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The use of IoT and modern technologies has boosted the expansion of e-health solutions significantly and allowed access to better health services and remote monitoring of patients. Every service provider usually implements its information system to manage and access patient data for its unique purpose. Hence, the interoperability among independent e-health service providers is still a major challenge. From the structure of stored data to its large volume, the design of each such big data system varies, hence the cooperation among different e-health systems is impossible. In addition to this, the security and privacy of patient information is a challenging task. Building a unified solution for all creates significant business and economic issues. In this work, we present a solution to migrate existing e-health systems to a unified Blockchain-based model, where access to large scale medical data of patients can be achieved seamlessly by any service provider. A core blockchain network connects individual & independent e-health systems without requiring them to modify their internal processes. Access to patient data in the form of digital assets stored in off-chain storage is controlled through patient-centric channels and policy transactions. e show that the proposed solution can interconnect different e-health systems efficiently.

Background: Exercise therapy can potentially relieve symptoms and improve functional status of the knee osteoarthritis population. Despite the proved practical benefits, there is no standard, comprehensive physiotherapeutic protocol available targeting the physical and physiological impairment cluster associated with disease. Osteoarthritis is a whole joint disease, affecting joint cartilage, ligaments, menisci and joint associated muscles, from variable pathophysiological processes. Hence, there is a need to develop a physiotherapy protocol to address the multi-structural physical, physiological and functional impairments associated with the disease. Objective: The objective of the present study is to evaluate the efficacy of designed, therapist supervised, patient education, progressive resistance exercises, passive stretching exercises, soft tissue manipulation, muscle energy technique, Maitland mobilization, aerobic exercise, and neuromuscular training physiotherapy protocol on pain, disability, balance, and physical functional performance in knee osteoarthritis patients. Methodology: The preliminary study was conducted on a (n = 60) sample of convenience. The samples were randomly allocated into two study groups, intervention, and control group. The control group was advised on a basic home program. On the other hand, the treatment of the intervention group was designed with a therapist supervised Physiotherapy Protocol. The outcome variables studied were the Visual Analogue Scale, Modified WOMAC Scale, Timed Up and Go Test, Functional Reach Test, 40 m Fast Paced Walk Test, Stair Climb Test, 30 s Chair Stand Test. Results: The results of the study revealed a significant improvement among most of the studied outcome measures in the intervention group, hence the designed supervised physiotherapy protocol was found effective in relieving multiple physiological impairments associated with this whole joint disease.

Disodium pamidronate, a second-generation bisphosphonate is a potent drug for the treatment of osteoporosis, which has been very well established by previous literature. It has very low oral permeability, leading to its low oral bioavailability, which restrict this drug to being administered orally. Therefore, the present research work includes the development of an orally effective nanoformulation of pamidronate. In this work, disodium pamidronate was complexed with phospholipon 90G for the enhancement of permeability and to investigate the phospholipon 90G-tagged pamidronate complex-loaded SNEDDS for oral delivery with promises of enhanced bioavailability and anti-osteoporotic activity. The rational design and optimization was employed using Central Composite Design (Design Expert

The high technology (high-tech) industry of China has gained a key strategic position in the Chinese economic goals. In this positioning, foreign direct investment (FDI) and technological innovation have emerged as strong pillars of the high-tech industry. However, there are growing concerns of carbon emission from this industry which is still debatable. In this context, this study measures the effect of FDI and technology innovation on carbon emissions in the high-tech industry from 28 provinces of China. The study uses the provincial data for China over the period 2000–2018. In addition to examining unit root properties, structural breaks, and cointegration, this study uses quantile regression for estimating long-run relationships among study variables. The findings reveal the negative impact of FDI on carbon emissions. Technology innovation positively impacts in the initial three quantiles, whereas negatively impacts in the next six quantiles. These results indicate that FDI and technology innovation have shaped the energy intensity in the high-tech industry, which causes fluctuation in carbon emissions over time. After controlling the effects of urbanization, energy intensity, and economic growth, this study recommends that policymakers should emphasize on the heterogeneous effects of FDI and technology-lead emissions at different quantiles during the process of CO2 emission reduction.

