Democracy's limited impact on innovation: Panel data evidence from developing countries.

This study investigates the relationship between democracy and innovation across 61 developing countries from 2013 to 2020, utilizing data from Global Innovation Index. Employing the Freedom House Index and Polity2 indicators as proxies for democracy, research employs Ordinary Least Squares (OLS), Fixed Effects and SystemGMM techniques to analyze their impact on innovation. The findings of the study reveal no statistically significant relationships between democracy and innovation in developing nations within specified timeframe. Through empirical analysis, including various econometric approaches, it is observed that the level of democracy as measured by these indicators, does not appear to exert a discernable impact on the innovation landscape of these countries. These results carry important implications for public policy. While the promotion of democracy remains a crucial goal, especially for societal development and political stability, this study suggests that solely focusing on enhancing democratic institutions might not necessarily yield immediate direct improvements in the innovation capacities of developing nations. Policymakers and stakeholders involved in fostering innovation ecosystems in these regions may need to consider a more nuanced approach, encompassing factors beyond the scope of democratic governance to effectively spur innovation. Understanding the nuanced relationship between democracy and innovation in developing countries has significant implications for designing targeted policies aimed at enhancing innovation capacities, economic growth and overall societal development in these regions.

Preparedness of Undergraduate Medical Students for Online Learning.

OBJECTIVE: To determine the preparedness of the first-year undergraduate medical students toward online learning. STUDY DESIGN: Descriptive study. Place and Duration of the Study: The study was conducted at the Department of Medical Education, Fazaia Ruth Pfau Medical College, Air University, Karachi, Pakistan, from September to December 2021. METHODOLOGY: The study participants were first-year undergraduate medical students. A pre-validated instrument developed by Lesley University in July 2014 named 'The Prospective Online Student Readiness Questionnaire' was used. Permission was taken via email. The questionnaire has two parts. Section A consists of the demographic characteristics. Section B evaluates the student's readiness for online learning. RESULTS: Data from 81 respondents were collected through an online questionnaire. The results showed that internet self-efficacy, self directed learning, learner control, and learner style have a positive and significant relationship with students' preparedness for e-learning. CONCLUSION: Students are aware of the use of technology. They could be more comfortable working independently at the beginning of the course. Online environment and communication for learning purposes with peers also appear to be weak areas. Students prefer visual aids for learning, and very few enjoy raising their hands in class to answer questions. They are confident in social communications but need more confidence in using online tools for effective online communication and posting questions on online forums during discussions. KEY WORDS: Medical students, Online learning, preparedness, Self-efficacy, Self-directed learning.

Role of workplace bullying and workplace incivility for employee performance: Mediated-moderated mechanism.

Workplace events play a significant role in shaping the performance of employees and organizations. Negative events, in particular, require careful attention due to their severe impact on employee wellbeing and performance. Workplace bullying and incivility are two negative events that can cause significant harm to employees and contribute to poor performance. This study examines the effects of workplace bullying and incivility on employee performance in the presence of perceived psychological wellbeing (PWB), with the moderating role of perceived organizational support (POS) considered for both independent variables and employee performance (EP). The study focuses on female nurses working in the healthcare sector of Azad Jammu and Kashmir. The results of the study indicate that workplace bullying and incivility have adverse effects on employee performance and that PWB mediates these relationships. Moreover, perceived organizational support moderates the relationship between both predictors and the employee performance criterion. In conclusion, the findings of this study highlight the importance of creating a positive and supportive work environment to mitigate the negative effects of workplace bullying and incivility on employee performance.

Economic policy uncertainty and stock market in G7 Countries: A panel threshold effect perspective.

Based on the literature, it is commonly understood that stock prices (SP) are influenced by economic policy uncertainty (PU), with a rise in PU typically having a negative impact on SP. However, the relationship between PU and SP may not always be linear due to the varying risk preferences of individuals. Risk preference theory posits that individuals respond differently to different levels of risk. Therefore, this study aims to investigate whether PU determines SP asymmetrically (i.e., in a non-linear manner) by considering risk preferences and addressing a gap in the literature. To answer this question, the study employs a panel threshold approach to examine the effect of PU on SP in the Group of Seven (G7) countries, namely Canada, France, Germany, Italy, Japan, UK, and the US. In contrast to previous research, this study finds evidence of an asymmetric effect of PU on SP in the G7 countries. Specifically, the panel threshold results reveal that the impact of increased PU on SP is positive up to a certain level (Threshold1), beyond which it becomes negative (Threshold2). These findings are in line with information asymmetry hypothesis, prospect theory, behavioural finance hypothesis, and market liquidity hypothesis and shed light on the asymmetric behaviour of SP in response to varying levels of PU. The implications of these findings are significant for understanding how to manage risks effectively in the financial markets.

