Accounting for Leverage in Intangible and Tangible Investments Across the Business Cycle

In this paper, I study the role of the leverage ratio and its impact on investing in tangible and intangible goods. The results confirm the hypotheses outlined in the introduction. Specifically, the results show that when accounting for differences in the leverage ratio between firms, investment is cyclical. However, when looking only at firms with low leverages, intangible investing becomes countercyclical. Moreover, during recessions, firms with lower leverages tend to invest more than firms with higher leverages. Finally, the results argue for the existence of financial frictions between investing in tangibles and intangibles

Think beyond ascites

In children with gross, persistent ascites wherein clinical scenario is not agreeable to common conditions, one needs to revise the diagnosis and rule out the surgical cause for abdominal distension mimicking ascites. We are reporting here, a case of two year old female child who presented with abdominal distension, clinically suggestive of ascites and subsequently diagnosed to have a large chylous mesenteric cyst which was determined on biochemical investigations, imaging and confirmed on surgical intervention. She was managed surgically with successful outcome

Effect of Inhalation Steroids in Children with Coexistent Atopic Disorders & Nephrotic Syndrome on Prevention of Relapses of Nephrotic Syndrome

In many nephrotic syndrome children, it has been observed that onset of rhinitis and/or wheezing attacks precipitate the relapseof nephrotic syndrome. This association is known since long time. We decided to observe the response of inhalation steroids inprevention of relapses of nephrotic syndrome in children who presented with frequently relapsing nephrotic syndrome andcoexistent atopic disorders

Knowledge and practice among the pediatric post graduate residents regarding the technique of blood culture sampling

Background: Errors in sampling during blood culture, may lead to contaminants or poor yield which result in faulty reports increasing patient's suffering, endanger patient safety and increasing cost of health care. Optimal knowledge about the sampling method for important microbiological test like blood culture translates into appropriate practices. Authors objectives was to assess the knowledge and practice of the Pediatric resident doctors, regarding sterile technique during blood culture collection. The change in the knowledge of the residents during blood culture sampling with regards to maintaining asepsis after watching educational video was evaluated.Methods: A quasi experimental, questionnaire based study with pre–post intervention,  involved post graduate resident’s knowledge and  practice regarding the sterile technique during blood culture collection. The data   analyzed using paired t test and Chi-square Test.Results: 18(60%) participants accepted that they have collected blood culture not maintaining complete asepsis at some time in past. The reasons for the same were lack of knowledge 14 (46.66%), no assistance from staff for the procedure 14 (46.66%), non-availability of sterile gloves 4 (13.33%), non-availability of antiseptic solution 4(13.33%), time consuming 8 (26.66%).Conclusions: Ultimately, blood culture contamination is a complex, challenging problem that requires a multidisciplinary approach. Regular teaching modules for the health personnel and ensuring environment conducive to correct practises would definitely help in improving the sampling practises for aseptic procedures

Evaluation of prescription pattern of antimicrobials in the treatment of respiratory tract infections in pediatric patients attending a tertiary care hospital

Background: Irrational use of antimicrobials is a complex and multifactorial problem in developing countries. Prescriptions not adhering to the treatment guidelines, self-medication, inappropriate use of drugs by patients can inadvertently lead to development of antimicrobial resistance. An observational study was designed to evaluate antimicrobial use in pediatric population with respiratory tract infections and its adherence to national treatment guidelines. Methods: This was a cross sectional observational study initiated after taking institutional ethics committee permission. The prescriptions of children diagnosed with upper respiratory tract infections and lower respiratory tract infections (LRTI) were screened. Their demographic profile and details of drugs prescribed were recorded. Results: Out of 230 pediatric prescriptions,155 (67%) were from outpatient department and 75 (33%) from those admitted in ward. Total 145 children were diagnosed with URTI whereas 85 had LRTI. In this study, 60 children with URTI received combination of amoxicillin and clavulanic acid (Co-amoxiclav) whereas 66 children with LRTI received Co-amoxiclav,18 ceftriaxone (N=18), 6 vancomycin (N=6) and 18 were prescribed oseltamivir (N=18), either alone or in combination. Other drugs prescribed included, paracetamol for fever and cough syrups. Out of 195 drugs prescribed by brand names, 138 (70.8%) were antimicrobials. Fixed dose combination amoxicillin and clavulanic acid, paracetamol and cough syrups were available from hospital pharmacy. None of the prescriptions had polypharmacy. Conclusions: URTI was treated using single antimicrobial whereas LRTI was treated with more than one antimicrobials or combination of antimicrobial and antiviral agent. The prescriptions were in accordance with the national treatment guidelines

Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening conditions with high morbidity and mortality. Supportive care management of SJS/TEN is highly variable. A systematic review of the literature was performed by dermatologists, ophthalmologists, intensivists, and gynecologists with expertise in SJS/TEN to generate statements for supportive care guideline development. Members of the Society of Dermatology Hospitalists with expertise in SJS/TEN were invited to participate in a modified, online Delphi-consensus. Participants were administered 9-point Likert scale questionnaires regarding 135 statements. The RAND/UCLA Appropriateness Method was used to evaluate and select proposed statements for guideline inclusion; statements with median ratings of 6.5 to 9 and a disagreement index of ≤1 were included in the guideline. For the final round, the guidelines were appraised by all of the participants. Included are an evidence-based discussion and recommendations for hospital setting and care team, wound care, ocular care, oral care, urogenital care, pain management, infection surveillance, fluid and electrolyte management, nutrition and stress ulcer prophylaxis, airway management, and anticoagulation in adult patients with SJS/TEN

Self-Interference Cancellation in Full Duplex Radios and LTE-Unlicensed

All the commercial radios are half duplex in a sense that they are unable to transmitand receive at the same time on the same frequency. A full duplex radio simultaneouslytransmits and receives at that same time and on the same frequency thus doublingthe throughput of the existing systems. One of the fundamental challenges in enablingfull duplex is the cancellation of the self-interference that is caused by device’s owntransmitter. Considering the high level of the self-interference at the receiver front end,it is necessary to cancel out the interference in the analog domain to avoid the ADCsaturation. As one of the major focus of this thesis, all the existing methods, algorithmsand accomplishments in enabling full duplex have been summarized. A novel methodfor interference cancellation using cables, power splitters and step attenuators has beenimplemented on the actual hardware and its performance evaluation and limitations have been summarized.Currently deployed cellular networks use bands which have been licensed andapproved by the FCC. With the developments in cellular standards Rel-10 LTE advanced which supports carrier aggregation has been established where a multiple carriers are aggregated to provide a larger bandwidth. As cellular operators explore the possibility of extending the carrier aggregation to the unlicensed spectrum in the 5GHz, current developments in creating a friendly ecosystem in unlicensed bands have been summarized which form the basis of Rel-13 LTE- Licensed Assisted Access