Background: Preeclampsia (PE) is a serious disorder that is unique to pregnancy marked by hypertension, proteinuria, and other systemic disruptions at or after 20th week of pregnancy leading to maternal and neonatal illness and death. Placental hypoxia leads to increased levels of cytokines and inflammatory syncytiotrophoblast microvillous membrane microparticles (STBM) which activates neutrophils leading to in preeclampsia, oxidative stress and endothelial dysfunction are seen.Methods: The present study includes 40 patients hospitalized at the Department of Obstetrics and Gynaecology, HIMSR & HAHC Hospital, Jamia Hamdard, New Delhi. Nitric oxide (NO), Neutrophil elastase (NE), and Neutrophil to Lymphocyte ratio of 20 healthy pregnant women and 20 pregnant women with PE aged 20-45 years were measured. The blood and biochemical parameters in PE patients were analysed. Results: The neutrophil-to-lymphocyte ratio (NLR) was significantly increased in PE patients as compared to the healthy pregnant women. All the biochemical and hemodynamic parameters were assessed. The serum NO concentrations were lower in PE patients as compared to healthy pregnant women. Endothelial dysfunction markers (NE and vWF) were markedly increased in PE patients. The difference was statistically significant with p value Conclusion: NLR has been found to be greatly increased in PE patients as compared to control pregnant. Increase in NLR in PE patients occur due to increase in inflammatory markers and endothelial damage. Hence neutrophil to lymphocyte ratio could act as a novel diagnostic biomarker for depicting PE.

Background Naringenin is a powerful antioxidant and anti-inflammatory flavonoid which has been widely used as a therapeutic agent in various toxic models. However, few studies have clearly discussed the neuromodulatory effects of naringenin against different neurodegenerative disorders. Aim We investigated the neuroprotective efficacy of naringenin against 3-nitropropionic acid (3-NP)-induced neurobehavioral, biochemical and histopathological alterations in rats. Methods Albino Wistar rats were randomly divided into three experimental groups. Group 1, the vehicle administered group, received saline. Group 2 received 3-NP (20 mg/kg body weight, i.p.) for 4 consecutive days. Group 3 received naringenin (50 mg/kg body weight, p.o.) twice daily for a period of 4 days, 30 min before and 6 h after the 3-NP administration. On the 5th day, neurobehavioral experiments were performed to access the behavioral outcomes and the striatum tissue was used for analysis of the monoamine oxidase (MAO) activity and serotonin (5-HT) levels. In addition, astrocytes activation was observed by glial fibrillary acidic protein (GFAP) immunostaining. Results Our results showed that naringenin co-treatment provides neuroprotection against 3-NP-induced neurological disorders. Naringenin also increased the MAO activity and 5-HT levels in the striatum. Moreover, co-treatment with naringenin reduced the expression of GFAP protein in the striatal part and significantly attenuated the neuronal cell death. The findings of the present study suggest that naringenin provides neuroprotection and mitigates neurobehavioral alterations in experimental rats. Conclusion The results show that co-treatment with naringenin ameliorates 3-NP-induced HD-like symptoms in rats.

Ransomware is a malicious software that takes files hostage and demands ransomware to release them. It targets individuals, corporations, organizations, and public services such as hospitals and police stations. It is a growing industry that affected more than three million users from 2019 to 2020. The ransom payments totaled 25 billion-plus dollars in the year 2019. The latest version of ransomware was developed using undetectable and nonanalysis techniques. This paper represents an intelligent KNN and density-based machine learning algorithm to detect ransomware pre-attacks on an endpoint system. The data preprocessing and feature engineering techniques are augmented with the KNN algorithm for finding the solution. This helps the anti-malware developer, vendors, endpoint security provider companies, or researchers work on malware detection using advanced machine learning algorithms to develop the more effective ransomware defensive solutions to detect and prevent ransomware pre-attack execution. The proposed KNN and density-based algorithm will predict ransomware detection with higher accuracy than other machine learning algorithms. The anti-malware and anti-ransomware solution provider companies can use this algorithm to improve their existing ransomware detection solutions for endpoint users.

