INFLUENCE OF INSTITUTIONAL OWNERSHIP ON EARNINGS QUALITY: EVIDENCE FOR FIRMS LISTED ON THE PAKISTAN STOCK EXCHANGE

Prior studies have shown that ownership structure of firmsaffects their performance, decision making and earnings. Studies havefound that institutional owners are well informed, organized andproactive as compared to other owners. In this study we empiricallyexamined the impact of institutional ownership on earnings qualityfor the listed firms of the Pakistan Stock Exchange (PSX). The data of200 non-financial listed firms from 2002 to 2014 is collected for thisstudy. The conceptual framework of Financial Accounting StandardsBoard (FASB, 1980) is used to measure the earnings quality. The fourdimensions of earnings quality studied are: predictive value, neutrality,timeliness and representational faithfulness. Results showedinstitutional ownership is positively related with earnings quality.Moreover, a greater level of institutional shareholding brings moreoversight and enhances earnings quality

Prevalence and practice of oestrogen use among the male gym participants

BackgroundOestrogen is the primary female sex hormone and has important functions in both female and male physiology. Recently oestrogen abuse among male gym participants had raised as it is considered to enhance gym performance and breast size. AimsThis study assesses the prevalence of oestrogen use among male gym patrons in Saudi Arabia, their practice related to oestrogen abuse, and the profiles of users. Methods A cross-sectional study was conducted from February 2017 to May 2017 and included 4,860 male gym patrons. The participants were given a questionnaire with a total of 19 questions regarding socioeconomic information, knowledge and practices related to oestrogen, and lifestyle habits.Results The participants had a mean age of 28.6+6.2 years, 6.1 per cent of them abused oestrogen, and the most common forms used were ethinylestradiol (0.03mg) and drospirenone (3mg). Furthermore, 80.7 per cent of the users used it before exercise only. Breast enlargement was the main reason for oestrogen use, and local drug stores were the main source. Compared to non-users, oestrogen users were older (P=0.322), reported lower incomes (P=0.395), were more likely to be active smokers (P=0.597), and had a longer duration of gym participation (P < 0.001).ConclusionThe results indicate that 6.1 per cent of the surveyed male participants abused a combination of oestrogen and progesterone for breast enlargement, which was significantly more likely among males who had longer durations of gym participation

Spread, circulation, and evolution of the Middle East respiratory syndrome coronavirus

The Middle East respiratory syndrome coronavirus (MERS-CoV) was first documented in the Kingdom of Saudi Arabia (KSA) in 2012 and, to date, has been identified in 180 cases with 43% mortality. In this study, we have determined the MERS-CoV evolutionary rate, documented genetic variants of the virus and their distribution throughout the Arabian peninsula, and identified the genome positions under positive selection, important features for monitoring adaptation of MERS-CoV to human transmission and for identifying the source of infections. Respiratory samples from confirmed KSA MERS cases from May to September 2013 were subjected to whole-genome deep sequencing, and 32 complete or partial sequences (20 were ≥99% complete, 7 were 50 to 94% complete, and 5 were 27 to 50% complete) were obtained, bringing the total available MERS-CoV genomic sequences to 65. An evolutionary rate of 1.12 × 10−3 substitutions per site per year (95% credible interval [95% CI], 8.76 × 10−4; 1.37 × 10−3) was estimated, bringing the time to most recent common ancestor to March 2012 (95% CI, December 2011; June 2012). Only one MERS-CoV codon, spike 1020, located in a domain required for cell entry, is under strong positive selection. Four KSA MERS-CoV phylogenetic clades were found, with 3 clades apparently no longer contributing to current cases. The size of the population infected with MERS-CoV showed a gradual increase to June 2013, followed by a decline, possibly due to increased surveillance and infection control measures combined with a basic reproduction number (R0) for the virus that is less than 1

Awareness and Regulatory Measures in Caffeine Addiction: Medical Statistical Review

