An empirical analysis of sustainability of trade deficit: Evidence from Sri Lanka

In this paper, the long-run relationship between Sri Lanka exports and imports during the period 1950 to 2006 is examined using unit root tests and co-integration techniques that allow for an endogenously determined structural break. The results failed to support the existence of a long-run equilibrium between exports and imports in Sri Lanka. This finding questions the effectiveness of Sri Lanka’s current long-term macroeconomic policies and suggests that Sri Lanka is in violation of its international budget constraint

An Empirical Analysis of Sustainability of Trade Deficit:Evidence from Sri Lanka

In this paper, the long-run relationship between Sri Lankan exports and imports during the period 1950 to 2006 is examined using unit root tests and cointegration techniques that allow for an endogenously determined structural break. The results failed to support the existence of a long-run equilibrium between exports and imports in Sri Lanka. This finding questions the effectiveness of Sri Lanka’s current long-term macroeconomic policies and suggests that Sri Lanka is in violation of its international budget constraint.Trade Deficit, Exports, Imports, Unit root, Structural Breaks,Cointegration, Sri Lanka

A comparative evaluation of I-gel and laryngeal mask airway supreme in laparoscopic surgeries: a randomized comparative study

Background: Supraglottic airway device results in less hemodynamic responses during laparoscopic surgery but supraglottic airway device to be used should have higher oropharyngeal seal pressure than peak pressure for effective ventilation as laparoscopic surgery also leads to higher airway pressure. In this study the efficiency of the I-gel with SLMA is compared in patients undergoing laparoscopic cholecystectomy surgeries.Methods: Sixty patients were randomized in to two groups, group A where I-gel was considered for airway management and group B where LMA Supreme was the device chosen for airway management.Results: Oropharyngeal seal pressure was significantly lower in group A than group B, 5 minutes after insertion of airway device it was 24.90±3.03 cm H2O and 27.30±3.41 cm H2O in group A and group B, respectively and 5 minutes after creation of pneumoperitoneum it was 25.53±3.17 cm H2O and 27.57±3.36 cm H2O in group A and group B, respectively. There was significant difference in the difference between inspiratory and expiratory tidal volume between the groups at all the time periods being higher in group A than group B. Hemodynamics were comparable between the two groups. Time taken to insert the airway device and Ryle’s tube insertion was significantly lesser in group B in comparison to group A. The percentage of complications was higher in group A than group B with no significant (p>0.05) association.Conclusions: Both the I-gel and SLMA devices can be used safely in laparoscopic cholecystectomy in non-obese patients. But in SLMA group oropharyngeal seal pressure was higher with lesser leak volume in comparison to I-gel group

Do External Shocks Have a Permanent or a Transitory Effect on Thailand\u27s Tourism Industry?

Given the number and the frequency of external shocks encountered by Thailand in the last two decades, this study identifies the number and the location of the breaks and tests to determine whether the breaks have a transitory or a permanent effect on international tourist arrivals to Thailand for its top 10 source countries using both univariate and panel unit root tests with structural breaks. The findings suggest that break dates coincide with the Asian financial crisis, the September 11 attack, and the SARS and the bird flu outbreaks. The univariate unit root tests with structural breaks reject the null hypothesis of a nonstationarity in tourist arrivals from all countries. Furthermore, panel unit root tests with one and two structural breaks also reject the joint null hypothesis of a nonstationarity. These findings imply that external shocks have only a transitory effect on tourist arrivals and Thailand\u27s tourism sector will return to its long-run equilibrium path

Fibro-osseous pseudotumor of the digit

Fibro-osseous pseudotumor of the digitis a very rare benign lesion however it may be a cause of concern as it forms differential diagnosis to aggressive bone forming tumors like extraskeletal osteosarcoma. Till date only a few cases have been reported in the literature. We came across a case of  7yr old female presented with complains of  post traumatic progressively growing hard swelling present on the palmar surface of the hand at the hypothenar region for last 6 months. Investigations i.e. X-rays, MRI and CT scan were done along with other blood investigations to rule out other common diseases such as exostosis or myositis ossificance or extraskeletal osteosarcoma. Excisional biopsy of the lesion confirmed the diagnosis of fibro-osseous pseudotumor of the digit.

