Systemic Risk in International Settlements

Examines the extent to which different settlement systems affect the nature and potential vulnerability of the financial system to systemic risks, and considers whether externalities can be reduced if individual institutions fully internalise the costs of their actions.systemic risk, international payments, financial regulation

Physiotherapy student’s perception of problem based learning

Background: Problem based learning ensures that students are actively engaged in their learning- they set their own objectives and they reinforce what they have learned through discussion with their colleagues. This approach is known to promote deep learning, in contrast to much of the superficial learning happens in traditional methods. To support their learning through engaging them in learning activities and providing feedback. Student’s ability to perform in a professional context, to recognize their need to acquire new knowledge and skills and to view learning holistically. Objective of the study was to assess the third year physiotherapy students’ perception of problem based learning sessions in musculoskeletal condition.Methods: The study was conducted on 22 students of III-year physiotherapy graduate course. Sequential arrangement of PBL sessions was implemented by triple jump assessment on osteoarthritis of knee. Post project feedback questionnaire from students obtained from self-assessment, peer assessment. The responses obtained were analyzed.Results: All the student strongly agreed that The PBL scenarios motivated them to use additional learning resources, The PBL scenarios stimulated their interest in musculoskeletal. The students also agreed that the content of the PBL scenarios fitted their level of knowledge; The PBL scenarios effectively illustrated medical concepts. All the students totally agreed that PBL sessions appeared able to assess their own strengths and weaknesses within PBL, accepted and responded to criticism gracefully. Their peers gave input which was focused and relevant to the case, they were able to communicate well with each other. Students agreed that everyone among group completed tasks on time, they were actively participated in session, they shared new relevant information with group hence they felt their peers were responsible and respected.Conclusions: Students felt that the cases effectively illustrated medical concepts and fitted and reinforced the student musculoskeletal knowledge. They were convinced that scenarios motivated them to use additional resources and stimulated their interest and they enjoyed the process

Capital Adequacy Standards: Are They Sufficient?

During the last two decades many countries have liberalised their financial markets. They have attempted to eliminate government intervention in setting interest rate ceilings, erecting entry barriers, interfering in credit allocation decisions, and have begun to privatise their financial institutions (FIs). However, recent banking crises have indicated a link between liberalisation and financial fragility and the subsequent trade-off between the benefits of liberalisation and the costs of increasing financial fragility in developing markets. Recent experiences in Asia have highlighted the importance of the soundness of domestic financial systems especially the need for a prudential regulatory, supervisory, and accounting framework before undertaking financial sector liberalisation. The object of the paper is to provide a link between the relative level of an individual bank's adequacy and its effects on the fragility of the banking system. Specifically, the probability of a banking crisis is modelled using the characteristics of individual banks - namely, their capital adequacy ratios. The paper concentrates on the importance of distinguishing between cosmetic and effective changes to capital adequacy ratios to avoid the systemic threats which can grow out of microeconomic weaknesses in domestic banking systems as witnessed in Asia.capital adequacy, banking standards, financial regulation

An Incentive Based Regulatory System: A Bridge Too Far

This paper argues that the operation of the financial sector as a whole will not be as effective if market discipline is relied upon as the only tool of financial regulation. Before enacting any incentive mechanisms, there must be adequate built-in measures to prevent the exploitation of information asymmetries as well as greater harmonisation and co-ordination of regulatory standards between countries. The paper considers the "incentive problem" in regulation using a principal-agent framework and the design of an incentive compatible regulatory system which encourages prudent behaviour and efficient financial intermediation. The discussion continues by assessing the nature of the trade-off between incentive and rule based regulation by analysing the interaction between regulatory and agency incentives. The paper concludes by considering the challenges in designing appropriate incentive mechanisms to regulate financial markets.Incentives, Market Discipline, Financial Regulation

Study of cutaneous manifestations in geriatrics

Background: Cutaneous signs and symptoms increases as the age advances. These are physiological as well as pathological changes. They can be due to systemic diseases present in old age.Methods: All the 200 geriatric patients have cutaneous manifestations.Results: Pruritus, eczema, stasis eczema, fungal infections were common. Diabetes was found in large incidence i.e. 27.5%, which show certain skin manifestations like pruritus, skin tag etc.Conclusions: Poor hygiene and systemic medical related senile skin dermatoses are observed. A significant no. of diabetics an emerging disease in India, presented with skin manifestations, which cannot be neglected

Enhancing Corporate Governance for Financial Institutions: The Role of International Standards

The threat of systemic risk in international financial markets necessitates the establishment of universal standards for corporate governance of financial institutions. This paper addresses some important issues and concepts in the governance of multinational financial institutions and why international standards are needed to guide financial institutions in assessing and protecting against risk in financial markets. It acknowledges that different structural approaches to corporate governance exist across countries, and encourages practices which can strengthen corporate governance under diverse structures. An important task for supervisors and regulators is to ensure that incentives exist to encourage senior bank management to adopt good regulatory practices that approximate the economic risk exposure of the financial institution. This paper analyses corporate governance within framework of international financial markets and how international standards can be applied in a way that can effectively reduce systemic risk.financial institutions, systemic risk, corporate governance, regulation

Correlation between ultrasonographic, hysteroscopic and histopathological findings in patients with abnormal uterine bleeding

