Assessing the Value Risk (VAR) for BSE Index consisting of 30 stocks by using various parametric, nonparametric and semiparametric models for estimating Value-at-Risk (VAR)

The objective of this report is to estimate Value-at-Risk (VAR) for Bombay Stock Exchange (BSE) Index consisting of 30 stocks for a single day and 5-day period using various methods of assessment and comment on the best estimate for VAR. In this report VAR theory and various models used to estimate VAR like Parametric models (GARCH, EWMA) and Semi-parametric model (Historical simulation methods and its variants) has been studied and explained. The report also explains the backtesting models to check the accuracy of results. Finally, the models have been applied to BSE Sensitive Index (SENSEX) which consists of 30 stocks in different sectors of Indian economy. The key findings of this report is that Volatility Clustering is one of the most prominent stylized fact for the index due to which there is no single value for VaR which could explain the risk in the market for all times. Rather, investors should base their decision on a range of VaR values based on the state of economy of the country (i.e. inflation, business cycle etc)

Retrograde Epidural Catheter Relieves Intractable Sacral Pain

Pain caused by tumor infiltration of the sacral area remains a major clinical challenge. Patients with poor pain control despite comprehensive medical management may be treated with neuraxial techniques such as continuous epidural or spinal anesthetic. We report a case in which a patient with metastatic breast cancer experienced inadequate pain relief after multiple intravenous pain management regimens as well as intrathecal (IT) drug delivery. The concentration of local anesthetics delivered via the IT catheter was limited due to the patient\u27s baseline motor weakness which would be exacerbated with higher concentrations of local anesthetics. Thus, a decision was made to insert an epidural catheter via a retrograde technique to provide the patient with a band of anesthesia which would provide profound sensory blockade without concomitant motor weakness. Pain refractory to other modalities of pain control was successfully treated with the epidural technique

Perioperative Quality Initiative (POQI) consensus statement on the physiology of blood pressure control as applied to perioperative medicine.

Background: A multi-disciplinary, international working subgroup of the Third Perioperative Quality Initiative (POQI) consensus meeting reviewed the (patho)physiology and measurement of arterial blood pressure (ABP), as applied to perioperative medicine. Methods: We addressed predefined questions by undertaking a modified Delphi analysis, in which primary clinical research and review articles were identified using MEDLINE. Strength of recommendations, where applicable, were graded by NICE guidelines. Results: Perioperative ABP management is a physiologically-complex challenge influenced by multiple factors: (i) ABP is the input pressure to organ blood flow, but is not the sole determinant of perfusion pressure; (ii) blood flow is often independent of changes in perfusion pressure, due to autoregulatory changes in vascular resistance; (iii) microvascular dysfunction uncouples microvascular blood flow from ABP (haemodynamic incoherence) From a practical clinical perspective, we identified that: (i) ambulatory measurement is the optimal method to establish baseline ABP; (ii) automated and invasive ABP measurements have inherent physiological and technical limitations; (iii) individualised ABP targets may change over time, especially during the perioperative period. There remains a need for research in non-invasive, continuous arterial pressure measurements, macro- and microcirculatory control, regional perfusion pressure measurement and the development of sensitive, specific and continuous measures of cellular function to evaluate blood pressure management in a physiologically coherent manner. Conclusion: The multivariable, complex physiology contributing to dynamic changes in perioperative ABP may be underappreciated clinically. The frequently unrecognised dissociation between ABP, organ blood flow, microvascular and cellular function requires further research that develops a more refined, contextualized clinical approach to this routine measurement