Comparison of single dose transdermal patches of diclofenac and ketoprofen for postoperative analgesia in lower limb orthopaedic surgery

Background: Transdermal patch is a very simple and painless method for providing postoperative analgesia. The aim of the study was to compare the  efficacy and safety of transdermal patch of ketoprofen in comparison to diclofenac patch for postoperative analgesia. It is a randomized single blind study.Methods: Sixty patients were randomly allocated to receive either ketoprofen or diclofenac patch at the end of surgery under spinal anaesthesia. Statistical analyses used, data were analyzed using statistical package for social sciences version 15.0.Results: In diclofenac group the post-operative VAS was 2.4±0.72 and in ketoprofen group, post-operative VAS was 1.4±0.3 which was significantly low when compared to group D (p<0.05 value). 11 patients in group D and 3 patients in group K required rescue analgesia (Inj. tramadol) in the first 24 hours which was statically significant (p<0.05).Conclusions: Both ketoprofen and diclofenac transdermal patch are effective for postoperative analgesia but less number of patients required rescue analgesic in ketoprofen group

Validation of Ponseti method for clubfoot deformity correction

Background: Idiopathic Congenital Talipes Equino-Varus (CTEV) is a complex deformity of foot that is difficult to treat. The goal of treatment is to gain a functional, pain free, plantigrade foot, with good mobility and without callosities. Currently, the most accepted and popular method is the Ponseti method which allows correction of all components of CTEV by manipulation and serial casting without any major surgical intervention. This prospective study was done in a tertiary care centre to statistically assess the efficacy of Ponseti method.Methods: We treated 150 children (210 feet) with idiopathic clubfoot deformity, using Ponseti technique. The severity of foot deformities were assessed by Pirani scoring system and were also recorded clinically, radiologically and podographically. The changes in the mean Catterall-Pirani scores at different follow ups were evaluated statistically.Results: The mean number of casts that were applied to obtain correction was 7.86 (range 5 to 11 casts). Percutaneous tendoachilles tenotomy was done in 70% of feet. All children were given foot abduction orthosis after the correction. The results were graded according to Ponseti and Smoley criteria. Good results were obtained in 83% of feet, acceptable results in 7% of feet and poor results in 10% of cases. Statistically significant correction was achieved in manipulation and casting stage which was maintained during bracing phase. The recurrences of the deformity were primarily due to poor compliance in the use of orthosis in post correction phase.Conclusion: The Ponseti method of correction is a safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery. Non-compliance with orthotics is the main factor causing relapse of the deformity.

Effect of Erector Spinae Block and PECS Block on Quality of Recovery and Analgesia After Modified Radical Mastectomy: A randomised controlled study

Objectives: Postoperative pain after modified radical mastectomy ranges from moderate to severe. Pectoralis block in comparison to Erector Spinae block have been found better in reducing pain scores and reducing consumption of rescue analgesic in postoperative period. This study aimed to compare the effect of Erector Spinae block and Pectoralis block on quality of recovery after Modified Radical Mastectomy using QoR-40 score. Methods: After general anaesthesia, patients were given block according to computer generated randomization. Group-I-Pectoralis block including PEC I AND PEC II(PECS), Group-II-Erector spinae block(ESP) and Group III-Control Group (No intervention). Quality of recovery (QoR-40) score was observed on morning of surgery and at 24 hrs. Time to rescue analgesia and total consumption of rescue analgesia in first 24 hrs. were also observed. Results: In the postoperative period at 24 hrs. Global QoR-40 scores were 183.64±6.36 in PECS group, 179.68± 6.38 in ESP group and 171.37±6.88 in control group. (p&lt;0.0001) But, there was no statistically significant difference between QoR score of PECS &amp; ESP group patients(p=0.0551). The total requirement of rescue analgesic was significantly lesser in PECS group (137.28±31.46 mg) in comparison to ESP Group(189.46±42.98mg) and control group (229.57±46.80 mg). (p&lt;0.0001). Time to first rescue analgesia was significantly higher in PECS group (6.53±2.78 hrs) in comparison to ESP (4.05±2.91 hrs) and control group (2.15±1.51 hrs). (p&lt;0.0001) Conclusion: Both Erector Spinae block and Pectoralis block are effective for improving QoR score and reducing consumption of rescue analgesic after modified radical mastectomy. Keywords: breast surgery, cancer, postoperative recovery, postoperative pai