South Asian Region Research Articles

Temporal Trends and Burden of Rheumatic Heart Disease in South Asia: A Comprehensive Analysis of Three Decades from Global Burden of Disease Study.

The objective of this study is to conduct a temporal analysis of rheumatic heart disease (RHD) disease burden trends over a 30-year period (1991 to 2021), focusing on prevalence, deaths, and disability-adjusted life years (DALYs) in the South Asia (SA). In this ecological study, we analyzed data regarding burden of RHD from the Global Burden of Diseases (GBD) study spanning the years 1991 to 2021 for the SA Region. Estimates of the number RHD-related prevalence, deaths, and DALYs along with age-standardized rates (ASR) per 100,000 population and 95% uncertainty intervals (UI) were evaluated. The overall prevalent cases of RHD in the 2021 were 54785.1 × 103 (43328.4 × 103 to 67605.5 × 103), out of which 14378.8 × 103 (11206.9 × 103 to 18056.9 × 103) were from SA. The ASR of point prevalence showed upward trend between 1991 and 2021, at global level and for SA with an average annual percentage change (AAPC) of 0.40 (0.39 to 0.40) and 0.12 (0.11 to 0.13), respectively. The overall number of RHD-related deaths in the 2021 were 373.3 × 103 (324.1 × 103 to 444.8 × 103), out of which 215 × 103 (176.9 × 103 to 287.8 × 103) were from SA, representing 57.6% of the global deaths. The ASR of deaths also showed downward trend between 1991 and 2021, at global level and for SA with an AAPC of -2.66 (-2.70 to -2.63) and -2.07 (-2.14 to -2.00), respectively. The ASR of DALYs showed downward trend between 1990 and 2019, at global level and for South Asian region with an AAPC of -2.47 (-2.49 to -2.44) and -2.22 (-2.27 to -2.17), respectively. The rising age-standardized prevalence of RHD remains a global concern, especially in South Asia which contribute to over 50% of global RHD-related deaths. Encouragingly, declining trends in RHD-related deaths and DALYs hint at progress in RHD management and treatment on both a global and regional scale.

Moving towards food security in South Asian region: Assessing the role of agricultural trade openness, production and employment

Despite several accomplishments in addressing malnutrition, the issue of food scarcity remains a persistent concern all over the globe, particularly in the South Asian region. One recommended solution to address this situation involves advocating for further liberalization of global food trading and opening employment opportunities. In this context, using panel data spanning 2000–2019, this study makes a novel attempt to quantify the impact of agricultural trade openness and agricultural employment on food security in countries belonging to the South Asian region while controlling the tariff and agricultural production. Using “Fully Modified Ordinary Least Square (FMOLS)” and “Dynamic Ordinary Least Square (DOLS)” modeling, this article concludes that increased agricultural trade openness hinders food security in this region. Because, the member countries of South Asia are heavily reliant on food imports to meet their domestic needs, implying that the expenses of food imports exceed the potential benefits of increasing exports. Moreover, tariffs have a detrimental impact on food security in this region. However, production and employment in the agricultural industry augment earnings, strengthen the capacity to buy food, and ensure adequate nutrition intake over the long term. The study's findings suggest that these nations should prioritize food self-sufficiency to expand agricultural exports and lessen their reliance on imported food. More than that, economies should provide rewards to broaden their agricultural production locally, which aids in reducing hunger and uplifting food security.

Conservation of resources for sustainable performance in tourism

This study aims to examine the impact of green purchasing, waste management, eco-friendly design of products and services, and customer relationship management on sustainable performance in the South Asian tourism industry. The contemporary tourism and hospitality industry increasingly focuses on environmental sustainability. The tourism sector is considered to contribute significantly to the economy. It allows employment and generates economic profits, resulting in an increase in overall economic activity. This study used deductive and quantitative approaches to evaluate the research hypotheses. Data was gathered from 463 tourism-related businesses situated across diverse locations in Pakistan. This study discovered that green purchasing has a significant impact on sustainable performance. Similarly, waste management, eco-friendly design of products and services, and customer relationship management all had a significant impact on sustainable performance. This research presents a framework that highlights the practices of tourism businesses in attaining sustainable performance, utilizing the Conservation of Resources (COR) theory for support. The inclusion of COR theory in examining variables related to sustainable performance is considered a unique and pioneering contribution to interdisciplinary fields such as supply chain management and the tourism industry. Furthermore, this study is the first of its kind in the South Asian region, specifically in Pakistan.

