In the instance of emerging economies, this research examines the firms’ investment decision and leverage relationship. This study examines a sample Pakistan Stock Exchange (PSX) listed firms. Time period consists of six years from 2015 to 2020. To investigate the investment and leverage link Generalized Least Square (GLS) regression is used because of its more precise estimates than the ordinary least squares (OLS) estimator. Results reveal that leverage is negatively and significantly associated with the investment. In the case of Pakistan, this indicates that increased debt financing results in a decrease in company investment. Firms' investment decisions are also influenced by several other variables such as profitability, liquidity, and cash flows. Findings are in support of the corporate agency hypothesis, revealing that leverage plays a key role in the firm's growth. To solve the possible problem of endogeneity, the robustness of these results is cross-checked by using the Generalized Estimation Equation (GEE) method. The current paper adds to the existing body of knowledge in several ways. To begin, we contribute to the continuing discussion about whether corporate investment decisions are influenced by firm leverage. Second, in the context of emerging markets, we present an empirical study. Future research can be done with an evaluation between emerging and advanced countries, this study can be expanded across industry lines and at the country level. Because investment divergence from an ideal level is linked to the agency problem, these findings have important implications for corporate governance to protect shareholders' interests as well as in the context of emerging markets, this conclusion has significant implications.
Background and Aim: Hemodialysis is a valuable treatment for elderly individuals progressing to chronic kidney disease (CKD). Globally, hemodialysis demand is increasing for elderly individuals as a life-sustaining therapy which might lead to prolonged suffering in geriatric patients. Therefore, the current study aimed to evaluate the outcomes of hemodialysis in elderly diabetic patients. Methodology: This retrospective study was carried out on 64 type 2 diabetic patients admitted to the Dialysis Unit at Social Security Hospital, Multan Road Lahore from January 2021 to April 2022. Ethical approval was taken from the institution research and ethical committee. All the type 2 diabetic patients above 65 years age having CKD on dialysis were included. Patients having disease that require immunosuppressive treatment, history of malignancy, and those who died within three months of initial treatment were excluded. Patient’s survival data and comorbidities such as cognitive, vascular, and autonomy were studied. Other comorbid conditions such as cerebrovascular disease, peripheral vascular disease (PVD), and coronary artery disease (CAD) were reviewed. SPSS version 25 was used for data analysis. Results: Of the total 64 diabetes patients, there were 34 (53.1%) males and 30 (46.9%) females. The overall mean age was 68.9±3.1 years whereas dialysis mean duration was 28±22 months. Cognitive impairment, lost autonomy, and prior cerebrovascular accident had significant association with mortality rate reported as 7.8% per year. The incidence of fistula or graft, depression, dementia, died, and bedridden cases were 39% (n=25), 18.8% (n=12), 15.6% (n=10), 12.5% (n=8), and 14.1% (n=9) respectively. Of the 25 cases of fistula or graft, about 9.5% used catheter. Conclusion: The present study found that mortality rate was 7.8% in elderly (>65 years) diabetes patients. The high mortality risk was substantially related with cognitive disorder, cerebral vascular accident, and lost autonomy. Generally, hemodialysis practice varies with the region’s clinical pattern due to age variation in elderly patients. Keywords: Hemodialysis, Chronic kidney disease, Elderly, Diabetes
Background and Aim: Globally, Hepatitis B virus (HBV) infection is a major health issue contributing to various diseases such as hepatocellular carcinoma (HCC) and liver cirrhosis. Virus replication complex interaction with host immune system response causes dynamic interplay leading to HBV infection. In developing countries, HBV infection plays a significant role in higher rates of morbidities and mortalities. The present study aimed to assess the clinical, laboratory, and virological characteristics of patients with positive HBV surface antigen. Methodology: This cross-sectional study was carried out on 182 positive HBV surface antigen (HBsAg) in the department of Medicine, Social Security Hospital, Multan Road Lahore from April 2021 to March 2022. All the patients with positive HBsAg and negative hepatitis C were enrolled. Patients with a history of chronic liver disease, acute hepatitis B infection, and antiviral therapy were excluded. All patients underwent CBC, liver function tests, clinical evaluation, and abdominal ultrasonography examination, HBV serological marker’s assessment, HBV transmission risk factors, and HBV-DNA quantitative detection. SPSS version 25 was used for data analysis. Results: Out of 182 HBV infected patients, there were 162 (89%) males and 20 (11%) females. The overall mean age was 38.6 ± 8.6 years. The most prevalent complaint and common findings was arthralgia and hepatomegaly with reported incidence of 32 (17.6%) and 16 (8.8%) respectively. Based on ultrasonography imaging results, the incidence of normal liver, coarse liver, splenomegaly, and cirrhosis were found in 81.3% (n=148), 12.6% (n=23), 5.9% (n=11), and 6.6% (n=12) respectively. Based on laboratory results, normal alanine aminotransferase, normal aspartate aminotransferase, reduced serum albumin, and low platelet count were found in 76.9%, 84.8%, 4.9%, and 10.2% respectively. Regarding laboratory, clinical, and imaging characteristics, HBV-DNA positive and negative had no significant differences. Conclusion: The present study found that HBV infected patient’s clinical manifestations were fatigue, bleeding gums, abdominal pain and fatigue. Majority of patients had normal liver on liver function tests and ultrasonographic examination. Most patients had negative HBV infection antigen. Based on comparisons made between HBV-DNA negative and positive, no substantial variations were reported on laboratory, clinical, and imaging characteristics. Keywords: HBV antigen, Virological characteristics, HBV
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