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Colorectal cancer (CRC) is the third most common cancer in the USA and worldwide. In the USA, nearly one-third of CRC cases are anatomically classified as rectal cancer. Over the past few decades, continued refinement of multimodality treatment and the introduction of new therapeutic agents have enhanced curative treatment rates and quality of life outcomes. As treatments improve and the incidence of young onset rectal cancer rises, the number of rectal cancer survivors grows each year. This trend highlights the growing importance of rectal cancer survivorship. Multimodality therapy with systemic chemotherapy, chemoradiation, and surgery can result in chronic toxicities in multiple organ systems, requiring a multi-disciplinary care model with services ranging from appropriate cancer surveillance to management of long-term toxicities and optimization of modifiable risk factors. Here, we review the evidence on these long-term toxicities and provide management considerations from consensus guidelines. Specific topics include bowel dysfunction from radiation and surgery, oxaliplatin-induced neuropathy, accelerated bone degeneration, the impact of fluoropyrimidines on long-term cardiovascular health, urinary incontinence, sexual dysfunction, and psychosocial distress. Additionally, we review modifiable risk factors to inform providers and rectal cancer survivors of various lifestyle and behavioral changes that can be made to improve their long-term health outcomes.

There is a dearth of knowledge regarding transmission of

Background: Racial inequities for patients with heart failure (HF) have been widely documented. HF patients who receive cardiology care during a hospital admission have better outcomes. It is unknown whether there are differences in admission to a cardiology or general medicine service by race. This study examined the relationship between race and admission service, and its effect on 30-day readmission and mortality Methods: We performed a retrospective cohort study from September 2008 to November 2017 at a single large urban academic referral center of all patients self-referred to the emergency department and admitted to either the cardiology or general medicine service with a principal diagnosis of HF, who self-identified as white, black, or Latinx. We used multivariable generalized estimating equation models to assess the relationship between race and admission to the cardiology service. We used Cox regression to assess the association between race, admission service, and 30-day readmission and mortality. Results: Among 1967 unique patients (66.7% white, 23.6% black, and 9.7% Latinx), black and Latinx patients had lower rates of admission to the cardiology service than white patients (adjusted rate ratio, 0.91; 95% CI, 0.84–0.98, for black; adjusted rate ratio, 0.83; 95% CI, 0.72–0.97 for Latinx). Female sex and age >75 years were also independently associated with lower rates of admission to the cardiology service. Admission to the cardiology service was independently associated with decreased readmission within 30 days, independent of race. Conclusions: Black and Latinx patients were less likely to be admitted to cardiology for HF care. This inequity may, in part, drive racial inequities in HF outcomes.

In Professor Wexler’s “bottle-liquid” metaphor, the legal landscapes or legal structures are “bottles,” and the roles, behaviors, practices and techniques used by legal actors (judges, lawyers, therapists) are “liquid”. Within this framework responsive judging requires judges to use Therapeutic Jurisprudence (TJ) practices to promote procedural fairness and better outcomes. However, enabling judicial responsiveness may also require legislative changes consistent with therapeutic design. This Chapter describes changes made in Pakistan, where the Juvenile Justice System Ordinance 2000, the Control of Narcotics Substance Act 1997 the Criminal Procedure Code 1898 and probation law contain therapeutic provisions. These laws, thus, are therapeutic in design—the bottles. However, the practice in trial courts and the decisions of constitutional courts suggest that there exists no mechanism and training regime for judges, prosecutors and lawyers to provide them with guidance into the humane side of law, i.e., TJ application—the liquid. This paper will provide a TJ “audit” of these Pakistani laws in accordance with the Therapeutic Design of Law (TDL) and Therapeutic Application of Law (TAL). It gives examples of judicial education concerning TJ in the form of joint lectures of the author and Professor Dr. David B. Wexler (who was available through Skype) at the Punjab Judicial Academy. The paper also discusses TJ literature produced in Pakistan, including reference to some court opinions, in relation to mainstreaming therapeutic jurisprudence practice.

This paper is written to narrate the history of therapeutic jurisprudence with respect to Pakistani legal and judicial system. The style of the paper also covers the email communication between the author and Prof David B Wexler being father of the TJ. Likewise, emails with other TJ practitioners around the globe are also part of this writing. It will help readers to know how the TJ is being mainstreamed in Pakistan, what is TJ literature for local audience and how it is relevant for constitutionalism and humane side of administration of justice.

