Select Financial Ratios as a Determinant of Profitability Evidence from Petrochemical Industry in Saudi Arabia

The pedestal of economic growth of the Kingdom of Saudi Arabia cardinally hinges upon the growth and development of the Petrochemical companies. Of late, there is risk of an increase in feedstock cost, which can pressurize margins for Saudi companies. This has encouraged the researchers to analyze the profitability and select financial ratios of petrochemicals industry in Saudi Arabia. The research paper makes an endeavor to determine the profitability of listed Petrochemical companies in Saudi Arabia with five years accounting period from 2008 to 2012. The paper encompasses six variables, namely, Creditors’ Velocity (CRSV), Debtors’ Turnover Ratio (DTR), Inventory Turnover Ratio (ITR), Long-Term-Debt to Equity Ratio (LTDER), Total Assets Turnover Ratio (TATR) and Net profit Margin (NPM). Profitability as a dependent variable is exhibited by Net profit Margin (NPM) while the select ratios (CRSV), (DTR), (ITR), (LTDER), (TATR) are expressed as independent variables. Based on the findings of the study, it is cogently revealed that there is a significant relationship between the four selected ratios and Net Profit Margin (NPM) of Petrochemical companies in Saudi Arabia. Keywords: Profitability, Financial Ratios, Petrochemical industr

Anterior Cervical Discectomy and Fusion Surgery: Results with Zero-Profile Spacer/Cage

Objective:  Study provides proof to support the promised benefits of employing stand-alone zero-profile cages in multilevel ACDF procedures, as the stand-alone zero-profile device has proven safety and a reduction of the risk of dysphagia in single-level ACDF surgeries. Materials and Methods:  This is a retrospective descriptive study, conducted at the Punjab Institute of Neurosciences, Lahore, Pakistan. Data of 36 patients evaluated for post-operative dysphagia and fusion, who had multi-level ACDF surgery employing stand-alone zero-profile cages. Results:  Total of 36 patients underwent ACDF surgeries. 86.1% (31/36) patients operated for 2 levels and 13.9% (5/36) patients operated for 3 levels. Dysphagia developed postoperatively in 2 (5.6%) patients in which zero-profile stand-alone cages were used. Fusion was achieved in 94.4% (34/36) patients. Conclusion:  Stand-alone zero-profile cages in multi-level ACDF surgeries have a good outcome in terms of post-operative less dysphagia and higher fusion rates. Keywords:  Anterior Cervical Discectomy (Decompression) And Fusion (ACDF), Zero-Profile Cages, Cervical Spondylotic Myelopathy

Incidence and Surgical Outcome of the Intracranial Epidermoid Cyst at Punjab Institute of Neurosciences Lahore, Pakistan

Objectives:  The incidence and microsurgical outcomes of intracranial epidermoid cysts in the Department of Neurosurgery III, Punjab Institute of Neurosciences (PINS), Lahore, Pakistan, are described in this case series. Materials and Methods:  This study was a data analysis of a case series of 15 patients (mean age, 40 years) of both gender with intracranial epidermoid cysts who had microsurgical surgical excision over five years. Results:  This study comprised 11 (73.3%) male and 4 (26.7%) female patients, 11 (73.3%) cases were infratentorial and 4 (26.7%) cases were in supratentorial region. The epidermoid was located in the CP angle in 11 (73.3%) patients, 3 (20%) in the midline supra sellar region, and 1 (6.66%) in the frontotemporal region. The presenting complaints were mainly headache in 11 (73.33%), cranial nerve palsy and cerebellar signs in 8 (53.3%) patients, Trigeminal neuralgia in 3 (20%) patients, Fits and hydrocephalus in 2 (13.3%) patients. There were 14 (93.3%) patients with GTR (gross total resection), 1 (6.6%) patients STR (subtotal resection). According to Karnofsky's performance scoring (KPS), 3 (20%) patients improved, 11 (73.3%) patients had the same KPS, and 1 (6.6%) patient had a lower KPS. Conclusion:  The epidermoid cysts in the brain are usually found in the infratentorial region rather than the supratentorial region. Infratentorial lesions typically cause cranial nerve deficits, whereas the supratentorial area symptom is a headache

Efficiency measurement of Islamic and conventional banks in Saudi Arabia:an empirical and comparative analysis

Saudi Arabia, beside Malaysia and many other Muslim countries, is one of those countries where Islamic and conventional banking operate in parallel. Over the last decade, the country’s banking industry is growing at rapid pace that accounts for the largest share in GCC. The present study measures and compares the performance of Saudi conventional and Islamic banking industry and identifies the areas where the strategic measures are required to improve the banking performance. It applies non-parametric Data Envelopment Analysis (DEA) for the data from 2008-2016 of Saudi banking industry and provides comprehensive empirical results at individual bank vis-a-vis industry levels. The empirical results demonstrate a mix trend among the banks in achieving technical, pure technical and scale efficiency. It is observed that with the common pledge to expanding market share and performance, both conventional and Islamic banks have been successful in improving their levels of efficiency. At individual bank level, Al-Rajhi is the only bank that has achieved the highest score in terms of technical, pure technical and scale efficiency, while in the conventional banking group, both Saudi Hollandi and National Commercial banks are found on the top position. Despite the growth of incomes and deposits of entire banking industry in Saudi Arabia, this study particularly recommends for the Islamic banks to redirect their short term and long-term marketing strategies and to focus on improving their management skills at the branch level

A framework and mathematical modeling for the vehicular delay tolerant network routing

Vehicular ad hoc networks (VANETs) are getting growing interest as they are expected to play crucial role in making safer, smarter, and more efficient transportation networks. Due to unique characteristics such as sparse topology and intermittent connectivity, Delay Tolerant Network (DTN) routing in VANET becomes an inherent choice and is challenging. However, most of the existing DTN protocols do not accurately discover potential neighbors and, hence, appropriate intermediate nodes for packet transmission. Moreover, these protocols cause unnecessary overhead due to excessive beacon messages. To cope with these challenges, this paper presents a novel framework and an Adaptive Geographical DTN Routing (AGDR) for vehicular DTNs. AGDR exploits node position, current direction, speed, and the predicted direction to carefully select an appropriate intermediate node. Direction indicator light is employed to accurately predict the vehicle future direction so that the forwarding node can relay packets to the desired destination. Simulation experiments confirm the performance supremacy of AGDR compared to contemporary schemes in terms of packet delivery ratio, overhead, and end-to-end delay. Simulation results demonstrate that AGDR improves the packet delivery ratio (5-7%), reduces the overhead (1-5%), and decreases the delay (up to 0.02 ms). Therefore, AGDR improves route stability by reducing the frequency of route failures. © 2016 Mostofa Kamal Nasir et al

Comparison of Cerebrospinal Fluid Leakage in Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Adenoma with and without Sellar Floor Reconstruction

Objectives:  This study aimed to compare CSF leak in endoscopic endonasal TSS of pituitary adenoma with and without reconstruction of the sellar floor with no intraoperative CSF leakage. Materials and Methods:  It was a randomized controlled trial of 116 patients of both genders diagnosed case of pituitary adenoma who underwent endoscopic endonasal TSS over 1 year. The cases were randomized into 2 groups. In Group A endoscopic endonasal TSS and the sellar floor, reconstruction was done while in Group B only endoscopic endonasal transsphenoidal surgery was done without reconstruction. Results:  The patient’s mean age in group A was 40.7 ± 9.56 years, and in group, B was 41.9 ± 10.5 years. The gender distribution, for group A, males and females were 29 each (50%) and in group B, the males were 36 (62%) and females were 22 (38%). There were 52 (89.7%) cases of macroadenoma and 6 (10.3%) cases of microadenoma in each group. On the 1st postoperative day, CSF leakage was noted in 2 (3.4%) patients of group A, and CSF leakage was observed in 2 (3.4%) patients of group B. Results revealed no difference in CSF leakage between both groups. There were minor nasal complications in both groups. Conclusion:  There is an equal chance of success with endoscopic endonasal transsphenoidal surgery (TSS) of pituitary adenoma with and without reconstruction of the sellar floor, concerning post-operative CSF leak, in patients who have no intraoperative CSF leak which enlarges the pool of options for treatment

Giant cerebellopontine Angle Tumor Surgery: Experience of a Tertiary Care Center in Lahore, Pakistan

Objectives:  In this case series, we report our experience of microsurgical resection of large and giant CPA tumors at the Department of Neurosurgery, Punjab Institute of Neurosciences (PINS). Materials and Methods:  This was a retrospective case series of 328 patients (mean age, 40 years) with large and giant CPA tumors (predominantly vestibular schwannomas) who underwent surgical removal using a retro sigmoid approach over 4 years. Results:  In the study, there were 58% (190) females while 42% (138) were males. 60% (197) of the tumors were right – sided and 40% (131) left – sided. Hearing loss was the main presenting complaint with 73% of the patients having non-serviceable hearing. There were 14 (4.3%) deaths reported during the retrospective analytic study. There were 3 cases of postoperative hemorrhage, and 11 patients expired due to post-operative wound infection. There were 13 cases diagnosed as having post-operative bacterial meningitis. Gross total tumor excision was achieved in 98% of patients based on postoperative imaging. There were 26 cases (8%) with postoperative CSF leakage that was managed with LP drain (5 patients) and in the rest VP shunt was done. Facial nerve function was graded according to the House Brackmann system. It was recorded in all patients following surgery: There were 16% patients with HB grade IV and 216 (66%) patients with HB grade III facial palsy.  Conclusion:  Suboccipital Retrosigmoid approach is ideal for dealing with giant CPA tumors. Complication rates in our series were comparable with other reported literature

Our Experience of Posterior Fossa Tumors Surgeries

Objective:  In Neurosurgery Unit III, Punjab Institute of Neurosciences, Lahore, we evaluated our posterior fossa tumor surgery results, complications, and surgical outcomes. Materials and Methods:  Between January 2017 and September 2021, 80 patients with posterior fossa tumors who underwent surgical excision at the Neurosurgery Department-III of the Punjab Institute of Neurosciences in Lahore were studied retrospectively. For each patient, the diagnosis was made clinically and confirmed radiologically and histopathologically. Results:  Males comprised 47 percent (37) of the 80 cases, while females made up 53 percent (43). The average age was 15 (with a range of 6 – 30 years). Medulloblastomas were the most frequent pathology in 25 patients (31%), followed by ependymomas in 21 patients (26%), pilocytic astrocytomas in 19 patients (24%), and hemangioblastomas in 7 individuals (8.8%). There were four cases of metastatic brain cancers (5%), two cases of choroid plexus papilloma (2.5%), one case of ganglioglioma (1.3%), and one case of Dermoid cyst (1.3%). In 90 percent of the cases (72 cases), gross total resection was obtained, while subtotal excision was performed in 10% of the cases (8 cases). The best results were seen in pilocytic astrocytoma surgery, followed by ependymoma surgery, whereas the worst results were seen in medulloblastoma surgery. Conclusion:  The surgical treatment of posterior fossa tumors still poses a significant challenge to neurosurgeons. Our experience shows that accepted results, complications, and surgical outcomes can be obtained by meticulous surgical techniques from previous clinical studies

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries