Fatal Intoxications Due to Administration of Isosorbide Tablets Contaminated with Pyrimethamine

In January 2012, 664 cases of pyrimethamine toxicity and 151 deaths were reported among cardiac patients that had recently received free medicines from pharmacy of Punjab Institute of Cardiology, Lahore, Pakistan. These patients, ages ranged from 58 to 75 years, were prescribed simvastatin, clopidogrel, aspirin soluble, isosorbide mononitrate, and amlodipine. On examination of medications being given to them, it was found that a particular batch of isosorbide mononitrate tablets was contaminated with 50 mg pyrimethamine. Cardiac patients were taking isosorbide contaminated with pyrimethamine twice daily (100 mg pyrimethamine/day), whereas therapeutic dose of pyrimethamine for malaria is 25 mg/week. Postmortem urine, cardiac blood, and femoral blood specimens of three deceased males were submitted to author's laboratory for analysis. Postmortem toxicological analysis revealed that pyrimethamine concentration fell within the range of 1–10 μg/mL by liquid chromatography. Clinical, autopsy, histopathological, and toxicological findings strongly suggested toxicity due to pyrimethamine accumulation that resulted in deaths of these cardiac patients.     

Adaptability of Kuwaiti Public Administration Employees to Total Quality Management Requirements

This exploratory study examines the infrastructure of total quality management （TQM） in Kuwaiti public administration. The research was based on a questionnaire administered to a random sample consisted of 600 government officials from various Kuwaiti ministries. The basic elements of TQM which were investigated relate to work relations, administrative procedures, and professionalism. The objective of the study is to improve quality of public services through diagnosing and strengthening positive points, shedding light on the negative aspects, and giving recommendations on how to enhance services＇ quality. The study results showed that public administration employees are highly adaptable to TQM requirements. Statistically significant variations were found in adaptability to TQM requirements due to gender, age, educational level, job level, and work relations with regard to many aspects. It is recommended that decision makers in Kuwaiti public administrators take some measures to enhance TQM orientation such as simplifying administrative procedures, making greater compatibility between employees and type of work, investing more resources on continuing education of public administration employees and conducting field studies concerning adaptability of other government bodies （public institutions, public companies, etc.） to TQM requirements to see similarities and differences between them and the ministries in this regard and draw appropriate lessons.     

Territorial functioning and victimisation: conceptualisation and scale development

The purpose of this study was to develop and validate territorial functioning measures and to examine the link between territorial functioning and victimisation in a high-crime context. To this end, four sequential stages of scale development were undertaken: conceptual model development, item generation and content validation, exploratory study and confirmatory study. Confirmatory factor analysis confirmed the three dimensions of territorial functioning, namely, neighbourhood attitudes, sense of control and marking behaviour, as dimensions of the second-order territorial functioning construct. The results of the structural model support findings reported in the literature that associate high territorial functioning with low victimisation. The theoretical and practical implications of the study and directions for future research are discussed in the concluding sections of this study.     

Correction to: Explaining regional inflation programmes in Indonesia: Does inflation rate converge?

Economic Change and Restructuring -     

Towards Strong Local Governance: Current Reform Scenario in Fiji

This article examines how the historical context of poor central-local relations and inefficient service delivery structure is used by the current military-led government in Fiji as a ploy for its local government reform agenda. Based on an analysis of secondary information on local government structure and a review of the reforms undertaken by the Review/Reform Committee, this article identifies the concentration of economic and political power at the central level as one of the major obstacles towards empowering local governance in Fiji. The article emphasizes the need for effective institutional reforms to devolve governance and resources from the centre to the grassroots.     

The Toxic Politics of Bangladesh: A Bipolar Competitive Neopatrimonial State?

In order to understand the structural dimensions of the problems concerning democratic governance in Bangladesh, this article seeks to explicate whether or not Bangladesh is a neopatrimonial state. This article examines contemporary Bangladesh politics with a particular focus on the notion of neopatrimonialism and with special reference to the personalization of state power. The concept of neopatrimonialism has great utility in explaining leadership behaviour in a dysfunctional democracy such as Bangladesh, where personalized exchanges, exploitation of bureaucratic and state mechanisms and political scandals are common. I argue that Bangladesh is a special variant of the neopatrimonial state, which I suggest to be bipolar neopatrimonialism. I contend that since independence, successive governments and political leaders always attempt to monopolize state power in various ways. The patron-client society of Bangladesh helps political leaders to personalize the state power they possess. To monopolize state power, the political elites of Bangladesh create networks and alliances, relying on exchanges to meet their objectives. In this regard, state elites use elements of the state and political system to mediate these exchanges.