The coronavirus disease (COVID-19) is caused by a positive-stranded RNA virus called severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), belonging to the Coronaviridae family. This virus originated in Wuhan City, China, and became the cause of a multiwave pandemic that has killed 3.46 million people worldwide as of May 22, 2021. The havoc intensified with the emergence of SARS-CoV-2 variants (B.1.1.7; Alpha, B.1.351; Beta, P.1; Gamma, B.1.617; Delta, B.1.617.2; Delta-plus, B.1.525; Eta, and B.1.429; Epsilon etc.) due to mutations generated during replication. More variants may emerge to cause additional pandemic waves. The most promising approach for combating viruses and their emerging variants lies in prophylactic vaccines. Several vaccine candidates are being developed using various platforms, including nucleic acids, live attenuated virus, inactivated virus, viral vectors, and protein-based subunit vaccines. In this unprecedented time, 12 vaccines against SARS-CoV-2 have been phased in following WHO approval, 184 are in the preclinical stage, and 100 are in the clinical development process. Many of them are directed to elicit neutralizing antibodies against the viral spike protein (S) to inhibit viral entry through the ACE-2 receptor of host cells. Inactivated vaccines, to the contrary, provide a wide range of viral antigens for immune activation. Being an intracellular pathogen, the cytotoxic CD8+ T Cell (CTL) response remains crucial for all viruses, including SARS-CoV-2, and needs to be explored in detail. In this review, we try to describe and compare approved vaccines against SARS-CoV-2 that are currently being distributed either after phase III clinical trials or for emergency use. We discuss immune responses induced by various candidate vaccine formulations; their benefits, potential limitations, and effectiveness against variants; future challenges, such as antibody-dependent enhancement (ADE); and vaccine safety issues and their possible resolutions. Most of the current vaccines developed against SARS-CoV-2 are showing either promising or compromised efficacy against new variants. Multiple antigen-based vaccines (multivariant vaccines) should be developed on different platforms to tackle future variants. Alternatively, recombinant BCG, containing SARS-CoV-2 multiple antigens, as a live attenuated vaccine should be explored for long-term protection. Irrespective of their efficacy, all vaccines are efficient in providing protection from disease severity. We must insist on vaccine compliance for all age groups and work on vaccine hesitancy globally to achieve herd immunity and, eventually, to curb this pandemic.

PGE2 plays a critical role in angiogenesis, ischemic, and neuro-inflammatory disorders of the brain, which breakdown the blood-brain barrier (BBB). However, the effects of PGE2 on human brain endothelial cell (HBECs) migration, a key process in the angiogenic response and BBB stability, are not well defined. In this study, we investigated the mechanism of PGE2 in HBECs migration in vitro. Here we showed that PGE2 stimulated migration of HBECs in a dose-time and matrix-dependent manner, evaluated by the Boyden chamber assay, but other prostanoids failed to do so. PGE2 receptor (EP2; butaprost), EP3 (sulprostone), and EP4 (PGE1-OH) receptor agonists stimulated HBECs migration, but the silencing of EP significantly attenuated this effect. EP1 agonist (11-trinor PGE1) had no effect on HBECs migration on silencing of the EP1 receptor. We further showed that PGE2 stimulated cAMP production and activated protein kinase A (PKA), whereas pretreatment with the adenyl cyclase inhibitor (dideoxyadenosine; 1 μM) or PKA inhibitors, H89 (0.5 μM)/PKAI (1 μM), completely abrogated PGE2-induced migration. Furthermore, silencing of the EP2/EP4 receptors significantly inhibited PGE2-induced cAMP and PKA activation, whereas EP3 receptor silencing failed to do so. These results suggest that PGE2 regulates HBEC migration via cooperation of EP2, EP3, and EP4 receptors. Coupling of PGE2 to these receptors resulted in increased production of cAMP, which regulates HBEC migration via PKA pathway. The elucidation of molecular events involved is critical for the development of targeted strategies to treat cerebrovascular diseases associated with dysregulated angiogenesis.