This study aimed at analyzing the degree of awareness and regulatory measures in the caffeine addiction within a medical statistical survey in Jordan, by attempting to answer the study two questions: What are the level of awareness and regulatory measures in caffeine addiction for positive psychological effects (alertness, attention and concentration)?, and: What are the level of awareness and regulatory measures in caffeine addiction for negative psychological effects (anxiety, depression and irritable)? The results of the study showed that there will be a statistically significant differences at the level of significance (α=0.05) of the awareness of caffeine addiction for both positive psychological effects (alertness, attention and concentration) and negative psychological effects (anxiety, depression and irritable) in Jordan. The researchers recommended to educate university students about the importance of controlling their caffeine intakes, and encourage university students to exploit the medical information provided by the medical studies about the risks of high doses of caffeine intakes

Breast cancer awareness and breast self-examination among future female university graduates: comparison between medical and non-medical students

Background: Breast cancer is a common health problem among females in Saudi Arabia. The disease account for 27% of all female malignancies representing 25.1% of all newly diagnosed female cancers. The objectives of the current study were to assess the level of carcinoma breast awareness of female university students, Majmaah University in Saudi Arabia and to compare the level of awareness, breast self-examination and breast cancer screening between medical and non-medical students.Methods: The current study was a cross-sectional, conducted among female students in Majmaah University in Saudi Arabia. The stratified and the systematic sampling were employed to select the colleges and the students respectively. The sample size was calculated as 325. Data was collected by a pre tested questionnaire and analyzed by SPSS.Results: The university students who acquired good knowledge were 111 (34.2%). Students who acquired average and poor knowledge were 42.2% and 23.6% respectively. Medical students who had good knowledge were 37.6% compared to 26.9% of non-medical students.  The results showed that 94 (28.9%) of the participants practice breast self-examination and 25 (7.6%) performed a screening test.Conclusions: The study concluded that Majmaah University students’ awareness of carcinoma breast is low. There is no significant difference in the level of awareness between students of medical colleges and those of non-medical colleges. The level of practicing breast self-examination and performing screening test for carcinoma breast among female university students is low. There is a significant difference in performing carcinoma breast screening test between medical and non-medical students.

The Impact Of Oral Health Education And Preventive Measures On Dental Caries And Periodontal Diseases

Oral problems, including dental caries, periodontal diseases, and tooth loss, are significant global public health concerns. This is due to the fact that inadequate oral health has extensive impacts on general health and quality of life. In improving oral health, especially in developing countries, there are obstacles that need to be addressed. It is crucial to enhance public health programs worldwide by implementing efficient preventative measures against diseases and simultaneously boosting oral health. Frequently, collective actions are employed for the purpose of oral health education. These actions often involve delivering lectures utilizing various materials such as flipcharts, videos, PowerPoint presentations, as well as implementing other activities like supervised teeth brushing and topical fluoride application. This paper aimed to review the impact of oral health education and preventive measures on dental caries and periodontal diseases

HIV-Care Outcome in Saudi Arabia; a Longitudinal Cohort

Background: Clinical characteristics of HIV-1 infection in people inhabiting Western, Sub-Saharan African, and South-East Asian countries are well recognized. However, very little information is available with regard to HIV-1 infection and treatment outcome in MENA countries including the Gulf Cooperation Council (GCC) states. Methods: Clinical, demographic and epidemiologic characteristics of 602 HIV-1 infected patients followed in the adult Infectious Diseases Clinic of King Faisal Specialist Hospital and Research Centre, in Riyadh, Kingdom of Saudi Arabia a tertiary referral center were longitudinally collected from 1989 to 2010. Results: Of the 602 HIV-1 infected patients in this observation period, 70% were male. The major mode of HIV-1 transmission was heterosexual contact (55%). At diagnosis, opportunistic infections were found in 49% of patients, most commonly being pneumocysitis. AIDS associated neoplasia was also noted in 6% of patients. A hundred and forty-seven patients (24%) died from the cohort by the end of the observation period. The mortality rate peaked in 1992 at 90 deaths per 1000 person-year, whereas the mortality rate gradually decreased to <1% from 1993-2010. In 2010, 71% of the patients were receiving highly active retroviral therapy. Conclusions: These data describe the clinical characteristic of HIV-1-infected patients at a major tertiary referral hospital in KSA over a 20-year period. Initiation of antiretroviral therapy resulted in a significant reduction in both morbidity and mortality. Future studies are needed in the design and implementation of targeted treatment and prevention strategies for HIV-1 infection in KSA

