The Impact of Corporate Governance on Financial Reporting Quality: Evidence from Pakistan

This research aims to investigate whether corporate governance (CG) mechanisms and Financial Reporting Quality (FRQ) are related with each other in the context of Pakistan. For this purpose panel data is used and a sample of 200 firms is extracted for the period 2003 to 2017. In this study system GMM and STATA software is used for estimation of parameters. The findings suggest that board independence enhances FRQ by 0.0011% in large sample, 0.0018% in medium sample and 0.0033% in small sample. In addition, audit committee independence raises FRQ in all three samples. Specifically, a rise of 1% in audit committee independence increases FRQ by 0.0088% in large sample, 0.0083% in medium sample and 0.0087% in small sample. Institutional ownership improved the FRQ of Pakistani firms. More specifically, the result indicates that a 1% rise in institutional ownership bring 0.022% increase in large sample, 0.029% in medium sample and 0.018% in small sample. The results show that a rise of 1% in gender diversity brings about 42% increase in large sample, 15% in medium sample and 7% increase in small sample. The result indicates that a 1% rise in shareholder activism is associated with an increase of 6% (large sample), 28% (medium sample) and 22% (small sample) respectively. Concentrate ownership insignificantly affect FRQ in case of large and small sample but on other hand in medium size firm’s the relationship is significant and positive with FRQ. Keywords: Financial Reporting Quality, Corporate Governance, Pakistan Stock Exchange. DOI: 10.7176/RJFA/11-17-17 Publication date:October 31st 202

Prophylaxis against heterotopic ossification after elbow and acetabular fractures — do we really need it

Abstract OBJECTIVE: To compare the efficacy and safety of prophylactic modalities for heterotopic ossification prevention after elbow and acetabular surgeries. METHODS: The retrospective chart review was conducted at the Aga Khan University Hospital and comprised record of patients who underwent open reduction and internal fixation for elbow and acetabular fractures between 2010 and 2013. Data was classified into three groups: Group A patients had received single dose of radiotherapy; Group B patients had received indomethacin, and Group C patients had not received any prophylaxis. Outcome variables included time-to-fracture healing, heterotopic ossification, non-union and wound infection. RESULTS: Of the 104patients 70(67.3%) had elbow fractures and 34(32.7%) had acetabular fractures. Out of the 70patients with elbow fractures, 28(27%) were in Group A, 24(23%) in Group B, and 18(17%) in Group C. In Group A, 4(22%) patients had wound infection compared to 1(5.5%) patient in Group C (p=0.131). One (4%) patient in Group B and 1(5.5%) in Group C developed heterotopic ossification (p=0.486). Non-union occurred in 1(4%) patient in Group B and 1(5.5%) in Group C. Out of the 34 patients with acetabular fractures, 11(32.3%) were in Group A, 10(29.4%) in Group B, and 13(38.2%) in Group C. In Group A, 2(18.2%) patients developed wound infection. Only 1(7.6%) patient in Group C developed heterotopic ossification. CONCLUSIONS: No role of radiotherapy or indomethacin was detected in the prevention of heterotopic ossification

New method for square root of non-singular M-matrix

Square root of a matrix play an important role in many applications of matrix theory. In this paper, we propose a new iterative method for square root of a non-singular M-matrix. We first transform the matrix equation X2 – A=0 into special form of a non-symmetric algebraic Riccati equation (NARE), and then solve this special NARE by Newton method. Efficiency and effectiveness proved by theoretical analysis and numerical experiments. Keywords: - Matrix square root, M-matrix, Non-symmetric algebraic Riccati equation, Newton method

Pearl pin inhalation accidents: an emerging tracheobronchial challenge to surgeons

Background: The practice of wearing head scarf pin or pearl pins is very common among young Muslim girls and wrong habit of holding a number of pins in the mouth and utilize them one by one to fix the scarf leading to accidental inhalation has emerged a frequently seen entity in our practice now and managing the tracheobronchial pearl pin foreign body poses a lot more different challenges to surgeon than conventional foreign bodies. The study presented an experience with pearl pin inhalation and discussed the unique clinical characteristics of this problem and challenges in management.  Methods: A cross sectional hospital based observational study was conducted in tertiary care hospital (SMHS), department of ENT for period of 2 years August 2013 to July 2015.Results: Total of 36 (34 females and 2 males) patient were considered with mean age of 14.2 years (range 6-32 years). The average duration of reporting to our emergency department was 5 hours with delayed presentation ranging from 24 to 36 hours. In 31 patients the pin was successfully removed with rigid bronchoscope and in 2 cases fibreoptic bronchoscopy was needed, thorocotomy for more distal location was done successfully in two cases and another one gastroenterologist consultation was sought for reverse ingestion in to the abdomen.Conclusions: Pearl pins behave as floating or/are mobile in nature especially in the early phase of inhalation and initial Immediate pre-op x-rays are beneficial. The removal can encounter certain difficulties and the surgeon needs to be vigilant & skilful.

Venous Thromboembolism in Cancer: An Update of Treatment and Prevention in the Era of Newer Anticoagulants

Cancer patients are at major risk of developing Venous Thromboembolism (VTE), resulting in increased morbidity and economic burden. While a number of theories try to explain its pathophysiology, its risk stratification can be broadly done in cancer related, treatment related and patient related factors. Studies report the prophylactic use of thrombolytic agents to be safe and effective in decreasing VTE related mortality/ morbidity especially in postoperative cancer patients. Recent data also suggests the prophylactic use of low molecular weight Heparins (LMWH’s) and Warfarin to be effective in reducing VTE’s related to long term Central Venous Catheter (CVC) use. In a double blind, multicenter trial, a new Ultra LMWH Semuloparin has shown to be efficacious in preventing chemotherapy associated VTE’s along with other drugs such as Certoparin and Nadoparin.. LMWH’s are reported to be very useful in preventing recurrent VTE’s in advanced cancers and should be preferred over full dose Warfarin. However their long term safety beyond 6 months has not been established yet. Further, this manuscript discusses the safety and efficacy of different drugs used in the treatment and prevention of recurrent VTE’s including Bemiparin, Semuloparin, oral direct thrombin inhibitors, parenteral and direct oral factor Xa inhibitors

Knowledge attitude and practices among urban women of Karachi, Pakistan, regarding breast cancer

Objective: To determine the knowledge,attitudes and practices of urban women regarding breast cancer and its available screening modalities.Methods: The cross-sectional, questionnaire-based, descriptive study was conducted in the urban population of Karachi in November 2010. Female attendants (n=373) visiting a tertiary care centre and four of its urban outreach centres during the study period were administered a questionnaire. The answers were then scored with regard to their knowledge. Frequencies and percentages were computed through SPSS 17, and analysis of variance was used to confirm significance.Results: Of the 373 participants with a mean age of 32.4+/-10.9 years, 293 (78.6%) were married, and 257 (69%) were housewives. The education level was considerably high; with 214 (57.4%) graduates. The mean score for knowledge of risk factors was 2.84 out of a total of 13; which was significantly associated with marital status and income. Age \u3e 40 years, education level, income and employment status were also significantly associated with higher mean screening awareness scores. Nearly 182 (48.8%) had heard about Breast Self Examination and 142 (38%) knew how to perform one. However, only 97 (25.9%) regularly performed such an exam. Almost all 3621 (97%) women wanted more media awareness campaigns regarding the issue.CONCLUSION: There is a real need for comprehensive health education programmes focusing on breast cancer awareness in Pakistan

Hoffmann's syndrome: a case report

This syndrome is characterized by the presence of hypothyroidism with myxoedema, muscle stiffness and pseudo hypertrophy. We describe the disorder in a 21 year old male, who got admitted with complaints of generalized weakness, cold intolerance, constipation, and hoarse voice, difficulty in walking and progressive enlargement of muscles of thighs and back with crampy pains for two years. Examination revealed mild mental retardation, enlarged tongue, dry and rough skin, enlargement of thighs and back muscles, motor weakness in flexors of hips and knees with delayed relaxation of deep tendon reflexes. Investigations revealed evidence of hypothyroidism with marked elevation of muscle enzymes. Following institution of replacement therapy with thyroxine, the patient showed marked clinical and biochemical improvements after six months, but insignificant decrease in muscle mass. In this report we review relevant literature

Molecular Signatures of Tumour and Its Microenvironment for Precise Quantitative Diagnosis of Oral Squamous Cell Carcinoma: An International Multi-Cohort Diagnostic Validation Study

Supplementary Materials: The following supporting information can be downloaded at: www.mdpi.com/xxx/s1, Table ST1 – qMIDSV2 Gene panel primer sequences; Figure S1 – qMIDSV1 vs qMIDSV2 384-well assay format and protocols; Figure S2. Individual target gene expression pattern in 1761 samples; Figure S3. Various statistical methods used for gene selection analysis on 1761 clinical samples; Figure S4. Diagnostic performance comparison between qMIDSV2 vs qMIDSV2* (with 4 less effective genes removed from the panel of 14 target genes of qMIDSV2); Figure S5. Effect of removing individual genes from the 14-target gene panel qMIDSV2 (qV2) on diagnostic test performance based on the UK patient cohort data

Transcriptome reprogramming by cancer exosomes: identification of novel molecular targets in matrix and immune modulation

We thank the Facial Surgery Research Foundation – Saving Faces; Guizhou Department of Education and Guizhou Science and Technology Department

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe