Endogeneity and dynamics of innovation and firm performance

Technological and innovation capabilities play an important role in determining the performance of firms, especially in knowledge intensive industries. Despite the plethora of studies testing the relationship between innovation capabilities and firm performance, little consensus has been achieved on the veracity of the theoretical claims. In this paper, we argue that the lack of consensus could be on account of the failure to take into account the endogeneity that arises from the decision process that underlies the relationship between development of technological capabilities and its impact on firm performance. We address both these issues and demonstrate that alternative empirical designs can help provide greater external validity. © 2014 Inderscience Enterprises Ltd

Endoscopic Management of Epistaxis in Lumbini Medical College

Introduction: Epistaxis is one of the commonest Ear Nose Throat (ENT) emergency. Proper guidelines for its management are lacking; on the other hand, the management is mostly done by the junior health service providers which has invited non-standardized practice of epistaxis management. Thereby this study was much inclined towards assessment of the effectiveness of endoscopic management of epistaxis.   Methods: This prospective study included patients above 16 years who were diagnosed with idiopathic epistaxis visiting Out Patient of ENT Department or in the Emergency Department of Lumbini Medical College from 1st of July 2014 to 30th of June 2015. ENT examination was done to find the cause and site of bleeding. Thereafter different epistaxis management interventions were done depending on the bleeding condition. The data were collected, entered and then analyzed using SPSS version 21. The descriptive statistics were applied.   Results: Of the total 116 patients, 53 (45.69%) were male and 63 (54.31%) were female showing no gender preponderance with epistaxis in our study. Majority (49%) of the patients were managed with cauterization with silver nitrate or electrocautery in out-patient clinic. Second most common (18%) procedure was endoscopic sphenopalatine artery cauterization. Nasal packing was done only in three cases with zero posterior pack.   Conclusion: Endoscopic intervention of epistaxis seems to be safe, simple, fast, and effective for the management of epistaxis with low rates of morbidity and complications. Thereby it can be preferred over the conservative nasal packing and considered as immediate second-line management

Innovation capabilities and international performance of firms: A quantile regression approach

This study examines the relationship between various dimensions of a firm\u27s technological innovation capabilities and its international performance. We use panel data with multiple indicators of firm level technological capabilities including generation, dissemination, strength and speed of innovation. We employ a quantile regression analysis which allowed us to test the impact of innovation capability on international performance of high, average and poor performers. Our empirical findings indicate significant disparity between the ordinary least square and quantile regression results. Copyright © 2012 Inderscience Enterprises Ltd

Psychological Distress in Patients having Globus Pharyngeus

Introduction: Globus sensation is described as a constant feeling of a lump or foreign body in the throat in absence of pain and dysphagia. It is a common complaint in Ear Nose and Throat clinics. Etiology of this condition remains multifactorial and unclear. Psychiatric disorder has been described as one of the cause of globus. The objective of this study is to evaluate the occurrence of psychological distress in patients complaining of globus sensation in throat coming to our centre. Methods: A case-control study was done. Patients coming to Outpatient of Ear Nose and Throat Department of Lumbini Medical College Teaching Hospital with complain of globus and not having an organic explanation of the condition were included. Age, sex and socio-economic condition matched control group was selected from healthy visitors (patient parties). Validated Nepali version of GHQ-12 was used to assess the psychological distress. Results: Psychological distress was present in 72.69% of the cases and 39.91% in the control group. The difference was statistically significant. Conclusion: Psychological distress was significantly higher in the patients with globus pharyngeus compared to the control group. It was also present in a larger fraction of the controlgroup. The patient who present with Globus should undergo psychiatric evaluation after organic causes have been ruled out. We recommend a national policy to evaluate the population for their psychiatric health

First Line Treatment of Meniere’s Disease

Introduction: There is no consensus on the first line medical treatment of Meniere disease to produce symptomatic improvement and slow the disease progress. Dietary salt restriction, diuretics, and vasodilators like betahistine are among the first line drugs that have been used for long. There is lack of evidence due to paucity of quality studies to support their effectiveness and advocate their use. This study is done to evaluate the effectiveness of three first line treatment of Meniere disease i.e. salt restriction, oral diuretics, and betahistine. Methods: Double blind randomized controlled trial was carried out in out-patient clinic of Ear Nose and Throat department of Lumbini Medical College Teaching Hospital. Cases were randomized into three groups; dietary salt restriction, diuretics as amiloride and furosemide, and vasodilator as betahistine. Pre and post treatment evaluation was done in terms of number and severity of vertigo, tinnitus, and hearing outcome. Results: There were a total of 97 cases with F:M ratio of 1.1:1. Mean age of patients was 47.86 yr (SD=12.7). Twenty-nine (30%) were treated with dietary sodium restriction alone (Group A), 35 (36%) were treated with diuretics (Group B) and the rest 33 (34%) were treated with vasodilator (betahistine, Group C). There was no significant difference in hearing outcome in any group. Tinnitus was significantly improved in Group B. Number of vertigo attack was significantly decreased in Group B and Group C. Severity of vertigo was significantly decreased in Group B. Conclusion: Dietary salt restriction alone was not effective in controlling any aspect of the disease whereas diuretics were effective in reducing tinnitus and number and severity of vertigo. Betahistine was effective in reducing the number of vertigo attacks but not effective on other aspects of the disease