Background COVID-19 pandemic has currently no vaccines. Thus, the only feasible solution for prevention relies on the detection of COVID-19-positive cases through quick and accurate testing. Since artificial intelligence (AI) offers the powerful mechanism to automatically extract the tissue features and characterise the disease, we therefore hypothesise that AI-based strategies can provide quick detection and classification, especially for radiological computed tomography (CT) lung scans. Methodology Six models, two traditional machine learning (ML)-based (k-NN and RF), two transfer learning (TL)-based (VGG19 and InceptionV3), and the last two were our custom-designed deep learning (DL) models (CNN and iCNN), were developed for classification between COVID pneumonia (CoP) and non-COVID pneumonia (NCoP). K10 cross-validation (90% training: 10% testing) protocol on an Italian cohort of 100 CoP and 30 NCoP patients was used for performance evaluation and bispectrum analysis for CT lung characterisation. Results Using K10 protocol, our results showed the accuracy in the order of DL > TL > ML, ranging the six accuracies for k-NN, RF, VGG19, IV3, CNN, iCNN as 74.58 ± 2.44%, 96.84 ± 2.6, 94.84 ± 2.85%, 99.53 ± 0.75%, 99.53 ± 1.05%, and 99.69 ± 0.66%, respectively. The corresponding AUCs were 0.74, 0.94, 0.96, 0.99, 0.99, and 0.99 (p-values

Introduction: The coronavirus pandemic has involved nearly all the countries of the world. The lockdowns and closure of educational institutes to reduce the risk of disease transmission has brought a change in the medium of teaching as most educational institutes have moved to the online mode. There is a widespread increase in stress as the number of cases and mortality associated with Coronavirus 2019 disease (COVID-19) continue each day. Aim: To assess the stress status of first year undergraduate medical students in reference to the coronavirus pandemic and the perception of first year undergraduate medical students in reference to the E-learning being carried out during the coronavirus pandemic. Materials and Methods: This was a cross-sectional web-based online survey that was conducted using a questionnaire in August 2020 at Hamdard Institute of Medical Sciences and Research, New Delhi, India. The questionnaire was prepared and reviewed by the involved faculty members of the project and it was approved by a faculty from Department of Psychiatry. Reliability of questionnaire was measured using Cronbach’s alpha (0.89). A questionnaire with 20 questions was administered via Google forms to all 100 students of first year MBBS course. Some of the questions in the questionnaire were framed to assess the stress status of the students; some were designed to study students’ perception of E-learning. Data was represented as the percentage distribution of response for each question. Results: Ninety five responses were received, after accounting for exclusion factors; data was compiled for 91 respondents. Out of the 91 participants in the study, 48.4% were males (n=44) and 51.6% were females (n=47). Most of the students in this study (84.6%) felt that online teaching had helped in learning Physiology theory; around 43% students found online practical teaching useful. Around 39% students have reported internet connectivity issues all the time while 59% faced problem sometimes. Total 51.6% of students had difficulty in accessibility to devices. Due to coronavirus pandemic, 37.4% of students have reported to be under stress. Around 33% reported feeling unsafe all the time while 39.5% felt unsafe some of the times. Conclusion: Students found online teaching more helpful in learning Physiology theory than practical. Majority of class reported internet connectivity issues. All the responders agreed that this pandemic affected their regular life. Most of the students felt that online classes have helped them to remain positive and motivated towards study.

Sterile inflammation (SI) is an essential process in response to snakebite and injury. The venom induced pathophysiological response to sterile inflammation results into many harmful and deleterious effects that ultimately leads to death. The available treatment for snakebite is antiserum which does not provide enough protection against venom-induced pathophysiological changes like haemorrhage, necrosis, nephrotoxicity and often develop hypersensitive reactions. In order to overcome these hindrances, scientists around the globe are searching for an alternative therapy to provide better treatment to the snake envenomation patients. In the present study TiO2 (Titanium dioxide)-NPs (Nanoparticles) has been assessed for antisnake venom activity and its potential to be used as an antidote. In this study, the synthesis of TiO2-NPs arrays has been demonstrated on p-type Silicon Si substrate (∼30 ohm-cm) and the surface topography has been detected by Field-emission scanning electron microscopy (FESEM). The TiO2-NPs successfully neutralized the Daboia russelii venom (DRV) and Naja kaouthia venom (NKV)-induced lethal activity. Viper venom induced haemorrhagic, coagulant and anticoagulant activities were effectively neutralized both in in-vitro and in vivo studies. The cobra and viper venoms-induced sterile inflammatory molecules (IL-6, HMGB1, HSP70, HSP90, S100B and vWF) were effectively neutralised by the TiO2-NPs in experimental animals.

