Banking risk and regulation: Does one size fit all?

Using data for more than 200 banks from 21 OECD countries for the period 2002 to 2008, we examine the impact of bank regulation and supervision on banking risk. Supervisory control, and regulations on capital and market entry have a significant impact on 'capital and asset risk', while supervisory control and regulations on activities restrictions, private monitoring, market entry, and liquidity, have a significant effect on 'liquidity and market risk'. However, quantile regressions suggest that the effect of regulation and supervision differs across banks: most indicators of bank regulation and supervision do not have a significant effect on low-risk banks, while they do affect high-risk banks.

Study of effect of sildenafil citrate in pregnant women with intrauterine growth restriction/oligohydramnios

Background: Fetal growth restriction affects up to 8% of all pregnancies with early onset and late onset fetal growth restriction with increased perinatal mortality. The objective of the study was to evaluate the effectiveness of Sildenafil citrate, the type 5 phosphodiesterase inhibitor which dilates myometrial arteries and improves uterine blood flow.Methods: 100 pregnant women with severe early and late onset fetal growth restriction and oligohydramnios, from 2012 to 2015 at Hassan institute of medical sciences, Karnataka, India were selected for the study. Intervention included the administration of Sildenafil citrate 25mg three times daily until delivery and the major outcome variables were Doppler studies of Uterine artery, umbilical artery, MCA and ductus venosus, Amniotic fluid volume and gestational age. Pregnant women were in the age group of 18-36 years and between 22 -34 weeks of gestational age at the time of recruitment into the study. All the subjects were given intervention and monitored for primary outcome variables once in fifteen days with fetal Doppler and ultrasound techniques.Results: Among the subjects students 2% resulted in stillbirths, 98% retained in the study up to delivery and 80% followed up to three years following delivery. Majority of the women (60%) in the 30 weeks of gestational age and 10% among 22 weeks and 30% between 32-36 weeks of gestation age showed USG abnormalities respectively. Among the USG abnormalities IUGR was found among 70% of women and 30% were found with oligohydramnios before intervention and became 0% and 10% after intervention respectively (p<0.005).Conclusions: Study concludes that Sildenafil citrate would be useful to improve perinatal outcome in women with IUGR both early onset and late onset and Oligomnios

Testicular shielding in penile brachytherapy

Abstract Purpose: Penile cancer, although rare, is one of the common genitourinary cancers in India affecting mostly aged uncircumcised males. For patients presenting with small superficial lesions &lt; 3 cm restricted to glans, surgery, radical external radiation or brachytherapy may be offered, the latter being preferred as it allows organ and function preservation. In patients receiving brachytherapy, testicular morbidity is not commonly addressed. With an aim to minimize and document the doses to testis after adequate shielding during radical interstitial brachytherapy for penile cancers, we undertook this study in 2 patients undergoing brachytherapy and forms the basis of this report. Material and methods: Two patients with early stage penile cancer limited to the glans were treated with radical high-dose-rate (HDR) brachytherapy using interstitial implant. A total of 7-8 tubes were implanted in two planes, parallel to the penile shaft. A total dose of 44-48 Gy (55-60 Gy EQD2 doses with α/β = 10) was delivered in 11-12 fractions of 4 Gy each delivered twice daily. Lead sheets adding to 11 mm (4-5 half value layer) were interposed between the penile shaft and scrotum. The testicular dose was measured using thermoluminescent dosimeters. For each patient, dosimetry was done for 3 fractions and mean calculated. Results: The cumulative testicular dose to left and right testis was 31.68 cGy and 42.79 cGy for patient A, and 21.96 cGy and 23.28 cGy for patient B. For the same patients, the mean cumulative dose measured at the posterior aspect of penile shaft was 722.15 cGy and 807.72 cGy, amounting to 16.4% and 16.8% of the prescribed dose. Hence, the application of lead shield 11 mm thick reduced testicular dose from 722-808 cGy to 21.96-42.57 cGy, an &quot;absolute reduction&quot; of 95.99 ± 1.5%. Conclusions: With the use of a simple lead shield as described, we were able to effectively reduce testicular dose from &quot;spermicidal&quot; range to &quot;oligospermic&quot; range with possible reversibility

