The risk-free rates are widely used as benchmark to measure excess stocks returns or excess market returns and contribute a significant role in Asset Pricing Models. The purpose of this study is to scrutinize the risk and real excess portfolio returns using inflation adjusted risk-free rates, a unique measuring technique with a primary focus on the momentum augmented Fama-French five-factor model, utilising monthly data for 1994-2022 from the Pakistan Stock Exchange. Using OLS regression technique, the findings reveal that except profitability, the market, size, value, momentum and investment move largely correlated with excess portfolio stocks returns. The Gibbons, Ross & Shanken test confirms that the momentum augmented Fama-French five-factor model outperforms in the market.
This study was undertaken to investigate the outcome of unreamed interlocking nail in open fractures of tibia in our setup. sixty cases of open tibial diaphyseal fractures were treated with unreamed intramedullary interlocking nail. The cases were followed up for a period of nine months and data regarding, infection, union, delayed union and nonunion was recorded. In our study union occurred in 50 (83.3%) patients within 5 months, delayed union in 9 (15 %) patients and nonunion in 1 (1.7%) patient after course of follow-up. Infection was observed in 8 (13.3%) cases while 52 (86.7%) cases did not show any sign of infection. Because of the high union rate and low infection rate, we consider unreamed interlocking nailing of tibial fractures as the best mode of treatment for open diaphyseal tibial fractures.
Purpose: We investigated Patients presenting with chronic orchialgia at Andrology in institute of kidney and diseases Peshawar, from 2003 August up to when were included. Materials and Methods: A thorough history and physical examination was undertaken including description of pain by the patient in terms of site, severity, radiation and associated pain. Extensive workup, directed by history and phsical examination, was done to rule out reversible causes of orchalgia. All patients had urinalysis, culture and ultrasound scrotum with color Doppler. Further investigations like semen analysis, culture and hormonal workup were done if indicated. The intensity of the pain was noted according to visual analogue scale. Patients were subdivided into three groups as mild pain (group A, pain score=1 - 3), moderate pain (group B, pain score=4 - 6) and severe pain, (group C, pain score=7 - 10). Site of pain and radiation/association to any other region was recorded. Finding: Results of the study indicated that 92 patients reported at institute of kidney diseases Peshawar with chronic orchialgia had their mean age at 37+/-4years. Five patients lost to followo 92 were included in final analysis (table 01). Pain was partially relieved in 14 patients and not relieved in another 9 patients which is almost 76% of total patients. These non-responders were compared with the remaining in which pain was completely relieved. There was no difference in etiology among responders and non-responders, however pain severity was more in non-responders at initial presentation (table 2). Conclusions: Patients with pelvic floor muscle spasm are more likely to experience treatment failure following microscopic subinguinal spermatic cord denervation for chronic scrotal content pain, even with a favorable response to spermatic cord block. A history relating to pelvic floor muscle spasm should be taken for all patients presenting with chronic orchialgia or chronic scrotal content pain, and digital rectal exam should be performed if the history is suggestive. If underlying pelvic floor dysfunction exists, pelvic floor physical therapy can be offered to patients prior to spermatic cord denervation. History of prior vasectomy, epididymectomy, prior inguinal or scrotal surgery or other patient demographic factors were not associated with treatment failure.
Purpose: Varicocele is a common type of male genital disease and can occur in men of any age, especially young people. Clinically venous enlargement or varicocele are found in about 15% of the general male population, up to 35% of men with primary fertility, and 75% of men with secondary fertility dysfunction. Varicoceles are known to be the most common cause of male infertility and can be corrected surgically, but the exact mechanism of sperm formation caused by varicocele-induced impairment remains controversial. Most men with varicocele are asymptomatic and infertile, with only 15% – 20% suffering from physical discomfort or other fertility-related problems. With therefore systematically evaluated the RCTs published together and summarized evidence evaluating the benefits of testicular delivery and ligation of gubernacular vein in microsurgical varicocelectomy. Methodology: Comprehensive electronic search using the keywords "microsurgical varicocelectomy", "gubernacular vein", "testicular delivery", "infertility" and "varicocele" was done in databases of Cochrane, PubMed, Embase, CINAHL and Web of Science databases. English language used to search databases. Some studies were taken from studies references. Result: Two studies reported grade II and III of varicoceles in patients that participated in the study. Overall sperm count in microsurgical resection with testicular delivery compared to microsurgical resection without testicular delivery, increased significantly (SMD = 0.23, 95% CI = 0.07-0.39, p =<.05), but sperm motility, sperm concentration and gradual increase have no difference in between the two microsurgical methods (p> 0.05). Conclusion: In conclusion, as a result of this systematic review and meta-analysis, compared with microsurgical varicocelectomy without testicular delivery, delivery of the testicles during microsurgical varicocelectomy to further to further ligate the gonadal veins leads to epidydemo orchitis and oedema, and longer surgery. In addition, testicular delivery may not improve parameters of sperm, serum testosterone, and incidence of varicose veins, wound inflammation and spontaneous pregnancy compared to non-delivered testicles. However, a higher level of research is needed to determine if testicular delivery is an important surgery in microsurgical venous ligation.
Background: The inflatable penile prosthesis (IPP) is typically the preferred implant for Peronei’s disease (PD) and malleable penile prostheses (MPPs) have been discouraged. Objective: To share experience of malleable penile implant in younger patients at institute of kidney disease Peshawar in a developing country. Materials and Methods: Total of 24 Patients were included in this study who underwent malleable penile prosthesis surgery from July 2017 till June 2020 were included. They all counseled thoroughly regarding procedure, success statistics, possible complications and post-operative follow up. During follow up any problem if occurred and satisfaction documented. Data analysis done with SPSS version 22. Results: mean age of 31.7 (27-65) years were included. The most common etiology of ED was vasculogenic (n=10, 41.7%). The comorbidities found were diabetes mellitus and hypertension in 12.5% each (n=3), these patients had no comorbidities (n=18, 75%). The mean size of penile prosthesis was 11.79mm (ranged from 9.5-13mm). We had four patients (16.7%) with unconsummated marriage due to ED. The post-operative problems noted were penile numbness (n=4, 16.7%), retarded ejaculation (n=4, 16.7%), penile pain (n=3, 12.55), hematoma (n=1, 4.2%) and lower urinary tract symptoms (n=1, 4.2%). Most of these patients were fully satisfied (n=15, 62.5%), some were partially satisfied (n=7, 29.2%), only two patients were not satisfied (8.3%) while all patients had their partner satisfaction with malleable penile prosthesis. Inappropriately, patients had presented initially to urologist, rest of all 24 patients were initially treated by quacks, general practitioners, homeopaths, spiritual healers, dermatologists, gynecologists and psychiatrists. All patients had no sense about erectile dysfunction. Patients have idea about discussion of specific field consultant. Their doctor only deal with urology, kidney and bladder pathologies. Conclusion: Malleable penile prosthesis has great success rate in end point erectile dysfunction with acceptable complication rate. E.D is a global problem. There has been an incredible ignorance in the public about proper referral and management of Sexual dysfunction. Herbal medications are marginally effective and management of erectile dysfunction.
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