document_title: Pakistani general election, 2018

question_text: who win the election of 2018 in pakistan

text: Pakistani general election, 2018

text: Background[edit]

text: 2013 elections[edit]

text: Following the elections in 2013, Pakistan Muslim League (Nawaz), led by twice Prime Minister of Pakistan Nawaz Sharif, emerged as the largest party with 166 seats out of a total of 342 in the National Assembly. Although this was short of a majority, Sharif was able to form a government after several independents joined his party.[20]

tag: p

text: During the election campaign, Pakistan Tehreek-e-Insaf (PTI), led by prominent cricketer turned politician Imran Khan, was widely expected to have huge success in the polls. The party fell short of these expectations, instead only taking 35 seats. It became the 3rd largest party in the National Assembly and formed a coalition government in the restive north-western province of Khyber Pakhtunkhwa.[21]

text: Azadi March (2014)[edit]

text: PTI had initially conceded the elections to PML (N), although they asked for manual recounts to be carried out in several constituencies where rigging had been allegedly carried out.[22][23] These calls were not answered by the government or the Supreme Court, despite a 2,100 page white paper by the party which allegedly contained evidence of vote-rigging in favour of the PML (N).[24] An ‘Azadi March’ was started by Khan on 14 August 2014 which demanded the government to call a snap election. The sit-in in Islamabad continued for 126 days, until the 2014 Peshawar school massacre occurred, which forced Khan to end the protest for the sake of ‘national unity’.[25] A judicial commission was formed by the government which would probe the allegations of vote-rigging: it found the election to have been largely conducted in a free and fair manner, while also stating that PTI's request for a probe was not "entirely unjustified".[26]

text: Panama Papers case (2016)[edit]

text: On 3 April 2016 the International Consortium of Investigative Journalists (ICIJ) made 11.5 million secret documents, later known as the Panama Papers, available to the public.[27] The documents, sourced from Panamanian law firm Mossack Fonseca, among other revelations about other public figures in many other countries,  included details of eight offshore companies with links to the family of Nawaz Sharif, the then-incumbent Prime Minister of Pakistan, and his brother Shehbaz Sharif, the incumbent Chief Minister of Punjab.[28] According to the ICIJ, Sharif's children Maryam Nawaz, Hassan Nawaz and Hussain Nawaz “were owners or had the right to authorise transactions for several companies”.[29]

text: Sharif refused to resign and instead make an unsuccessful attempt to form a judicial commission. The opposition leader Khan filed a petition to the Supreme Court of Pakistan on 29 August seeking the disqualification of Sharif from the premiership and as a member of the National Assembly. Political leaders Sheikh Rasheed and Siraj-ul-Haq also supported this petition. Khan called, once again, for his supporters to put Islamabad in lockdown until Sharif resigned, although this was called off soon before it was meant to take place.[30]

text: On 20 April 2017, on a 3-2 verdict, the Supreme Court decided against the disqualification of Sharif, instead calling for a Joint Investigation Team (JIT) to be created which would probe these allegations further.[31]

text: On 10 July 2017, JIT submitted a 275-page report in the apex court.[32][33] The report requested NAB to file a reference against Sharif, his daughter Maryam, and his sons under section 9 of National Accountability Ordinance. Additionally, the report claimed that his daughter Maryam was guilty of falsifying documents, as she submitted a document from 2006 which used the Calibri font despite the font itself not being available for public use until 2007.[34]

text: Disqualification of Nawaz Sharif (2017)[edit]

text: On 28 July 2017, following the submittal of the JIT report, the Supreme Court unanimously decided that Sharif was dishonest, therefore not fulfilling the requirements of articles 62 and 63 of the constitution which require one who holds public office to be Sadiq and Ameen (Urdu for Truthful and Virtuous). Hence, he was disqualified as Prime Minister and as a Member of the National Assembly.[35][36] The court also ordered National Accountability Bureau to file a reference against Sharif, his family and his former Finance Minister Ishaq Dar on corruption charges.[37]

text: Electoral system[edit]

text: The 342 members of the National Assembly are elected by two methods in three categories; 272 are elected in single-member constituencies by first-past-the-post voting;[38] 60 are reserved for females and 10 for religious minority groups; both sets of reserved seats use proportional representation with a 5% electoral threshold.[39] This proportional number, however, is based on the number of seats won rather than votes cast.[40] To win a simple majority, a party would have to take 137 seats.[41]

text: The 2018 General Elections were held under new delimitation of constituencies as a result of 2017 Census of Pakistan.[42] Parliament of Pakistan amended the Constitution, allowing a one-time exemption for redrawing constituency boundaries using 2017 provisional census results.[43] As per the notification issued on 5 March 2018, the Islamabad Capital Territory (ICT) now has three constituencies, Punjab 141, Sindh 61, Khyber Pakhtunkhwa 39, Balochistan 16 and Federally Administered Tribal Areas (FATA) has 12 constituencies in the National Assembly.[44][45][46] 106 million people were registered to vote for members of the National Assembly of Pakistan and four Provincial Assemblies.[47]

text: Likewise for elections to provincial assemblies, Punjab has 297 constituencies, Sindh 130, Khyber Pakhtunkhwa 99 and Balochistan 51.

text: Electoral reforms[edit]

text: In June 2017 the Economic Coordination Committee approved the procurement of new printing machines with a bridge loan of 864 million rupees.[48] The government has also developed new software for the Election Commission of Pakistan and NADRA to ensure a "free, fair, impartial, transparent and peaceful general election."[49] The former Federal Law Minister Zahid Hamid elaborated that youth reaching the age of 18 will automatically be registered as voters when they apply for a CNIC from NADRA.[49]

text: Contesting parties[edit]

text:
Party

Political Position

Leader

Seats won previously (FPTP)

Pakistan Muslim League (N)

Centre-right

Shehbaz Sharif

126

Pakistan Peoples Party

Centre-left

Bilawal Bhutto Zardari

33

Pakistan Tehreek-e-Insaf

Centre to Centre-right

Imran Khan

28

Muttahida Qaumi Movement-Pakistan

Left wing

Khalid Maqbool Siddiqui

19

Muttahida Majlis-e-Amal

Far right

Fazl-ur-Rehman

14

Pashtunkhwa Milli Awami Party

Left wing

Mahmood Khan Achakzai

3

Awami National Party

Left wing

Asfandyar Wali Khan

2

Pak Sarzameen Party

Left wing

Syed Mustafa Kamal

0

Tehreek Labbaik Pakistan

Far right

Khadim Hussain Rizvi

0

Balochistan Awami Party

Centre

Jam Kamal Khan

0

Grand Democratic Alliance

Big tent

Pir Pagaro

0

Balochistan National Party (Mengal)

Left wing

Akhtar Mengal

0

text: Campaign[edit]

text: Major by-elections (2017–2018)[edit]

text: Following the disqualification of Nawaz Sharif, several by-elections were held throughout Pakistan.

text: Lahore by-election, September 2017[edit]

text: The first of these was the by-election in Sharif’s former constituency, NA-120 Lahore, which is located in the capital city of the Punjab province, a province where the PML (N) was the ruling party. It retained this seat, albeit with a much reduced majority due to gains by the PTI and minor Islamist parties.[50]

text: Peshawar by-election, October 2017[edit]

text: The second of these was a by election in Peshawar, capital city of the Khyber Pakhtunkhwa province, where the Pakistan Tehreek-e-Insaf| was the ruling party. NA-4 once again voted for PTI, despite a reduced majority: once again mainly due to the rise of Islamist parties. These by-elections largely were largely seen as indicators that the ruling parties in both Khyber Pakhtunkhwa and Punjab were still electorally strong.[51]

text: Lodhran by-election, 2018[edit]

text: On 15 December 2017, Jahangir Khan Tareen, General Secretary of the PTI, was disqualified from holding public office. Hence, his NA-154 Lodhran seat was vacated.[52]

text: In a previous by-election in this constituency in 2015, Tareen won this seat with a majority in excess of 35,000 votes. Therefore, this seat was seen as a stronghold for the PTI.

text: In what was seen as an upset result, Iqbal Shah of the PML (N) won this by-election with a majority over 25,000 votes against Jahangir Tareen’s son, Ali Tareen. Many saw this as a failure on the PTI’s behalf, and the result led to a drop in morale for PTI workers.[53]

text: Pakistan Muslim League – N[edit]

text: Pakistan Muslim League – N launched its election campaign on 25 June 2018 from Karachi.[54] On 5 July 2018, PMLN unvieled its election manifesto.[55]

text: Pakistan Tehreek-i-Insaf[edit]

text: Pakistan Tehreek-i-Insaf started its election campaign on 24 June 2018 from Mianwali.[56] On 9 July 2018, Imran Khan launched PTI's election manifesto.[57] On 23 July 2018, PTI concluded its electioneering with rallies in Lahore.[58]

text: Pakistan Peoples Party[edit]

text: On 28 June 2018, PPP became the first political party to unviel its election manifesto.[59] PPP kicked off its election campaign on 30 June 2018, as Bilawal inaugurated their election office in Lyari, Karachi.[60]

text: Campaigning[edit]

text: The National Assembly and provincial assemblies of Pakistan dissolved as early as 28 May for Khyber Pakhtunkhwa and Sindh, and as late as 31 May for Punjab, Balochistan, and the National Assembly.[61]

text: The assemblies dissolved during the holy month of Ramadan, a month where Muslims worldwide refrain from eating or drinking from sunrise to sundown. Hence, most major parties did not start campaigning until late June.[62]

text: Nomination papers[edit]

text: On 4 June, parties and individuals started filing nomination papers for the elections. This process continued until 8 June.[63] After this, the returning officer in each constituency began scrutiny of the nominated candidates and decided whether or not to accept the nomination papers.

text: The scrutiny resulted in many high-profile politicians having their nomination papers rejected: Imran Khan (chairman of PTI), Farooq Sattar (chairman of Muttahida Qaumi Movement (Pakistan) (MQM-P) and Pervez Musharraf (chairman of All Pakistan Muslim League and former President), had their nomination papers rejected. Both Sattar and Khan had their nomination papers  later accepted.[64][65][66]

text: Additionally, politicians Fawad Chaudhry (Information Secretary of PTI) and Shahid Khaqan Abbasi (former Prime Minister) were disqualified from contesting these elections by election tribunals due to the non declaration of assets in their nomination papers. This was controversial because election tribunals were seen as not having the jurisdiction to disqualify candidates, rather only to accept or reject their nomination papers. The Lahore High Court eventually overturned these judgements and allowed the respective candidates to contest their elections.[67][68] Two major politicians of Tehreek-e-Insaf from Chakwal, Sardar Ghulam Abbas and  Sardar Aftab Akbar Khan were disqualified to contest elections producing major problem in Chakwal district for the party.[69]

text: Opinion polls[edit]

text:
Date

Pollster

Publisher

Sample

PML-N

PTI

PPP

MQM-P

MMA*

ANP

Others

Lead

25 July 2018
Election 2018
ECP
53,123,733

24.35%
31.82%
13.01%
1.38%
4.81%
1.53%
22.98%
7.47%

12 July 2018

SDPI[70]

Herald

6,004

25%

29%

20%

N/A

3%

1%

20%

4%

4 July 2018

IPOR[71]

GSP

3,735

32%

29%

13%

2%

3%

1%

20%

3%

6 June 2018

Gallup Pakistan[72]

Geo/Jang

3,000

26%

25%

16%

N/A

2%

1%

30%

1%

28 May 2018

Pulse Consultant[72]

3,163

27%

30%

17%

1%

4%

1%

20%

3%

May 2018

Gallup Pakistan[73]

Self

3,000

38%

25%

15%

22%

13%

Mar 2018

Gallup Pakistan[74]

WSJ

2,000

36%

24%

17%

23%

12%

1 November 2017

Gallup Pakistan[75]

Geo/Jang

3,000

34%

26%

15%

2%

2%

2%

19%

8%

25 October 2017

Pulse Consultant[75]

3,243

36%

23%

15%

2%

1%

1%

22%

13%

24 October 2017

IPOR[76][77]

GSP

4,540

38%

27%

17%

3%

1%

1%

14%

11%

11 May 2013
Election 2013[78]
ECP
45,388,404

32.77%
16.92%
15.23%
5.41%
3.22%
1.00%
25.57%
15.85%

text: *Muttahida Majlis-e-Amal is an alliance of Islamist political parties, formed in 2002 and dissolved after the 2008 elections. The restoration of this alliance occurred in December 2017. Polls conducted before the restoration show the sum for Jamiat Ulema-e-Islam (F), the major political party in this alliance.

text: Conduct[edit]

text: There were 272 national and 577 provincial assembly constituencies,[79] contested by over 3,600 and 8,800 candidates respectively.[80] A total of 811,491 staff were deployed for election duties as presiding officers, assistant presiding officers, and polling officers, in addition to 371,000 armed forces personnel who provided security duties alongside police and other law enforcement agencies. There were 85,317 polling stations set up, comprising over 242,000 polling booths.[79]

text: Pre-election violence[edit]

text:
In the beginning of July, a bombing took place in Ramzak tehsil of North Waziristan at the office of Malik Aurangzeb Khan, PTI's candidate for NA-48 (Tribal Area-IX) leaving 10 people injured.[81]
On 7 July, a bomb planted in a motorcycle was remotely exploded at an election campaign of Muttahida Majlis-e-Amal's PK–89 candidate Shein Malik in the Takhti Khel area of the Bannu.[82]
On 10 July, a suicide bombing attack claimed by Tehrik-i-Taliban Pakistan (TTP) on political rally of Awami National Party (ANP) in Yakatoot neighborhood of Peshawar left twenty people dead and sixty three others injured. Among the killed was ANP's Khyber Pakhtunkhwa Assembly candidate, Haroon Bilour. Following Bilour's death, elections for Constituency PK-78 were postponed to an disclosed date by the Election Commission.[83]
On 12 July, a spokesperson for former Member of National Assembly Alhaj Shah Jee Gul Afridi was killed and another citizen was injured after unidentified men opened fire at the spokesperson's car in Peshawar.[84] On the same day, the Balochistan Awami Party (BAP)'s office in Khuzdar came under gunfire before a bomb detonated injuring 2 people.[85]
On 13 July, two separate bombings on election rallies in Mastung and Bannu left 154 people dead and injured more than 220 others. In Bannu, 4 citizens were killed and 10 were injured after a planted bomb exploded near the car of JUI-F candidate Akram Khan Durrani.[86] In Mastung, a suicide bomber affiliated with Islamic State of Iraq and the Levant (ISIL) blew himself up  at the election rally of Balochistan Awami Party's candidate for the Balochistan Assembly, Nawabzada Siraj Raisani, killing him and 148 others people and injured over 186.[87]
On 22 July, PTI's candidate for constituency PK-99 Ikramullah Gandapur and his driver were killed after a suicide bomber blew himself near his car as he was headed towards a corner meeting in the outskirts of Dera Ismail Khan.[88] The same day, unknown gunmen opened fires on the vehicle of Durrani in Bannu. No one was hurt during firing as the vehicle was bulletproof. This was second unsuccessful attempt to assassinate Durrani and third terrorist incident in the city in the span of two weeks.[89]
On 24 July, four people were killed including three Pakistani Army soldiers in Kech District, Balochistan.[90]

tag: ul

text: Election day violence[edit]

text:
On 25 July, during polling in Quetta, a bomb went off which resulted in 31 people being killed and 35 injured.[91]
In Swabi, a city in the northern province of Khyber Pakhtunkhwa, one person was killed and three injured after PTI supporters exchanged fire with those from the secularist Awami National Party (ANP).[92]
At least three other people were injured in a grenade attack outside a polling station in Larkana, in the southern province of Sindh.[93]
In Khanewal, a man was shot dead and another one was injured in a political clash.[94] Several more people were injured in 7 other incidents.

text: Allegations of election meddling[edit]

text: Pre-poll[edit]

text: There have been allegations by some international journalists and scholars, claiming that there was a plan between judiciary and military bodies to influence the outcome of the election.[10] These allegations were also made by the outgoing PML-N following Nawaz Sharif's disqualification for corruption.[95] It was suggested that alleged goal of these attempts was to halt the party of Nawaz Sharif from coming into power and to bring the results in favor of PTI, so that Imran Khan – who is alleged as close to the military – can be installed as the prime minister.[96][2][3][10] Khan has denied these allegations as a "foreign conspiracy" and "against the facts" , while the military also categorically rejected them.[97] There have been claims of PML (N)'s campaign material being ripped apart by authorities while leaving alone material belonging to PTI.[98] There have been suggestions that candidates belonging to PML (N) have been coerced by ISI to switch to those parties whose future government can be better controlled by military.[99][100] On the last day of scrutiny of nomination papers, seven PML (N) candidates from Southern Punjab returned their tickets leaving no option for PML (N) to field replacement candidates, depriving them an opportunity to win those seats.[101] There have also been reports of election engineering by army and intelligence agencies in Balochistan province in favor of Balochistan Awami Party.[102]

text: Reports further suggested that there was evidence of collusion between the judiciary and military, in that two military officials were appointed to the Joint Investigation Team to investigate corruption allegations against former prime minister Nawaz Sharif, which were further strengthened by the circumstances of the Avenfield case verdict against the Sharifs.[96][2][3][10] Justice Shaukat Aziz Siddiqui, an Islamabad High Court senior justice, released a statement on 22 July alleging that judges were pressured by ISI not to release Sharif before the election.[103][104] However, he provided no evidence[105] and was at the time facing corruption and misconduct charges pending at the Supreme Judicial Council, leading to rumours about the timing of his statement.[106] Pakistan's Chief Justice Saqib Nisar said he felt "saddened" at Siddiqui's comments, and whilst criticising them, stated that "as the head of judiciary, I assure you that we are not under any sort of pressure".[106] There have been allegations that the micromanagement of political parties and the censorship of the newspapers, social media and TV channels is to further influence the election result.[7][5][107] An official from the Human Rights Commission of Pakistan stated that "The level of army interference and political engineering is unprecedented."[99] Another institution, the National Accountability Bureau has been described as being used by military intelligence agencies, including ISI, to bring politicians in line by threatening to bring corruption cases against them.[8][9] Due to interference by military and intelligence agencies, The Financial Times described these elections as "the dirtiest in years".[108]

