Since independence, Pakistan, like many other countries, has been facing the problem of the balance-of-payments deficit. A number of policies have been introduced during different periods for rapid and continuous growth in Pakistan’s exports. These policies, like import substitution, devaluation of the rupee in 1972, export finance schemes, tax concessions, delinking of the rupee from the U.S. dollar in 1982, etc., have helped in boosting its exports to some extent but not enough to stabilise its export earnings. The fluctuations in export earnings are known to have serious consequences. Specifically, unstable export earnings affect the investment decisions by hindering the continuous import of industrial raw materials. This, in turn, impedes the growth of the industrial sector. Moreover, it causes fluctuations in the GNP and promotes uncertainty in the economy. This uncertainty plays a decisive role in the private sector’s hesitation to invest in the large-scale manufacturing industries, thereby hampering the country’s overall development. Keeping in view the possibly serious consequences of export earnings instability, a study exploring its causes is in order. Concentration of exports on a few commodities and exporting to only a few markets is among the possible explanations of the current instability in Pakistan’s export earnings. Due to commodity concentration, the chances of offsetting the impact of adverse price movements in the international market are reduced. This commodity concentration is often associated with the concentration on primary products and is, therefore, the basis for a policy of diversification away from primary products. A diversification away from primary products and towards industrial goods is desirable for another reason, not central to this paper; and that is that the terms of trade argument which claims that the relative prices of the primary products have increased slowly relative to the prices of the manufactured goods in the international market.

Urolithiasis is a common urological disease predominantly affecting males. The lifetime risk of urolithiasis varies from 1% to 5% in Asia, 5% to 9% in Europe, 10% to 15% in the USA and 20% to 25% in the middle-east; lowest prevalence is reported from Greenland and Japan. Such differences have been explained on the basis of race, diet and climate factors. Furthermore, changing socio-economic conditions have generated changes in the prevalence, incidence and distribution for age, sex and type of lithiasis in terms of both the site and the chemical as well as the physical composition of the calculi. The aim of our study was to determine the association between body mass index (BMI) and urine pH in patients with urolithiasis and the influence of body size, as reflected by the BMI, on the composition. The study was conducted in the Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences and Research, on urolithiatic patients. The data included patient's age, sex, BMI, urine pH, serum calcium, serum uric acid, serum creatinine and stone composition. Data from 100 patients, 70 men (70%) and 30 women (30%), were analyzed, with 28 patients having normal weight, 38 patients being overweight and 34 patients being obese. The mean age of the patients was 36.58 ± 9.91 years in group I, 40.47 ± 14.48 years in group II and 37.85 ± 12.46 years in group III (P > 0.05). The stone composition was calcium oxalate (CaOx) in 66 patients, calcium phosphate (CaP) in 60 patients, uric acid (UA) in 38 patients, combined calcium oxalate and calcium phosphate in 28 patients and three stones in 10 patients. The urinary pH levels (mean ± SD) were 7.78 ± 1.49 in group I, 7.15 ± 1.11 in group II and 6.29 ± 1.14 in group III patients (P = 0.0001). Urine pH showed a stepwise decrease with increasing BMI (inverse correlation). Urine pH is inversely related to BMI among patients with urolithiasis, as is the occurrence of urate, calcium oxalate and calcium phosphate stones. Similarly, the serum creatinine increased as the BMI and number of stones increased among the study population.

Background: Overcrowding, poor hygiene, socio-economic status, climate, lack of resources to avail medical facilities, poor medical awareness have their bearing on the incidence of hearing loss. The family of each hearingimpaired child has its own cultural, social, educational, and financial background, and its own special needs. The aim of this study is to determine the percentage of hearing impaired school going children in Ghaziabad city. Methods:The material for the present study were a representative sample constituting 1000 school children selected from various localities of Ghaziabad city within age group of 6-12 years. The children belonged to all the strata of society and children from both sexes were evaluated for hearing loss and its underlying etiological factors. Children were subjected to detailed ENT examination in our OPD. Results: In the present study sample the incidence of hearing loss is 9.3%. The maximum cases 60.22% belonged to the low socio-economic strata. A statistically significant difference of distribution by gender was noticed with a male preponderance (61.29%) as against 38.71% for females. The hearing loss in majority of cases was of a mild degree i.e., 26 to 45 dB (34.41%) of which majority of cases (87.10%) had conductive loss. Wax was the commonest cause of hearing loss (41.94%). CSOM was found in 21.50 % of all cases. Peak prevalence of hearing loss was found at 8 years of age, again declining after that from 20.43 % to 5.38 % by 12 years of age. Also it was observed that 59.14% children were living in crowded localities of city & 40.86% were living in non-crowded/open locality which is again statistically significant (P ≤0.05). Conclusion:The inferences drawn from the present study substantiates the view point of earlier workers that school screening is the most effective method of diagnosing deafness in school going children and should be extended to all schools in all the areas. Proper assessment and diagnosis of hearing loss in children at a very early age is important because an early diagnosis determines the efficacy of methods used for the correction of the hearing loss. Also early diagnosis of hearing impairment is a key to proper rehabilitation. The cases reporting to the hospital for treatment and rehabilitation can be regarded as the tip of the ice-berg and can have more management difficulties when compared to sub-clinical cases.

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