Environmental Aid and Economic Development in the Third World

Climate change has a profound impact on the planet, especially on developing countries – as highlighted by the Stern Report to the British government in 2006. One solution to mitigating environmental degradation and achieving better outcomes appears to be through the provision of aid to poor countries. Using newly available data from the PLAID (Project-Level Aid) database project, we ask what determines the level of environmental aid to developing countries – and in particular whether such aid is affected by the level of economic development of the recipient country. At the same time, we investigate whether economic development is affected by the receipt of environmental aid. Implicit in the second question, of course, is the notion that, besides addressing the ecological outcomes, environmental aid may have the potential to enhance the economic prosperity of poor countries.Economic Development; Aid; Developing Countries

The Impact of Leverage Levels on Firm’s Performance and Profitability: a case of Pakistani Industries

This paper examines the relationship between the leverage levels, performance and profitability of the 19 Pakistanis firms with in three sectors, commercial banking, cement and fertilizer sector starting from 2004 to 2010. The purpose was to check the trends which are being followed by these industries and how much their capital structure policy is dynamic and relating to their sale, earnings, performance and stock values. Arithmetic Mean (A.M), standard derivation (S.D) were used to check the trend of data and then correlation was used sector wise to check the relationship of dependent and independent variables. At the end Regression test was employed on data .Study finds that there is relationship between leverage ratio i.e. DTCM (independent variable) and its determinants i.e size, tangibility, return on asset and RET except cash. A debt does not represent a suitable form of financing with value-enhancing investment projects of the firms, as an alternative, such firms issue equity. On the other hand, when there is a lack of profitable projects, a firm prefers issuing debts and increasing dividends. Management can increase the performance and profit indicators just by changing the debt equity structure

Metanephric adenoma: A rare benign renal tumour

Metanephric adenoma is a rare benign renal tumour. We are reporting one histologically proven such case in a 23 year old male from Afghanistan. He presented with severe right flank pain since 3 weeks. Nephrectomy was done and histopathology was consistent with the diagnosis of metanephric adenoma. This novel renal mass has been reported to have benign clinical course despite its symptomatic presentation and large tumour size. There is no distinguishing radiological feature with can differentiate it from malignant tumours. So far, a uniformly benign clinical course has been associated with Metanephric adenoma, but given its relatively recent identification and rarity and the lack of clinical, radiographic, or cytologic means to establish a definite diagnosis, Metanephric adenoma remains primarily a pathologic diagnosis

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Donor Motivation of Inter-Temporal Foreign Assistance to Nepal

This paper asks what motivates Western donors to provide foreign aid to Nepal. Results reveal existence of both donor interest and recipient need considerations in the disbursement of aid to this country over the period 1981 to 2005. Donors’ desire for promotion of commercial opportunities, their general economic affluence, as well as Nepal’s per capita GDP are all significant determinants of aid. On the other hand, neither Nepal’s economic growth nor its people’s political freedoms and civil liberties bear a significant relationship to the level of assistance it receives

Mammary myofibroblastoma: a clinico- pathologic study of six cases

Background: Mammary myofibroblastoma is a rare and benign neoplasm of the breast stroma, showing features of fibroblasts and myofibroblasts. It has also been noted to exhibit smooth muscle cell characteristics.Objective: The aim of this study was to describe the clinical and pathological features of mammary myofibroblastoma reported at our institution.Methods: Cases of mammary myofibroblastoma reported in our laboratory were retrieved by electronic search. H&E slides were reviewed and clinico-pathologic features were noted. Immunohistochemistery was performed by Envision method. Only CD34 and CKAE1/AE3 were performed in all 6 cases. ASMA, desmin and S-100 were performed in 5, 4 and 2 cases, respectively. Vimentin and Bcl-2 were performed in one case.Results: A total of 6 cases were identified. Five were female and one was male. The mean age of patients was 45.5 years. The mean size of tumors was 7.7 cm in the largest dimension. Histologically, four cases showed clusters of uniform bipolar spindle shaped cells separated by broad bands of hyalinized collagen. Mitotic figures ranged from none to 3 mitoses/10 HPFs. One case showed combined features of cellular and fibrous areas. Another case was epithelioid-cell type. On immunohistochemistry, CD34 stain was positive in 5/6 cases, ASMA in 3/5 cases, desmin in 2/4 cases, S-100 in none and vimentin and Bcl-2 in 1/6 cases. None of the cases stained positive for CKAE1/AE3.CONCLUSIONS: Due to the varying degree of fibro-myofibroblastic differentiation, myofibroblastoma shows multiple morphologies and several intratumoral and intertumoral types. It is essential to distinguish each variant from the other to avoid inaccurate diagnosis of other benign or malignant breast conditions, becoming a noteworthy diagnostic dilemma for histopathologists

Biotransformation of oral contraceptive ethynodiol diacetate with microbial and plant cell cultures

<p>Abstract</p> <p>Background</p> <p>Biotransformation by using microbial and plant cell cultures has been applied effectively for the production of fine chemicals on large scale. Inspired by the wealth of literature available on the biotransformation of steroids, we decided to investigate the biotransformation of ethynodiol diacetate (<b>1</b>) by using plant and microbial cultures.</p> <p>Results</p> <p>The biotransformation of ethynodiol diacetate (<b>1</b>) with <it>Cunninghamella elegans</it> and plant cell suspension cultures of <it>Ocimum basilicum</it> and <it>Azadirachta indica</it> is being reported here for the first time. Biotransformation of <b>1</b> with <it>Cunninghamella elegans</it> yielded three new hydroxylated compounds, characterized as 17α-ethynylestr-4-en-3β,17β-diacetoxy-6α-ol (<b>2</b>), 17α-ethynylestr-4-en-3β,17β-diacetoxy-6β-ol (<b>3</b>), and 17α-ethynylestr-4-en-3β,17β-diacetoxy-10β-ol (<b>4</b>) and a known metabolite, 17α-ethynyl-17β-acetoxyestr-4-en-3-one (<b>5</b>). The biotransformation of <b>1</b> with <it>Ocimum basilicum</it> included hydrolysis of the ester group, oxidation of alcohol into ketone, and rearrangement of the hydroxyl group. Thus four major known metabolites were characterized as 17α-ethynyl-17β-acetoxyestr-4-en-3-one (<b>5</b>), 17α-ethynyl-17β-hydroxyestr-4-en-3-one (<b>6</b>), 17α-ethynyl-3 β-hydroxy-17β-acetoxyestr-4-ene (<b>7</b>) and 17α-ethynyl-5α,17β-dihydroxyestr-3-ene (<b>8</b>). Biotransformation of <b>1</b> with <it>Azadirachta indica</it> culture yielded compounds <b>5</b> and <b>6</b>. Spectroscopic data of compound <b>8</b> is being reported for the first time. Structure of compound <b>6</b> was unambiguously deduced through single-crystal x-ray diffraction studies.</p> <p>Conclusion</p> <p>Biotransformation of an oral contraceptive, ethynodiol diacetate (<b>1</b>), by using microbial and plant cell cultures provides an efficient route to the synthesis of a library of new steroids with potential contraceptive properties. These methods can be employed in the production of such compounds with high stereoselectivity.</p