Regulation, Auditor Litigation and Settlements

This paper aims to understand the determinants of lawsuits against auditors in securities class action litigation and the settlement pattern by auditors when the suit is not dismissed. The issues we consider are: (i) when are auditors named as defendants (ii) when do auditors choose to settle and (iii) what proportion of the settlement do auditors pay in relation to the settlement by all the other parties; and (iv) differences in settlement strategies among the big-n firms. This paper also examines how the lawsuit and settlement patterns have changed following the enactment of major regulation such as the Private Securities Litigation Reform Act (PSLRA), Sarbanes Oxley Act (SOX). Following prior literature, we first establish that auditors are more likely both to be named and to settle in cases involving restatement of earnings, accusations of violation of GAAP or accounting improprieties. We then show that the likelihood of suit and settlement increase in a measure that we construct measuring the complexity of litigation. We then examine differences in settlement patterns across periods preceding and after the passage of PSLRA and SOX. We find that auditors are named less often in the post PSLRA period (relative to the pre-PSLRA period), settle with the same frequency in both periods but pay less proportional damages. The same set of comparisons show that auditors are just as likely to be sued post-SOX as pre-SOX, but settle with lower frequency and pay the same proportion of damages. Overall this study documents the beneficial role of both PSLRA and SOX on reducing the litigation burden on auditors. With regard to settlement strategies, we document the varying strategies employed by the Big-n firms that settle at different rates, vary in their aggressiveness and time to settle signaling the willingness to fight or cooperate in the settlement

Diversity rich solutions

Every household is diverse and diversity can be observed within household in terms of crops, varieties and landraces, soil type, food preferences and preparation methods, knowledge and practices related with production management of agrobiodiversity and other genetic resources. Farmers are practicing agricultural practices that promotes the use of diversity such as growing mixture of landraces, composting, fertigation. Modern agriculture focuses on developing large scale uniform technology eg use of urea, mono-genotype variety. Such system puts pressure and disturbs the ecological balance causing high risk for crop failure and genetic erosion. Any technological option with greater diversity is less risky, more sustainable and higher adaptability in agriculture. Diversity rich solution is any technology or problem associated solution that considers diversity as an option and address problems with inter and intra level diversity as well as combinations of different components. it also includes multiple technology for a single problem. Some examples are broad genetic base variety, cultivar mixtures, compost (made from different species), biopesticide (made from different species), etc. Diversity rich solution is in practice since 2014 in Nepal with the objective of conserving agrobiodiversity, promoting ecologically oriented sustainable agriculture that also enhances ecosystem services

Emergency department management of acute exacerbations of chronic obstructive pulmonary disease and factors associated with hospitalization

Background: Currently there is a paucity of information about biomarkers that can predict hospitalization for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients presenting to the emergency department (ED). There is limited data on the consistency of ED management of AECOPD with local COPD guidelines. The aim of this study was to identify biomarkers associated with hospitalization in AECOPD patients and to determine if the ED management was concordant with local COPD guidelines. Materials and Methods: We performed a retrospective audit of consecutive AECOPD patients presenting to the Gold Coast Hospital ED over a 6-month period. Results: During the study period, 122 AECOPD patients (51% male, mean age (SE) 71 (±11) years) presented to the ED. Ninety-eight (80%) patients were hospitalized. Univariate analysis identified certain factors associated with hospitalization: Older age, former smokers, home oxygen therapy, weekday presentation, SpO 2 < 92%, and raised inflammatory markers (white cell count (WCC) and C-reactive protein (CRP)). After adjustment for multiple variable, increased age was significantly associated with hospitalization (odds ratio (OR) 1.09; 95% confidence interval (CI): 1.00-1.18; P = 0.05). Radiology assessment and pharmacological management was in accordance with COPD guidelines. However, spirometry was performed in 17% of patients and 28% of patients with hypercapneic respiratory failure received noninvasive ventilation (NIV). Conclusion: We identified several factors on univariate analysis that were associated with hospitalization. Further research is required to determine the utility of these biomarkers in clinical practice. Also, while overall adherence to local COPD guidelines was good, there is scope for improvement in performing spirometry and provision of NIV to eligible patients

Non syndromic synchronous multiple odontogenic keratocysts in a western Indian population : a series of four cases

Odontogenic keratocysts (OKCs) are developmental odontogenic cysts affecting the maxillofacial region and their association with a syndrome especially Naevoid basal cell carcinoma syndrome (NBCCS) is a common occurrence in comparison to non syndromic multiple OKCs. In a first, we present a series of four non syndromic cases with multiple OKCs in western Indian population. The presence of multiple OKC in our present case series may be because of the multifocal nature of the lesion rather than its association with any syndrome. Thus, a comprehensive evaluation of any patients reporting with multiple cysts/OKCs always has to be undertaken and the dental practitioner may be the play a key role in early detection and subsequent follow-up

Efficacy of ultrasound guided single level thoracic paravertebral block for post-operative analgesia in patients undergoing percutaneous nephrolithotomy: a randomized controlled study

Background: Percutaneous nephrolithotomy (PCNL) is a common surgical method used for the treatment of renal calculi. Post-operative pain is due to dilatation of the renal capsule, the parenchymal tract and peritubal distressing of the nephrostomy tube. Addition of ultrasound guided paravertebral block to the multimodal postoperative analgesic regimen after general anaesthesia can achieve adequate somatic and visceral sensory blockade to provide post op analgesic cover for PCNL. Methods: It was a randomized controlled study where 60 ASA I and II patients scheduled for elective PCNL surgery were divided into 2 groups of 30 each, group P and group N. Both groups underwent PCNL under general anaesthesia. After the conclusion of surgery, group P were given ultrasound guided single level paravertebral block at T9-T10 level on the operated side using 10 ml 0.25% bupivacaine while group N did not receive paravertebral block after the conclusion of surgery. Results: VAS score, time for first rescue analgesic, number of rescue analgesics in post-operative period were significant in group P compared to group N. Conclusions: Addition of thoracic para vertebral block to multimodal analgesic regimen significantly provides effective analgesia, reduces requirements of intravenous opioids, maintains stable postoperative hemodynamics, improves respiratory mechanics and lowers the incidence of chronic postoperative pain

Mucoadhesive microemulsion of ibuprofen: design and evaluation for brain targeting efficiency through intranasal route

This study aimed at designing mucoadhesive microemulsion gel to enhance the brain uptake of Ibuprofen through intranasal route. Ibuprofen loaded mucoadhesive microemulsion (MMEI) was developed by incorporating polycarbophil as mucoadhesive polymer into Capmul MCM based optimal microemulsion (MEI) and was subjected to characterization, stability, mucoadhesion and naso-ciliotoxicity study. Brain uptake of ibuprofen via nasal route was studied by performing biodistribution study in Swiss albino rats. MEI was found to be transparent, stable and non ciliotoxic with 66.29 ± 4.15 nm, -20.9 ± 3.98 mV and 98.66 ± 1.01% as average globule size, zeta potential and drug content respectively. Transmission Electron Microscopy (TEM) study revealed the narrow globule size distribution of MEI. Following single intranasal administration of MMEI and MEI at a dose of 2.86 mg/kg, uptake of ibuprofen in the olfactory bulb was around 3.0 and 1.7 folds compared with intravenous injection of ibuprofen solution (IDS). The ratios of AUC in brain tissues to that in plasma obtained after nasal administration of MMEI were significantly higher than those after intravenous administration of IDS. Findings of the present investigation revealed that the developed mucoadhesive microemulsion gel could be a promising approach for brain targeting of ibuprofen through intranasal route.O objetivo deste trabalho foi planejar microemulsão/mucoaesiva em gel a fim de melhorar a captação cerebral de ibuprofeno por via intranasal. A microemulsão para mucoadesão com ibuprofeno (MMEI) foi desenvolvida pela incorporação de policarbofil como polímero mucoadesivo em microemulsão otimizada (MEI) com base em Capmul (MCM) e foi submetida à caracterização, estabilidade, mucoadesão e naso-ciliotoxicidade. A captação cerebral de ibuprofeno pela via nasal foi estudada por meio de estudo de biodistribuição em ratos albinos suíços. MEI se mostrou transparente, estável e não ciliotóxica, com 66,29 ± 4,15 nm, -20,9 ± 3,98 mV e 98,66 ± 1,01%, respectivamente, de tamanho médio dos glóbulos, potencial zeta e conteúdo do fármaco. O estudo revelou o estreita distribuição do tamanho dos glóbulos de MEI. Após administração intranasal única de MMEI e MEI, em dose de 2,86 mg/kg, a captação de ibuprofeno no bulbo olfativo foi em torno de 3,0 e 1,7 vezes maior, comparativamente, à injeção endovenosa de ibuprofeno (IDS). As taxas de ASC em tecido cerebral em relação ao plasma, obtidas após administração da MMEI nasal, foram, significativamente, mais elevadas do que aquelas observadas após a administração intravenosa de IDS. Os resultados do presente estudo mostraram que a microemulsão/mucoadesiva em gel poderia ser uma abordagem promissora para o direcionamento cerebral de ibuprofeno por via intranasal

