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This paper reports the results of a survey of vaccination status and smallpox history undertaken in the city of Lahore West Pakistan in 1968-69 6 months before introduction of an eradication program. An aim of the survey was to develop reliable estimates of the immunization status of a typical urban population that could be used as a baseline for assessment of the subsequent eradication program. The sampling procedure used in this study was a 3-stage cluster sample of the population. This provided an acceptable degree of precision with a minimum utilization of field resources. 6952 (86%) individuals from the final enumerated sample of 8064 were examined and interviewed. Overall 90.3% of the population was found to have vaccination scars; there were no significant sex differences. On the basis of interviews 93.4% had a positive vaccination history although 24.4% had received only primary vaccination. An estimated 68.3% of the population had a history of vaccination or revaccination within the last 3 years and 80.2% within the last 10 years. Vaccination status was directly related to location of the city area; lower rates of reported vaccination were obtained in peripheral areas and agricultural neighborhoods. An estimated 4.7% of the population had a history of previous smallpox. When the 90.3% with visible evidence of successful immunization were combined with the 2.8% with a history of past smallpox and no vaccination scars an overall level of past experience with pox virus antigens of 93.1% was obtained. These results suggest a relatively high level of vaccination in the Lahore area. The persistence of endemic smallpox despite this achievement is attributed to the considerable numbers of younger children who are not vaccinated and the waning of immunity in older age groups.

The senior author has elsewhere argued [8] that foreign exchange earned by the export of West Pakistan-manufactured goods has a high domestic cost. Much the same contention has been advanced by Hecox [7], Islam [9] and MacEwan [11]. In these papers the relationship between costs and earnings is usually based on fairly abstract assumptions. The purpose of this note is to reduce the calculations to a "plain man" level. Specifically, we try to calculate how many rupees of indigenous resources are expended to earn each extra rupee of foreign exchange which is received from exporting cotton textiles and leather goods rather than their primary ingredients, namely raw cotton and hides and skins i. Since this note was written, the Board of Economic Inquiry, Lahore, at the request of the West Pakistan Planning and Development Department, has undertaken a wider study applying the same general approach used here.

BACKGROUND: The first appendectomy was performed by Claudius Amyand in 1736 when he wasoperating on a boy for hernia and found appendix lying in hernial sac. Reginald Fitz introduced the wordappendicitis in 1886 and before that it was called typhlitis or perityphlitis.Frederick Treves performedthe lstappendicle surgery in England for the new disease ‘appendicitis’ in 1887.OBJECTIVE: To study the accuracy of modified Alvarado scorning system in diagnosis of acuteappendicitis.MATERIAL & METHODS: This descriptive cross sectional study was conducted at DHQ HospitalTimergara Dir lower from January 2015 to July 2015 to find out the accuracy of Alvarado Scoringsystem in the diagnoses of acute appendicitis. A total of 50 patients admitted in surgical ward from OPDand Casualty with suspected appendicitis were included in the study. Patients less than 7 years andpatients with mass right iliac fossa were excluded. Every patient was evaluated with modified Alvaradoscoring system on a standard Proforma. Patients with Alvarado score of > 6 underwent appendectomy.The removed appendices were sent for histopathology to confirm or otherwise the provisional diagnosisof acute appendicitis and hence the accuracy of Alvarado scoring system.RESULTS: Out of 50 patients, 20 were male &30 were female with a male to female ratio of 1:1.5. Themean age of the patients was 19.7 ± 9.6years. The mean Alvarado score was 7.92 ± 1.383. TheHistopathology reports of the specimens of 37 patients were confirmative of acute appendicitis whereasthe rest of the (13 patients) removed appendices were reported normal by histopathalogist. So thesensitivity is 74%.CONCLUSION: Our study shows that Alvarado scoring system is a simple and quick tool in theevaluation and management of suspected cases of acute appendicitis. Its accuracy increases if used inpatients above 14 years of age.KEYWORD: Alvarado scoring system, Appendicitis, Accuracy.

The curriculum of elementary schools revolves around the pivot of the three R's. Arithmetic is considered to be the most important subject, and right from the first grade it absorbs the most of the teachers' and pupils' attention in Pakistan. But, at the same time, this is the subject which is perhaps least liked by children. For them it is a hard nut to crack. They are punished because they are poor at figures. A large number of children give up their education during the first five years of elementary education. A relatively small percentage of the boys and girls who complete their elementary-school education go on to complete high school.1 Along with other factors, a child's failure to grasp the knowledge imparted is the most important reason. In the last several decades in Pakistan, mathematics and English have been considered responsible for the poor pass percentage, which usually lies in the range of 50 to 60 per cent. Thousands of disgusted high-school students bid farewell to education forever for the lower attainment in arithmetic and foreign language. What a horrible waste!