Does team-based learning affect test scores of the basic medical sciences students in a modular curriculum?

Objectives: The aim of the study was to determine the effectiveness of team-based learning (TBL) sessions as a learning tool and to assess the satisfaction level of medical students towards TBL in modular curriculum. Methods: Using the quasi-experimental study design, TBL sessions were conducted, involving students of 1st and 2nd year of Bachelor of Medicine and Bachelor of Surgery. The TBL infrastructure comprised of pre-class preparation, in-class individual readiness assurance pre-test and post-test, before and after group discussion, respectively. The responses of the students regarding TBL satisfaction were recorded through a structured questionnaire (5-point Likert-type scale) while Wilcoxon signed rank test was applied to measure the effectiveness of TBL sessions. Results: Out of 192 students, 85% agreed or strongly agreed that TBL helped them think critically, identify their knowledge gaps, boosted their confidence, and motivated them in group participation. Significantly better post-test scores were found in all modules where TBL was used as a teaching tool (Z range = -5.33 to -11.81, P < 0.00). Conclusion: TBL increases the post-test score in majority of the students, indicating improved learning process. It not only keeps students engaged throughout the learning process but incites critical thinking, problem solving skills, and confidence. Further studies are required to see long-term benefit of TBL in students' learning.

Prevalence of Periodontal Disease among Obese Young Adult Population in Saudi Arabia-A Cross-Sectional Study.

Background and objectives: We aimed to assess the prevalence of periodontal disease among obese young adults in Saudi Arabia and to analyze the association between different body mass indexes and the severity of periodontal disease. Materials and methods: This descriptive cross-sectional study consisted of 307 obese patients aged 18-39 years, with body mass index (BMI) ≥30. Demographic variables for periodontal disease, anthropometric parameters such as BMI along with clinical parameters such as oral hygiene index-simplified, community periodontal index (CPI) score and loss of attachment (LOA), were assessed. Multivariate binary logistic regression analysis was used to identify the predictors for chronic periodontitis in obese young adults between 18-40 years of age. Results: The majority of the participants (71.3%) had periodontal disease. Obese and extremely obese patients together showed a statistically significant difference in the age group of 21-30 years in terms of CPI score for inflammation (p < 0.05) and LOA (p < 0.001). Logistic regression analysis showed age (OR: 3.180; 95%CL: 1.337-7.561; p <.001), occasional dental visit (OR: 5.965; 95%CL: 3.130-11.368; p < 0.001), smoking >10 cigarettes (OR: 11.868; 95%CL: 3.588-39.254; p < 0.001) and poor oral hygiene status (OR: 17.250; 95%CL: 6.958-42.764; p < 0.001) were associated with a significantly higher risk of having periodontal disease. Conclusions: This study showed a high prevalence of periodontal disease in obese patients among the Saudi Arabian population.

Protective potential of Vitamin E against methylphenidate-induced male gonadal changes in albino rats.

OBJECTIVE: Attention deficit hyperactivity disorder ranks among the top neuropsychiatric disorder of childhood and adolescents. Methylphenidate (MPH) is the most frequently used pharmacologic agent to treat this condition. Its long-term use has been associated with many unwanted and adverse effects on many organs including male gonads, but so far no study has been done to find out a protective agent. This study investigated the protective potential of Vitamin E (Vit E) against the microscopic and morphometric alterations in male gonads induced by MPH, using albino rats. METHODS: Adult male albino rats were assigned into three equal groups including one control and two experimental groups. Experimental groups administered with MPH (10 mg/kg) and MPH (10 mg/kg) + Vit E orally (50 mg/kg), daily for 40 days. Testes of the sacrificed animals were removed, processed, and stained with hematoxylin and eosin for examining the microscopic and morphometric alterations and protective potential of Vit E. Data were analyzed using ANOVA. RESULTS: Experimental animals treated with MPH showed a significant decrease in the diameter of seminiferous tubules (296.86 ± 14.70 µm) and height of germinal epithelium (51.73 ± 3.15 µm) with a corresponding gain in the thickness of the interstitium (47.05 ± 4.94 µm). Animals treated with MPH + Vit E did not reveal any significant testicular microscopic changes and seminiferous tubular alterations induced by MPH. CONCLUSION: Vit E demonstrated a protective potential against the adverse changes induced by MPH in the male gonads in albino rats.

Methylglyoxal and insulin resistance in berberine-treated type 2 diabetic patients.

BACKGROUND: Diabetes mellitus is a chronic metabolic disorder of hyperglycemia. Chronic hyperglycemia produces advanced glycation end products such as the methylglyoxal (MGO) which interferes with cell functions, insulin signaling, and ß-cell functions. The present study was conducted to determine the effects of berberine (BBR) therapy on serum MGO and insulin resistance in newly diagnosed type 2 diabetic patients. MATERIALS AND METHODS: The present case-control study was conducted at the Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad, from March 2016 to January 2017. A sample of 200 newly diagnosed type 2 diabetic patients was divided into two groups. Group 1 received metformin 500 mg (×3 daily) and Group 2 received BBR 500 mg (×3 daily) for 3 months. Blood samples were collected at baseline and after 3 months to analyze biochemical parameters on Roche biochemical analyzer. MGO was assayed by ELISA kit and homeostasis model assessment of insulin resistance (HOMA-IR) model. SPSS version 23.0 (IBM, Incorporation, USA) analyzed the data at 95% confidence interval (P ≤ 0.05). RESULTS: Baseline HOMA-IR (% IR) and MGO were found elevated in metformin and BBR groups. After 3 months of metformin and BBR therapy, the HOMA-IR (% IR) and MGO were decreased to 3.69 ± 1.13 and 2.64 ± 0.76 and 35.84 ± 12.56 and 26.64 ± 10.73 ng/dl, respectively (P = 0.0001). HOMA-IR (% IR) was improved by 40% and 73% (P = 0.0001) and MGO by 43% and 56% in metformin and BBR groups, respectively (P = 0.0001). CONCLUSION: BBR is more effective in decreasing the serum MGO levels and insulin resistance through improved glycemic control in newly diagnosed type 2 diabetic patients.

Gastroesophageal reflux disease prevalence among school teachers of Saudi Arabia and its impact on their daily life activities.

BACKGROUND: Gastroesophageal reflux disease (GERD) is the most common upper gastrointestinal disorder encountered in the elderly patient. It is highly prevalent worldwide with a prevalence of 10-20% in the western world. The health-related quality of life (HRQL) is lower in individuals with GERD than in the general population and is comparable to that in individuals with other chronic diseases. It has a considerable impact on the quality of the patient's life through its symptoms and economically by following consultation procedures and medical care. A few studies have been done in Saudi Arabia using general population as subject and have reported a very high prevalence. OBJECTIVE: (1) Estimation of gastro GERD prevalence among school teachers in Qassim region. (2) To assess the impact of GERD symptoms on teacher's daily life activity. (3) To compare prevalence and risk factors of GERD between age-groups and gender. METHODOLOGY: A cross-sectional study that was conducted among 200 school teachers selected by multi-stage stratified random sample method in Qassim region during 2015. A reliable and valid self-administered GERD questionnaire for diagnosis of GERD was used. GERD-HRQL questionnaire was used to assess the impact of GERD on the patient's life quality. Data were analyzed using Statistical Package for Social Sciences Version 20.0; Chi-square was used to test the association between GERD and sociodemographic data. RESULTS: The total number of the participants was 200 with an equal male to female ratio. 55% (116/200) of the participants reported with GERD. 53 point 5% of these (62/116) were female and 46.6% (54/116) were male. The commonest age group was 31-40 years with 45.5% (91/200) participants. 13/200 (6.5%) participants were smokers, of which only 15.9% were female. 41 point 3% (48/116) of the GERD +ve participants were having blood group O +ve 7.8% (9/116) of GERD participants reported symptoms which affected their daily life activity. CONCLUSION: This study revealed a prevalence of GERD symptoms among 58% of school teachers. 7 point 8% of GERD participants reported symptoms which affected their daily life activities. These data indicate a need for a comprehensive approach to managing the GERD and related diseases and a more intensified level of awareness about GERD symptoms and its complications. In addition, a health care and preventive measure may be implemented to tackle the problem among school teachers.

Translating knowledge for action against stroke--using 5-minute videos for stroke survivors and caregivers to improve post-stroke outcomes: study protocol for a randomized controlled trial (Movies4Stroke).

BACKGROUND: Two thirds of the global mortality of stroke is borne by low and middle income countries (LMICs). Pakistan is the world's sixth most populous country with a stroke-vulnerable population and is without a single dedicated chronic care center. In order to provide evidence for a viable solution responsive to this health care gap, and leveraging the existing >70% mobile phone density, we thought it rational to test the effectiveness of a mobile phone-based video intervention of short 5-minute movies to educate and support stroke survivors and their primary caregivers. METHODS: Movies4Stroke will be a randomized control, outcome assessor blinded, parallel group, single center superiority trial. Participants with an acute stroke, medically stable, with mild to moderate disability and having a stable primary caregiver will be included. After obtaining informed consent the stroke survivor-caregiver dyad will be randomized. Intervention participants will have the movie program software installed in their phone, desktop, or Android device which will allow them to receive, view and repeat 5-minute videos on stroke-related topics at admission, discharge and first and third months after enrollment. The control arm will receive standard of care at an internationally accredited center with defined protocols. The primary outcome measure is medication adherence as ascertained by a locally validated Morisky Medication Adherence Scale and control of major risk factors such as blood pressure, blood sugar and blood cholesterol at 12 months post discharge. Secondary outcome measures are post-stroke complications and mortality, caregiver knowledge and change in functional outcomes after acute stroke at 1, 3, 6, 9 and 12 months. Movies4Stroke is designed to enroll 300 participant dyads after inflating 10% to incorporate attrition and non-compliance and has been powered at 95% to detect a 15% difference between intervention and usual care arm. Analysis will be done by the intention-to-treat principle. DISCUSSION: Movies4Stroke is a randomized trial testing an application aimed at supporting caregivers and stroke survivors in a LMIC with no rehabilitation or chronic support systems. TRIAL REGISTRATION: NCT02202330 (28 January 2015).

Effect of Previous Exposure to HBV on Liver Histology and Treatment Response in CHC Patients.

OBJECTIVE: To analyze the influence of previous exposure to HBV on liver histology and treatment outcomes in chronic hepatitis C (CHC) patients. STUDY DESIGN: Case control study. PLACE AND DURATION OF STUDY: Rawalian Liver Clinic, Department of Medicine, Holy Family Hospital, Rawalpindi, from January 2011 to December 2012. METHODOLOGY: Medical records of CHC patients attending the Rawalian Liver Clinic were retrospectively analyzed. Virological and treatment responses along with histological changes were compared between cases (anti-HBc positive) and controls (anti-HBc negative). Significance was determined through chi-square test at p < 0.05. RESULTS: Among the 592 CHC patients, 254 (42.9%) had serological evidence of a positive anti-HBc (cases) and 338 (57.1%), patients had negative anti-HBc (controls). No significant difference was found between ETR, SVR and treatment responses (n=220) between the two groups. Out of 65 patients whose liver biopsy data was available, cases were more likely to respond in the absence of fibrosis [63.2%, (n=24) vs. 36.8%, (n=14), p=0.001]. The controls responded more in the presence of fibrosis [100% (n=9) vs. 0, p=0.001]. There was no significant effect of anti-HBc positivity on grades of inflammation and consequent treatment response (p=0.14). CONCLUSION: There are a significant number of CHC patients with markers of previous HBV infection in Pakistani population. Previous HBV (anti-HBc positive) does not seem to have an adverse effect on liver histology and treatment responses in HBV infection.

Factors responsible for the prolonged stay of surgical neonates in intensive care units.

