Derivative Usage In Corporate Pakistan: A Qualitative Research Of Listed Companies

The motivation behind this study was to see why Pakistani companies are releuctant to use derivative instruments. The study aims to look into factors that influence the corporate finance managers to use derivatives. A structured questionnaire was used to obtain the response of finance managers of companies. The questionnaire aims at ascertaining the factors that influence the usage or non-usage of derivatives in corporate Pakistan. The questionnaire incorporated factors like trend of derivative usage, risk level, awareness with modern finance, correlation between hedging and firm’s value, firm’s performance and business cycle effect, and correlation between nature of business and financial risk. For this purpose, 67 non-financial firms were selected based on their nature of business, turnover, and risk level. Out of 67, 31 firms responded. We concluded that managerial knowledge of modern finance, development of full fledged derivatives market and measuring the risk level of corporation may enhance the derivative usage thus minimizing the financial risk of companies

Pattern and Practice of Paediatric Neurosurgical Procedures- An analysis of one year initial experience at resource challenged setup of Children Hospital, Faisalabad.

patients presenting to Children Hospital, Faisalabad. Materials and Methods:  Retrospective case series of 778 consecutive cases admitted in Pediatric Neurosurgery Department, Children Hospital, Faisalabad over one year (October 2019- September 2020). Patients of age less than 15 years, any gender, admitted in Pediatric Neurosurgery ward for management were included and studied for their demographic data hospital stay, a procedure done and outcome. Results:  A total of 778 patients who required some neurosurgical intervention were admitted, 725 underwent various types of procedures and the remaining were treated conservatively. 320 (44.14%) were male and405 (55.86%) were female. The age range was 20 days to 13 years. The most common diagnosis was hydrocephalous, and then was Meningomyelocele (MMC). The first three common procedures performed included monitoring of Cerebrospinal fluid (CSF) in 36% of cases, Placement of shunt (21%), and placement of external ventricular drain (EVD) in 13% of cases of cerebrospinal fluid (CNS) infections in patients of hydrocephalous. Conclusion:  Pattern of presentation of pediatric neurosurgical cases take in almost all types of diseases like neural tube defects, hydrocephalous, cranial trauma, tumors, cysts, and infections but surgical procedures in routine practice in Faisalabad district cover mainly hydrocephalous and its complications. Endoscopic or advanced procedures are not commonly practiced due to multiple factors but existing constraints do not prevent the best management of pediatric neurosurgery patients

Prevalence of active hepatitis C virus infections among general public of Lahore, Pakistan

BACKGROUND: To find out the prevalence of active hepatitis C virus (HCV) infections among general public in Lahore city, since data concerning the prevalence of active HCV in this city is currently unavailable. METHODS: Blood samples were collected randomly from individuals visiting different clinical laboratories in Lahore. Serum was separated and processed by nested PCR qualitative assay for the detection of HCV RNA. The samples were categorized into different age groups on the basis of pre-test questionnaires in order to record the age-wise differences regarding the prevalence of active HCV. Data were analyzed statistically using Chi-Square test. RESULTS: Out of the 4246 blood samples analyzed in this study, 210 were confirmed to be positive for active HCV infection. Gender-wise active HCV prevalence revealed no significant difference [OR = 1.10 CI = (0.83-1.46), p > 0.05]. However, among the age groups the highest prevalence was observed in the age groups 20–29 (7.7%) and 30–39 years (6.4%) with odds of prevalence of 14.8% (OR = 2.48, CI = (1.40-4.38), p < 0.05) and 10.3% (OR = 2.03, CI = (1.10-3.71), respectively. In age groups above 40 years (40–49, 50–59 and >59 years), a decrease in levels of active HCV prevalence was observed. CONCLUSIONS: Among tested samples, 4.9% of the subjects were confirmed to harbour active HCV infections and the “middle aged” population in Lahore was found to be at a higher risk of the HCV ailments compared to both their younger and older peers

COVID-19 Pandemic: Influences on the Practice of Neurosurgeons all over Pakistan

Objective:&nbsp;&nbsp;The aim of this survey was to observe the impacts of COVID-19 pandemic on neurosurgery practices during this pandemic, assess various types of adaptations taken by them, protective measures during patient examination and effects on their health, family and socioeconomic life. Material &amp; Methods:&nbsp;&nbsp;A Questionnaire comprising 32 questions was circulated among practicing Neurosurgeons of Pakistan by social media, e-mails for 8 weeks (January-February 2021) and their responses were analyzed. Results:&nbsp;&nbsp;108 participants were involved from all over Pakistan. 32% respondents stated reduction in clinical practice to a level of less than 25%. While, 10% reported complete closure of outpatient services during pandemic. There were varied responses on the use of protective measures and most used N95 mask only (31%). Pandemic also affected the research work, finances and leisure time activities. Conclusion:&nbsp;&nbsp;Our study showed that neurosurgical practice was influenced by COVID-19 pandemic in many aspects in Pakistan. Proper method of protective measures and COVID testing of patients were lacking among them. Neurosurgeons should follow standard guidelines according to institutional directives in local neurosurgical practices so as to avoid being influenced by such crisis.

Does early surgery prevent Postoperative ICU admission after surgery for the fracture of the hip. Nested case control study of 911 patients

Introduction: Since most hip fractures are treated surgically, it is imperative to find an optimum fracture-to-surgery time to decrease the potential complications and enhance postoperative outcomes. In comparison to the vast plethora of literature available on surgical delay and its implications on mortality, very little, if any, research is available on the impact of delayed surgery on postoperative ICU admission. The primary objective of our study is to examine the factors influencing post-surgical ICU admission in order to work on preventive strategies to reduce the potential associated morbidity.Material and methods: Investigators did a nested case control study in a university hospital. A case was defined as a patient who had postoperative ICU admission while controls were patients who did not have postoperative ICU admission after hip fracture surgery. The primary outcome variable was postoperative ICU admission. The exposure variable was defined as the time to surgery which was categorized into two categories; early and late; the early surgery included patients who were operated within ≤ 48 h and the late included patients who had their surgery \u3e48 h. Information on potential confounders including age, type of the procedure and comorbidities were also obtained. Result reported in-line with STROCSS criteria.Results: A total cohort of 1084 hip fracture surgeries were performed from January 2010 to December 2018. After screening for eligibility criteria, 911 patients were eligible for the final simple logistic regression analysis (48 cases and 863 controls). Our exposure variable i.e. time from admission to surgery showed no difference between cases and controls. The odds of being treated with Hemiarthroplasty among cases admitted in ICU was 2.42 times as compared to controls (aOR = 2.42; 95% C.I. 1.21-4.86).Conclusion: Our study did not find an association between surgical delay and post-operative ICU admission after accounting for other covariates and potential confounders

Spatial and Temporal Variations of Temperature in the Punjab Province, Pakistan

Identifying the temperature change at a regional level is one of the essential parameters to determine the intensity of climate change. The current investigation provides an examination of changing trends of temperature in the Punjab province from 1970 to 2019. Sen's slope estimator method is applied to monthly data of mean temperature (Tmean), maximum temperature (Tmax), and minimum temperature (Tmin) to calculate the rate of temperature change. Statistical methods were used to find out the level of significance in terms of negative or positive trends to examine the variability among various weather observatories. Moreover, predicted values have also been observed for a detailed analysis of temperature variability and trends. Significant and pronounced changes in the mean temperature (T mean) are distinguished all over the Punjab regions with an increasing trend from North to South Punjab. In the case of maximum temperature (Tmax), a faster rate of rising in temperature is observed over the Southern and Western regions of Punjab. In contrast, the minimum temperature (Tmin) shows an increasing trend in Central Punjab. The findings provide detailed insight to policymakers for the planning of mitigating efforts and adaptation strategies in response to climate change

Insights into phytonutrient profile and postharvest quality management of jackfruit: A review

Jackfruit (Artocarpus heterophyllus Lam.), also known as ‘vegetarian’s meat’, is an excellent source of carbohydrates, protein, fiber, vitamins, minerals, and several phytochemicals. It is a climacteric fruit that exhibits an increase in ethylene biosynthesis and respiration rate during fruit ripening. The market value of jackfruit is reduced due to the deterioration of fruit quality during storage and transportation. There is a lack of standardized harvest maturity index in jackfruit, where consequently, fruit harvested at immature or overmature stages result in poor quality ripe fruit with short storage life. Other factors responsible for its short postharvest life relate to its highly perishable nature, chilling sensitivity and susceptibility to fruit rot which result in significant qualitative and quantitative losses. Various postharvest management techniques have been adopted to extend the storage life, including cold storage, controlled atmosphere storage, modified atmosphere packaging, edible coatings, chemical treatment, and non-chemical alternatives. Diversified products have been prepared from jackfruit to mitigate such losses. This comprehensive review highlights the nutritional profile, fruit ripening physiology, pre and postharvest quality management, and value addition of jackfruit as well as the way forward to reduce postharvest losses in the supply chain

Brain Abscesses in Children: A Study of Microbiological Spectrum and Outcome of 80 Cases

Objective:&nbsp;&nbsp;Brain abscess is a focus of pus in the brain due to infection somewhere else in the body. It is common in males than females and the average age in children ranges from 4 to 7 years. It develops by skull trauma or contiguous or hematogenous spread of infection. The study aimed to identify the pattern of microbiological involvement in the etiology of pediatric brain abscesses and the outcome so as to enable us to ensure definitive treatment with the appropriate and specific antimicrobial regimen. Materials and Methods:&nbsp;&nbsp;A prospective study was conducted in 80 pediatric patients of brain abscess admitted to the Pediatric Neurosurgery Department, Children Hospital, Lahore, Pakistan. Results:&nbsp;&nbsp;The median age was 5.2 years with a predominance of males (60%). The most common presentation was fever (72.5%) and then fits (35%). Congenital heart disease was the commonest factor in 32% of cases. Streptococcus was a commonly isolated pathogen in 17% cases out of 70% of culture positive cases. Recovery was seen in 70% of cases and the mortality was 7.5%. Conclusion:&nbsp;&nbsp;Congenital heart disease is the most common causative factor in pediatric brain abscesses and most of the abscesses were found culture negative. There is a pressing need to carry out multicenter studies over a large sample size over extended study duration in developing countries to help establish guidelines in treating pediatric brain abscesses

Correlation of red cell distribution width with inflammatory markers and its prognostic value in patients with diabetes and coronary artery disease

Background. Recent studies have shown red blood cell distribution width (RDW) as a marker for severity and prognosis in coronary artery disease patients. Other studies have also correlated RDW with diabetes mellitus and inflammation. However, such correlation and prognosis in patients with concomitant coronary artery disease and diabetes after percutaneous intervention remains unclear. Material and methods. Our study group comprised of 730 subjects including 700 patients (cases) and 30 normal subjects (control group). Patients who presented with coronary artery disease were divided into diabetic and non-diabetic groups. All patients had RDW measured at admission and percutaneous intervention was done. Follow-up for adverse events was carried out between 6 to 12 months. Results. RDW was elevated in patients as compared to control group (p &lt; 0.05). RDW correlated well with inflammatory markers including erythrocyte sedimen­tation rate, C-reactive protein, HbA1c, white blood cells and troponin. RDW was higher with more severe atherosclerosis based on SYNTAX and Gensini scores (p &lt; 0.05). Prognosis was found to be worse in patients with high RDW as well as in diabetics. Conclusions. RDW has positive correlation with other inflammatory marker. It may be used as a marker in determining the severity and prognosis in diabetic patients with coronary artery disease