Background: Menstrual disorders are common indication for medical visits among women of reproductive age and heavy menstrual bleeding affects up to 30% of women throughout their reproductive lifetime. This study aims at evaluating the different causes and, the clinical presentation of AUB and to compare the role of hysteroscopy, ultrasonography and histopathology in patients with AUB.Methods: 100 women above 45 years of age, presenting with abnormal bleeding per vaginum were evaluated. All patients underwent transvaginal scan to note down the endometrial thickness and to rule out uterine and adnexal pathology. All the patients underwent diagnostic hysteroscopy, followed by a biopsy of the endometrium using a curette. The endometrium was sent to the pathologist. Findings of these diagnostic modalities then correlated.Results: Incidence of AUB was present between the age groups of 45-49 years of age (66%). The commonest presenting complaint in this series was menorrhagia or heavy menstrual bleeding (60%). The finding of thickened endometrium as the most common abnormality on USG (44%) and also on hysteroscopy (45%). As per present study the sensitivity of hysteroscopy is 97.78% and specificity was 34.55%, the negative predictive value of the test is 95%.Conclusions: TVS may be the first line of investigation while evaluating the endometrium in a perimenopausal AUB. It helps to triage the patients into high risk or low risk. Endometrial thickness >4mm as per the present study needs further evaluation. Patients with endometrial thickness less than 4 mm can be reassured. Hysteroscopy is the gold standard in the diagnosis of focal pathology like sub mucous fibroid, polyps or anomalies. Histopathology probably is an indispensable tool specially to rule out premalignant and malignant conditions. Thus, all the modalities instead of being competitive to one another, are complimentary to each other. For complete evaluation of patient with AUB all the three modalities should be used together to come at exact diagnosis

A study of the menstrual pattern and problems among rural school going adolescent girls of Amravati district of Maharashtra, India

Background: Onset of menstruation is considered as a landmark in the growth and development of an adolescent girl. The age of onset and the pattern of menstrual cycles vary on different factors. After menarche many adolescent girls faces problems of irregular menstruation, excessive bleeding and dysmenorrhea and many more. Present study was carried in this line to find out problems. Objectives: To study the menstrual pattern & problems among school going adolescent girls in rural area of Amravati district of Maharashtra.Methods: The Prospective observational study was carried out among selected 435 Secondary and higher secondary girls students (12-16 years of age) of Ner Pinglai by purposive sampling method. The study was done in the month August 2013 to February 2014. Statistical analyses were done using SPSS 16.0 version.Results: Total 435 adolescent girls had attained menarche. The mean age of menarche was 13.5 (1.0) years. 17.9% of adolescent girls reported premenstrual syndrome. 81.3% girls had abdominal pain during menstruation followed by 28.5% cramp, 11% were uncomfortable, 11% had backache, 6.6% had headache and 2.5% girls had depression. 3.4% of the adolescent girls were did not have any symptoms during menses. Dysmenorrhoea was the most common menstrual complaint reported by 62.3% girls. 33.5 % girls have reported use of sanitary pads during menstruation. 41.6% girls have reported use of old clothes during menstruation. 21.8% had irregular menstrual cycle.Conclusion: Menstruation is an important milestone for adolescent girls and menstrual problems are common among adolescent girls. The mean age of menarche was 13.1 ± 1.0 of years. There were 1.5 menstrual symptom per adolescent girls commonest being abdominal pain. Dysmenorrhoea was seen in 62.3% of the adolescent girls. 33.5% girls have reported use of sanitary pads during menstruation. 41.6% girls have reported use of old clothes during menstruation.

Effect of chewing gum on the postoperative recovery of gastrointestinal function after gynaecological laparoscopic surgery

Background: The incidence of postoperative ileus (POI) after gynaecological surgery is 10-15%. Chewing gum following general surgery improves outcomes, including early flatus, early bowel sounds, and shortening of the hospitalisation period. This study aims to investigate the effect of postoperative gum chewing on bowel motility after laparoscopic gynaecologic surgery.Methods: 101 women who underwent laparoscopic surgery for benign gynaecological conditions under general anaesthesia were recruited. 50 patients received sugar free chewing gum post operatively and the outcomes were compared with the control group. The study’s primary end points were the time to first regular bowel sounds and time to passage of flatus after surgery. Secondary end points were the time to first defecation, patient satisfaction, and potential side effects of postoperative gum chewing.Results: We found a significantly shorter interval between surgery and passage of flatus in the intervention group (median 10 hours compared with 13 hours p=0.0151) and a significantly higher rate of regular bowel sounds 3 hours (74% compared with 45%; p= 0.003) and 5 hours after surgery (91% compared with 78%; p=0.01). There was no significant difference in time to first defecation between groups (median 18 hours compared with 20 hours; p=0.222).Conclusions: Gum chewing seems to have beneficial effects on bowel motility when used in postoperative care after minimally invasive surgery. Gum chewing should be recommended to patients after gynaecological laparoscopic surger

Knowledge, attitude and behaviour of women towards abnormal menstrual bleeding and its impact on quality of life

Background: Abnormal menstrual bleeding has a major impact on a woman's quality of life. Any intervention therefore should aim to improve this rather than focusing on the amount of menstrual blood loss. The aim of this study was to gain an in depth understanding of women’s current knowledge, attitudes and beliefs around abnormal menstrual bleeding. Also, to understand how it affects their lives, while identifying current misconceptions and gaps in knowledge and their expectations and attitudes towards the treatment so that treatment can address their most bothersome complaint.Methods: A total of 200 women, between 18-55 years of age, not on any hormonal treatment attending the gynaecology OPD at a tertiary care centre between Jan 2017 to May 2017 were interviewed by a questionnaire. Women who had undergone hysterectomy were excluded from the study.Results: Of the 200 women interviewed, 49 women felt that their bleeding was heavy and formed the heavy menstrual bleeding group (HMB) while 151 women who perceived their bleeding to be normal formed the normal bleeding group. In the (HMB) group, a significantly greater proportion of women identified their menstrual bleeding as being an inconvenience and a disruption to their lives. HMB also significantly affected their relationships, social life and productivity at work place.Conclusions: Despite its common occurrence, awareness and understanding of HMB and its treatment within the survey population was poor