Training in cardiothoracic surgery: The role for simulation.

Adequate cardiothoracic surgical training is essential for provision of quality care to patients. In recent years, simulation-based training has been advocated as an adjunct to traditional surgical training. Advances in simulation technology has resulted in many low- and highfidelity simulators being employed in cardiothoracic surgical training. Such models allow trainees to practice an array of realistic full-length procedures in a safe and controlled environment, with the window to make mistakes and consider them learning points. There is significant evidence to demonstrate the effectiveness of cardiothoracic surgery simulation in improving surgical skills and operating room performances in addition to building confidence among trainees. However, owing to the high financial cost of arranging it, simulation-based training is not widespread in low- and middle-income countries, including Pakistan. More work is warranted on the cost effectiveness of implementing simulation-based learning, which, in turn, would increase the uptake of simulation to enhance cardiothoracic surgical training in Pakistan.

Microplastic accumulation in groundwater: Data-scaled insights and future research.

Given that microplastics (MPs) in groundwater have been concerned for risks to humans and ecosystems with increased publications, a Contrasting Analysis of Scales (CAS) approach is developed by this study to synthesize all existing data into a hierarchical understanding of MP accumulation in groundwater. Within the full data of 386 compiled samples, the median abundance of MPs in Open Groundwater (OG) and Closed Groundwater (CG) were 4.4 and 2.5 items/L respectively, with OG exhibiting a greater diversity of MP colors and larger particle sizes. The different pathways of MP entry (i.e., surface runoff and rock interstices) into OG and CG led to this difference. At the regional scale, median MP abundance in nature reserves and landfills were 17.5 and 13.4 items/L, respectively, all the sampling points showed high pollution load risk. MPs in agricultural areas exhibited a high coefficient of variation (716.7%), and a median abundance of 1.0 items/L. Anthropogenic activities at the regional scale are the drivers behind the differentiation in the morphological characteristics of MPs, where groundwater in residential areas with highly toxic polymers (e.g., polyvinylchloride) deserves prolonged attention. At the local scale, the transport of MPs is controlled by groundwater flow paths, with a higher abundance of MP particles downstream than upstream, and MPs with regular surfaces and lower resistance (e.g., pellets) are more likely to be transported over long distances. From the data-scaled insight this study provides on the accumulation of MPs, future research should be directed towards network-based observation for groundwater-rich regions covered with landfills, residences, and agricultural land.

Atypical retinal function in a mouse model of Fragile X syndrome.

Altered function of peripheral sensory neurons is an emerging mechanism for symptoms of autism spectrum disorders. Visual sensitivities are common in autism, but whether differences in the retina might underlie these sensitivities is not well-understood. We explored retinal function in the Fmr1 knockout model of Fragile X syndrome, focusing on a specific type of retinal neuron, the "sustained On alpha" retinal ganglion cell. We found that these cells exhibit changes in dendritic structure and dampened responses to light in the Fmr1 knockout. We show that decreased light sensitivity is due to increased inhibitory input and reduced E-I balance. The change in E-I balance supports maintenance of circuit excitability similar to what has been observed in cortex. These results show that loss of Fmr1 in the mouse retina affects sensory function of one retinal neuron type. Our findings suggest that the retina may be relevant for understanding visual function in Fragile X syndrome.

Tailoring Bi2Se3 Topological Insulator for Visible-NIR Photodetectors with Schottky Contacts Using Liquid Phase Exfoliation.

Layered semiconductors of the V-VI group have attracted considerable attention in optoelectronic applications owing to their atomically thin structures. They offer thickness-dependent optical and electronic properties, promising ultrafast response time, and high sensitivity. Compared to the bulk, 2D bismuth selenide (Bi2Se3) is recently considered a highly promising material. In this study, 2D nanosheets are synthesized by prolonged sonication in two different solvents, such as N-methyl-2-pyrrolidone (NMP) and chitosan-acetic acid solution (CS-HAc), using the liquid-phase exfoliation (LPE) method. X-ray diffraction confirms the amorphous nature of exfoliated 2D nanosheets with maximum peak intensity at the same position (015) crystal plane as that obtained in its bulk counterpart. SEM confirms the thin 2D nanosheet-like morphology. Successful exfoliation of Bi2Se3 nanosheets up to five layers is achieved using CS-HAc solvent. The as-synthesized 2D nanosheets in different solvents are employed to fabricate the photodetector. At minimum selected power density, the photodetector fabricated using exfoliated ultrathin 2D nanosheets exhibits the highest range of responsivity, varying from 15 to 2.5 mA/W, and detectivity ranging from 2.83 × 109 to 6.37 × 107. Ultrathin 2D Bi2Se3 nanosheets have fast rise and fall times, ranging from 0.01 to 0.12 and 0.01 to 0.06 s, respectively, at different wavelengths. Ultrathin Bi2Se3 nanosheets have improved photodetection parameters as compared to multilayered nanosheets due to the high surface to volume ratio, reduced recombination and trapping of charge carrier, improved carrier confinement, and faster carrier transport due to the thin layer.

Ketamine to Prevent Endotracheal Intubation in Adults with Refractory Non-convulsive Status Epilepticus: A Case Series.

BACKGROUND: Non-convulsive status epilepticus (NCSE) is defined as status epilepticus (SE) with no obvious motor phenomenon and is diagnosed based on electroencephalogram (EEG). Refractory SE (RSE) is the persistence of seizures despite treatment with an adequately dosed first-line and second-line agents. Although guidelines for convulsive RSE include third-line agents such as intravenous anesthetic drugs (midazolam, propofol, or barbiturates), the therapeutic approach to NCSE is not well outlined. Treatment with traditional anesthetics invariably includes endotracheal intubation, which is associated with significant adverse events. Comparatively, ketamine, a non-competitive N-methyl-D-aspartate receptor antagonist is not associated with significant cardiorespiratory depression and may help in avoiding intubation. OBJECTIVE: In this case series, we describe our experience with the early use of intravenous ketamine as the first anesthetic agent in patients with refractory NCSE to avoid endotracheal intubation. METHODS: We present a case series of nine patients managed in the Neurointensive Care Unit at a university-affiliated tertiary care hospital. The study was approved by the hospital and university institutional review boards and the requirement for informed consent was waived for retrospective analysis of existing data, per institutional policy. All cases of SE were identified from a prospective database, and a subsequent retrospective chart review identified all patients with a diagnosis of refractory NCSE in whom ketamine was used as the first anesthetic agent. The primary endpoint was the avoidance of endotracheal intubation while on ketamine infusion. The secondary endpoint was defined as cessation of both clinical and electrographic seizures recorded on continuous EEG within 24 h of ketamine administration. RESULTS: A total of nine patients experiencing refractory NCSE were included in this case series, with a median age of 61 (range 26-72) years and seven patients were male. The primary endpoint, avoiding intubation, was achieved in five out of nine (55%) cases. Six patients experienced resolution of refractory NCSE with ketamine administration as the sole anesthetic agent. Four patients required endotracheal intubation and three patients had a failure of seizure cessation with ketamine. Hypersalivation and pneumonia were the most common ketamine associated adverse events. In non-intubated patients, no deaths occurred. One patient was discharged home, four to subacute rehabilitation, one to a long term acute care hospital, and one patient to hospice. CONCLUSION: The use of ketamine as the primary anesthetic agent may be a reasonable option to avoid endotracheal intubation in a subset of patients with refractory NCSE. This study is limited by its small sample size, retrospective design, and reliance on information obtained from chart review.

Niche suitability and spatial distribution patterns of anurans in a unique Ecoregion mosaic of Northern Pakistan.

The lack of information regarding biodiversity status hampers designing and implementing conservation strategies and achieving future targets. Northern Pakistan consists of a unique ecoregion mosaic which supports a myriad of environmental niches for anuran diversity in comparison to the deserts and xeric shrublands throughout the rest of the country. In order to study the niche suitability, species overlap and distribution patterns in Pakistan, we collected observational data for nine anuran species across several distinct ecoregions by surveying 87 randomly selected locations from 2016 to 2018 in Rawalpindi District and Islamabad Capital Territory. Our model showed that the precipitation of the warmest and coldest quarter, distance to rivers and vegetation were the greatest drivers of anuran distribution, expectedly indicating that the presence of humid forests and proximity to waterways greatly influences the habitable range of anurans in Pakistan. Sympatric overlap between species occurred at significantly higher density in tropical and subtropical coniferous forests than in other ecoregion types. We found species such as Minervarya spp., Hoplobatrachus tigerinus and Euphlyctis spp. preferred the lowlands in proximal, central and southern parts of the study area proximal to urban settlements, with little vegetation and higher average temperatures. Duttaphrynus bengalensis and D. stomaticus had scattered distributions throughout the study area with no clear preference for elevation. Sphaerotheca pashchima was patchily distributed in the midwestern extent of the study area as well as the foothills to the north. Microhyla nilphamariensis was widely distributed throughout the study area with a preference for both lowlands and montane terrain. Endemic frogs (Nanorana vicina and Allopaa hazarensis) were observed only in locations with higher elevations, higher density of streams and lower average temperatures as compared to the other seven species sampled. It is recommended to provide legal protection to amphibians of Pakistan, especially endemic species, through revision in the existing wildlife laws. We suggest studying the effectiveness of existing amphibian tunnels and corridors or designing new ones tailored to the needs of our species to prevent their local extinction due to ongoing or proposed urban development which might affect their dispersal and colonization.

Identification and selection of suitable landfill sites using GIS-based multi-criteria decision analysis in the Peshawar District, Pakistan.

Managing municipal solid waste (MSW) is indispensable for public health and quality living standards in urban and rural environments. Suitable landfill site selection (LSS) requires the consideration of many diverse criteria. This study uses various environmental, social and economic criteria in a sophisticated multi-criteria decision analysis (MCDA) within the geographical information system (GIS) and aims to provide a scientific basis for the identification of suitable landfill sites which can efficiently be used for MSW in one of the most urbanized cities (Peshawar district) in Pakistan. The methodology involves pairwise comparisons of the selected and ranked criteria using the analytical hierarchy process (AHP). A weighted linear combination (WLC) was applied to generate the most suitable landfill site for MSW disposal within the study area. The results show that approximately 11.4% (14,485.15 ha) and 16.6% (21,211.95 ha) of the total study area are either very highly suitable or highly suitable, 20.8% (26,525.56 ha) area is unsuitable and the remaining areas are either low (27.3%; 34,834.84 ha) or moderately suitable (23.8%; 30,356.84 ha) for the construction of landfill sites. It is recommended that using the proposed landfill sites would have the least consequences of public health risks and environmental degradation.

Lab protocol for investigating impacts of climate change on frogs.

We developed a method to investigate impacts of temperature (elevated) on breeding, growth and development in endemic frogs under laboratory conditions. The method provides details on housing and rearing of larvae, taking various important measurements and observing developmental deformities. The method could also be applied to rescue approach or head-start program for amphibian species experiencing climate change elsewhere in the world. • Rearing of larvae to investigate effects of temperature on larvae • Measurement of data on growth and development • Rescue/ head-start program.

Mitigations pathways towards sustainable development: assessing the influence of higher education on environmental quality in BRICS economies.

Education plays a significant role in the development of economies. This study empirically contributes to the literature by examining the impacts of higher education on CO2 emissions of BRICS economies over the period 1998-2020. For empirical analysis, we used the ARDL bound testing approach. The findings of the study show that higher education significantly and negatively contributed to the CO2 emissions of China and confirm the education-CO2-led hypothesis in the long run. The results of the study also reveal that higher education in Russia, India, and South Africa exerts a positive impact on CO2 emissions in the long run and rejects the education-CO2-led hypothesis. Moreover, financial inclusion has a negative impact on CO2 emissions in China, Russia, and South Africa, while financial inclusion positively affects CO2 emissions in only India in the long run. Based on findings, authorities should extend financial and social support for higher academic activities aimed at the mitigation of environmental pollution. Policymakers should also consider the synergy influence of financial inclusion in designing carbon mitigation policies.

VQProtect: Lightweight Visual Quality Protection for Error-Prone Selectively Encrypted Video Streaming.