Piperidine is an important pharmacophore, a privileged scaffold and an excellent heterocyclic system in the field of drug discovery which provides numerous opportunities in studying/exploring this moiety as an anticancer agent by acting on various receptors of utmost importance. Cancer is an uncontrolled division of cells that results in the formation of tumour which have the potential to migrate to other parts of the body (metastasis) finally becoming a major threat to human population. Since piperidine displayed great potential in this area it is being further probed to get novel entities for the treatment of cancer. This review throws light on recent biological expansions of piperidine along with structure activity relationships to deliver association between various synthesized newer/novel derivatives and receptor sites.

Myocardial infarction (MI), atherosclerosis and other inflammatory and ischemic cardiovascular diseases (CVDs) have a very high mortality rate and limited therapeutic options. Although the diagnosis is based on markers such as cardiac Troponin-T (cTrop-T), the mechanism of cTrop-T upregulation and release is relatively obscure. In the present study, we have investigated the mechanism of cTrop-T release during acute hypoxia (AH) in a mice model by ELISA & immunohistochemistry. Our study showed that AH exposure significantly induces the expression and release of sterile inflammatory as well as MI markers in a time-dependent manner. We further demonstrated that activation of TLR3 (mediated by eRNA) by AH exposure in mice induced cTrop-T release and Poly I:C (TLR3 agonist) also induced cTrop-T release, but the pre-treatment of TLR3 immuno-neutralizing antibody or silencing ofTlr3gene or RNaseA treatment two hrs before AH exposure, significantly abrogated AH-induced Caspase 3 activity as well as cTrop-T release. Our immunohistochemistry and Masson Trichrome (MT) staining studies further established the progression of myocardial injury by collagen accumulation, endothelial cell and leukocyte activation and adhesion in myocardial tissue which was abrogated significantly by pre-treatment of RNaseA 2 hrs before AH exposure. These data indicate that AH induced cTrop-T release is mediated via the eRNA-TLR3-Caspase 3 pathway.

PGE

High mobility group box 1 protein (HMGB1), a sterile inflammatory molecule and damage-associated molecular pattern (DAMP) released from various cells during stress has been implicated in inflammation. Several reports show that there is a direct relationship between inflammation and cardiovascular diseases (CVDs) such as thrombosis, hypertension, insulin resistance, preeclampsia, etc. Here, we intend to summarize the concept of the emerging link between HMGB1 and CVDs. Furthermore, we will discuss the possible therapeutic strategies that target HMGB1 for the treatment of different CVDs.

We herein report the design, synthesis and molecular docking studies of 2,4-thiazolidinedione derivatives containing benzene sulphonyl group which are docked against the Peroxisome Proliferator Activated Receptor (PPARγ) target. Compound 7p was most effective in lowering the blood glucose level as compared to standard drugs pioglitazone and rosiglitazone. Compound 7p exhibited potent PPAR-γ transactivation of 61.2% with 1.9 folds increase in gene expression. In molecular docking studies 7p showed excellent interactions with amino acids TYR 473, SER 289, HIE 449, TYR 327, ARG 288, MET 329 and LEU 228. Compound 7p did not cause any damage to the liver without any noteworthy weight gain and may be considered as promising candidates for the development of new antidiabetic agents.

Counting of Red Blood cell (RBC) is a significant measure that helps to diagnose specific diseases. Manual pathological RBCs counting process by experienced specialist is extremely tedious, time consuming, and imprecise which may be prone to high chance of error. Due to recent advancement, automated detection of red blood cell using image processing techniques is gaining popularity. In order to increase the accuracy of the results, it is preferred to accommodate experienced specialist in the RBC counting. In this paper, a new approach is presented for semi-automatically count of the RBCs. The user can specify the dimension of RBC by dragging two points over the image and then apply the Hough transform to detect the oval and biconcave shape of RBC with the specified diameter. The proposed semi-automatic system outperformed the automated system in terms of the executing time. In addition, the proposed system is supported by a GUI to facilitate the pathologist interaction with the proposed system.

This paper describes the research methodology followed in the ‘Livelihoods of the Extreme Poor Project’, a collaborative research project in Bangladesh between PROSHIKA (a large national NGO) and DFID (the UK government department for international development). The dual purpose of this project was to learn about poor people's livelihoods and train the PROSHIKA research team in the use of qualitative research methods. The research findings were to be fed directly into policy formulation and the planning of new development interventions for the poorest people in Bangladesh. The paper provides an assessment of what the approach used achieved both in terms of building staff capacity and in policy influence, concluding that it has been largely successful in achieving its purpose.