Hepatitis B and C Virus Infections among Blood Donors in Blood Transfusion Center, Pokhara, Nepal: Seroprevalence and its Associated Risk Factors

Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections lead to chronic diseases and are the most common causes of liver cirrhosis and cancer in developing countries like Nepal. The study is carried out to determine the seroprevalence of HBV and HCV by using a Rapid kit method and Elisa Method to find out its risk factors. The cross-sectional study was done among blood donating people from 16th August 2016 to 19th November 2016. Blood donors in Pokhara Valley were screened for anti-HCV antibodies, anti-HBV antibodies using third generation ELISA kits and automated ELISA Processor in serology laboratory at Central Blood Transfusion Service (CBTS) of Nepal Red Cross Society (NRCS) in Pokhara, Nepal. 1777 (87.2%) units were male blood donors and 260 (12.6%) units were female donors out of 2037 participants. Gender wise, the ratio between male and female was 1:0.1. HBV and HCV infection rate in blood donors were detected at 0.7% (15/2037) and 0.5% (8/2037) respectively. HBV infection rate in volunteer blood donor people was 0.7% (14/1881) which was higher than the replacement donors i.e. 0.6% (1/156). Similarly, in HCV infection rate in volunteer donor were 0.4% (8/1881). HBV infected people are detected higher than the HCV infected people among the blood donors. In addition, there was no significant relationship between positive results of HBV and HCV tests with the gender, age, tattoo, donor type

Methods of Collection and Transport of Materials to Laboratory from Oral and Dental Tissue Lesions

The oral pathology laboratory is the most resourceful place for the diagnosis of oral lesions. Most clinicians err on the collection and transport of oral and associated tissues to the laboratory. Oral tissue examination includes a wide range such as oral biopsy (for routine formalin fixed and fresh tissue), saliva, swabs, cytology smears and fine needle-aspirated, cystic fluid. This in turn adversely affects the final diagnosis of the disease. Thus, it is high time to appreciate and acknowledge the role of collection containers, fixing reagents and transport media as an adjunct for successful diagnosis

Comparison of hemodynamic stability of propofol ketamine versus etomidate ketamine during induction in peritonitis cases posted for emergency surgery

The aim: The aim of the present study is to evaluate the hemodynamic stability of propofol ketamine versus etomidate ketamine during induction of anaesthesia in peritonitis cases posted for emergency surgery. Methods: Sixty patients with peritonitis, posted for emergency surgery under general anaesthesia, were randomly allocated to two groups. Group propofol ketamine (P + K) comprised of 30 patients (n=30) were induced with propofol 1 mg/kg and ketamine 0.75 mg/kg IV. Group etomidate ketamine (E + K) comprised 30 patients induced with etomidate 0.3 mg/kg and ketamine 0.75 mg/kg. The hemodynamic effects of the combination of the drugs in both groups were compared before and after induction. Results: The change in saturation (SPO2) and Heartrate between the groups P+K &amp; group E+K before induction and after intubation was similar in both groups. There was a statistically insignificant fall in systolic blood pressure (SBP) and diastolic blood pressure (DBP), and mean arterial pressure (MAP) in group P+K before and after induction when compared to group E+K. Conclusions: The propofol ketamine and etomidate ketamine combinations have a similar haemodynamic profile and are equally effective in maintaining haemodynamic stability during induction and intubation