SMEs Exports are Influenced by Different Risk Factors: Empirical Study of Emerging Economy

Study intent to identify the direct (indirect) risk factors that can influence the export of medical instruments from SMEs sector of Pakistan by using the time series monthly data sample for a period of fifteen years that is from FY 2003 to FY 2017. Empirically a strong long term relation between the export of medical instruments with operational risk, market risk, export refinance schemes and steel prices are proven by Johansen co-integration. Study also establishes a direct positive relation of operational risk and market risk with the export of medical instruments as a result of Vector Error Correction Model

Impact of Ownership Structure on Investment Efficiency of Sharia Compliant Firms

Sharia compliance is very common preference among Muslim nations of world, requiring to meet certain criteria as a sharia compliant firm. Muslims prefer to either invest in stocks or buy products from firms that are working as per the sharia rules and does not contribute in non-sharia activities in the society. This research is conducted, focusing on sharia compliant firms’ ownership structure and impact on firm’s investment efficiency. The workable data comprises of 65 non-financial sharia compliant firms listed in Islamic index of Bursa Malaysia and the span of study was 10 years from 2011 to 2020. Panel data analysis using two-step System Generalized Method of Moments technique was used in the study. The results showed that ownership concentration has a direct positive relationship with investment inefficiency while dispersed shareholdings displayed a negative relationship. Managerial shareholdings proved to have a positive relation with investment inefficiency as in line with agency theory. Institutional ownership was found to be negatively related to investment inefficiency while Mutual Fund ownership and Retail ownership were found to increase investment inefficiencies. Impact of Independent Non-Executive Ownership in firm was found to be statistically insignificant in impacting the investment efficiencies. The findings are in line with previous studies conducted on conventional non-financial institutions. Furthermore, the study could be further enhanced through inclusion of owner’s activism and cash flow rights

The impact of COVID-19 shocks on the volatility of stock markets in technologically advanced countries

This study examines the volatility of China and the most advanced countries of the world stock markets due to the pandemic of COVID-19 using the TGARCH model. This research study presents empirical support for the TGARCH specification for explaining the daily time dependence in the rate of information arrival to the market for stocks traded on China stock market. Using the sample containing closing stock market returns from 05 January 2015 to 04 April 2020 of sample countries, we found that through the COVID-19, there is no significant impact of returns volatility coming from advanced countries towards the China stock market. Further, results state that China has a significant impact on explaining the volatility of the most advanced countries of the world (Switzerland, Sweden, Netherlands, and the UK) except the U.S.A. during COVID-19. We found no significant impact of China stock market returns on the U.S.A.’s volatility, but there is a presence of leverage effect during COVID 19

Risk factors for mortality of patients with ceftriaxone resistant E. coli bacteremia receiving carbapenem versus beta lactam/beta lactamase inhibitor therapy

Objective: Extended spectrum β-lactamases (ESBL) producing Enterobacteriaceae predominantly E. coli and K. pneumoniae bacteremia have limited treatment options and high mortality. The objective was to determine the risk factors for in-hospital mortality particularly treatment with carbapenem versus beta lactam/beta lactamase combination (BL/BLI) in patients with ceftriaxone resistant E. coli bacteremia. A retrospective cohort study was conducted at the Aga Khan University, Karachi, Pakistan. Adult patients with sepsis and monomicrobial ceftriaxone resistant E. coli bacteremia were enrolled. Factors associated with mortality in patients were determined using logistic regression analysis. Results: Mortality rate was 37% in those empirically treated with carbapenem compared to 20% treated with BL/BLI combination therapy (p-value: 0.012) and was 21% in those treated with a carbapenem compared to 13% in patients definitively treated with BL/BLI combination therapy (p-value: 0.152). In multivariable logistic regression analysis, only Pitt bacteremia score of ≥ four was significantly associated with mortality (OR: 7.7 CI 2.6-22.8) while a urinary source of bacteremia was protective (OR: 0.26 CI 0.11-0.58). In-hospital mortality in patients with Ceftriaxone resistant E. coli bacteremia did not differ in patients treated with either a carbapenem or BL/BLI combination. However, Pitt bacteremia score of ≥ 4 was strongly associated with mortality

Role of awake prone positioning in patients with moderate-to-severe COVID-19: An experience from a developing country

There is limited evidence on the efficacy of awake prone positioning (PP) in non-ventilated patients with COVID-19 who have hypoxemia. We, therefore, aim to describe our experience with the use of early proning in awake, non-intubated patients with confirmed COVID-19. In our retrospective observational study, 23 patients with confirmed positive PCR test results for Severe Acute respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and hypoxemia that required oxygen therapy with or without non-invasive ventilation were treated with PP. Patients were classified into mild, moderate and severe COVID-19 disease. There were no targeted number of hours for proning per day and patients were kept in prone position according to their tolerance. The primary outcome measure was the avoidance of intubation and secondary outcomes were in-hospital mortality, length of hospital stays and complications related to PP. The mean (standard deviation) age of our cohort was 54.5 (11.7) years, and the majority were males (21/23, 91.3%). Sixty-one per cent (14/23) of the patients were suffering from severe disease and 82.6% (19/23) had bilateral lung involvement with interstitial infiltrates. Majority of the patients were prone positioned for a median of 6 days (IQR 4 - 8). Only one patient required transfer to ICU for mechanical ventilation and subsequently died due to severe ARDS. All 22 patients showed progressive improvement in oxygen requirement and PF ratio, mostly after 3-5 days of proning. The mean length of hospital stay was 12 days. All patients, except one, were discharged in stable conditions, on room air or on a minimal oxygen requirement of 1-2 liters. No major complication of PP was recorded. Awake prone positioning is a valuable and safe therapeutic adjunct that can be applied in patients with moderate-to-severe COVID-19. It can also be included in the home-based management protocols of COVID-19 to improve patient outcomes and mitigate the burden on health care facilities