Mobile multimedia communication requires considerable resources such as bandwidth and efficiency to support Quality-of-Service (QoS) and user Quality-of-Experience (QoE). To increase the available bandwidth, 5G network designers have incorporated Cognitive Radio (CR), which can adjust communication parameters according to the needs of an application. The transmission errors occur in wireless networks, which, without remedial action, will result in degraded video quality. Secure transmission is also a challenge for such channels. Therefore, this paper's innovative scheme "VQProtect" focuses on the visual quality protection of compressed videos by detecting and correcting channel errors while at the same time maintaining video end-to-end confidentiality so that the content remains unwatchable. For the purpose, a two-round secure process is implemented on selected syntax elements of the compressed H.264/AVC bitstreams. To uphold the visual quality of data affected by channel errors, a computationally efficient Forward Error Correction (FEC) method using Random Linear Block coding (with complexity of O(k(n-1)) is implemented to correct the erroneous data bits, effectively eliminating the need for retransmission. Errors affecting an average of 7-10% of the video data bits were simulated with the Gilbert-Elliot model when experimental results demonstrated that 90% of the resulting channel errors were observed to be recoverable by correctly inferring the values of erroneous bits. The proposed solution's effectiveness over selectively encrypted and error-prone video has been validated through a range of Video Quality Assessment (VQA) metrics.

Atypical presentation of a rare gestational trophoblastic neoplasm: A case report.

A 34-year-old woman had a history of 3 miscarriages and presented with symptoms of an unproductive cough and rising serum beta-human chorionic gonadotropin (b-hCG) levels. There were no gynaecological symptoms. A diagnosis of Choriocarcinoma with pulmonary metastasis was made. In Pakistan, the incidence of Choriocarcinoma remains exceedingly rare, accounting for less than 0.3% of all gynaecologic tumours. Though rare, if managed appropriately, it has a reasonably good prognosis, as demonstrated by the outcome of the current case.

Pulmonary Adenoid Cystic Carcinoma Presenting Late With Intrapericardial Extension: Case Report.

Adenoid cystic carcinoma, also known as cylindroma, is one of the rare and unexplored clinical presentations of lung cancer, for which existing knowledge is scarce. This case report discusses a presentation of this tumor in the right lung, which subsequently extended to the left atrium through the right superior pulmonary vein. The extension of this rare tumor into the left atrium makes this case both uniquely distinctive and clinically relevant. The management strategy opted for this case was a right posterolateral thoracotomy and right pneumonectomy with partial resection of the left atrium. The desired outcome of this report is to shed light on the unusual clinical pathophysiology, register its atypical extensions, and navigate surgeons who may encounter this manifestation in the future.

Non-compliance to social distancing during COVID-19 pandemic: A comparative cross-sectional study between the developed and developing countries.

BACKGROUND: Despite mass vaccination campaigns, the world has seen a steady rise in the number of SARS-CoV-2 cases, with 178,765,626 cases and 3,869,994 COVID-19 related deaths by June 19th, 2021. Therefore, it is important to enforce social distancing to control its spread. With the variation observed in the severity of the pandemic in different countries, it is also imperative to study the social distancing behaviors amongst the population in developed and developing countries. DESIGN AND METHODS: In this cross-sectional study, a total of 384 participants from 14 different countries were surveyed via an online REDCap form. RESULTS: In this study, it was highlighted that despite adequate knowledge, the overall compliance to COVID-19 related preventive measures remains poor, the lowest being in the senior age group (≥ 65 years), and the highest being in adults aged between 25-64 years (p=0.003). Population from the developing countries were more compliant to all preventative measures against COVID-19 spread, except for handwashing, where the difference between the two populations remained insignificant (p=0.038, p<0.001, p=0.016) Socioeconomic status, prior history of COVID-19 infection or presence of comorbidities did not significantly affect compliance rates, however, participants with no prior history of this infection were found to be more compliant to donning a mask in public as compared to those with a positive history (p=0.044). CONCLUSIONS: Since compliance remains subpar in both the developing and the developed countries, mass campaigns about COVID-19 related preventive measures remain essential in controlling the disease spread.

Ethnobotanical and Biochemical Study of Berberis lycium Royle Collected from Different Areas of Azad Jammu and Kashmir.