The following article focuses on the Islamic Emirate of Afghanistan Rules for the Mujahideen** to determine their conformity with the Islamic jus in bello. This code of conduct, or Layha, for Taliban fighters highlights limiting suicide attacks, avoiding civilian casualties, and winning the battle for the hearts and minds of the local civilian population. However, it has altered rules or created new ones for punishing captives that have not previously been used in Islamic military and legal history. Other rules disregard the principle of distinction between combatants and civilians and even allow perfidy, which is strictly prohibited in both Islamic law and international humanitarian law. The author argues that many of the Taliban rules have only a limited basis in, or are wrongly attributed to, Islamic law.

To investigate the percentage reactor animals to SCCIT in sheep and goat the present study was carried out by using bovine and avian PPDs at 7 Livestock Experiment Stations of Punjab and villages around two cities. The overall percentage of reactor animals to SCCIT at farms in sheep and goat was 0.9% and 2.4%, while it was 0.4% and 0.0% around two cities, respectively. Hundred percent of goat and 86% of sheep farms under study had positive reactor animals. The reactor animals to SCCIT around two cities were 0% in goat and 0.4% in sheep. Goats (P0.05) and sheep (P0.001) kept with large ruminants at farms had higher percentage of reactor animals. Age showed significant (P0.01) association with tuberculosis in sheep and goat. In goats of more than 6 years of age, the reactor animals to SCCIT were 5, 8 and 11 times higher than goats of 4.1-6, 3-4 and3 years of age. The reactor animals were significantly (P0.05) higher in goats of30kg (3.5%) and40kg (3.5%) body weights, while these were less in goats weighing between 30 and 40kg (1.5%). Sheep and goat breeds showed significant (P0.001; P0.05) difference in percentage of reactor animals to SCCIT. Beetal (3.9%) and Teddy breeds (2.9%) had 3.3 and 2.4 times higher percentages of reactor animals to SCCIT as compared to Pak-Angora (1.2%) breed. However, no animal of Nachhi and Dera Din Pinah breeds showed positive reaction to PPDs.

Suicide attacks are a recurrent feature of many conflicts. Whereas warfare heroism and martyrdom are allowed in certain circumstances in times of war, a suicide bomber might be committing at least five crimes according to Islamic law, namely killing civilians, mutilating their bodies, violating the trust of enemy soldiers and civilians, committing suicide and destroying civilian objects or properties. The author examines such attacks from an Islamic jus in bello perspective.

Stress-activated cardiac signaling cascades ultimately converge on defined transcriptional pathways that drive pathologic gene expression programs. Excessive or prolonged activation of these pathways culminates in hypertrophy, fibrosis, and contractile dysfunction. As the gene-regulatory machinery functions as a distal signal integrator in this disease process, defining mechanisms by which upstream pathways couple to chromatin-dependent signal transduction in cardiomyocytes (CMs) has been an area of intense scientific and therapeutic interest. It has long been recognized that dynamic positioning of acetyl-lysine on nucleosomal histone tails, regulated by histone acetyltransferase (HAT) and histone deacetylase (HDAC) enzymes, plays a central role in cardiac plasticity and HF pathogenesis. In this chapter, we will discuss signaling events downstream of local chromatin acetylation in the heart and their role in pathologic cardiac plasticity and HF pathogenesis. We will highlight recently published studies that implicate BET family bromodomain-containing coactivator proteins as a critical link between activated cardiac enhancers, P-TEFb (positive transcription elongation factor b), and RNA polymerase II (Pol II) dynamics in the stressed myocardium.

This work focuses on the teachings of Islamic law and violence against children, their abuse, and their exploitation. It analyses child labour under Islamic law. In addition, it considers whether a child is responsible under Islamic law if he commits crimes individually or in the company of adults. The main findings of this work are that Islam prohibits violence against children; their abuse is unlawful and their exploitation is banned. Islamic law is against child labour. Islamic law differentiates between adults and children as far as their criminal responsibilities are concerned. Child exploitation, child labour, and selling or buying children for sex are prohibited under the Pakistan Penal Code.