Essential Palatal Myoclonus

Introduction: Palatal myoclonus is a rare condition presenting with clicking sound in ear or muscle tremor in pharynx. There are two varieties: essential and symptomatic. Various treatment options exists ranging from watchful observation to botulinum toxin injection. We have not found any reported case of palatal myoclonus from our country. Here we present a case of essential palatal myoclonus managed with clonazepam. Case report: A young female presented in Ear Nose and Throat clinic with complain of auditory click and spontaneous rhythmic movement of throat muscles for eight months. On examination, there was involuntary, rhythmic contraction of bilateral soft-palate, uvula, and base of tongue. Neurological, eye, and peripheral examination were normal. A diagnosis of essential palatal myoclonus was made. It was managed successfully with clonazepam; patient was still on low dose clonazepam at the time of making this report. Conclusion: Essential palatal myoclonus can be clinically diagnosed and managed even in settings where MRI is not available or affordable

Ear Nose Throat (ENT) disorders in Government Schools of Far-Western Nepal

Background: ENT disorders specially hearing impairment negatively impacts students’ development of academic, language and social skills. If left undiagnosed, these conditions may result in significant irreversible damage such as varying degree of hearing loss that can affect the social or professional performance of the individuals in later stages of life. Students going to government school in our country generally come from under privileged society. We investigated the occurrence of ENT diseases among various government school students in Kailali district. Methods: Nine government school of Kailai district were chosen at random. All students of those school present on the day of examination went routine ENT examinations. Brief history, if any, was recorded and findings were noted. The study was done throughout the month of September, 2013. Results: There were a total of 2256 students enrolled in the study. There were 1126 male and 1130 female students. Mean age of the students was 9.88 years. Forty One percent of students had ENT problems. Ear wax was the most common (17%) findings followed by suppurative ear diseases, otittis media with effusion as so on in decreasing frequency. Conclusions: ENT diseases and specially ear diseases are important health problems among school children of Nepal. Regular school health services, screening program, public awareness, improvement of socioeconomic status, timely referral to a specialist doctor can help to reduce the disease-related burden

The effect of heteroskedasticity on factors affecting stock repurchases

We demonstrate the effect of ignoring the role of heteroskedasticity modelling in applied corporate finance studies and show that it may have important consequences in corporate financial decisions. In this paper, we specifically focus on the effect of heteroskedasticity on the factors affecting the open market operations of the firm. We show that in the absence of modelling heteroskedasticy results from prior research are consistent. By explicit modelling of heteroskedasticity some results are reversed. In particular, we find that the effect of key variables such as dividends, leverage and the likelihood of takeover on the probability of repurchase differs after controlling for heteroskedasticity. © 2014 Inderscience Enterprises Ltd

Effectiveness of Same-Day Human Ear Wax Removal as an Office Procedure and Factors Associated with its Successful Removal

Introduction: There are various methods of ear wax extraction and there are no specific guidelines on this subject. Many times we ask patients to instil some wax softening product for a few days and revisit for wax removal. These revisits result in increased cost, discomfort and loss of time. We conducted this study to determine the effectiveness of same-day ear wax removal as an office procedure with one or more techniques. Our secondary objective was to find the association between various factors and successful wax removal. Methods: During the study period, all patients with ear wax managed by a single ENT surgeon were included. History and examination were done and findings noted. One or more methods including probe, forceps, hooks, curette, suction, wax softening with wax softening agents, syringing were applied for wax removal. Complete wax removal was noted as success. Results: There were a total of 63 cases of ear wax among 34 participants. Wax was successfully removed in 52 (82.5%) cases in the same day. Presence of ear ache, narrow canal, complete obstruction and hard dry wax were adversely associated with successful wax removal. Presence of ear fullness, ear discharge, or use of ear drops in home was not significantly associated with successful ear wax removal. Conclusion: We were able to extract wax from a large proportion of patients on the same day of visit, thereby reducing their cost of revisit, however there were 17.5% of cases who could not be treated successfully on the same day

Survival Outcomes of Pancreatic Intraepithelial Neoplasm (PanIN) versus Intraductal Papillary Mucinous Neoplasm (IPMN) Associated Pancreatic Adenocarcinoma

A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Pancreatic intraepithelial neoplasms (PanINs) and intraductal papillary mucinous neoplasms (IPMNs) are common pancreatic adenocarcinoma precursor lesions. However, data regarding their respective associations with survival rate and prognosis are lacking. We retrospectively evaluated 72 pancreatic adenocarcinoma tumor resection patients at the University of Kansas Hospital between August 2009 and March 2019. Patients were divided into one of two groups, PanIN or IPMN, based on the results of the surgical pathology report. We compared baseline characteristics, overall survival (OS), and progression free survival (PFS) between the two groups, as well as OS and PFS based on local or distant tumor recurrence for both groups combined. 52 patients had PanINs and 20 patients had IPMNs. Patients who had an IPMN precursor lesion had better median PFS and OS when compared to patients with PanIN precursor lesions. However, the location of tumor recurrence (local or distant) did not show a statistically significant difference in OS