Effectiveness of spaced repetition for clinical problem solving amongst undergraduate medical students studying paediatrics in Pakistan

BackgroundStudies using spaced repetition for teaching and learning in undergraduate clinical rotations such as paediatrics are limited, even more so in the South Asian region. Therefore, this study aimed to identify the effectiveness of utilizing spaced repetition compared to traditional learning methods among undergraduate medical students during their paediatric rotation at a medical university in Pakistan.MethodsBahria University Medical and Dental College (BUMDC) conducted quasii-experimental research in Karachi. Four topics were identified from the Year 5 Pediatrics curriculum to be used in the study, using which the study content was developed along with 50 multiple choice questions (MCQs) for assessment. All BUMDC Year 5 medical students rotating in Pediatrics were included and randomly allocated to the control or intervention group. In the control group, they provided the students with traditional study methods consisting of books and lectures to learn topics. In the intervention group, we created an Anki flashcard deck of the same topics to enable learning via spaced repetition. The researchers conducted a pretest and post test assessment of the 50 MCQs in both groups at the beginning and after the four-week study interval. The data were analysed using SPSS 19.ResultsA total of 115 BUMDC medical students agreed to participate in the study; 70 (59.1%) were in the intervention group, and 45 (41.7%) were in the control group. The pretest mean score of the control group was 27.96 ± 3.70, and the posttest mean score was 27.22 ± 5.02, with no statistically significant difference at the 95% confidence level. The mean score of the pretest for the intervention group was 27.93 ± 4.53, and that of the posttest was 30.8 ± 4.56, with a statistically significant difference at the 95% confidence level. The intervention showed a significant effect size of 0.8.ConclusionThe use of spaced repetitions resulted in significantly greater scores for medical students studying paediatrics than for those using more traditional methods of learning, compromising medical books and lectures. Considering that medical students need to retain a vast amount of information, using spaced repetition through flashcards can be a more effective learning tool that is more cost-efficient and time-efficient than traditional learning methods.

Decision Support Systems Based on a Multiple-Criteria Decision Analysis to Promote a Whole-of-Resource Approach for Water Management, with a Case Study of Rural Bengaluru in India

The sustainable availability and resilient supply of safe drinking water remains a challenge that is far from fulfilled. As of 2024, around 2 billion people worldwide do not have access to safe drinking water. The regions of Sub-Saharan Africa and South Asia are the most vulnerable regions in this regard. This is despite the fact that these regions are home to some of the world’s fastest-growing economies. However, economic growth and rapid urbanization may also be connected to the increasing water stress in the suburban and rural areas. We propose addressing the two main challenges in this regard, which are the selection of the suitable treatment and distribution systems for different contexts using a decision support system following a Whole-of-Resource Approach (WORA). This approach considers the different water sources and sinks as contributing to a positive or negative change in the single resource, irrespective of whether the resource, in this case water, is used for domestic, industrial, or agricultural purposes. In this regard, this paper presents an illustrative proof of concept for such a decision support tool based on a multiple-criteria decision analysis. The decision support tool is aimed at facilitating water management within a WORA by providing recommendations regarding rainwater harvesting and savings in agricultural water consumption, in addition to suggesting water treatment and distribution systems, enabling systemic water resource management adapted to local context-specific conditions and needs.

Epidemeiology of Burns in Peadiatric Patients in Pakistan: A Systemic Review

Burns are graded as the fourth most common trauma type globally followed by other traumas including accidents, interpersonal violence and falls. South Asian regions account for 187- 243 incidences of burns in adults per hundred thousand annually. Moreover, about 22.5% of all burns occur in children and youth. 42% of those in children between the ages of 5 to 16 years old. Whereas Pakistan lacks national data and cannot measure the burn burden annually. Due to the lack of clinical and epidemiological studies on burns in pediatrics patients in Pakistan, we performed this study. This systemic review study aimed at summarizing available Pakistan’s epidemiological data, based on national studies in the past 32 years. The data of our systemic review were collected from six search engines, i.e. PubMed, Google Scholar, PakMediNet, Scopus, Springer and DOAJ. The studies which were reviewed for the article were from 1990 to 2022. The articles of nonhuman participants, duplication and lacking in primary focus were excluded. The PRISMA guidelines were used. A total of 11 articles were included out of which 4 are from Islamabad ICT, 2 from Sindh, 1 from Balochistan and 4 from Punjab. The overall gender ratio shows male dominance of 55.83 %. Scald burn were recorded at a higher percentage of 48.7%. The mean TBSA recorded in this research was 17%. The mean mortality rate of all the studies shows a percentage of 14.84%. More research studies are needed to be done in the areas lacking information about the victims of burn injuries so that policymakers know the actual figure of the injuries with whom they have to deal.

Public Health Impacts on Economic Growth in Developing Countries: An Analytical Review of Research

This paper identifies an analytical review of the study on how public health impacts economic growth in developing countries of South Asia such as Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan and Sri Lanka by using the data from 2009 to 2023 by WDI. This research used the panel data framework for data analysis. Overall panel regression finding shows that the effect of public health such as capital stock and life expectancy on sustainable economic growth is positive. Furthermore, fertility rate and mortality rate negative impact on GDP or sustainable economic growth in South Asia region of developing countries. These findings suggest that sustainable economic growth can be improved by increasing public health facilities as a result, sustainable economic growth improves. The study also suggested recommendations for policy options and innovative solutions that lead to improved economic growth.

Building-SAT: a whole building life cycle assessment tool framework to quantify the global warming potential of buildings in South Asian Region

Building-SAT: a whole building life cycle assessment tool framework to quantify the global warming potential of buildings in South Asian Region

Control Of Corruption In Moderating The Effect Of Per Capita Income And Shadow Economy On Tax Revenue

The less optimal tax revenue, the low level of income, the large proportion of shadow economy in the economies and the high level of corruption are problems for development. This study tries to revisit the linkage of these four development problems, and find out how corruption control conducted by the government can strengthen or weaken the impact of per capita income and shadow economy activities on tax revenue. A dataset of eighteen countries in the South Asia and Asia-Pacific region from 2002 to 2017 is analyzed using panel data regression. It was found that per capita income and government efforts to control corruption significantly have a positive effect on tax revenue, while the shadow economy significantly has a negative effect on tax revenue. Furthermore, as a moderating variable, government efforts to control corruption can significantly reduce the negative effect of the shadow economy on tax revenue. This finding suggests the urgency of controlling corruption by the government to optimize tax revenue, thereby overcoming development problems.

Global, regional and national burdens of nutritional deficiencies, from 1990 to 2019.

The epidemiological and burden characteristics of nutritional deficiencies (ND) have been evolving, and it is crucial to identify geographical disparities and emerging trends. This study aimed to analyse the global, regional and national trends in the burden of ND over the past 30 years. Data were obtained from the Global Burden of Disease (GBD) 2019 database for the period 1990-2019. The study examined the incidence rates and disability-adjusted life years (DALY) of ND at various levels. Globally, the incidence rate of ND decreased from 2226·2 per 100000 in 2019 to 2096·3 per 100000 in the same year, indicating a decline of 5·8 %. The average annual percentage change (AAPC) was -0·21 (-0·31, -0·11). Similarly, DALY, prevalence and mortality rates of ND exhibited significant declines (AAPC = -3·21 (-3·45, -2·96), AAPC = -0·53 (-0·55, -0·51) and AAPC = -4·97 (-5·75, -4·19), respectively). The incidence rate of ND varied based on age group, sex, cause and geographical area. Moreover, a negative association was observed between incidence and the sociodemographic index. At the regional level, the South Asia and sub-Saharan Africa regions had the highest incidence rates of ND. In conclusion, the global incidence rate of ND showed a mixed pattern, while the DALY rate consistently declined. Additionally, prevalence and mortality rates of ND decreased between 1990 and 2019.

Demographic and Clinicopathological Spectrum of Gallbladder Carcinoma in a Tertiary Care Centre in Jharkhand: A Retrospective Study.

Introduction Gallbladder carcinoma is a rare but aggressive cancer of adults that affects females more than males. Its occurrence is more common in the regions of South America and Asia. Chronic inflammation and cholelithiasis are frequently associated risk factors of gallbladder carcinoma. The incidental discovery of a gallbladder carcinoma during cholecystectomy, gross or microscopic examination of the unsuspected gallbladder specimens is termed incidental gallbladder carcinoma (IGBC). Considering the lack of extensive studies on gallbladder carcinoma in the Eastern region of India, especially in Jharkhand, this study has been done to present the demographic and clinicopathological characteristics of gallbladder carcinoma in this region. Methods A retrospective and descriptive study was done at Rajendra Institute of Medical Sciences (RIMS), Ranchi, a tertiary care center in Jharkhand. The study sample comprised 2386 gall bladder casesreceived in the Department of Pathology over five years, from December 2018 to December 2023. Results Of 2368 specimens, 25 cases (n=25) were reported as primary gallbladder carcinoma. The female-to-male ratio was 4:1. Pain was the most common complaint by the patients. Of the 25 cases, 12 were suspected intra-operatively or diagnosed microscopically (IGBC). Most showed a mass at the neck. In six cases, no gross mass/lesion was seen. Cholelithiasis is present in 19/25 cases.Most cases showed adenocarcinoma (not otherwise specified). Out of the adenocarcinoma cases, most were well differentiated. At the time of diagnosis, most were at the pT2 stage. Twelve cases of IGBC were found. Eight out of 12 IGBC were early-stage carcinoma when diagnosed. Conclusion Twenty-five cases of gallbladder carcinoma were diagnosed in the last five years in our center, with 19 (76%) of them associated with cholelithiasis. Twelve (48%) of the cases were incidentally diagnosed either preoperatively or during gross/microscopic examination, and eight (66%) of those were discovered early, out of which five (62.5%) were observed to be in the T1b stage. At this stage, there is a diversion from the general surgical management of gallbladder carcinoma for a better prognosis. This underscores the significance of routine histopathological examination of gallbladder specimens, even if there is no preoperative suspicion of gallbladder carcinoma.

Causative Analysis of Domestic Violence against Women in Punjab, Pakistan

Domestic violence against women is a significant issue globally, particularly in developing regions of Africa, Latin America, and South Asia. Many movements have been initiated to preserve human rights, advocating for women in developing countries like Pakistan. Despite addressing this issue, the desired outcomes have not been achieved. Therefore, the present study aimed to determine the causative patterns of Domestic Violence against Women (DVAW) in Punjab, Pakistan. A cross-sectional survey was conducted in the divisional districts of Punjab, Pakistan, using snowball sampling. Data were collected using an interview schedule among 216 married and divorced/separated victims of DVAW. Cross tabulation and logistic regression analyses were performed to analyze data. Results showed that economic exploitation was a significant cause of domestic violence (56%), leading to separation/divorce (27.8%). Women often experienced threats of divorce (50%), killing (44%), and kicking out (50%). Younger women, particularly those aged less than 20 years, 21–25, and 26–30, were more vulnerable to domestic violence. Education was a protective factor, with illiterate women experiencing a higher probability of domestic violence (OR = 14.693, p = 0.001) compared to highly educated women. Extended family patterns and unemployment were associated with an increased probability of domestic violence. The present study also concluded that immediate and multidimensional actions are needed to address this issue.

Impact of Health and Non-health Inputs on Health Outcomes: A Comparative Study of South Asia, Southeast Asia, BRICS and ASEAN Regions

This study assessed the impact of health and non-health factors on crude death rate, infant mortality rate and life expectancy at birth across 21 developing and emerging countries. Utilising panel regression and Z-score methods, it identified two country clusters based on the relationship between health input augmenting factors and health outcomes. Findings revealed variations in health outcomes among emerging countries like the Russian Federation, Brazil, China, and India compared to some developing countries. The study emphasised the significant role of health input augmenting factors and noted varied influences of socio-economic, environmental and health factors on health outcomes. Additionally, a notably stronger elasticity of health outcomes was observed concerning non-health determinants. JEL: I12; I13; I15

The atmospheric aerosol spatial distribution and tropical intra-seasonal oscillations over the South Asian region

Intra-seasonal oscillations (ISO) are well known to modulate the weather phenomena which in turn are known to influence the atmospheric aerosol loading. This study investigates how aerosol loading is modulated in ISO spatio-temporal scales over the Indian region using long-term satellite aerosol optical depth data from Moderate Resolution Imaging Spectroradiometer (MODIS) sensor, onboard Terra Satellite. It is shown that Madden-Julian Oscillation (MJO) and Equatorial Rossby waves (ER) have the highest effect (15–20% of the mean) followed by Mixed-Rossby-gravity and Tropical depressions (MT), and Kelvin wave (KE) (5–15%). Further, a dipolar pattern in aerosol loading was observed, with poles over the Arabian Sea and the Bay of Bengal. These variabilities were found to be mainly driven by anomalous winds associated with the ISOs. Similar to aerosol, dipolar signatures in the atmospheric aerosol radiative forcing (ARF) were also observed with clearer patterns. However, the forcing poles are not centered exactly where aerosol poles were observed, indicating the effect of differential properties of aerosols on the aerosol radiative forcing. Quantitatively, at the surface level, modulation in ARF is up to 3 Wm-2 (15%) for MJO and ER, and up to 2 Wm-2 (5%) for KE and MT; in the atmosphere and at the top of the atmosphere, modulation is up to 2 Wm-2 (15%) for MJO and ER, and up to 1 Wm-2 (5%) for KE and MT.

Role of governance in attracting foreign direct investment inflow: empirical evidence from South Asia region

Role of governance in attracting foreign direct investment inflow: empirical evidence from South Asia region

Energy Dependency of South Asian Economies: A Comparative Analysis

The main purpose of this research study is to assess and compare energy dependency (ED) performance scores by focusing on South Asian economies within the Data Envelopment Analysis (DEA) framework. Data is utilized for the period 2003 to 2021. The results indicate that the energy sectors of Pakistan and India exhibited inefficient performance within the South Asian region. Both countries faced challenges in effectively using and producing energy from their primary energy resources, leading to a remarkable growth rate in ED. Considering these findings, it is crucial for Pakistan and India to critically review their existing energy policies based on scientific principles. The primary objective should be to develop and implement an appropriate energy policy that effectively reduces their dependency on energy imports and addresses the inefficiencies within their energy systems.

Humanizing the Line: Indo-Pak Border in Ashvin Kumar’s Little Terrorist

India and Pakistan are neighboring countries in the South Asian region, bearing centuries of united history, culture and collective struggle against colonial rule. The end of the colonial era of this subcontinent with partition to adhere to the separate nation demanded for Hindus and Muslims created massive havoc to these countries that were once united. Furthermore, the partition of the sub-continent has become the genesis of the severed relationship between these nations. This article delves into discussing the idea of the India and Pakistan border visualized in Ashvin Kumar’s critically acclaimed Hindi short film Little Terrorist (2004). The film presents an alternative viewpoint to the presence of borders and the separation of humans based on nationality by showing the border villages of India and Pakistan. The short film forges a path for friendship between the two nations by reminiscing the shared history through the characters Jamal and Bhola. The film, by showing the border village, is subverting the idea of the Indo-Pak border for the people who once lived together. This article analyzes the concept of borders in the film using the research on Indo-Pak border studies.

Investigating the environmental Kuznets curve hypothesis with urbanization, industrialization, and service sector for six South Asian Countries: Fresh evidence from Driscoll Kraay standard error

South Asia is the most polluted region in the world and is struggling to deal with the effects of growing CO2 emissions and the ecological impact it has left. The region needs to identify the variables that are most effective in reducing pollution in order to achieve long-term sustainable growth. The current study aims to investigate the environmental impacts of the current and projected urbanization rate, the service sector, and the availability of natural resources to test the environmental Kuznets-curve (EKC) theory in six South Asian countries (SAARC). With cross-sectional dependence present, this research examines panel data from 1972 to 2021 using the newly developed Driscoll Kraay Standard Error (DKSE) approach. To check the robustness of DKSE estimation, the study employs a novel Cross Sectional Autoregressive Distributive Lag (CS-ARDL) method. The results of DKSE show that GDP significantly minimizes CO2 emissions in both the short and long run. At the same time, GDP2, urbanization, and the service sector increase CO2 emissions in the South Asian region. The DKSE estimator also shows that industrialization and abundant natural resources have insignificant impacts on CO2 emissions. Inconsistent with the EKC hypothesis, the findings show that higher economic growth leads to increased environmental pollution and CO2 levels. Meanwhile, the CS-ARDL analysis found that GDP and industrialization reduce CO2 emissions, while urbanization, GDP2, and natural resource availability increase CO2 emissions. This research emphasizes the need for establishing appropriate industrialization and urbanization strategies and promoting cleaner energy adoption to reduce CO2 emissions.

Effects of different irrigation methods and mulching on yield, growth and water use efficiency of strawberry

ABSTRACT A greenhouse experiment was conducted from 2015–2016 to 2017–2018 on an Aeric Haplaquept to evaluate the effect of irrigation (surface irrigation at furrows at irrigation water: cumulative pan evaporation = 1, drip irrigation to meet 100%, 80% and 60% of actual crop evapotranspiration demand), and mulch (nonwoven jute agro textile, biodegradable plastic film, rice straw and no mulch) regimes on strawberry. Average soil water storage in root zone (86 mm) and fraction of potential plant available water (61%) was highest in jute agrotextile mulched and drip irrigated at 80% actual evapotranspiration. This combination of mulch and irrigation regime increased belowground (root length density, 7.15 × 103 mm−3) and above ground (leaf area index, 9.4) crop growth and emerged as the best option with three- and four-times higher yield (31.1 Mg ha −1) and water use efficiency (23.1 kg m−3), respectively than surface irrigated unmulched strawberry. Results suggest that these findings be incorporated into packages and practices of strawberry cultivation in the moist tropical sub-humid region of Bengal basin and other similar agroecological regions of South Asia.

Westerlies-driven transboundary transport of atmospheric mercury to the north-central Tibetan Plateau

The transboundary mercury (Hg) pollution has caused adverse effects on fragile ecosystems of the Tibetan Plateau (TP). Yet, knowledge of transport paths and source regions of atmospheric Hg on the inland TP remains poor. Continuous measurements of atmospheric total gaseous mercury (TGM) were conducted in the central TP (Tanggula station, 5100 m a.s.l., June–October). Atmospheric TGM level at Tanggula station (1.90 ± 0.30 ng m−3) was higher than the background level in the Northern Hemisphere. The identified high-potential source regions of atmospheric TGM were primarily located in the northern South Asia region. TGM concentrations were lower during the Indian summer monsoon (ISM)-dominant period (1.81 ± 0.25 ng m−3) than those of the westerly-receding period (2.18 ± 0.40 ng m−3) and westerly-intensifying period (1.91 ± 0.26 ng m−3), contrary to the seasonal pattern in southern TP. The distinct TGM minima during the ISM-dominant period indicated lesser importance of ISM-transported Hg to Tanggula station located in the northern boundary of ISM intrusion, compared to stations in proximity to South and Southeast Asia source regions. Instead, from the ISM-dominant period to the westerly-intensifying period, TGM concentrations showed an increasing trend as westerlies intensified, indicating the key role of westerlies in transboundary transport of atmospheric Hg to the inland TP.