OBJECTIVES: The length of hospital stay (HS) for patients is a major concern due to its social, economic and administrative implications; this is particularly important for neonates admitted to intensive care units (ICUs). This study aimed to determine the factors responsible for prolonged HS in surgical neonates. METHODS: This retrospective study was conducted at Sultan Qaboos University Hospital, in Muscat, Oman. The medical records of 95 neonates admitted to the neonatal ICU who underwent general surgical procedures between July 2009 and June 2013 were reviewed. Mann-Whitney U and Pearson's Chi-squared tests were used for non-parametric numerical and categorical variables, respectively. A multiple regression analysis was performed to find a relationship between the variables and to detect the most important factor responsible for prolonged HS. A P value of <0.05 was considered statistically significant. RESULTS: Gestational age, birth weight, number of days on a ventilator and postoperative morbidity were associated with prolonged HS. Furthermore, the age of neonates at first full enteral feed was associated with increased HS using both independent and multiple regression analyses. CONCLUSION: Prolonged HS can occur as a result of many factors. In this study, a number of factors were identified, including low gestational age, low birth weight, increased number of days on a ventilator and postoperative morbidity. Additionally, neonate age at first full enteral feeds also correlated with increased HS. Further research on this topic is suggested to explore this correlation in more detail and to inform future practices.

Early predictability of virological response in patients of chronic hepatitis-C with genotype-3, treated with pegylated interferon and ribavirin.

BACKGROUND: This study was conducted to assess the early predictability of virological response in chronic hepatitis-C patients (Genotype-3), treated with pegylated interferon alpha-2a and ribavirin with an objective of determining predictive values of Rapid Virological Response (RVR) and Early Virological Response (ETR) on Sustained Virological Response (SVR). METHOD: This cross sectional study was conducted in January 2014, at Holy Family Hospital, Rawalpindi by inclusion of 582 patients of chronic hepatitis being treated with Pegylated Interferon a 2b and ribavirin. Based on Polymerase Chain Reaction (PCR) for HCV RNA Qualitative on 4th, 12h and 24th week of treatment regimen, RVR, EVR and End treatment Response (ETR) was assessed respectively whereas 24th week post treatment PCR concluded as SVR. Effect of treatment was determined as proportions for responses in total and then compared for treatment naive, responders and relapsers to previous conventional therapy using Chi square test. Positive and Negative Predictive Values were also calculated. RESULTS: Qualitative PCR for HCV revealed that 281 (69.2%) achieved RVR where 60.3% attained SVR. PPV and NPV of RVR in study population were 67.41% and 44.45% respectively and 66.29% and 57.14% respectively for EVR..Statistically significant differences in RVR, EVR and ETR were observed in patients based on conventional treatment response. CONCLUSION: Attainment of RVR is a prospect to categorize patients appropriate for abridged treatment and this study supported the evidence that failure to achieve EVR was congruent with failure to achieve SVR.

The patterns and causes of neonatal mortality at a tertiary hospital in oman.

OBJECTIVE: To report the patterns and causes of neonatal death from a tertiary care neonatal intensive care unit over a period of four years. METHODS: This is a retrospective cohort study where four years data (January 2006 - December 2009) of all inborn neonatal admissions and deaths were collected from the neonatal intensive care unit at Sultan Qaboos University hospital on predesigned forms. All out born admissions and deaths were excluded. The causes of neonatal death were classified using Wigglesworth's classification. RESULTS: The number of inborn live births during the study period was 10064 and the total number of inborn neonatal admissions was 1475. The total deaths (neonatal and post neonatal) at the neonatal intensive care unit was 73 (63 inborn and 10 out born). Among the inborn, five deaths were post neonatal deaths and hence, excluded from analysis. Among the remaining inborn neonatal deaths (n=58), 34 (59%) were males and 24 (41%) were females. The number of neonatal admissions increased over the years during the study period from 248 to 356, while the number of deaths also increased from 10 deaths in 2006, to 20 deaths in 2009. The primary causes of neonatal deaths were prematurity and its complications 52% (n=30). Lethal congenital malformations lead to 17 (29%) newborn deaths, specific diagnosis in 7 newborns (12%), and birth asphyxia in four (7%) of cases. CONCLUSION: There was an increasing trend of neonatal admissions and deaths among inborn babies. Prematurity, with sepsis as its major complication and congenital malformations were the leading cause of neonatal mortality.

Molecular epidemiology of ß-thalassemia in Pakistan: Far reaching implications.

BACKGROUND: ß -Thalassaemia, an autosomal recessive hemoglobinopathy, is one of the commonest genetically transmitted disorders throughout the world. Collective measures including carrier identification, genetic counseling and prenatal diagnosis are required for preventing ß-thalassemia. AIM: To achieve this objective, Identification of the spectrum of genetic mutations, especially for various ethnic backgrounds in Pakistan. Therefore, we designed a cross sectional prospective study to identify the frequency of various gene mutations in different ethnic groups of Pakistan. MATERIALS AND METHODS: Over a 5-year period, DNA from 648 blood samples {including specimens of chorionic villus sampling (CVS)} were analyzed for the twelve most common ß-thalassemia mutations found in the Pakistani population by a Multiplex amplification refractory mutation system (ARMS). Each sample was analyzed for the mutation as well as the normal gene, appropriate with negative and positive controls, and reagent blanks. RESULTS: Out of 648 samples mutations were identified in 640 (98.75%) samples by multiplex ARMS. 8 common ß-thalassemia mutations were identified in 8 different ethnic groups accounting for 93.9% of the ß-thalasemia alleles. CONCLUSIONS: Based on the outcome of this study a cost effective proposal is formulated for detection of ß-thalassemia mutations.

Early versus Late Parenteral Nutrition in Very Low Birthweight Neonates: A retrospective study from Oman.

OBJECTIVES: The aim of this study was to compare the biochemical parameters, weight gain, osteopenia and phosphate supplementation in very low birth weight (VLBW) neonates receiving early versus late parenteral nutrition (EPN versus LPN). METHODS: A RETROSPECTIVE STUDY WAS UNDERTAKEN IN THE LEVEL III NEONATAL INTENSIVE CARE UNIT AT SULTAN QABOOS UNIVERSITY HOSPITAL, OMAN: from January 2007 to October 2008 (LPN group, n = 47) and from January 2009 to June 2010 (EPN group, n = 44). Demographic data, anthropometric and laboratory parameters were extracted from the electronic record system. RESULTS: The mean age of PN initiation was LPN = 47.3 hours versus EPN = 14.3 hours. Biochemical parameters analysed during the first week of life revealed a reduction in hypernatraemia (12.7% versus 6.8%) and non-oliguric hyperkalemia (12.7% versus 6.8%) in EPN, with no significant differences in acidosis and urea levels between the two groups. Hyperglycemia >12 mmol/L in <1000g was higher in EPN. Nutritional parameters in 81 babies who survived/stayed in the unit up to a corrected gestational age (CGA) of 34 weeks (40 in LPN and 41 in EPN), revealed a reduction in metabolic bone disease (osteopenia of prematurity [OOP], 17.5% versus 7.3%) and the need for phosphate supplementation (22.5% versus 7.3%) in the EPN group. There was no increase in acidosis or cholestasis. No difference was noted in albumin levels, time to full feeds, time to regain birthweight and mean weight gain per day till 34 weeks corrected CGA. CONCLUSION: EPN in VLBW newborns is well tolerated and reduces hypernatraemia, non-oliguric hyperkalemia, OOP and the need for phosphate supplementation.

Molecular epidemiology of ß-thalassemia in Pakistan: far reaching implications.

ß-thalassaemia, an autosomal recessive hemoglobinopathy, is one of the commonest genetically transmitted disorders throughout the world. Collective measures including carrier identification, genetic counseling and prenatal diagnosis are required for preventing ß-thalassemia. To achieve this objective, Identification of the spectrum of genetic mutations, especially for various ethnic backgrounds in Pakistan is necessary. Therefore, we designed a cross sectional prospective study to identify the frequency of various gene mutations in different ethnic groups of Pakistan. Over a 5-year period, DNA from 648 blood samples [including specimens of chorionic villus sampling (CVS)] were analyzed for the twelve most common ß-thalassemia mutations found in the Pakistani population by a Multiplex amplification refractory mutation system (ARMS). The most common mutation identified was Intervening Sequence 1-5 (IVS 1-5 (G-C)); accounting for 40.89% mutated alleles, and was represented in all ethnic groups. 15.7 % of the ß-thalassemia alleles were found to have Frameshift 8-9 (Fr 8-9) as the second most common mutation Other common genetic defects responsible for ß-thalassemia: IVS 1-1 (G-T) was found in 8.17%, Codon-30 (Cd-30 (G-C)) 8.02%, Codon-5(Cd-5 (-CT)) contributed 2.16% and Deletion 619 base pair (Del 619bp) affected 11.11% were found in Pakistan. This large study adds to the pre-existing data in Pakistan. Knowledge of the predominant mutation in a given ethnic group will not only help in developing a short panel of (population-specific) primers of mutations thereby providing a cost-effective method for prenatal diagnosis and also help the clinicians to counsel regarding blood transfusion regimen/ pregnancy termination.