to construct five scenarios which include Business-As-Usual (BAU), BAU-OPT (BAU-optimization), Demand Side Management (DSM), DSM-OPT, and National Energy Mix (NEM). The model estimates the electricity demand projection of 3.2 TWh in 2050, at an annual average growth rate of 3.19%, and suggests that hydropower is the most dominant variable renewable source in GB's electric power system. The adoption of the BAT would avoid 1.34 TWh or about 41% of the projected electricity consumption, which shows the maximum potential of energy efficiency measures in GB. Moreover, the results indicate that: i) home appliances and lighting account for nearly halved of the reduction potential; while lighting and cooking are the most cost effective measures in terms of energy saving at regional level; ii) least cost constraint displays the transition towards large scale renewable projects; iii) the penetration of small scale renewable project is nearly doubled under least cost constraint by the introduction of demand side measures; and iv) higher emission penalties aggressively shift energy mix toward renewables with the cost of annual environmental externalities reducing in long-term. Overall, these findings can provide a scientific basis for the sustainable development of regional power-generation systems, as well as co-benefits of penetration of VRE and BAT in low-carbon electric power regions. • RE-EEM (Renewable Energy-Energy Efficiency Measures) interactions are modeled for power sector. • 41% reduction potential with the adoption of BAT at regional level. • Faster transition to multi-scale renewable projects with incorporation of BAT. • Development of Marginal Abatement Cost Curve (MACC) at regional level to assess the cost effectiveness of measures. [ABSTRACT FROM AUTHOR]

This study was carried out to investigate the effects of foreign remittances on social festivities by the beneficiary households in District Kurrum, Khyber Pakhtunkhwa Province of Pakistan. A total of 206 households were selected by using the proportional allocation sampling technique. A semi-structured questionnaire was used to collect data. The effects of foreign remittances on social festivities were determined by using multiple regression analysis. Results of the regression model show that foreign remittances have a positively significant effect on social festivities as confirmed by the coefficient of 0.739 and p<0.000. ANOVA for regression was also performed to check the overall significance of the model. The results of ANOVA confirmed that the estimated model was highly significant as shown by the F-values greater than the critical value and p<0.001. The study concludes that foreign remittances are very important sources of households' participation in social festivities. [ABSTRACT FROM AUTHOR]

Purpose: Cataract surgical rate (CSR) (cataract surgeries performed per million population) is an eye health indicator that helps assess the state of eye care services. A survey in 2002 revealed a CSR of 2254. The current survey aimed to establish a new and sustainable development goal compliant baseline for the volume of cataract surgery performed by different service providers in Pakistan at district, provincial, and national levels., Methods: The survey was commissioned by the National Committee for Eye Health under the Ministry of National Health Services, Regulations and Coordination. The methodology used for the survey included identification and mapping of all service providers by district and category and data collection from all districts in the country., Results: There were more cataract surgeries performed in women than men with a male-to-female ratio of 0.95. About 98.9% of all cataract surgeries were performed with intraocular lenses, while 63.9% were performed by phacoemulsification. About 17.7% of cataract surgical services were provided in the government sector (including Forces), while nongovernmental organizations and the private sector contributed to 82.3%. Pakistan achieved a national CSR of 5307 which is almost double the CSR determined in 2002., Conclusion: In order to achieve a CSR of 7500+ by 2030, there is a need for at least 1,840,000 cataract surgeries to be performed annually. If there is no change in the current annual cataract surgical output, the CSR will drop to 4628 by 2030., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Middle East African Journal of Ophthalmology.)

Objective: To determine the frequency of inducible clindamycin resistance in clinical isolates of Staphylococcus species by phenotypic D-test., Study Design: Observational study., Place and Duration of Study: Ziauddin University Hospital, Karachi, from July to December 2011., Methodology: Consecutive clinical isolates of Staphylococcus species were collected and identified by conventional microbiological techniques. Antimicrobial susceptibility testing and inducible clindamycin resistance was carried out by performing D-test using CLSI criteria. Methicillin resistance was detected by using Cefoxitin disk as a surrogate marker. Statistical analysis was performed by SPSS version-17., Results: A total of 667 clinical isolates of Staphylococcus species were obtained during the study period. In these isolates, 177 (26.5%) were Staphylococcus aureus, and 490 (73.5%) were coagulase negative Staphylococci. The total frequency of inducible clindamycin resistance among isolates of Staphylococcus species was 120/667 (18%). Frequency of inducible clindamycin resistance among coagulase negative Staphylococci group and Staphylococcus aureus group were 18.57% and 16.38% respectively. Median age of patients in D-test positive group was 19.5 (1 - 54) years., Conclusion: The frequency of inducible clindamycin resistance among Staphylococcus species may differ in different hospital setup. Clinical microbiology laboratories should implement testing simple and effective D-test on all Staphylococcus species. D-test positive isolates should be reported clindamycin resistant to decrease treatment failure.

Naegleria fowleri is a free living parasite which habitats in fresh water reservoirs. It causes a fatal nervous system infection known as primary amoebic meningoencephalitis by invading through cribriform plate of nose and gaining entry into brain. We report a case of primary amoebic meningoencephalitis caused by Naegleria fowleri in Karachi, Pakistan, in a 42 years old male poultry farm worker having no history of swimming. Clinical course was fulminant and death occurred within one week of hospital admission. Naegleria fowleri was detected by wet mount technique in the sample of cerebrospinal fluid collected by lumbar puncture of patient. This is a serious problem and requires immediate steps to prevent general population to get affected by this lethal neurological infection.

Objective: To determine the frequency of extended-spectrum beta lactamase (ESBL) producing Enterobacteriaceae in urinary isolates., Study Design: Observational study., Place and Duration of Study: Ziauddin University Hospital, Karachi, from February to October 2008., Methodology: All members of Enterobacteriaceae isolated from urinary samples of in-patients were included and identified using standard biochemical tests. Urinary samples from out-patients were excluded. Detection of ESBL was carried out by double disk diffusion technique. Statistical analysis was performed by SPSS version 10., Results: A total of 289 isolates of Enterobacteriaceae were identified during the study period. Of those 190/289 (65.7%) of the isolates were found to be ESBL producing. ESBL positivity within individual organism group was highest in Klebsiella species 84.16%, followed by Escherichia coli 68.55%, Enterobacter species 36.84%, and Proteus mirabilis 28.55%. Mean age of patients with ESBL producing organisms was 58.69 ± 18.97 years. ESBL production was almost similar in all age groups., Conclusion: A high frequency of ESBL producing organisms especially Klebsiella species and Escherichia coli amongst the hospital obtained urinary isolates was documented particularly in the older age group. The data points towards an urgent need for regular screening and surveillance for ESBL producing organisms in this region.

During a large outbreak of dengue serotype 3 in Pakistan in 2006, multiple serum samples were routinely collected for laboratory testing. Two hundred ninety-seven samples were collected between August and November 2006. Serological testing for dengue IgM was performed in Pakistan and polymerase chain reaction (PCR) testing for dengue RNA detection and serotyping were performed in Hong Kong. Dengue-specific IgM was detectable as early as 1 day, and dengue RNA remained detectable for up to 14 days, post-onset of illness. Further statistical analysis found that IgM status (positive, negative, or equivocal) was significantly correlated to clinical (duration of illness, severity of patient-reported arthralgia pain, the presence of any evidence of bleeding, a positive tourniquet test, shock), and other laboratory (platelet and total white cell counts) parameters. In contrast, the qualitative dengue RNA status (PCR positive or negative) was not statistically significantly correlated with any of these other parameters. The results for this population during this outbreak, obtained from single acute samples, demonstrate a wide range of intervals post-onset of illness during which dengue IgM and dengue RNA may be detected. Interestingly, in this study, the dengue IgM positivity correlates more closely with significant clinical illness than the dengue RNA positivity, which may be a feature specific to this particular outbreak.

Introduction: To compare the conventional creatinine clearance measured on 24-h urine collection with the estimated Glomerular Filtration Rate by Cockcroft & Gault (CG) and Modification of Diet in Renal Disease (MDRD) prediction equations in adults aged 20 years and above in Pakistani population., Methods: All the patients, including inpatient admitted in hospital and outpatients, more than 20 years of age, reporting for the test of creatinine clearance in clinical chemistry department of Dr. Ziauddin Hospital clinical laboratory from 1st January to 31st December 2006 were studied., Results: Comparison was made between conventional creatinine clearance and Cockcroft & Gault (CG) and Modification of Diet in Renal Disease (MDRD) prediction equations on 369 cases which revealed strong correlation with conventional creatinine clearance, MDRD equation has better correlation as compared with Cockcroft- Gault creatinine clearance. Statistical correlation was better in cases where serum creatinine was more than 1.50 mg/dl (r = 0.625 for Cockcroft- Gault creatinine clearance and r = 0.724 for MDRD equation) as compared when serum creatinine levels were less than 1.50 mg/dl (r = 0.608 for Cockcroft- Gault creatinine clearance and r = 0.596 for MDRD equation). There was positive bias in both calculated GFRs from conventional creatinine clearance in healthy as well as diseased population., Conclusion: The creatinine based formulas with their inherent property of convenience and cost effectiveness can be a useful tool for monitoring the progression of disease. They can be applied in clinical practice on our population but they should be interpreted with caution as they over estimate the GFR.