A long period of uncertainty about the demographic situation in Pakistan may finally be coming to an end. The uncertainty has resulted from data collection problems common to many developing countries compounded ironically by the unusually large number of data sources available for Pakistan. It now seems fairly certain that the apparent population growth trends have been distorted by different degrees of accuracy of enumeration in the past four population censuses. The censuses show a decline in the population growth rate since 1961. In fact however that rate rose steadily from the early 1960s to the late 1980s and only then began to decline. These conclusions are based on analyses of fertility and mortality data from all major sources but especially from the unjustly neglected Pakistan Demographic Survey conducted annually by the Federal Bureau of Statistics since 1984. The conclusions are among the findings of a recent project to evaluate and analyze the data produced by the 1998 census of population; results of the project are scheduled for publication later this year. (authors)

The demographic landscape of Asia has seen unprecedented changes over the past 50 years. The transition from high to low mortality and fertility rates has made the eventual stabilization of the worlds population a real possibility. The demographic success of Asia is associated with the stunning economic and social changes that have taken place during this period. Aside from social and economic improvements population and health policies also played a major part in shaping the regions demographic transformation. National programs made a substantial contribution to increasing contraceptive use lowering fertility and slowing population growth. The success of family planning programs was frequently supported by positive changes in the demand for children. As the initial impact of the recent financial and economic crisis has shown the Asian demographic miracle cannot be taken for granted. Since mid-1997 the crisis has interrupted and reversed the regions remarkable development gains. Economic downturns often tend to affect the social sectors unevenly. Strengthening the provision of basic social services including reproductive health and care of the elderly particularly in poor nations will remain a challenge in the next century. The establishment of goals including in areas such as HIV/AIDS will help Asian countries realize the vision of the International Conference on Population and Development s 20-year Programme of Action.

Snake venom, particularly of vipers from the Indian subcontinent, contains Phospholipase A2 (PLA2) as one its constituents which is widely implicated in hemorrhagic, cardiac arrest and death. Development of inhibitors of the protein can facilitate the weakening or annihilation of the venom toxicity and save many human lives. In the present communication, our studies relate to the design and development of structure-based ligands as inhibitors of PLA2 of Viper venom. The study involves the computational approach towards evaluating a library of molecules comprising of natural products, and synthetic molecules through docking studies on the venom protein PDB ID: 1OXL (a dimer, available in the literature). In silico experiments have resulted in the identification of several of them as PLA2 inhibitors. The inhibitory effect of PLA2 by these compounds is attributed to a great extent to their interaction with the residues Phe 46 and Val47 of chain B of the target protein and hence these two residues are identified as the key contributor for the said activity. In order to validate the in silico findings, a selected panel of compounds have been tested by in vitro and in vivo experiments against the venom, which has led to the observance of significant corroboration between the wet lab and in silico findings, validating thereby the in silico approach used in the present study.

Uterine rupture is a deadly obstetrical emergency endangering the life of both mother and fetus. This descriptive study was conducted to determine the frequency of ruptured uterus at Ayub Teaching Hospital Abbottabad and to elicit possible causes/reasons of ruptured uterus.The study was conducted at the department of ObstetricsGynaecology, Ayub Teaching Hospital, Abbottabad, Pakistan over a period of one year from July 1st, 2001 to June 30th, 2002. All cases of uterine rupture presenting during the study period were recorded and managed in the department using a protocol prepared for the purpose of this study. Data was recorded on pre-designed Proforma.There were 34 cases of ruptured uterus out of a total of 3435 deliveries (including 1128 Caesarian sections) over a one-year time period (incidence of 1/100 deliveries) with 31 intra-partum deaths. The most common age group was from 31-35 years (16/34, 47%), followed by the 26-30 years age group (13/34, 38.2%). A majority (29/34, 85.3%) were cases of unscarred uterus presenting with rupture; the most common cause of rupture in all cases was inappropriate injections of Oxytocin (11/34, 32.35%), followed by obstructed labour (9/34, 26.5%). All were anemic and most of them were in shock.The leading cause of ruptured uterus was found to be mismanagement by traditional birth attendants. We can reduce maternal mortality due to rupture uterus by giving proper training to traditional birth attendants and by mass education through electronic media.