text: Furthermore, the EU observer mission released their report after the election stating that there were "systematic attempts to undermine the ruling party", "lack of equality of opportunity", pressure on the media, far stronger efforts than usual to encourage switching parties and judicial conduct had all negatively influenced the vote.[18]

text: Some of these allegations have also been made by certain political parties and figures more prominently by PML (N).[95] Among the politicians, Farhatullah Babar has been very vocal against the election meddling by military describing it as a "creeping coup against civilian authority".[109] Raza Rabbani also leveled same allegations including the Election Commission of Pakistan, National Accountability Bureau and security agencies as the culprit behind pre-poll rigging.[110]

text: Election day[edit]

text: Almost all political parties, with the exception of PTI, have alleged large scale election day rigging.[111][112][113] The winning PTI have alleged rigging in some constituencies as well.[114] Doubts were raised by unprecedented delays in the declaration of results.[115] The fairness of the election was also criticized due to the Election Commission's failure to provide Form 45s, official forms which include the tally of votes and are prepared in the presence of political agents of all the candidates.[116] Party leaders alleged that their representatives were barred from polling stations before counting began and the Form 45s were prepared in their absence and behind closed doors.[116] In some instances, the representatives were given results on plain paper instead of official forms.[116] In another instance, the presiding officer signed blank forms, allowing the possibility of results being manipulated afterwards.[116] Independent candidate Jibran Nasir also made similar allegations.[117] There was also an incident of seven people being  arrested for alleged vote rigging in Karachi.[118] According to FAFEN observer Sarwar Bari, "Only one polling agent of every party is allowed when Form 45 is given out by the polling staff, so we can’t rule out the fact that it could be a misunderstanding."[79] A few days after the election, in the NA-241 (Korangi Karachi-III) constituency, ballots cast for candidates of PML (N), PPP, and MQM-P were found in a garbage heap. A PTI candidate won the election in that constituency.[119]

text: Chairman of winning party Imran Khan pledged that he will allow to open any constituency his opponents think are rigged, he said that opposition has full right into recounting or accountability over election process to ensure transparency.[120]

text: The Free and Fair Election Network, an election watchdog, said the 2018 polls were "more transparent" in some aspects than the previous elections and that "significant improvements in the quality of critical electoral processes" inspired "greater public confidence".[79] According to former Indian Chief Election Commissioner S. Y. Quraishi, a member of the international observers group in Pakistan, the election system was transparent, free and fair, and the minor technical glitches which showed up later in the day were due to inexperience.[121]

text: On 12 August 2018, it was reported that 90% of Form-45s were not signed by any polling agent, which is a violation of Election Act 2017.[122] However, an ECP spokesperson clarified the discrepancy by stating that there was no designated space on the Form-45s to obtain the signatures of polling agents. The signatures were instead done on tamper-evident bags that were used to transport the results.[123] For the transparency reasons and to combat controversy surrounding form 45, election commission of Pakistan published all form 45 publicly on their website.[124]

text: Results[edit]

text: National Assembly[edit]

text:
Party

Votes

%

Seats

General

Reserved[125]