Portfolio Optimization Using Mean-Semi Variance approach with Artificial Neural Networks: Empirical Evidence from Pakistan

Purpose: The challenge of managing a portfolio effectively is allocating capital among numerous stock holdings to achieve maximum profit. Therefore, the purpose of this study is to guide investors in developing optimal portfolios in the stock market of Pakistan. Design/Methodology/Approach: To pick and optimize a portfolio in the most effective way possible, we used the daily closing stock prices of a sample of listed firms at the Pakistan stock exchange. The study applied the mean semi-variance approach and compared the performance of portfolios with equally weighted portfolios under artificial neural networks and historical-based return estimation in Pakistan. Findings: The result shows that artificial neural network-based estimation of the expected return vector has outperformed the historical return estimation under mean semi-variance portfolio optimization and constrained mean semi-variance portfolios based on the Sharp ratio in Pakistan. Implications/Originality/Value: The study suggests that investors, fund managers, and portfolio analysts should focus on the more sophisticated neural network-based choice for the development of portfolios in the equity market of Pakistan.&nbsp

ADVERTISING SPEND: ADOPTION OF ISLAMIC BANKING IN THE BOTTOM OF THE PYRAMID MARKET OF PAKISTAN: Muhammad Taimoor Hassan, Safia Nosheen

The study investigated to remedy the research gap of measuring the moderating effect of advertising spend on consumer adoption behavior of Islamic banking at the bottom of the pyramid (BOP) market of Pakistan. Cross-sectional research data collected from a total of 300 respondents of which 267 (89%) were useful to analyze the test on the framework of the research. SEM approach was used to test the hypothesized relationship of the framework in two sequential steps wherein the 1st step the reliability and validity analysis was performed and in the 2nd step sequential structural analysis among the variables were conducted with and without moderation. The empirical analysis confirmed a positive direct relationship of Perceived Usefulness (PU), Perceived Ease of Use (PEOU), and Advertising Spend (AS) on the adoption of Islamic banking (AIB) in the Bottom of the Pyramid Market. AS further confirmed the hypothesized relationships of the variables through increased individual predicting power of the PU and PEOU on the AIB with an overall effect size of f 2 value of 0.565. The overall adoption value of the r2 increased from simple moderation of 0.482 to moderating r2 value of 0.669 thus depicting 18.7 percent interaction effect of the AS. The study suggests that the advertising spends on marketing communication practices should be well-focused by the managers to penetrate in the BOP market of Pakistan. Moreover, future research can eliminate the limitation of the cross-sectional analysis and generalizability of the results as a functional probability in the other regional settings and industrial sectors by adding more variables to predict the adoption behavior with different roles. The consumer adoption behavior of the low-income markets has not yet been examined for Islamic banking in Pakistan. The research is useful for the industry to keep pace with the competition by focusing on the advertising and communication practices in this industr

Moderating effect of vertical integration on the relationship between sustainability and performance: evidence from oil and gas energy sector

Abstract This research study aims to examine the impact of sustainability on firm performance and analyze how vertical integration moderates the connection between performance and sustainability in the oil and gas sector. We analyzed a sample dataset of oil and gas companies from the top ten oil-producing countries spanned over ten years (2011–2020). The pool-fixed regression technique confirms that sustainability and its three components, i.e., social, environmental, and governance, are negatively related to performance. However, vertical integration moderated the connection between sustainability and performance in the case of the oil and gas sector. We have identified firm size, age, and return share price positively related to firm performance in the oil and gas industry. At the same time, the debt ratio negatively impacts the firm’s performance. The findings are significant for the management of oil and gas firms and the policymakers and regulatory authorities of oil-producing and exporting countries

Evaluation of hospital antibiotic prescription patterns using WHO AWaRe Classification in Karachi, Pakistan

Background: Antimicrobial resistance poses a significant and escalating public health threat. One of the biggest drivers of AMR is the misuse and overuse of antibiotics. Pakistan is the third-highest antibiotic-consuming country among low- and middle-income countries (LMICs). Our study aims to evaluate antibiotic consumption using the WHO AWaRe Classification in hospitalized patients from 2016 to 2023 at a major tertiary care academic medical center in Karachi, Pakistan. METHODS: This retrospective study examined inpatient antibiotic utilization by extracting data from Electronic Medical Records and pharmacy services at Aga Khan University Hospital in Karachi between 2016 and 2023. Data was collected on patient demographics, antibiotic types, and prescription counts. The consumption of each antibiotic was converted to defined daily dose (DDD)/1,000 patient-days. RESULTS: During the period from January 2016 to September 2023, a total of 267,972 antibiotics were prescribed. WATCH antibiotics were the most prescribed, ranging from 68.8% to 73.9% of prescriptions followed by ACCESS antibiotics (58-63.9%) of prescriptions between 2016 and 2023 in hospitalized patients. There was a trend towards an increase in prescriptions of RESERVE antibiotics from 3.8% to 5.3% (p<0.001) and a decrease in prescriptions of ACCESS antibiotics from 63.9% to 58 %(p<0.001) (Figure 1). CONCLUSION: Our study identified a notable increase in the utilization of WATCH group antibiotics compared to ACCESS group and an alarming increase in the utilization of RESERVE group antibiotics. These findings underscore the shifting patterns in antibiotic usage, emphasizing the importance of monitoring and strategic interventions to promote responsible antibiotic prescribing practices