Berberis lycium Royle has a long history of medicinal uses to treat different diseases. It naturally grows on the mountains of Indian subcontinent. Its ethnobotanical and biochemical study from the state of Azad Jammu and Kashmir (AJ&K) was not previously explored. So, the objective of the current study was to explore the ethnobotanical and biochemical properties of the B. lycium Royle population of AJ&K. For this purpose, samples of B. lycium Royle were randomly collected from five districts of Azad Jammu and Kashmir, including thirty-five locations. Demographic features of informants such as plant part used, methods of preparation, modes of administration, conservation status, and ethnomedicinal uses were documented. It was used for treating different diseases such as diabetes, arthritis, joint pain, and stomach ulcer. This plant is very famous for providing medicinal roots, leaves, and fruits which are extensively used in many parts of the world. The biochemical analysis was conducted for total phenolic contents (TPC), chlorophyll contents, and antioxidant activity. The highest level of TPC found was 88.66 ± 1.07 µg/g of gallic acid equivalent phenolic (GAE) from leaves collected from Patikka (Chanjhal), Muzaffarabad District, AJ&K. The highest total chlorophyll contents (3.75 ± 0.53 µg/ml) were found in samples collected from Sathrian, Neelum District. The highest antioxidant activity with lowest IC50 value (33.26 µg/ml) was obtained from the root of sample collected from Bakreyali, Muzaffarabad District, as compared with other districts. The concentration of berberine was found to be 4.76 percent in the root bark of B. lycium Royle, estimated by high-performance liquid chromatography (HPLC). In syrup composition, 0.95 mg/5 ml of berberine was used. Hence, it is concluded that amongst the five districts, the plant parts (stem, fruits, and root) collected from Muzaffarabad District, AJ&K, showed the highest medicinal potential due to its unique climatic conditions.

First insight into the occurrence, spatial distribution, sources, and risks assessment of antibiotics in groundwater from major urban-rural settings of Pakistan.

Antibiotics contamination in the water environment is a high priority global concern. Growing levels of antibiotics in freshwater resources, especially groundwater, due to anthropogenic sources such as pharmaceutical and veterinary applications, are alarming. The present study aims to investigate the occurrence, spatial distribution, source apportionment, ecological, and human health risks of antibiotics (n = 23) in groundwater samples (n = 144) of highly populated cities of Pakistan. The elevated level of antibiotics was detected in Faisalabad with the mean concentrations of 13.8 ng/L, followed by Gujrat (7.8 ng/L), Lahore (4.04 ng/L), Quetta 3.9 ng/L, Rawalpindi/Islamabad (2.29 ng/L), and Peshawar (2.03 ng/L), respectively. Out of 23 investigated antibiotics, tigecycline and ciprofloxacin were predominantly present in groundwater with average concentrations of 21.3 ng/L and 18.2 ng/L, respectively. The spatial distribution analyses revealed that among the targeted cities, Faisalabad, an industrial hub of the country, had the most polluted groundwater with dominant classes of antibiotics including quinolones (except flumequine), ß-Lactams, tetracyclines, sulfonamides, and amphenicols, implying an elevated consumption of human and veterinary drugs in the city. The occurrence of targeted antibiotics varied greatly among cities (p < 0.05). PCA-MLR analysis confirmed domestic discharge (31%), animal husbandry (19%), and pharmaceutical/hospital discharge (48%) as the chief contributors to antibiotics contamination in groundwater of Faisalabad. The risk quotient (RQ) values of targeted antibiotics were reported as 1.16E-07 to 1.03E-02, and demonstrated that antibiotics pose no risks to human health, while hazard quotient (HQ) values were observed as 09.5E-05 to 6.6E-01, and only ciprofloxacin, flumequine, oxytetracycline, and sulfamethoxazole revealed moderate to low ecological risks to water species (0.1 < HQ < 1). Since, no detailed study has been conducted to evaluate the antibiotics' contamination in groundwater of Pakistan, this robust investigation provides a way forward to further explore the environmental and human health implications of antibiotics in major urban-rural settings in the region.

Ambispective study of adverse drug reactions in multi-drug resistant tuberculosis patients in Warangal, Telangana.

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) has become a global threat concerning to a risk of high mortality with the potential to cause adverse drug reactions (ADRs) which if not managed properly may affect patient compliance, resulting in below par treatment outcome. AIM: The aim of the study was to study, assess, and report the ADRs of patients diagnosed with MDR-TB. SUBJECTS AND METHODS: An ambispective, observational study was conducted among confirmed cases of MDR-TB patients without any comorbidities during the period of January 2015-December 2018 in patients of age 15 years and above. STATISTICAL ANALYSIS: Data were analyzed descriptively using MS-Excel sheet 2013 and Chi-square test in GraphPad Prism 8.2.1. Results were expressed as either frequency, percentage, or mean ± standard deviation. ADRs were evaluated for causality, severity, and preventability attributes. RESULTS: In the sample size of 400 patients, 236 (ADRs) were reported among 136 patients. The proportion of ADRs was higher in males (P = 0.0001) and in the age group of 36-75 years (P = 0.0211). Most commonly encountered ADRs include nausea and vomiting (35.31%) and arthralgia (14.04%), followed by peripheral neuropathy (8.93%) and giddiness (8.93%). Overall, 53% were of possible category and 60% of moderate level severity and 85% were unpreventable ADRs. CONCLUSION: Our study included 13 types of ADRs, of which most commonly reported were nausea and vomiting, arthralgia, and peripheral neuropathy and least common were psychosis, nephrotoxicity, and gynecomastia with a higher incidence in males. Majority of ADRs were moderate, unpreventable ADRs and had a possible relationship with the suspected drugs.