Total

+/–

Women

Minorities

Pakistan Tehreek-e-Insaf
16,903,702
31.82
116
28
5
149
+114

Pakistan Muslim League (N)
12,934,589
24.35
64
16
2
82
–84

Pakistan Peoples Party
6,924,356
13.03
43
9
2
54
+12

Muttahida Majlis-e-Amal
2,573,939
4.85
12
2
1
15
–4

Tehreek-i-Labbaik Pakistan
2,234,316
4.21
0
0
0
0
New

Grand Democratic Alliance
1,260,147
2.37
2
1
0
3
–4

Awami National Party
815,998
1.54
1
0
0
1
–2

Muttahida Qaumi Movement
733,245
1.38
6
1
0
7
–17

Pakistan Muslim League (Q)
517,408
0.97
4
1
0
5
+3

Balochistan Awami Party
319,348
0.60
4
1
0
5
New

Balochistan National Party (Mengal)
238,817
0.45
3
1
0
4
+3

Allah-o-Akbar Tehreek
172,120
0.32
0
0
0
0

Sindh United Party
140,303
0.26
0
0
0
0

Pashtunkhwa Milli Awami Party
134,846
0.25
0
0
0
0
–4

Pak Sarzameen Party
126,128
0.24
0
0
0
0

Awami Muslim League
119,362
0.22
1
0
0
1
0

Pakistan Awami Raj
115,226
0.22
0
0
0
0

Pakistan Muslim League (F)
72,553
0.14
0
0
0
0

Qaumi Watan Party
57,249
0.11
0
0
0
0

Pakistan Rah-e-Haq Party
55,859
0.11
0
0
0
0

Balochistan National Party (Awami)
55,206
0.10
0
0
0
0

Tehreek-e-Labbaik Islam
55,155
0.10
0
0
0
0

All Pakistan Muslim League
36,566
0.07
0
0
0
0

Pakistan National Muslim League
35,415
0.07
0
0
0
0

Jamiat Ulama-e-Islam Nazryati
34,247
0.06
0
0
0
0

Pakistan Human Party
34,246
0.06
0
0
0
0

National Party
33,432
0.06
0
0
0
0

Mutahidda Qabail Party
28,469
0.05
0
0
0
0

Jamiat Ulama-e-Islam Pakistan (S)
24,582
0.05
0
0
0
0

Jamhoori Wattan Party
23,274
0.04
1
0
0
1
+1

Jamiat Ulama-e-Pakistan  (Noorani)
22,145
0.04
0
0
0
0

Mohajir Qaumi Movement Pakistan
21,521
0.04
0
0
0
0

Majlis Wahdat-e-Muslimeen
19,615
0.04
0
0
0
0

Awami Workers Party
17,935
0.03
0
0
0
0

Pakistan Justice and Democratic Party
12,637
0.02
0
0
0
0

Pakistan Kissan Ittehad (Ch. Anwar)
12,255
0.02
0
0
0
0

Pakistan Peoples Party (Shaheed Bhutto)
10,032
0.02
0
0
0
0

Hazara Democratic Party
7,942
0.01
0
0
0
0

Pakistan Tehreek-e-Insaf Nazriati
6,755
0.01
0
0
0
0

Pakistan Muslim Alliance
6,703
0.01
0
0
0
0

Pakistan Siraiki Party (T)
6,523
0.01
0
0
0
0

Pakistan Sunni Tehreek
5,943
0.01
0
0
0
0

Sunni Ittehad Council
5,939
0.01
0
0
0
0

Tehreek Jawanan Pakistan
5,841
0.01
0
0
0
0

Pakistan Awami Inqelabi League
5,046
0.01
0
0
0
0

Roshan Pakistan League
4,267
0.01
0
0
0
0

Tehreek Tabdili Nizam Pakistan
4,161
0.01
0
0
0
0

Pakistan Tehreek-e-Insaf-Gulalai
4,146
0.01
0
0
0
0

Balochistan National Movement
3,971
0.01
0
0
0
0

Tabdeeli Pasand Party Pakistan
3,698
0.01
0
0
0
0

Amun Taraqqi Party
3,646
0.01
0
0
0
0

Jamote Qaumi Movement
3,269
0.01
0
0
0
0

Barabri Party Pakistan
2,702
0.01
0
0
0
0

Move On Pakistan
2,580
0.00
0
0
0
0

All Pakistan Muslim League (Jinnah)
2,418
0.00
0
0
0
0

Pakistan Falah Party
2,167
0.00
0
0
0
0

Pasban Pakistan
2,154
0.00
0
0
0
0

Pakistan Awami League
1,780
0.00
0
0
0
0

Pakistan Aman Tehreek
1,718
0.00
0
0
0
0

Pakistan Peoples Party
1,587
0.00
0
0
0
0

Pakistan Quami Yakjehti Party
1,571
0.00
0
0
0
0

Pakistan Muslim League (Z)
1,406
0.00
0
0
0
0

Pakistan Muslim League (Sher-e-Bangal)
1,332
0.00
0
0
0
0

Pakistan Freedom Movement
1,096
0.00
0
0
0
0

Mustaqbil Pakistan
1,053
0.00
0
0
0
0

Humdardan-e-Watan Pakistan
936
0.00
0
0
0
0

Pakistan Aman Party
852
0.00
0
0
0
0

Aam Admi Tehreek Pakistan
828
0.00
0
0
0
0

Awami Justice Party Pakistan
730
0.00
0
0
0
0

Saraiskistan Democratic Party
724
0.00
0
0
0
0

Pakistan Supreme Democratic
708
0.00
0
0
0
0

Aam Log Party Pakistan
606
0.00
0
0
0
0

Tehreek-e-Suba Hazara Pakistan
545
0.00
0
0
0
0

Awam League
493
0.00
0
0
0
0

Pakistan Welfare Party
426
0.00
0
0
0
0

Aam Awam Party
364
0.00
0
0
0
0

Jannat Pakistan Party
248
0.00
0
0
0
0

National Peace Council Party
242
0.00
0
0
0
0

Front National (Pakistan)
233
0.00
0
0
0
0

Pakistan Muslim League Organization
211
0.00
0
0
0
0

All Pakistan Tehreek
155
0.00
0
0
0
0

Pakistan Human Rights Party
139
0.00
0
0
0
0

Pakistan Tehreek-e-Insaniat
98
0.00
0
0
0
0

Pakistan Muslim League Council
91
0.00
0
0
0
0

Peoples Movement of Pakistan (PMP)
37
0.00
0
0
0
0

Independents
6,087,410
11.46
13
0
0
13
+5

Postponed
–
–
2
–
–
2
–

Invalid/blank votes

—
–
–
–
–
–

Total
53,123,733
100
272
60
10
342
0

Registered voters/turnout

51.6
–
–
–
–
–

Source: ECP

text: Government formation[edit]

text: Despite rejecting the results of the election due to alleged rigging, the Pakistan Muslim League (N) made the decision to take oath in the elected assemblies for the sake of democracy, conceding that Pakistan Tehreek-e-Insaf’s Imran Khan was likely to be the Prime Minister. Hence, the government formation at the federal level was left to the PTI alone.[126]

text: Talks began with smaller parties and independents to form a government. Muttahida Qaumi Movement which won six seats, Pakistan Muslim League (Q) which won four, Balochistan Awami Party which won four, Grand Democratic Alliance which won two, and thirteen independent candidates were invited to join the PTI-led government. Additionally, Awami Muslim League led by Sheikh Rasheed Ahmed, the party’s only MNA, had already vowed its support to PTI before the elections.[127]

text: On 28 July, PML (Q) pledged its support to PTI’s candidates for Chief Minister of Punjab, making it unlikely to oppose PTI in the National Assembly.[128] On 31 July, Balochistan Awami Party announced its support for a PTI led federal government.[129]

text: On 1 August, Muttahida Qaumi Movement was told by the PPP that it had to choose between sitting in a coalition with them in Sindh or sitting in a coalition with PTI in the centre. On the same day, MQM-P convener Khalid Maqbool Siddiqui announced the party’s six MNAs would lend their support to the PTI in the National Assembly.[130]

text: On 2 August, Pakistan Muslim League (N), Pakistan Peoples Party, Muttahida Majlis-e-Amal and Awami National Party announced to form a “Grand Opposition Alliance” whereby the Speaker, Prime Minister and other key posts would be jointly nominated and elected. The Speakership would be given to the PPP, the Deputy Speakership to the MMA and the Premiership to the PML-N. However, on 16 August, after the elections for speaker, PPP decided to withdraw their support for Shehbaz Sharif for the post of Prime Minister, owing to previous statements made by the individual about the party’s co-chairman and ex-President of Pakistan, Asif Ali Zardari.[131][132]

text: Over the next few weeks, other parties pledged their support towards the PTI nominees for speaker, deputy speaker. These parties include Balochistan National Party (Mengal), Grand Democratic Alliance and Jamhoori Watan Party. In addition to this, 9 independents joined the party.[133][134][135]

text: Election for Speakers of the National Assembly[edit]

text: The election for the Speaker and Deputy Speaker of the National Assembly took place on 15 August 2018.

text:
Candidate

Party

Contesting for

Votes Obtained[136]

Required majority →

172 out of 342

Asad Qaiser

Pakistan Tehreek-e-Insaf (151)supporters: MQM-P (7), BAP (5), BNP-M (4), PML-Q (3), GDA (3), AML (1), JWP (1), IND (1)

Speaker

176 Y

Qasim Suri

Deputy Speaker

183 Y

Khurshid Shah

Pakistan Peoples Party (54)Muttahida Majlis-e-Amal (15)supporters: PML-N (81), ANP (1)

Speaker

146 N

Asad Mehmood

Deputy Speaker

144 N

text: Election for Prime Minister[edit]

text: The election for the premiership took place on 17 August 2018.

text:
Candidate

Party

Votes Obtained[137]

Required majority →

172 out of 342

Imran Khan

Pakistan Tehreek-e-Insaf (151)supporters: MQM-P (7), BAP (5), BNP-M (4), PML-Q (3), GDA (3), AML (1), JWP (1), IND (1)

176 Y

Shehbaz Sharif

Pakistan Muslim League (N) (81)supporters: PPP (54)[132], MMA (15), ANP (1)

96 N

Abstentions

53

text: Reactions[edit]

text: Domestic[edit]

text: As the results began to pour in, many of the main opposition parties declared that the elections were not 'free and fair'.[138]

text: The Election Commission of Pakistan denied the allegations but announced that it would be willing to investigate if proof was provided.[139]

text: PTI chairman Imran Khan also addressed the allegations in his first national address and said that he would be willing to look into any allegations of rigging.[140] He also added that he thought that the elections were the "cleanest in Pakistan's history."[141]

text: Celebrations across Pakistan also erupted as early results indicated a win for Tehreek-e-Insaf.[142] Khan's fellow cricketers and celebrities took to Twitter in celebration of his assumed victory even before election results were finalized or a government formed.[143]

text: Economic[edit]

text: The Pakistan Stock Exchange (PSX) reacted positively and opened 2% higher as the prospect of a hung government dissipated. The KSE index closed 749 points higher on Thursday.[144] On 3 July 2018, the benchmark KSE-100 index gained 314 points to reach 43,100 points. It closed up 770 points at 43,556 points. The US dollar shed Rs5.36 against the rupee in the inter-bank market for the first time in four years, falling to Rs122.5. The positive economic indicators are considered to be largely driven by what investors consider the return of political stability following the 25 July polls.[145]

text: International[edit]

text:
United Nations – United Nations spokesperson Stéphane Dujarric did not acknowledge the results of the election, he commended the Electoral Commission for their organizational efforts, "noting positive initiatives related to training and efforts to enhance the inclusion of women, persons with disabilities and other marginalized groups, as well as first-time voters, in the electoral process."[146]
 European Union – The European Union’s monitoring delegate Michael Gahler said, "Our overall assessment of the election process is that it is not as good as in 2013... [but] the election results are credible."  Gahler particularly criticized the ill-treatment given to the former ruling party and threats against the press from the various campaigns.[146] Ambassador of the European Union to Pakistan Jean Francois Cautain congratulated Khan on his party's recent electoral victory and assured the PM-in-waiting that the EU is keen to work with his government. Cautain said, "We are ready to collaborate in the fields of security, economy, education and rural development. We will assist the newly elected government in securing investments from EU's member countries as we wish to see stability and development in Pakistan. The EU is also ready to help Pakistan escape the grey list of the Financial Action Task Force." He further added, "The EU also does not have any objections to the Iran–Pakistan gas pipeline project."[147][148][149]