Carbuncle in Diabetics-Our Experience

Abstract: Carbuncle is an uncommon skin and soft tissue infection, predominantly occurring in diabetics. It is quite surprising that there are very few series on carbuncle over last 2-3 decades. The aim of this study is to provide our experience on carbuncle in diabetics. Majority of the carbuncles occur over the nape of the neck (40%). Most patients present to the hospital 2 weeks after the onset of the symptoms. Our study shows that staphylococcus aureus continues to be the commonest bacteria isolated. There is no mortality in this series

Plasmodium vivax myocarditis in a child

We report the first documented case of myocarditis associated with Plasmodium vivax malaria in a child who presented with features of cerebral malaria. Clinical features of shock developing in a patient of severe Plasmodium vivax malaria, especially with stable haematocrit, should be investigated by electrocardiogram and/ or cardiac enzymes and echocardiogarphy to rule out myocarditis

Personal non-commercial use only

ABSTRACT. Objective. To put forward a new concept -Blau arteritis, a form of large-vessel vasculitis phenotypically related to Takayasu disease but genetically and clinically part of an expanded phenotype of Blau syndrome. Methods. We provide a clinical description of a new case and summarize previously published cases of arteritis associated with Blau syndrome. Genetic testing was performed by direct sequencing of exon 4 of the NOD2 gene. Results. The case described and those reviewed from the literature demonstrate the emerging phenotype of Takayasu-like arteritis in patients with Blau syndrome. Although most patients described to date depict an otherwise classic Blau syndrome phenotype, the current case was atypical in that the predominant features were arteritic. A novel substitution, G464W, in a highly conserved position near the nucleotide oligomerization domain of the NOD2 protein is also described. Blau syndrome is a monogenic granulomatous disease characterized in its most typical form by a triad of exuberant polyarthritis, uveitis, and granulomatous dermatitis 1 . It is caused by single amino acid substitutions at or near the NACHT domain of NOD2 2 . Although its systemic expression is well recognized after the descriptions of the expanded phenotype of Blau syndrome 3,4 , large-vessel vasculitis remains one of its serious and yet underrecognized manifestations if not actively sought by the treating physician. We describe an 8-year-old girl with symptomatic Takayasu-like arteritis and cardiomyopathy against the background of Blau syndrome with a G464W substitution in NOD2. We reported a similar case in 1989 5 , while others have observed arteritis among children with both sporadic and familial Blau phenotype before the mutation was known MATERIALS AND METHODS A girl, now 11 years old, from rural India, presented to us for the first time at 18 months of age, with bilateral knee effusions of a few months&apos; duration in the absence of rash, uveitis, or systemic features. From the age of 1 month she had had recurrent and unexplained episodes of fever. Her antinuclear antibody result was negative. With a working diagnosis of oligoarticular juvenile arthritis she was administered intraarticular steroids, to which she responded well. She was lost to followup for almost 6 years thereafter. At the age of 8 years, she presented with gradually progressive dyspnea and palpitations of 3 months&apos; duration. She had not thrived, and at this stage she weighed 17.2 kg and her height was 113 cm. There were no systemic features but joint examination showed &quot;boggy synovitis&quot; of the right elbow and knee. Cardiovascular examination showed an irregular pulse with a pulsatile precordium and evidence of congestive heart failure. A rhythm strip on electrocardiography showed ventricular extra beats. The echocardiogram revealed dilated ventricles, generalized hypokinesia with an ejection fraction of 20%, mild tricuspid and aortic regurgitation, and abnormal echogenicity within the wall of the left ventricle. With oligoarticular arthritis in a setting of dilated cardiomyopathy, elevated erythrocyte sedimentation rate, and family history of recurrent unexplained fevers in her mother, a diagnosis of early-onset sarcoidosis was considered. Her eye examination continued to be normal and all biopsies requiring sedation were deferred because of poor cardiac function. Oral methotrexate 10 mg/m 2 and corticosteroids 2 mg/kg were initiated in addition to decongestive treatment consisting of digitalis, diuretics, and captopril. She showed a gradual but steady improvement in effort tolerance, although her ejection fraction on electrocardiography did not mirror her clinical improvement. One and a half years later on a routine followup she was found to be hypertensive. Her carotid pulsations were decreased and a renal bruit was detected. Antihypertensive treatment was instituted and a compute

Guide for monitoring child development in Indian setting

A study to know the prevalence of neurobehavioral developmental delay among children aged three years residing in rural communities of India using Guide for monitoring child development (GMCD). About 530 children at three years were assessed for developmental delay. The GMCD was administered to mothers by a trained interviewer. Prevalence of neurobehavioral developmental delay was estimated and validity of GMCD screening tool was monitored in Indian children. Chi-square test was used to compare categorical variables. Differences were considered significant at

Personal non-commercial use only

ABSTRACT. Objective. To put forward a new concept -Blau arteritis, a form of large-vessel vasculitis phenotypically related to Takayasu disease but genetically and clinically part of an expanded phenotype of Blau syndrome. Methods. We provide a clinical description of a new case and summarize previously published cases of arteritis associated with Blau syndrome. Genetic testing was performed by direct sequencing of exon 4 of the NOD2 gene. Results. The case described and those reviewed from the literature demonstrate the emerging phenotype of Takayasu-like arteritis in patients with Blau syndrome. Although most patients described to date depict an otherwise classic Blau syndrome phenotype, the current case was atypical in that the predominant features were arteritic. A novel substitution, G464W, in a highly conserved position near the nucleotide oligomerization domain of the NOD2 protein is also described. Blau syndrome is a monogenic granulomatous disease characterized in its most typical form by a triad of exuberant polyarthritis, uveitis, and granulomatous dermatitis 1 . It is caused by single amino acid substitutions at or near the NACHT domain of NOD2 2 . Although its systemic expression is well recognized after the descriptions of the expanded phenotype of Blau syndrome 3,4 , large-vessel vasculitis remains one of its serious and yet underrecognized manifestations if not actively sought by the treating physician. We describe an 8-year-old girl with symptomatic Takayasu-like arteritis and cardiomyopathy against the background of Blau syndrome with a G464W substitution in NOD2. We reported a similar case in 1989 5 , while others have observed arteritis among children with both sporadic and familial Blau phenotype before the mutation was known MATERIALS AND METHODS A girl, now 11 years old, from rural India, presented to us for the first time at 18 months of age, with bilateral knee effusions of a few months&apos; duration in the absence of rash, uveitis, or systemic features. From the age of 1 month she had had recurrent and unexplained episodes of fever. Her antinuclear antibody result was negative. With a working diagnosis of oligoarticular juvenile arthritis she was administered intraarticular steroids, to which she responded well. She was lost to followup for almost 6 years thereafter. At the age of 8 years, she presented with gradually progressive dyspnea and palpitations of 3 months&apos; duration. She had not thrived, and at this stage she weighed 17.2 kg and her height was 113 cm. There were no systemic features but joint examination showed &quot;boggy synovitis&quot; of the right elbow and knee. Cardiovascular examination showed an irregular pulse with a pulsatile precordium and evidence of congestive heart failure. A rhythm strip on electrocardiography showed ventricular extra beats. The echocardiogram revealed dilated ventricles, generalized hypokinesia with an ejection fraction of 20%, mild tricuspid and aortic regurgitation, and abnormal echogenicity within the wall of the left ventricle. With oligoarticular arthritis in a setting of dilated cardiomyopathy, elevated erythrocyte sedimentation rate, and family history of recurrent unexplained fevers in her mother, a diagnosis of early-onset sarcoidosis was considered. Her eye examination continued to be normal and all biopsies requiring sedation were deferred because of poor cardiac function. Oral methotrexate 10 mg/m 2 and corticosteroids 2 mg/kg were initiated in addition to decongestive treatment consisting of digitalis, diuretics, and captopril. She showed a gradual but steady improvement in effort tolerance, although her ejection fraction on electrocardiography did not mirror her clinical improvement. One and a half years later on a routine followup she was found to be hypertensive. Her carotid pulsations were decreased and a renal bruit was detected. Antihypertensive treatment was instituted and a compute