This work analyses the reforms carried out in some of the Muslim states regarding the issue of triple divorce in one session. According to a majority of Sunni jurists, pronouncing the word “talaq” three times in succession, equates with three “talaqs.” On the contrary, according to Ibn Taimiyah, Ibn al-Qayyim, and the Shi‘a Imamiyah, three pronouncements of the word talaq in one session equals only one talaq. Most Arab, as well as many Muslim states such as Egypt, Syria, Jordan, Iraq, Sudan, Morocco, Kuwait, Yemen, Afghanistan, Libya, Kuwait, Qatar, Bahrain, and the United Arab Emirates, have, while formulating their own laws, followed Ibn Taimiyah's and Ibn al-Qayyim's positions on this issue. In this regard, Sri Lanka's Marriage and Divorce (Muslim) Act, 1951, as amended up to 2006, seems to be the most ideal legislation on triple talaq. In Pakistan, the Muslim Family Law Ordinance 1961, has abolished triple talaq, as the procedure laid down in section 7 is largely applicable to one or two pronouncements only and excludes three pronouncements. Furthermore, some portions of section 7 are in clear contravention of the dictates of Islamic law, which adds to this precarious section's peculiarity. The superior courts in Pakistan and Bangladesh have not been consistent in interpreting the law on this important subject, while on the other hand, some Indian High Courts have treated triple talaq as invalid. يحلل هذا البحث الإصلاحات والتعديلات التي أجريت في بعض الدول الإسلامية فيما يتعلق بمسألة الطلاق ثلاث مرات في مجلس واحد. ذهب غالبية فقهاء السنة إلى أن "الطلاق" ثلاث مرات بألفاظ متتابعة يقع ثلاث طلقات. وذلك بخلاف مذهب ابن تيمية وابن القيم وأئمة الشيعة الذين يعتبرون الطلاق ثلاثاً في مجلس واحد بمثابة طلقة واحدة فقط. معظم الدول العربية وكذلك العديد من الدول الإسلامية مثل مصر، وسوريا، والأردن، والعراق والسودان، والمغرب، والكويت، واليمن، وأفغانستان، وليبيا، والكويت، وقطر، والبحرين، والإمارات العربية المتحدة، قد اتبعت أثناء صياغة قوانينها الخاصة مذهب ابن تيمية وابن القيم بشأن هذه المسألة. وفي هذا الصدد يمثل قانون الزواج والطلاق (للمسلمين) لعام 1951، في سريلانكا، بصيغته المعدّلة لعام 2006، أكثر التشريعات القانونية المثالية التي تخص طلاق الثلاث

This work analysis the various arguments put forward by the supporters of female genital mutilation (FGM) under Islamic law to find out whether this practice is Islamic or whether it is a customary or cultural tradition or is a matter of personal preference in different parts of the Muslim world where it exists. The findings of this work are that the arguments given in support of FGM are either not reliable or are weak or do not order Muslims to carry out this practice. Instead, this horrific practice is rooted in custom-cum-cultural tradition or is a matter of personal preference for some Muslims but cannot be legitimized under Islamic law.

One of the most disturbing developments in the history of warfare under Islamic law and international humanitarian law is the phenomenon of suicide attacks. In this chapter, the author focuses on their use by Muslims from the perspective of Islamic jus in bello . Historically, the first organized suicide attacks in Islam were carried out by the Nizari Isma‘ili, a Shi‘ite community. Under Islamic law “martyrdom” attacks are allowed only if the following conditions are met: they may only take place during a war; they must be carried out by combatants; the soldiers must not pretend to be non-combatants; and the attacks must not harm civilians or civilian property. The permissibility of suicide attacks and combating while feigning by the Layha are strictly prohibited in Islam. The opinions of the ‘ulamā who endorse suicide attacks are their personal opinions; they are not binding on others. Keywords:international humanitarian law; Islamic law; martyrdom; suicide attack

This work traces the history of the polluter pays principle (the PPP) in the early economic literature from 1920s. The OECD recommended the PPP as the ‘Guiding Principle Concerning the International Economic Aspects of Environmental Policies’ in 1972. In 1973 the Council of the European Communities approved the First Program of Action on the Environment and the PPP was made one of the principles of the Community environmental policy. The PPP has been mentioned as one of the principles in many regional and international conventions. Thus, the polluter pays principle is one of the most efficient principles of environmental policies.

Confidentiality issue in legal practice is part of legal ethics. Advocates are required to maintain the confidentiality of the information provided by the client. This becomes of more importance when the information is provided or shared by a woman who is victim of harassment, forced marriage, domestic violence, sexual abuse, threat of honor killing etc and who has taken shelter in darul aman (safe homes established by the government for women to provide them residence on court orders when their safety is in danger. Women can only be ordered to stay there if they consent or if they opt to stay there). Free legal aid volunteer lawyers need sensitization over the issue of confidentiality as the leakage of information may bring disastrous impacts like killing of woman or a person related to her (e.g., a man with whom she wanted to get married), injury, domestic violence and psychological depressions. Even she may loose her job or business in circumstances. This presentation made to volunteer lawyers in a seminar organized by the Punjab Bar Council, Lahore in collaboration with MDM France. It highlights that the study of legal ethics and rules/legislative instruments with therapeutic lens will help the volunteer lawyer to find out the healing capacity of laws. The lawyers were much interested, after the presentation, to know more about tj and wanted to apply the tj concepts in their professional work.In Pakistan, my experience spanning over almost a decade of introducing TJ to the lawyers, judges, law officers, court personnel, jail authorities, prosecution officers, probation officers and others is really encouraging. For this reason, I have started my presentation from introduction of TJ and how it is developing in other countries. Thereafter, the main topic was touched upon.

Based on HEC criteria, this powerpoint presentation helps us in understanding the basic requirements to get one's PhD published in Pakistan.

This power point presentation highlights important points laid down by the Hon'ble Lahore High Court with respect to powers, jurisdiction and nature of the Office of the Justice of Peace (JoP) in Pakistan. This presentation highlights key points discussed in the judgment. It will help judges, magistrates, advocates and law students to understand the ratio of judgment. The Justices of Peace can find immediate reference to the powers, jurisdiction and extent of their powers in this regard. The powers given to the district and additional district and sessions judges as ex-officio justices of peace under s.22-A and 22-B of the Criminal Procedure Code (CrPC) are the main focus of this judgment.

This work argues that the cause(s) of war in Islam is never the elimination or subjugation of infidelity or the bringing of the whole world under the supremacy of Islam; rather it is to defend Islam and Muslims from external attacks. This work shows that the evolutionary theory of warfare in Islam cannot be sustained and must be rejected. Thirdly, it demonstrates that the global jihadhists have declared a war of “absolute destruction” which is totally contrary to Islam. Fourthly, it is argued that the Qur’anic verses on qital (fighting) have mostly been read out of context, misunderstood and misinterpreted. Fifthly, this work attempts to refute the perpetual war theory and asserts that hostile relations between the Muslims and non-Muslim communities are exception to the normal relations that are peace. Sixthly, the theory of the division of the world into two domains - Dar al-Harb and Dar al-Islam - must be understood in the context for which it was devised by the fuqaha (Muslim jurists). Seventhly, this work finds inconsistencies and self-contradictions in the jihad theory explained in some classical treatises of Islamic law. Finally, this work evaluates the jihadi theories of four prominent Pakistani scholars.

This work focuses on the judicial system of great Mughals, especially Jalal uddin Akbar (1556-1605) and Muhiyuddin Muhammad Awrangzib (1658-1707). It also analyses some of the judicial reforms in the reign of Nuriddin Muhammad Jahangir (d.1037/1627). The main findings of this work are: judiciary under Akbar, Jahangir and Awrangzib was independent and was not under the control of Kings. Akbar has wrongly been accused by some historians of founding a new religion. Akbar by a large did not interfere in the work of his judges. Even his controversial acts have some basis in Islamic law. Awrangzib had carried out tremendous law reforms some of which have survived and are part of the legal systems of India, Pakistan and Bangladesh. The paper critically evaluates the judicial systems of Akbar and Awrangzib, especially the reforms of the latter.

Islamic law makes a distinction between combatants (those who fight) and non-combatants (those who do not fight) and allows fighting with the former and protection to the latter. The Prophet (PBUH) and his four successors have been issuing instructions to their armies against the killing of civilians. Modern Orientalists rely on Khudduri who has relied on Tabari and who in turn has relied on Waqidi to present a very distorted version of Islamic jus in bello. The work critically evaluates Tabari’s methodology.

This powerpoint presentation was made at the Federal Judicial Academy Islamabad to Civil Judges/Judicial Magistrates from all over Pakistan on the subject. Software infringement and internet piracy are now worldwide phenomenon and no country on the globe is saved from its scourges. Judiciary has to be oriented on this core issue of emerging information explosion through use of internet. Software industry is one of the emerging industries of 21st century which is becoming a major source of earning foreign exchange and to support inhouse requirements of trade and businesses. More of the transactions are through internet. Hence, these issues have been highlighted for the orientation of the judicial officers. It has also provided information regarding relevant Pakistani laws that cater for the issue at both civil and criminal side of administration of justice. Federal Judicial Academy is organizing training programs on the issue regularly.

This powerpoint presentation, on the juvenile justice law, has been made, time and again, at the Federal Judicial Academy, Islamabad by the author. It provides an insight into the juvenile justice system as working in Pakistan and what are its characteristics. What particular rights are protected under this law? How the juveniles are saved from unnecessary incarcerations and what impact therapeutic jurisprudence has over the administration of juvenile justice. The importance resources, including leading case law from Pakistan, are also mentioned at the end of the presentation. This presentation mentions the leading case law on issue of determination of age of juvenile and how the courts have to take up this matter at the very initial stage of trial. It will be beneficial to all judges, magistrates, lawyers, court administrators and law school teachers to have a bird's eye view of the law.

This paper explores the rights of protection available to the prisoners of war under Islamic law. It analyzes the differences of opinion among the early fuqaha’ regarding the POWs. The paper finds that the Qur’an mentions only two ways to terminate\ captivity, that is, mann (freedom gratis) and fida’ (ransom) (Qur’an 47: 4) a verse that was not superseded; that ransom was taken by the Prophet only from the POWs of Badr whereas the general practice of the Prophet (peace be on him) and his caliphs was to set POWs free without any condition or ransom. Non-Muslim states used to ask for ransom for the release of Muslim or non-Muslim POWs. In addition, enslavement of POWs as well as their execution had never been the general practice in Islam. Slaying the POWs had been very rare in Islamic military history. Finally, the Prophet and his caliphs had exchanged POWs on some occasions. Majority of classical Muslim jurists seem to have generalized exceptional cases regarding the execution and enslavement of POWs. The question of treatment has been debated particularly with reference to the La'ihah for the Mujahidin, a document issued by the Taliban in Afghanistan in 2010. The paper argues that The Taliban have created new rules for terminating the captivity of POWs but have wrongly attributed them to Islamic law.

This work explains the origin, sources, and evolution of Islamic international law (Siyar). It attempts to locate the role and place of Islamic International law (Siyar). It argues that Abu Hanifa was the first jurist to treat Siyar as a separate legal science and who systematically explained the rules of Siyar. This works discusses the role of Siyar within the domestic law in Pakistan. It concludes that since Islamic law is not only one of the principal legal systems in the world but also that Islam is one of the main forms of civilizations; therefore, Islamic law must be one of the sources of international law. Finally, it argues that since public international law is not secular in nature, but rather ‘neutral’ so as to ‘accommodate’ Muslim states. Siyar only strengthens the obligations of Muslim states and does not impose Islamic law on non-Muslim states.

Article 184(3) of the Constitution of Pakistan 1973 provides the concept of protection of Fundamental Rights through the use of Article 199 of the Constitution. Hence, the Supreme Court of Pakistan can pre-empt the jurisdiction of High Courts under Art.199 whenever “a question of public importance with reference to the enforcement of any of the Fundamental Rights conferred by Chapter I of Part II is involved.” The power of Art.184(3) is “original jurisdiction” of the Supreme Court to enforce fundamental rights. We will also find words “human rights” used by the Supreme Court in its judgments given under the caption “Human Rights Cases” while they have not been mentioned anywhere in 1973 Constitution. It is the combined effect of the provisions of Art.184(3) and Art.199 that help us to understand as to what might be the human rights to be enforced. “Human Rights” is a general term while the term “Fundamental Rights” is specific one and is used in the Constitution as a practical term defining and limiting the exact meanings of various rights provided to all those who are citizens of Pakistan. However, certain Fundamental Rights are provided to everyone who is within the territorial jurisdiction of Pakistan, whether citizen or not, at any given time period. This thesis will study various aspects of the powers of Supreme Court under Art.184(3) of the Constitution along with allied matters.

This work analyses the various arguments put forward by the supporters of female genital mutilation (FGM) under Islamic law to determine whether this practice has its roots in Islam, whether it is a customary or cultural tradition, or whether it is a matter of personal preference in different parts of the Muslim world where the practice exists. The findings of this work are that the arguments given in support of FGM are either not reliable, are weak or, do not order Muslims to carry out this practice. Instead, this horrific practice is rooted in customary-cum-cultural tradition or, is a matter of personal preference for some Muslims but cannot be legitimized under Islamic law. يتناول هذا البحث الحجج المختلفة التي يطرحها المناصرون لختان الإناث استناداً إلى الشريعة الإسلامية، وذلك لمعرفة ما إذا كان ختان الأطفال الإناث واجباً على المسلمين وفقاً للشريعة، أم أنه تقليد عرفي وثقافي، أم أنه أمر يعود للتفضيل الشخصي في مختلف البلدان الإسلامية التي تطبق هذه الممارسة. يخلص هذا البحث إلى أن تلك الحجج التي تدعم ختان الإناث إما غير موثوق منها أو ضعيفة أو لا تلزم المسلمين بتطبيق هذا الممارسة. وأن أصل هذه العادة يرجع إلى تقاليد تجمع بين العرف والثقافة أو لا يتعدى كونها مسألة تفضيلية عند بعض المسلمين