text:
Afghanistan – President of Afghanistan Ashraf Ghani congratulated Khan and wrote, "I just spoke to Imran Khan and congratulated him on the victory in parliamentary elections. We both agreed to overcome the past and to lay a new foundation for a prosperous political, social and economic future of both countries."[150] He also invited Khan to visit Kabul and Khan has accepted the invitation.[151]
 Azerbaijan – President of Azerbaijan Ilham Aliyev has congratulated Imran Khan on his election as Prime Minister of Pakistan. He expressed the hope that the two governments would work to improve the bilateral relationship.[152][153]
 Canada – Canada’s High Commissioner in Pakistan issued the statement on the elections in Pakistan, “We congratulate the millions of Pakistani citizens who exercised their democratic rights by casting votes in the National Assembly and Provincial Assembly elections on July 25. The participation of tens of millions of voters is a testament to the strong democratic convictions of the people of Pakistan. We are saddened by the incidents of violence which occurred on July 25 and in the lead-up to the election, resulting in significant loss of life. Canada condemns these senseless acts and vicious attacks on democracy and conveys its condolences to the families of those whose lives were lost, as well as those injured."[154]
 China – The spokesperson for the Ministry of Foreign Affairs of the People's Republic of China Geng Shuang expressed pleasure for smooth completion of the general election and congratulated Imran Khan. At the regular press conference, he said, “China welcomes the smooth completion of the general election in Pakistan and congratulates the Pakistan Tehreek-e-Insaf led by Mr. Imran Khan for winning this election. We are willing to work together with the new Pakistani government to push China-Pakistan all-weather strategic partnership to a new level.”[155]
 France – Spokesperson of the French Ministry for Europe and Foreign Affairs issued the statement, "France welcomes the mobilization of the Pakistani people, who went to the polls to exercise their electoral rights despite calls from extremist groups and incidents during the electoral process, which will be detailed in the final report of the Election Observation Mission of the European Union. We strongly condemn the violence that has bereaved the electoral process, including the attacks in Mastung and Quetta, and express our condolences to the families of the victims. France congratulates the future leaders of the country and stands ready to start constructive relations with the government which will be chosen by the parliament. This election marks, for the first time in the history of Pakistan, the second consecutive transfer of power between two democratically elected governments. It constitutes a new step in the strengthening of democracy in Pakistan. France will stand alongside Pakistan in the continuation of this process, as well as support the economic and social development of the country."[156]
 Germany – Government of Germany commended the 25 July general election held in Pakistan, saying it was "ready to work closely and confidently" with the new leadership. In a statement, the German Foreign Office spokesperson said, "Our country looks forward to [assisting] them in accomplishing these tasks. Germany understands that the new government will face great challenges that include improving the living conditions of all Pakistanis, combating corruption, and strengthening regional stability. Germany stands by and ready to work closely and confidently with the new Pakistani government and to assist them in accomplishing these task," referring to the newly-elected Pakistani government.[157]
 India – Prime Minister Narendra Modi telephoned Khan and congratulated him over his party's success in the general elections and expressed hope that the democracy will take deeper roots in Pakistan, and reiterated his vision of peace and development in the entire neighborhood.[158] Indian Ministry of External Affairs Spokesperson Raveesh Kumar expressed hope for better bilateral relations with Pakistan and said, "India desires a prosperous and progressive Pakistan at peace with its neighbors. We hope that the new Government of Pakistan will work constructively to build a safe, stable, secure and developed South Asia free of terror and violence." India’s Foreign Affairs Ministry did not directly comment on Khan’s call for talks, but said it welcomed that “the people of Pakistan have reposed their faith in democracy through general elections”.[159][160]
 Iran – Iranian President Hassan Rouhani extended his sincere congratulations to Imran Khan on his election as the new Prime Minister of Pakistan and expressed hope that the two countries would further improve relations during his tenure. In his congratulatory message to Imran, Rouhani said that the Islamic Republic of Iran as always and particularly during the new era expresses its readiness to expand relations and cooperation with the Islamic Republic of Pakistan. The Iranian president said that Imran Khan’s election is the result of willpower of the brave Pakistani nation.[161] Iran’s ambassador to Pakistan Mehdi Honardoost congratulated Khan on winning the general elections, and expressed to enhance cooperation with the government-in-waiting. He said in a letter written to Khan, "People of Pakistan have demonstrated their desire to achieve progress and development by turning up in large numbers and using their right of franchise in the 25 July polls."[162]
 Japan – Government of Japan congratulated Imran Khan and his political party on victory in the general election 2018. The government expressed hopes that the relations between the two countries will get better with the new Pakistani leadership in place and that Imran’s government will continue to work on deals between the two countries.[163]
 Maldives – President of Maldives Abdulla Yameen telephoned Khan and felicitated him on his success in the general elections, and expressed his best wishes for him.[164] The Prime Minister-designate Imran Khan thanked the President of Maldives.
   Nepal – Prime Minister of Nepal Khadga Prasad Oli, sent a message of congratulations to Imran Khan on his assumption of the high office of the Prime Minister of Pakistan.In the message, Prime Minister Oli has recalled friendly relations between Nepal and Pakistan and has wished for successful tenure of the newly elected Prime Minister of Pakistan.Prime Minister Oli has also expressed hope that bilateral relations between Nepal and Pakistan will be further strengthened during the tenure of Prime Minister Imran Khan.[165]
 Qatar –  Qatar’s Emir Sheikh Tamim bin Hamad Al-Thani telephoned PTI Chairman Imran Khan and congratulated him on election win. Extending an invitation to the prime minister-in-waiting to visit Qatar, Sheikh Tamim expressed his desire to expand ties with the incoming government in Pakistan. Khan, on his part, said that Pakistan accords great respect to its ties with Qatar and expressed the hope that the two governments would work to improve the bilateral relationship.[166][167]
 Russia –  Russian Ambassador to Pakistan Alexey Dedov called on Prime Minister-in-waiting and Chairman PTI Imran Khan in Bani Gala and congratulated him on the victory in elections 2018. The Russian Ambassador expressed desire to further enhance cooperation between Pakistan and Russia.[168][169]
 Saudi Arabia – Saudi Arabian Ambassador to Pakistan Nawaf bin Said Al-Malki met Imran Khan and congratulated him. Talking about Khan’s speech he termed it as “comprehensive and positive.” Ambassador said that the Saudi Crown Prince would visit Pakistan soon after Imran Khan takes the oath and the transition to the new government, and put in place a new stronger bilateral relationship between the two countries.[170][171]
 Sri Lanka – Sri Lankan President Maithripala Sirisena congratulated Imran Khan after he took oath today as the Prime Minister of Pakistan.  "I am confident that your leadership will help steer Pakistan towards peace, prosperity and sustainability, as relations between our two countries grow further".[172]
 Turkey – President of Turkey Recep Tayyip Erdoğan telephoned Khan and congratulated him on his victory. He also offered his well wishes to Pakistan Tehreek-e-Insaf and expressed hope for the future government.[173] During the telephonic exchange, the two leaders exchanged the hope for the beginning of a positive chapter in the bilateral relations.[174]
 United Arab Emirates – United Arab Emirates Ambassador Hamad Obaid Ibrahim Salem Al Zaabi called on Imran Khan at his Bani Gala residence and congratulated him for his party’s victory in the parliamentary elections. The two sides also touched on the political and bilateral ties between the two friendly countries.[175]
 United Kingdom – Foreign Secretary Jeremy Hunt congratulated "the millions of voters who participated in Pakistan’s elections" in spite of terrorism, calling it an "important moment for democracy in Pakistan". Hunt also expressed concern about the reports of "pressure on the media" and the number of parties "who preach violence and intolerance". He also wished for a successful transition, adding that he hopes that all sides will "resolve any disputed results peacefully and in accordance with Pakistan’s electoral laws."[176]
 United States – The Trump administration and the US State Department, which had no election observers on the ground mainly due to security concerns, refused to confirm that the elections were free and fair,[177][178] and the State Department "expressed concern over reports regarding limits on freedom of expression before the polls".[179] It added that the United States will look for opportunities to work with the new government "to advance our goals of security, stability, and prosperity in South Asia".[179] State Department spokesperson Heather Nauert congratulated the Pakistani people, especially the women, for having the courage to vote in view of the violent circumstances surrounding the election.[146]


document_title: Pleurisy

question_text: pain in left side of chest while sneezing

root

text: Pleurisy

text: Signs and symptoms[edit]

text: The defining symptom of pleurisy is a sudden sharp, stabbing, burning or dull pain in the right or left side of the chest during breathing, especially when one inhales and exhales.[9] It feels worse with deep breathing, coughing, sneezing, or laughing. The pain may stay in one place, or it may spread to the shoulder or back.[10] Sometimes, it becomes a fairly constant dull ache.[11]

text: Depending on its cause, pleuritic chest pain may be accompanied by other symptoms:[12]

text:
Dry cough
Fever and chills
Rapid, shallow breathing
Shortness of breath
Tachycardia
Sore throat followed by pain and swelling in the joints

text: Causes[edit]

text: The pleural space can be invaded by fluid, air, and particles from different parts of the body which fairly complicates the diagnosis.[12][13] Viral infection (coxsackie B virus, HRSV, CMV, adenovirus, EBV, parainfluenza, influenza) is the most common cause of pleurisy. However, many other different conditions can cause pleuritic chest pain:[11]

text:
Aortic dissections
Autoimmune disorders such as systemic lupus erythematosus (or drug-induced lupus erythematosus), Autoimmune hepatitis (AIH) and rheumatoid arthritis
Bacterial infections associated with pneumonia and tuberculosis
Chest injuries (blunt or penetrating)
Familial Mediterranean fever, an inherited condition that often causes fever and swelling in the abdomen or the lungs
Fungal or parasitic infections
Heart surgery, especially coronary-artery bypass grafting
Cardiac problems (ischemia, pericarditis)
Inflammatory bowel disease
Lung cancer and lymphoma
Other lung diseases like cystic fibrosis, sarcoidosis, asbestosis, lymphangioleiomyomatosis, and mesothelioma
Pneumothorax
Pulmonary embolisms, which are blood clots that enter the lungs

text: When the space between the pleurae starts to fill with fluid, as in pleural effusion, the chest pain can be eased but a shortness of breath can result, since the lungs need room to expand during breathing. Some cases of pleuritic chest pain are idiopathic, which means that the exact cause cannot be determined.

text: Diagnosis[edit]

text: A diagnosis of pleurisy or another pleural condition is based on a medical history, physical examinations, and diagnostic tests.[12] The goals are to rule out other sources of the symptoms and to find the cause of the pleurisy so that the underlying disorder can be treated.