Transmission and evolution of the Middle East respiratory syndrome coronavirus in Saudi Arabia:a descriptive genomic study

BACKGROUND: Since June, 2012, Middle East respiratory syndrome coronavirus (MERS-CoV) has, worldwide, caused 104 infections in people including 49 deaths, with 82 cases and 41 deaths reported from Saudi Arabia. In addition to confirming diagnosis, we generated the MERS-CoV genomic sequences obtained directly from patient samples to provide important information on MERS-CoV transmission, evolution, and origin. METHODS: Full genome deep sequencing was done on nucleic acid extracted directly from PCR-confirmed clinical samples. Viral genomes were obtained from 21 MERS cases of which 13 had 100%, four 85-95%, and four 30-50% genome coverage. Phylogenetic analysis of the 21 sequences, combined with nine published MERS-CoV genomes, was done. FINDINGS: Three distinct MERS-CoV genotypes were identified in Riyadh. Phylogeographic analyses suggest the MERS-CoV zoonotic reservoir is geographically disperse. Selection analysis of the MERS-CoV genomes reveals the expected accumulation of genetic diversity including changes in the S protein. The genetic diversity in the Al-Hasa cluster suggests that the hospital outbreak might have had more than one virus introduction. INTERPRETATION: We present the largest number of MERS-CoV genomes (21) described so far. MERS-CoV full genome sequences provide greater detail in tracking transmission. Multiple introductions of MERS-CoV are identified and suggest lower R0 values. Transmission within Saudi Arabia is consistent with either movement of an animal reservoir, animal products, or movement of infected people. Further definition of the exposures responsible for the sporadic introductions of MERS-CoV into human populations is urgently needed. FUNDING: Saudi Arabian Ministry of Health, Wellcome Trust, European Community, and National Institute of Health Research University College London Hospitals Biomedical Research Centre

Mucormycosis co-infection in COVID-19 patients: An update

Mucormycosis (MCM) is a rare fungal disorder that has recently been increased in parallel with novel COVID-19 infection. MCM with COVID-19 is extremely lethal, particularly in immunocompromised individuals. The collection of available scientific information helps in the management of this co-infection, but still, the main question on COVID-19, whether it is occasional, participatory, concurrent, or coincidental needs to be addressed. Several case reports of these co-infections have been explained as causal associations, but the direct contribution in immunocompromised individuals remains to be explored completely. This review aims to provide an update that serves as a guide for the diagnosis and treatment of MCM patients’ co-infection with COVID-19. The initial report has suggested that COVID-19 patients might be susceptible to developing invasive fungal infections by different species, including MCM as a co-infection. In spite of this, co-infection has been explored only in severe cases with common triangles: diabetes, diabetes ketoacidosis, and corticosteroids. Pathogenic mechanisms in the aggressiveness of MCM infection involves the reduction of phagocytic activity, attainable quantities of ferritin attributed with transferrin in diabetic ketoacidosis, and fungal heme oxygenase, which enhances iron absorption for its metabolism. Therefore, severe COVID-19 cases are associated with increased risk factors of invasive fungal co-infections. In addition, COVID-19 infection leads to reduction in cluster of differentiation, especially CD4+ and CD8+ T cell counts, which may be highly implicated in fungal co-infections. Thus, the progress in MCM management is dependent on a different strategy, including reduction or stopping of implicit predisposing factors, early intake of active antifungal drugs at appropriate doses, and complete elimination via surgical debridement of infected tissues

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide