Impact of Central Bank Decisions and Communications on Sentiment, Uncertainty, Risk Aversion and Investment Behaviour

Central bank’s policy decisions and communication influence financial markets through managing investor expectations related to the current and future economic scenario and achieve desired macroeconomic goals. This thesis empirically evaluates the role of signals given in the central bank’s actions and communication in driving investor sentiment, formulating the expected risk premium and shifting the investment behaviour in financial markets. This thesis comprises of three empirical chapters focusing on the response of market participants to the central bank quantitative and qualitative announcements. Chapter 2 investigates the impact of the United States (US) and domestic monetary policy announcements on consumer and managers’ confidence in the United Kingdom (UK) and 10 countries within the euro area during conventional and unconventional policy times. More specifically, using the confidence indicators of the European Commission, the study examines the response of consumers and managers to monetary policy surprises around the global financial crisis. The findings confirm that during the conventional policy period, the domestic expansionary shock has a significant positive impact on the consumer and manager confidence in the UK and across the ten countries in the euro area. Furthermore, the US conventional monetary policy has more impact on managers’ sentiment compared to domestic policy. However, after the introduction of unconventional policy programme, the monetary announcements turn to be less effective in boosting the confidence of households and businesses. Chapter 3 analyses the influence of the Federal Reserve’s (Fed’s) communications on investors’ risk perception and appetite in the global equity markets. The results suggest that the Fed’s optimism (pessimism) decreases (increases) the market-wide uncertainty and investors’ risk aversion not only in the US but also in the UK and the euro area. In addition, investors respond to the signals inbound in the communications more significantly during recessionary and uncertain times. Moreover, after estimating unique topics and their relative tone from the Fed’s commutations, this chapter finds that investors pay attention particularly to the discussion related to the financial market, credit conditions, employment, and economic growth in forming their response. Finally, investors react heterogeneously to the discussion about prospering economic outlook and future contractionary policy. Chapter 4 investigates the effect of the Fed’s communications on the returns and traders’ positions in the commodity markets. Using computational linguistic analysis, this study extracts the policymakers’ indication of the future path of the policy rate. This study documents that the degree of hawkishness in the Fed’s communications decreases the one month ahead returns on metal, energy and overall commodity indexes. In addition, the Fed’s hawkish tone increases (decreases) the commodity traders’ speculating (hedging) positions. This implies that the central bank tone contains information about the economic conditions and provides signals about the future path of the policy which drive the traders’ positions and affect the commodity returns. Furthermore, a topic modelling analysis of the central bank communications reveals that a hawkish discussion about consumption, financial market, and inflation plays a particularly important role in influencing the commodity returns and traders’ positions

Mapping Change in Spatial Extent and Density of Mangrove Forest at Karachi Coast Using Object Based Image Analysis

Karachi shoreline is more than 135 Km long significant for marine fishery breeding and spawning. During 2005 to 2018 the mangrove forest areas in Karachi increased in extent but declined in density. The main cause of mangrove cover change in this region are coastal region development (port building, industrial area and waterfront project). This study aims to monitor both extent and density changes of mangrove forest at Karachi coast. For this purpose, the Landsat imagery was used of the years 2005 and 2018 covering a span of 14 years. The imageries were processed through Normalized Difference Vegetation Index (NDVI) analysis. Simultaneously, random sample locations were identified for mapping and validation of mangrove forest extent and density during 2005 to 2018. The sample locations were categorized as dense, normal and sparse classes. In the next step, sample locations were plotted on NDVI images to determine mean, minimum and maximum values for each class of mangrove forest. In the final step, the accuracy assessment was done using Kappa statistics. Results show that overall accuracy of 2018 imagery is better than 2005 Landsat imagery. The overall extent of mangrove forest increased in the past years

Fifteen years experience of managing penetrating extra-peritoneal rectal injuries

Background: Although civilian injuries are generally less severe, they nevertheless remain a challenging problem for the surgeons. In isolated rectal injury patients, though proximal diversion, pre-sacral drainage, distal rectal wash-out and wound debridement are the various surgical options employed in various combinations, the optimum strategy especially for civilian injuries remains unknown. We reviewed our experience of managing penetrating extra peritoneal rectal injuries. Methods: We conducted a Retrospective review of Adult patients with penetrating extra-peritoneal rectal injuries. Follow-up information of at least one month was needed for early post-operative complications. Results: A total number of fifteen patients met inclusion criteria. Median age of our patients was 46 years with range being 20-80 years. All our patients were males. Thirteen of our patients (86%) suffered from gunshot injury while one was a blast victim and one had a stab injury to rectum. Nine patients (60%) had pelvic fracture associated with rectal injury. Diversion stoma was made in all of our patients. Overall post-operative morbidity was 40%. Two patients developed necrotizing fasciitis and required repeated debridements followed by graft placement and one patient developed intra-abdominal abscess which was treated by radiological guided drain placement and antibiotics. Conclusion: Drainage with fecal diversion is the most commonly employed management of extra-peritoneal rectal injuries. Delayed or inadequate drainage can lead to disastrous consequences including necrotizing fasciitis, intra-abdominal abscess

Reducing the donor site morbidity in radial forearm free flaps by utilizing a narrow radial forearm free flap

Background: The radial forearm free flap (RFFF) has remained a leading choice of many plastic surgeons as a fasciocutaneous flap due to its versatility, pedicle length, and simple elevation technique. However, donor site morbidity has led many reconstructive surgeons to limit their use of the RFFF and to use other flaps instead. We propose that using a narrow RFFF (nRFFF) decreases the aesthetic and functional morbidity of the donor site.Methods: We report our experiences with the nRFFF from April 2012 through May 2015 at the Department of Plastic, Reconstructive, and Hand Surgery at Liaquat National Hospital, Karachi. The donor defects were closed primarily. The Stony Brook Scar Evaluation Scale and comparison with the contralateral hand were used to assess aesthetic and functional outcomes, respectively.Results: A total of 24 patients underwent nRFFF procedures during the study period. The donor arm showed excellent motor function in 22 cases (91.7%), and very good function in the remaining two cases (8.3%). The aesthetic outcomes were excellent in four patients (16.6%), very good in eight patients (33.3%), good in 10 patients (41.6%), and fair in two patients (8.3%) who developed a hypertrophic scar. All flaps were successful and there were no cases of partial or complete loss.Conclusions: For small to medium-sized soft tissue defects, the nRFFF had acceptable outcomes due to its thinness, pliability, and major reduction in donor site aesthetic and functional morbidity

Template operative note: A better documentation

Operative notes are a valuable part of patient\u27s medical record, and carry the medico-legal significance. One way of improving it is to introduce the template form operative notes. Only few studies have been done worldwide to compare both the forms of operative notes. This cross-sectional study was conducted in the department of General Surgery, AKUH. This included the patients who underwent Laparoscopic cholecystectomy (Complying with inclusion criteria) from August 2013 till March 2014. Out of 24 patients, 19 were females. The completeness of data in template group was significantly better than traditional group (79.2% vs. 8.3%). There was no significant difference among the residents of different level (writing the notes) and the completeness of data in both the groups. Similarly the timing of day did not affect significantly on the completeness

Role of extent of resection on quality of life in patients with newly diagnosed GBM

Glioblastomas known for their adverse outcomes are most reportedly managed by surgical resection. Studies on the impact of (Extent of Resection) EOR against Quality of Life (QOL) are very limited. We have collected data from recent studies in this review to extract a general consensus among the neurosurgeons regarding the EOR. Key parameters like functional independence, neurocognitive improvements and global health status have been explored in the context of QOL. The currently available data suggests that an increased EOR may help improve QOL in GBM patients. With the help of recent advancements it may be possible to attain a better extent of resection while operating on GBMs

Fistulotomy versus fistulectomy for simple fistula in ano: a retrospective cohort study

OBJECTIVE: To compare fistulotomy with fistulectomy for wound healing, duration of surgery, post-operative pain, incontinence and recurrence in patients with fistula in ano. METHODS: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of adults who had undergone fistulotomy/fistulectomy for simple fistula in ano from January 2007 to August 2012. Data collection was done in August 2013 using questionnaire and telephonic interviews. Outcome variables like duration of wound healing, recurrence, incontinence, duration of surgery and post-operative pain were compared in both the groups. SPSS 19 was used for data analysis. RESULTS: Of the 192 cases, there were 96(50%) in each group. The mean age was 40.51 years (range: 21-72 years) in the fistulotomy group and 41.14 years (range: 21-66 years) in the fistulectomy group (p=0.66). Both groups were comparable for baseline demographic variables. The median duration of wound healing was shorter in the fistulotomy group 15 days (Interquartile range: 7-20 days) compared to the fistulectomy group 30 days (Interquartile range: 15-42 days) (p\u3c0.001). The incidence of recurrence was comparable in fistulotomy vs. fistulectomy (3[3.12%] vs. 4[4.16%]; p=0.70). The incidence of incontinence was higher in fistulotomy compared to fistulectomy (5[5.3%] vs. 12[12.5%]; p=0.07). The severity of incontinence was also compared but the difference was insignificant (p=0.06). The median duration of surgery was significantly shorter in fistulotomy group 17 minutes (Interquartile range: 12-25 minutes) compared to fistulectomy group 25 minutes Interquartile range: 20-35 minutes (p\u3c0.001). The median post-operative pain in the surgical day care unit and at the first follow-up in clinic was zero for both groups. CONCLUSIONS: Fistulotomy yielded better results than fistulectomy since it significantly decreased the duration of wound healing and duration of surgery without increasing the incidence of recurrence, incontinence and post-operative pain

Tuberculoma Brain and its Early Radiological Presentation; Descriptive Analytical Study

OBJECTIVE: To highlight the radiological presentation of tuberculoma brain in association with clinical features of the disease METHODOLOGY: As Descriptive analytical nature of study, it was held in Radiology Department of liaquat University Hospital Hyderabad from June 2018 to December 2018. The cases were referred from medicine and neurosurgery ward to the radiology department for MRI and CT scans. The fillings of questionnaire and co relation of its radiological findings with clinical aspect were examined by evaluating patients file and diagnosed on clinical suspicion, CSF findings, improvement on empirical treatment, diagnosis of exclusion and multi discipline discussion. RESULTS: Total numbers of 20 patients were included, mostly younger age were affected with male preponderance. Mostly cases were presented with meningitis (80%), seizures (60%) and history of tuberculosis (60%). On CT and MRI brain scan, the most common findings were multiple lesions (95%) showed central hyper-intensity on T2 (55%) with meningeal enhancement (80%), fluid- attenuate inversion recovery (FLAIR) signals (35%) and hypo-intense core with hyper-intense rim (30%) reflecting the most of cases with early non caseating nature of tuberculoma. Ring like lesions (80%) and irregular shape (45%) with (25%) target like lesions were found and associated with edema (55%) and calcifications (10%). CONCLUSION: The presentation of tuberculoma is no more a rare manifestation of infective CNS disease. Early identification on scans with characteristics of early non caseating granuloma can help in prompt diagnosis and treatment which in turn decreased the disabling nature of disease and its progression

Adaptive Subaperture Integration for Wide-Angle Synthetic Aperture Radar

In this article, we present an adaptive subaperture integration method for wide-angle synthetic aperture radar (SAR) for improved imaging, with emphasis on short-to-medium range applications. In order to avoid full-aperture integration, traditional approaches use fixed-width subapertures, which may not conform to the persistence angle of the scatterers. Coherent integration gains over the aperture are possible if integration is carried out over the persistence angle of the scatterers, because integrating shorter than the persistence angle may spread the scattering response across multiple subapertures or, conversely, integrating more than the persistence angle may cause noise accumulation along with the useful signal. In this article, we propose to use change-point detection methods to estimate the persistence widths of the scatterers, and consequently enhance the coherent integration gains, resulting in improved imaging. We compare our proposed methods with the standard integration approaches as well as a recently proposed adaptive integration approach. We provide qualitative and quantitative analyses to prove that our proposed methods outperform the existing approaches. We present experimental results on the real-data of our low-terahertz radar as well as a publicly available dataset to validate our claims.</p

Predictors of poor quality of life after primary lower limb deep venous thrombosis: A perspective from a developing nation

Objective: We aimed to determine predictors of poor long term quality of life, using the VEINES Quality of Life (QOL) questionnaire, in patients with lower limb deep venous thrombosis (DVT).Material and Methods: This study included adult patients with primary lower limb DVT between January 2007 and December 2017. Post thrombotic syndrome (PTS) was assessed using the Villalta score and Quality of Life (QoL) by the VEINES quality of life questionnaire.Results: Our study included 125 patients, 57 (45.6%) of whom were males. The patient population\u27s median age was 41 years (IQR: 34-47 years). The median follow up was 450 days (IQR: 390-1020 days). PTS occurred in 49 (39.2%) patients. Independent predictors of poor quality of life post DVT were progression to PTS, complete occlusion of vein, proximal (Ileofemoral) DVT, poor control of INR, poor compliance with compression stockings, severity of PTS, ileofemoral DVT and poor control of therapeutic anticoagulation.Conclusion: Predictors who are independently associated with poor quality of life post DVT are PTS, inability to maintain therapeutic anticoagulation and ileofemoral DVT