text: Physical examination[edit]

text: A doctor uses a stethoscope to listen to the breathing. This method detects any unusual sounds in the lungs. A person with pleurisy may have inflamed layers of the pleurae that make a rough, scratchy sound as they rub against each other during breathing. This is called pleural friction rub.

text: Diagnostic tests[edit]

text: Depending on the results of the physical examination, diagnostic tests are sometimes performed.

text: Chest x-ray[edit]

text: A chest x-ray takes a picture of the heart and lungs. It may show air or fluid in the pleural space. It also may show the cause (e.g., pneumonia, a fractured rib, or a lung tumor) of the pleurisy.

text: Sometimes an x-ray is taken while lying on the painful side. This may show fluid, as well as changes in fluid position, that did not appear in the vertical x-ray.

text: Blood test[edit]

text: Blood tests can detect bacterial or viral infections, pneumonia, rheumatic fever, a pulmonary embolism, or lupus.

text: ECG[edit]

text: Electrocardiography test can determine if a heart condition contributes to the symptoms.

text: Ultrasound[edit]

text: Ultrasonography uses sound waves to create an image. It may show where fluid is located in the chest. It also can show some tumors. Although ultrasound may detect fluid around the lungs, also known as a pleural effusion, sound waves are scattered by air. Therefore, an actual picture of the lungs cannot be obtained with ultrasonography.

text: Computed tomography (CT) scan[edit]

text: A CT scan provides a computer-generated picture of the lungs that can show pockets of fluid. It also may show signs of pneumonia, a lung abscess, or a tumor.

text: Magnetic resonance imaging (MRI)[edit]

text: Magnetic resonance imaging (MRI), also called nuclear magnetic resonance (NMR) scanning, uses powerful magnets to show pleural effusions and tumors.

text: Arterial blood gas[edit]

text: In arterial blood-gas sampling, a small amount of blood is taken from an artery, usually in the wrist. The blood is then checked for oxygen and carbon-dioxide levels. This test shows how well the lungs are taking in oxygen.

text: Thoracentesis[edit]

text: Once the presence of an excess fluid in the pleural cavity, or pleural effusion, is suspected and location of fluid is confirmed, a sample of fluid can be removed for testing.[14] The procedure to remove fluid in the chest is called a diagnostic thoracentesis.[15] The doctor inserts a small needle or a thin, hollow, plastic tube in the chest wall and withdraws fluid.[16]

text: Thoracentesis can be done in the doctor's office or at the hospital. Ultrasound is used to guide the needle to the fluid that is trapped in small pockets around the lungs.

text: Thoracentesis usually does not cause serious complications. Generally, a chest x-ray is done after the procedure to evaluate the lungs. Possible complications of thoracentesis include the following:

text:
Bleeding and bruising where the needle went in. In rare cases, bleeding may occur in or around the lung. The doctor can use a chest tube to drain the blood. In some cases, surgery is needed.
Infection where the needle went in
Injury to the liver or spleen (in rare cases)
Pain.
Pneumothorax, or buildup of air in the pleural space, with a collapsed or partially collapsed lung. Sometimes air comes in through the needle or the needle makes a hole in the lung. Usually, a hole will seal itself. But sometimes air can build up around the lung and make it collapse. A chest tube can remove the air and let the lung expand again.

text: The lung fluid is examined under a microscope and is evaluated for the presence of chemicals and for its color and texture. The degree of clarity is an indicator of infection, cancer, or other conditions that may be causing the buildup of fluid or blood in the pleural space.

text: Biopsy[edit]

text: If tuberculosis or cancer is suspected, a small piece of the pleura may be examined under a microscope to make a definitive diagnosis. This is called a biopsy.

text: Several approaches to taking tissue samples are available

text:
Insertion of a needle through the skin on the chest to remove a small sample of the outer layer of the pleura.
Insertion of a small tube with a light on the end (endoscope) into tiny cuts in the chest wall in order to visualize the pleura. Small pieces of tissue can be biopsied though the endoscope.
Removal of a sample of the pleura through a small cut in the chest wall. This is called an open pleural biopsy. It is usually done if the sample from the needle biopsy is too small for an accurate diagnosis.

tag: ol

text: Treatment[edit]

text: Treatment has several goals:[12]

text:
Relief of symptoms
Removal of the fluid, air, or blood from the pleural space
Treatment of the underlying condition

text: Procedures[edit]

text: If large amounts of fluid, air, or blood are not removed from the pleural space, they may cause the lung to collapse.

text: The surgical procedures used to drain fluid, air, or blood from the pleural space are as follows:

text:
During thoracentesis, a needle or a thin, hollow, plastic tube is inserted through the ribs in the back of the chest into the chest wall. A syringe is attached to draw fluid out of the chest. This procedure can remove more than 6 cups (1.5 litres) of fluid at a time.
When larger amounts of fluid must be removed, a chest tube may be inserted through the chest wall. The doctor injects a local painkiller into the area of the chest wall outside where the fluid is. A plastic tube is then inserted into the chest between two ribs. The tube is connected to a box that suctions the fluid out. A chest x-ray is taken to check the tube's position.
A chest tube is also used to drain blood and air from the pleural space. This can take several days. The tube is left in place, and the patient usually stays in the hospital during this time.
Sometimes the fluid contains thick pus or blood clots, or it may have formed a hard skin or peel. This makes it harder to drain the fluid. To help break up the pus or blood clots, the doctor may use the chest tube to put certain medicines into the pleural space. These medicines are called fibrinolytics. If the pus or blood clots still do not drain out, surgery may be necessary.

text: Medications[edit]

text: A couple of medications are used to relieve pleurisy symptoms:

text:
Paracetamol (acetaminophen) or anti-inflammatory agents to control pain and decrease inflammation. Only indomethacin (brand name Indocin) has been studied with respect to relief of pleurisy.[17]
Codeine-based cough syrups to control the cough

text: There may be a role for the use of corticosteroids (for tuberculous pleurisy), tacrolimus (Prograf) and methotrexate (Trexall, Rheumatrex) in the treatment of pleurisy. Further studies are needed.

text: Lifestyle changes[edit]

text: The following may be helpful in the management of pleurisy:

text:
Lying on the painful side may be more comfortable
Breathing deeply and coughing to clear mucus as the pain eases. Otherwise, pneumonia may develop.
Getting rest

text: Treating the cause[edit]

text: Ideally, the treatment of pleurisy is aimed at eliminating the underlying cause of the disease.

text:
If the pleural fluid is infected, treatment involves antibiotics and draining the fluid. If the infection is tuberculosis or from a fungus, treatment involves long-term use of antibiotics or antifungal medicines.
If the fluid is caused by tumors of the pleura, it may build up again quickly after it is drained. Sometimes anti-tumor medicines will prevent further fluid buildup. If they don't, the doctor may seal the pleural space. This is called pleurodesis. Pleurodesis involves the drainage of all the fluid out of the chest through a chest tube. A substance is inserted through the chest tube into the pleural space. This substance irritates the surface of the pleura. This causes the two layers of the pleurae to squeeze shut so there is no room for more fluid to build up.
Chemotherapy or radiation treatment also may be used to reduce the size of the tumors.
If congestive heart failure is causing the fluid buildup, treatment usually includes diuretics and other medicines.

text: The treatment for pleurisy depends on its origin and is prescribed by a physician on a base of an individual assessment.[18] Paracetamol (acetaminophen) and amoxicillin, or other antibiotics in case of bacterial infections, are common remedies dispensed by doctors to relieve the initial symptoms and pain in the chest, while viral infections are self-limited. Non-steroidal anti-inflammatory drugs (NSAIDs), preferably indometacin, are usually employed as pain control agents.[12]

text: Alternative treatments[edit]

text: A number of alternative or complementary medicines are being investigated for their anti-inflammatory properties, and their use in pleurisy. At this time, clinical trials of these compounds have not been performed.

text: Extracts from the Brazilian folk remedy Wilbrandia ebracteata ("Taiuia") have been shown to reduce inflammation in the pleural cavity of mice.[19][20] The extract is thought to inhibit the same enzyme, cyclooxygenase-2 (COX-2), as the non-steroidal anti-inflammatory drugs.[20]

text: Related problems[edit]

text: Pleurisy is often associated with complications that affect the pleural space.

text: Pleural effusion[edit]

text: In some cases of pleurisy, excess fluid builds up in the pleural space. This is called a pleural effusion. The buildup of fluid usually forces the two layers of the pleura apart so they don't rub against each other when breathing. This can relieve the pain of pleurisy. A large amount of extra fluid can push the pleura against the lung until the lung, or a part of it, collapses. This can make it hard to breathe.

text: In some cases of pleural effusion, the extra fluid gets infected and turns into an abscess. This is called an empyema.

text: Pleural effusion involving fibrinous exudates in the fluid may be called fibrinous pleurisy. It sometimes occurs as a later stage of pleurisy.

text: A person can develop a pleural effusion in the absence of pleurisy. For example, pneumonia, heart failure, cancer, or a pulmonary embolism can lead to a pleural effusion.

text: Pneumothorax[edit]

text: Air or gas also can build up in the pleural space. This is called a pneumothorax. It can result from acute lung injury or a lung disease like emphysema. Lung procedures, like surgery, drainage of fluid with a needle, examination of the lung from the inside with a light and a camera, or mechanical ventilation, also can cause a pneumothorax.

text: The most common symptom is sudden pain in one side of the lung and shortness of breath. A pneumothorax also can put pressure on the lung and cause it to collapse.

text: If the pneumothorax is small, it may go away on its own. If large, a chest tube is placed through the skin and chest wall into the pleural space to remove the air.

text: Hemothorax[edit]

text: Blood also can collect in the pleural space. This is called hemothorax. The most common cause is injury to the chest from blunt force or surgery on the heart or chest. Hemothorax also can occur in people with lung or pleural cancer.

text: Hemothorax can put pressure on the lung and force it to collapse. It also can cause shock, a state of hypoperfusion in which an insufficient amount of blood is able to reach the organs.

text: Prognosis[edit]

text: Pleurisy and other disorders of the pleurae can be serious, depending on what caused them. Generally, pleurisy treatment has an excellent prognosis, but if left untreated it can cause severe complications. For example, a resulting pulmonary heart disease cor pulmonale, which manifests itself with an inflammation of the arms and legs, can lead to heart failure. If the conditions that caused the pleurisy or other pleural disorders were adequately diagnosed and treated early, one can expect a full recovery. Help of a pulmonologist (respiratory physician in the U.K. and Australia) may be enlisted to address the underlying cause and chart post-illness rehabilitation.

text: Notable cases[edit]

text:
Gaius Marius, a Roman general and statesman, according to Plutarch died of the disease in 86 BC.[21]
Flavius Constantius III, a co-emperor of the Western Roman Empire, died of pleurisy according to Sidonius Apollinaris on 2 September 421 AD.[22]
Charlemagne, known as the father of Europe for reuniting much of the Roman Empire, died in 814 of pleurisy.[23]
Catherine de' Medici, sometimes described as a "wife of one King and mother of three others", died from pleurisy in January 1589 at age 69.[24]
Benjamin Franklin developed fever and chest pain in 1790 at the age of 84. He spent ten days in bed having severe cough and difficulty breathing. He died after an abscess in his lungs burst from what is believed to be a case of pleurisy.[25]
Juan O'Donojú, last viceroy of the Spanish colony of New Spain (Mexico), died of pleurisy on 8 October 1821.[26]
Francis Scott Key died in 1843 at the home of his daughter Elizabeth Howard in Baltimore from pleurisy.[27]
William Wordsworth, the English poet, died of pleurisy aged 80 on 23 April 1850.[28]
Dominic Savio, Italian Saint, became ill and died in March 1857 at the age of 14 possibly from pleurisy.[29]
Tad Lincoln, the fourth and youngest son of Abraham Lincoln, had difficulty breathing when lying down and had to sleep sitting in a chair, and probably died of pleuristic attack, which was believed to be tubercular in origin, in Chicago in 1871 at age 18.[30]
Devil Anse Hatfield, a leader of the Hatfield clan and the driving force of the infamous Hatfield–McCoy feud, had a bout of pleurisy in the 1890s (probably 1897).[31]
Frank C. Stanley, former Peerless Quartet member, died of pleurisy at the age of 41 on 12 December 1910 at his home in Orange.[32]
Mahatma Gandhi suffered from pleurisy during the First World War, while he was in London.[33]
Enrico Caruso was struggling with pleurisy in the winter of 1920–1921, which contributed to his premature death.[34][35]
Eli Bowen, a circus performer known as "The Legless Wonder", or "The Legless Acrobat", died on 2 May 1924 in Coney Island of pleurisy days before a scheduled performance for The Dreamland Circus at age 79.[36]
Erik Satie, French composer, died from pleurisy at l'Hôpital St. Joseph on 1 July 1925.[37]
Rudolph Valentino, an international movie star, died in August 1926 from pleurisy at age 31.[38]
Alvin Kraenzlein was the first athlete to win four Olympic titles in a single event at the 1900 Summer Olympics in Paris. He suffered from bouts of pleurisy at the end of 1927 and died from a related complication early 1928 at the age of 51.[39]
Thomas Hardy, English novelist and poet, became ill with pleurisy and died of related causes in 1928 at age 87.[40]
Anna Pavlova, one of the world's most famous ballerinas, died unexpectedly of pleurisy at age 49 at the Hotel des Indes in The Hague in January 1931,[41]
Florenz Ziegfeld, Jr., a Broadway impresario, who was credited with staging several hit musicals including Show Boat (1927), died on 22 July 1932 of pleurisy after a lung infection at age 65.[42]
Kenji Miyazawa, a Japanese poet and writer, suffered from chronic pleurisy and died of pneumonia in September 1933 at age 37.[43]
Nino Manfredi, prominent actor in the commedia all'italiana genre, was given three months to live for his bilateral pleurisy in 1937. He eventually survived and died at age 83 in 2004.[44]
Sir Robert Chesebrough, inventor of Vaseline, suffered pleurisy in his 50s and is said to have treated it by rubbing his whole body with petroleum jelly.[45]
Carson McCullers, author of The Heart Is a Lonely Hunter, was diagnosed with influenza and pleurisy in 1944.[46]
Ringo Starr, former Beatles drummer and solo artist, had chronic-pleurisy at age 13 in 1953.[47]
LeBron James, an American professional basketball player, was diagnosed with pleurisy after being admitted to the Cleveland Clinic in October 2005 with complaints about chest pain during practice.[48]
Ken Griffey Jr., an American professional baseball player, complained of soreness in the chest and, after a chest x-ray, was diagnosed with pleurisy in April, 2007.[49]
Edmund Husserl, a German philosopher who established the school of phenomenology died of a form of pleurisy on 27 April 1938.[50]


document_title: List of I Know Why the Caged Bird Sings characters

question_text: main character in i know why the caged bird sings

text: Primary characters[edit]

text: Marguerite Johnson ("Maya")[edit]

text: The main character, "an unlikely heroine",[7] from whose perspective the story is told.  She has been described as "a symbolic character for every black girl growing up in America".[3]  The book covers most of her childhood, from the age of three, when she and her older brother Bailey are sent to their grandmother in Stamps, Arkansas, until she was sixteen, when she gives birth to her son Clyde.  Through the character of Maya, Angelou uses her own childhood to demonstrate how she was able to survive as a black child in a white-dominated world.[8] Maya is resilient, highly intelligent and loves literature.  She goes from feeling shame about her race and appearance to feeling pride, in spite of experiences of racism and trauma. She is raped at the age of eight by her mother's boyfriend and responds by choosing not to speak for five years.  She is brought out of her muteness by Mrs. Bertha Flowers, who introduces her to great literature.[9]

text: Annie Henderson ("Momma")[edit]

text: Maya and Bailey's paternal grandmother, "a church-going, God-fearing woman whose store is the heart of black socializing in Stamps".[10]  She is the most important influence in Maya's life.  Momma deals with racism by submitting to it without a struggle and by developing "a strategy of obedience",[11] believing that to do any differently would be unsafe.  Momma is tall, over six feet, and is very strong physically.  She is wise, hard-working, and a good businesswoman.  She is undemonstrative in her love for Maya but "uncompromising in that love".[12]  As Angelou writes, "A deep-brooding love hung over everything she touched".[13][14]

text: Bailey Johnson Jr.[edit]

text: Maya's brother, Bailey is a year older than she is.  He has the most influence on Maya's childhood.  "He is bright, clever, and good-spirited".[15]  He was often her strongest supporter and ally.  Maya measures others by her small-framed brother, who was her hero and "Kingdom Come".[16]  Reviewer John McWhorter calls Bailey Maya's "intense little James Baldwin stand-in of a brother".[17]  Maya and Bailey have an intense bond, and enjoy their private world of jokes.  She is strengthened by his love and support; he is the only one able to comfort her after her rape, and becomes her voice when they return to Stamps.  When he witnesses the murder of a black man by a group of white men, he is confused and unable to understand their hatred.

text: Uncle Willie[edit]

text: Maya and Bailey's uncle and Annie Henderson's son, he was crippled at the age of three when a babysitter dropped him.  He walks with a cane.  Early in Caged Bird, Momma hides him in a bin of potatoes and onions to avoid being detected by the Ku Klux Klan.  He helps Momma run her store and shows Maya kindness to the point that she wishes that he could be her father.  He is just as strict as Momma, however, beating Maya and Bailey after they disrupt a church service and threatening to burn her on a potbelly stove for not learning her multiplication tables.

text: Vivian Baxter Johnson ("Mother Dear")[edit]

text: Maya and Bailey's "glamorous if feckless mother".[18]  Maya is in awe of her beauty:she is "too beautiful to have children".[19]  Vivian captivates both her children with her worldliness and euphoria, especially Bailey.  Maya is emotionally separated from her mother.  Angelou stated later in her life that she recognized that her mother had abandoned her and her brother, which meant that Vivian was "a terrible parent of young children".[20]  Vivian is concerned about providing for her children, but negligent towards them.  When Maya becomes pregnant at the end of the book, Vivian accepts Maya and her child; it is the birth of her grandson that causes a connection between mother and daughter.[21]

text: Bailey Johnson Sr.[edit]

text: Maya and Bailey's "no-account daddy".[18]  He is tall and handsome, with a "smile as slick as brilliantine".[18]  He attempts to portray importance, but speaks in a halting manner.  He is insensitive towards his children.  As Lupton states, "He represents the absent father, the man who is not there for his children, literally and figuratively".[22]  Bailey Sr. "has respect for neither morals nor money", but Maya is fascinated by his "ironic pretentiousness".[23]  He appears twice in Caged Bird, when he shows up in Stamps to drive his children to St. Louis, and when Maya visits him for a summer in San Diego.

text: Mr. Freeman[edit]

text: Vivian Baxter's boyfriend, he lives with Vivian and her family in St. Louis when Maya and Bailey are sent there to be with their mother.  At first, he is a father substitute for Maya, who is hungry to be accepted by a male.  He takes advantage of this by raping her, when she is eight years old, and then threatens to kill Bailey if she told anyone about it.  Bailey encourages Maya to disclose what has happened, and Mr. Freeman goes to trial.  He is sentenced to one year and one day, but is released, anyway. Four days later he is found murdered, probably by Maya's uncles.  Maya is so devastated and traumatized, she chooses to not speak for five years. She gets her voice back when someone asks her to read one of her poems in public.

text: Mrs. Bertha Flowers[edit]

text: The "aristocrat of Stamps"[24] and the town's "black intellectual",[25]  Mrs. Flowers is a "self-supporting, independent, graceful"[26] Black woman.  She is the first person to treat Maya as an individual, and teaches her about the relationship between Blacks and the larger society, as well as "the beauty and power of language".[12]  She gently nurses Maya out of her mutism by reading to her and by loaning her books that inspire Maya to speak again.

text: Minor characters[edit]

text: There are a number of minor characters in Caged Bird, members of the Black and white community in Stamps that fill out Maya's world and inform her influences and early experiences.  Among the most notable are:

text: Sister Monroe[edit]

text: A member of the Black church in Stamps.  She is not always able to come to services, but when she does, she shouts as loud as possible to make up for her absences.  Many humorous church-related anecdotes focus on her and her behavior. Also, one of the most comical chapters in the book.

text: Reverend Thomas[edit]

text: A "repulsive church official"[26] who visits Stamps every 3 months.  Maya and Bailey despise him because he is obese and never remembers their names, and because he eats the best chicken pieces at Sunday dinner.  One Sunday, Sister Monroe is so inspired by his preaching that she hits him over the head with her purse; his teeth fall out and onto the floor near Maya, which results in Maya and Bailey's uncontrollable laughter and subsequent beating by Uncle Willie.

text: Mr. McElroy[edit]

text: Momma's neighbor, and the only black man Maya has seen whose trousers match his jackets.  She and Bailey admire him because he does not go to church, which makes him "courageous".[27]

text: "Powhitetrash" girls[edit]

text: Three white rural girls who attempt to humiliate and intimidate Momma in front of her store when they taunt and expose themselves to her.  Momma reacts by passively humming a spiritual, while Maya, watching from inside the store, weeps with shame and humiliation.

text: Dentist Lincoln[edit]

text: A white dentist who refuses to treat Maya's tooth pain, in spite of his debt to Momma, incurred during the Great Depression.  He states that he would rather put his "hand in a dog's mouth than in a nigger's".[28]  Momma reacts to this with passivity, while Maya is horrified and dreams up an elaborate fantasy about Momma threatening the racist dentist.

text: Mrs. Viola Cullinan[edit]

text: Maya's employer when she is ten years old.  She insists upon calling her "Mary" or "Margaret".  Maya is unable to tolerate this because "whites called black people too many other names",[29] so Maya deliberately tries to get fired.  She finally succeeds by breaking Mrs. Cullinan's prized china.

text: Mr. Donleavy[edit]

text: A white man, he is the guest speaker at Maya's eighth grade graduation.  He puts a pall over the ceremony and crushes the educational dreams of the audience by insinuating that black students are only capable of becoming athletes.

text: Henry Reed[edit]

text: The valedictorian of Maya's eighth grade class.  He makes up for Mr. Donleavy's discouragement by leading the audience in "Lift Ev'ry Voice and Sing", the "Negro national anthem".[30]

text: Miss Kirwin[edit]

text: Maya's teacher at George Washington High School in San Francisco.  "A rare educator",[31] she is white but shows no favoritism to her students based upon their race.  Angelou states that she is "the only teacher I remembered",[32] and probably the only white person who befriended her.

text: Baxter Family[edit]

text: When Maya and Bailey are sent to live with her mother when they are eight and nine, they stay with her family in St. Louis.  Grandmother Baxter, Vivian's mother, is a neighborhood precinct leader of German/black descent who has connections with the local police.  Tutti, Tom, and Ira are Vivian's brothers; they allegedly murder Mr. Freeman after he rapes Maya.

text: Dolores[edit]

text: Bailey Sr.'s pretentious girlfriend, who becomes jealous of Maya.  After a violent argument, Maya runs away from her father's home and is homeless for a short while.

text: Notes[edit]

text:
Jump up ^ Lupton, pp. 29–30

Jump up ^ Lupton, p. 52

^ Jump up to: a b Tate, Claudia. (1999 ). "Maya Angelou". In Joanne M. Braxton, Maya Angelou's I Know Why the Caged Bird Sings: A Casebook. New York: Oxford Press, p. 150. ISBN 0-19-511606-2

Jump up ^ Arensberg, p. 114

Jump up ^ Lupton, p. 34

^ Jump up to: a b Rogers, Ronald R. (Spring 2006). "Journalism: The Democratic Craft". Newspaper Research Journal.

Jump up ^ Arensberg, p. 111

Jump up ^ Lupton, p. 57

Jump up ^ Lupton, p. 56

Jump up ^ Lupton, pp. 57–58

Jump up ^ Lupton, p. 58

^ Jump up to: a b McPherson, p. 26

Jump up ^ Angelou, p. 55

Jump up ^ Momma Henderson, as described by Angelou in her third autobiography Singin' and Swingin' and Gettin' Merry Like Christmas (1976), died in 1953.

Jump up ^ Lupton, p. 59

Jump up ^ Angelou, p. 23

Jump up ^ McWhorter, John. (2002). "Saint Maya". The New Republic 226, no. 19: 35–41. Retrieved 2011-10-20

^ Jump up to: a b c Als, Hilton. (2002-08-05). "Songbird: Maya Angelou Takes Another Look at Herself". The New Yorker.  Retrieved 2008-06-06

Jump up ^ Cite error: The named reference Angelou-60 was invoked but never defined (see the help page).

Jump up ^ Cite error: The named reference Moore was invoked but never defined (see the help page).

Jump up ^ Vivian Baxter died in 1991 (Gillespie et al, p. 155).

Jump up ^ Lupton, p. 60

Jump up ^ McPherson, p. 32

Jump up ^ Angelou, p. 77

Jump up ^ McPherson, p. 36

^ Jump up to: a b Lupton, p. 62

Jump up ^ Angelou, p. 21

Jump up ^ Angelou, p. 189

Jump up ^ Lupton, p. 63

Jump up ^ Angelou, p. 183

Jump up ^ Angelou, p. 215

Jump up ^ Angelou, p. 217

text:
Cite error: A list-defined reference named "angelou-60" is not used in the content (see the help page).

Cite error: A list-defined reference named "moore" is not used in the content (see the help page).

text: Works cited[edit]

text:
Angelou, Maya (1969).  I Know Why the Caged Bird Sings.  New York: Random House.  ISBN 0-375-50789-2
Arensberg, Liliane K. (1999).  "Death as Metaphor for Self".  In Maya Angelou's I Know Why the Caged Bird Sings: A Casebook, Joanne M. Braxton, ed.  New York: Oxford Press.  ISBN 0-19-511606-2
Gillespie, Marcia Ann, Rosa Johnson Butler, and Richard A. Long. (2008).  Maya Angelou: A Glorious Celebration.  New York: Random House. ISBN 978-0-385-51108-7
Lupton, Mary Jane (1998).  Maya Angelou: A Critical Companion. Westport, CT: Greenwood Press.  ISBN 0-313-30325-8
McPherson, Dolly A. (1999).  "Initiation and Self-Discovery".  In Maya Angelou's I Know Why the Caged Bird Sings: A Casebook, Joanne M. Braxton, ed.  New York: Oxford Press.  ISBN 0-19-511606-2

text: African-American autobiographies

text: Pages with reference errorsPages with incorrect ref formattingPages with broken reference names