Of considerable interest to social scientists, particularly the demographers, is the process of family limitation-a critical link in the demographic transition from high to low fertility. The available literature identifies numerous macro socio-economic and cultural variables found to be correlated with fertility behaviour [9]. However, little is known regarding the key motivational factors which, by impinging upon individual couples, result in a reduction of family size. The advocates of family planning programmes claim that family limitation can be achieved by providing couples with information about contraception along with effective means of birth control. The critics of current family planning programmes while recognising the importance of accessibility of effective contraception in family limitation, however, strongly feel that the reduction in fertility of the developing countries may not be achieved

This paper is an attempt at analysing female labour force participation and its various socio-economic and demographic correlates in Pakistan. Data for the four provinces have been analysed separately in order to get an idea of the diversity between regions and to identify characteristics that influence female work participation in different parts of the country. The area relating to the size and structure of female labour force has received considerable attention in recent years in Pakistan. A preliminary attempt, using 1961 Census data, was made by Bhatti and Alam [1] at iden¬tifying the significant correlates of female work in Pakistan. Yusuf [20] analysed correlttes of male participation in labour force by using data from the 1961 Census. Constraints and cultural definitions relating to types of female work were discussed by Papanek [15], Pastner [14] and Shah [18]. Saeed [17] analysed the factors important in female participation in farm operations, and differentiated between work participation by women belonging to various castes in four villages in Lyallpur. A case study of women's attitudes, environment and activities has recently been made by Khan and Bilquees [4] for a Punjabi Village. Shah [19] analysed from survey data the demographic and socio¬economic influences on female labour force participation in the rural and urban areas of Pakistan.

As is the case in many other countries, mortality has been undergoing substantial, though not precisely understood, changes in Pakistan. In the absence of a reliable and adequate system of vital registration in the country, the precise measurement of these changes is well nigh impossible. In Pakistan, an attempt to estimate levels of fertility and mortality on a sample basis was made through the Population Growth Estimation (PGE) project undertaken from 1962 through 1965 [5, 12]. Subsequently, another demographic survey, called the Population Growth Survey (PGS), was initiated and carried out from 1968 through 1971 [13]. In the PGE a dual system of data collection was utilized based on continuous (Longitudinal) registration and a periodic (Cross-Sectional) survey. In the PGS, data were collected through periodic surveys only. Data from the PGS have only recently been made available to researchers. The present set of life tables is based on the mortality statistics collected in 1968 and 1971 field operations of the PGS.

1t has been generally observed that ages are grossly misreported in developing countries due to various institutional reasons. As a result, all the demographic indicators which are related to age are largely affected. Similarly the effect of-age misreporting 'on fertility rates is liable to have serious implications when data are drawn from different sources such as the Population Growth Estimation (PGE) Project [5, 12] and Population Growth Survey (PGS) [13, 14, IS} in the case of Pakistan. If the patterns of age misreporting are different in these two surveys and in a 'real' population distribution then such fertility measures as Total Fertility Rates (TFRs) and Age-Specific Fertility Rates (ASFRs), derived from them, will be highly affected.

The fertility of a population is the consequence of a number of different but interrelated, demographic, social and economic causes. In a country, such as Pakistan, where total fertility is high [16] and the population young [8], age at marriage of women is one of the major determinants of future fertility. In a non-industrial society marriage is often the most important factor which regulates the production of off-spring [9]. The pattern of marriage varies greatly from one country to another under the influence of social factors, and the gross expectation of marital life below the age of 50 years (a rough estimate of the end of the fecund period) for a girl at the beginning of fecund period varies from about two decades in European countries to about three decades in Tropical Africa [9]1. Because the upper age limit of the fecund period is biologically determined, age at marriage is the major factor which regulates the potential reproductive span of women. Coale and Tye, using the stable population technique, have demonstrated that in general fertility declines with an increased age at marriage, which in fact means the shortening of the average marital life span [2]. In the Mysore population study it was estimated that if no woman married before reaching 18 years of age, then the overall fertility would decline by about 15 per cent [13]. Agarwala, in 1965, estimated that in India an increase in average age at marriage from existing 15.6 years to 19-20 years, would result in an annual crude birth rate 30 years latter of 33.9 births per 1000 population instead of 47.8, a decline of 29 per cent [1]. Sadiq [11] has observed that in