Impact of Competition on the Financial Performance of Listed Deposit Money Banks in Nigeria

The impact of bank competition on bank performance remains a widely debated issue. At present, scholars investigate either the competition-stability or the competition-fragility relationships. The traditional competition-fragility view equates bank competition with instability as competition reduces market power and profit margins which in turn encourages bank managers to take higher risks. In contrast, the competition-stability view stipulates that competition leads to lower loan interest rates and consequently lower moral hazard and adverse selection problems and less risky loan portfolios. This study examines both paradigms using panel data from deposit money banks in Nigeria over a period of ten years (2005-2014). Results show that the overall relationship between competition and financial performance of banks is negative. The study, therefore, concludes that competition has a negative effect on the financial performance of banks in Nigeria. The study suggests that regulators should promote healthy competition among deposit money banks so as to reduce the negative effect of competition on bank financial performance. Managers should take measures to enhance profit margin by reducing expenses. Current efforts of the government in terms of improved power generation may help to cut cost of power borne by the banks. Managers should also ensure healthy loan portfolio by ensuring that only customers with high credit scores get loans. Keywords: Bank, competition, financial performance, loan, market share, Nigeria, profit margin, risk.

Open-array analysis of genetic variants in Egyptian patients with type 2 diabetes and obesity

Background: Diabetes mellitus is considered a major public health problem worldwide. Susceptibility to diabetes is influenced by both genetic and environmental determinants.Aims/hypothesis: The aim of the present study was to test for 16 independent single nucleotide polymorphisms (SNPs) in established Type 2 diabetes (T2D) and obesity susceptibility loci by GWAS in a sample of Egyptian patients to find out if there is shared genetic background underlying both disease entities.Methods: Genotyping was performed using OpenArray protocol on the QuantStudioTM 12K Flex Real- Time PCR System. In the present case control study a custom array was designed to facilitate costeffective analysis of selected SNPs related to glycolysis, gluconeogenesis, inflammation, insulin signalling, and immune function.Results: Seven gene variants showed significant association with the risk of T2D patients including FCGRA2, STAT4, CELSR2, PPARG, EXT2 rs3740878, GCKR, PTGS1. Factors that significantly affect T2D were obesity (p < 0.001) and GCKR (p = 0.001) and PTGS1 (p = 0.001) gene variants. Gene variants that showed significant or borderline effect on obesity were MTHFD1, EXT2 rs3740878, GCKR and PTGS1 (p = 0.03, 0.017, 0.059, 0.006) respectively.Conclusions/interpretation: Overlapping genetic aspects should be considered and the presence of risk alleles of different genes together could contribute to the risk of T2D or obesity or both. The MTHFD1 and EXT2rs3740878 gene variants significantly affect obesity and not shared with T2D. Gene variants that showed combined effect on both disease entities were GCKR and PTGS1. These findings provide a basis for future studies on a larger scale. More stress on the risk gene variants that have a combined impact on both diabetes and obesity is recommended to improve risk prediction and preventive strategies

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Kebangkitan Arab: permulaan kepada keadilan sosial, multi Parti Demokrasi dan Pluralisme Agama

Satu peristiwa yang paling penting yang telah tercetus di dunia Islam pada tahun-tahun belakangan tidak lain dari Musim Semi Arab atau apa yang diungkapkan sebagai Kebangkitan Arab oleh Profesor Tariq Ramadan dalam bukunya yang terbaru

Negara Madani: ide dan cabaran

Salah satu dari bentuk yang paling menyerlah dalam politik Islam di awal abad ke dua puluh adalah tuntutannya kepada penubuhan negara Islam. Manhaj dan strategi mungkin berbeza, tetapi matlamatnya tetap sama. Struktur negara yang dilakar berdasar kerangka prinsip Islam – seperti dibangun dalam tradisi Sunni dan Shi‘i, dan diartikulasi seputar konsep pokok dari “undang-undang Islam” bermakna suatu konsep syariah. Ia bukan suatu kebetulan dimana pada akhir abad ke sembilan belas pertubuhan-pertubuhan Islam menzahirkan upaya untuk menghidupkan semula warisan sosial dan politik Islam

Memikirkan semula reformasi Islam: keperluan pada wacana yang tenang tentang etika Islam

Prinsip tidak dapat berubah, mutlak, dan kekal, tetapi pelaksanaannya dalam waktu ini atau dalam sejarah – model sejarah – adalah relatif, bertukar dan terus menerus berubah. Lantaran itu, prinsip keadilan, kesetaraan, hak asasi dan persaudaraan bangsa manusia yang memandu Nabi (saw) Islam sesungguhnya kekal sebagai rujukan yang melangkaui sejarah, tetapi model kota Madina yang diasaskan oleh Nabi Muhammad (saw) pada kurun ketujuh adalah realisasi historis yang terkait dengan realiti dan keperluan pada waktunya

Determination of cadmium and lead levels in meat, liver and kidney of cow and goat marketed in Zaria, Nigeria

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