The height as an independent risk factor of atrial fibrillation: A review.

Atrial fibrillation (AF) is characterized by abnormal heart rhythm. Among other well-known associations, recent studies suggest an association of AF with height. Height is related to 50 diseases spanning different body systems, AF is one of them. Since AF, a heterogeneous disease process, is influenced by structural, neural, electrical, and hemodynamic factors, height alters this process through its contribution to increasing atrial and ventricular size, leading to altered conduction patterns, autonomic dysregulation, and development of AF. Multiple underlying mechanisms associate height with AF. Apart from these indirect mechanisms, genome-wide association studies suggest the involvement of the same genes in AF and growth pathways. Tall stature is independently associated with a higher risk of AF development in healthy individuals. Since adult height is achieved much earlier than the onset of AF, protective measures can be taken in individuals with increased height to monitor, manage, and prevent the progression of AF.

Antibiotics and antibiotic resistant genes (ARGs) in groundwater: A global review on dissemination, sources, interactions, environmental and human health risks.

The discovery and evolution of antibiotics for humans and animals are among the most significant milestones of the 20th century. However, antibiotics play a significant role in the induction and dissemination of antibiotic resistance genes (ARGs) in groundwater that has recently become the primary environmental concern. They are administrated to humans and animals on a large scale and are persistent in the environment. Long term impacts of antibiotics in the ecological environment are not still clearly understood, and their occurrence and consequences have become an important research topic worldwide. The hotspot reservoirs of antibiotics and ARGs include medical facilities, livestock farming, aquaculture, landfills, on-site sanitation systems, sewage, and wastewater treatment plants. Our meta-analysis demonstrated that antibiotics, including ciprofloxacin, sulfamethoxazole, erythromycin, and tetracycline were found at high concentrations while sulfonamide and tetracycline ARGs were more prevalent in groundwater. Moreover, the highest reported concentrations of targeted antibiotics were used to calculate hazard quotient (HQ) and risk quotient (RQ) in global groundwater bodies to estimate environmental and human health risks, respectively. Due to limited available ecotoxicity data, RQ and HQ can only be calculated for a few antibiotics in groundwater. The risk assessment of antibiotics demonstrated that antibiotics with their current groundwater levels pose no human health risks, whereas only ciprofloxacin, erythromycin, flumequine, and sulfamethoxazole revealed moderate to low risks to aquatic species. The occurrence of ARGs and antibiotic resistant bacteria (ARBs) in groundwater is also not likely to pose human health risk but consumption of groundwater contaminated with ARGs and ARBs might contribute to the development of antibiotic resistance in humans. The present review also sheds light on the relationship between ARGs, antibiotics, microbial communities, and environmental factors in groundwater, and reported a significant correlation between them. It also addresses prospects for future outlooks into further areas of relevant research.

Analysis of asymmetries in the nexus among clean energy and environmental quality in Pakistan.

This study examines the short-run and long-run asymmetric effects of clean energy consumption on carbon emission in Pakistan, over the annual time period 1975-2018, by using a non-linear ARDL approach. The findings of the study confirm the existence of asymmetries, in the nexus between the clean energy consumption and carbon emission in the short and long run. The findings of non-linear model confirm that carbon emission responded contrary to positive shocks of energy variables as compared with their negative shocks. Asymmetric findings recommend that positive and negative shocks of the alternative and nuclear energy and combustible and waste energy have affected differently. Although, short- and long-run results suggest an insignificant positive and negative relationship between electric power consumption and carbon emissions. Therefore, more taxation of non-renewable energy and clean energy supports are suggested for the Pakistan economy. We concluded that Pakistan has potential in clean energy which will improve environmental quality in the near future.