ABSTRACT
The current research aims to investigate the financial management of Jordanian listed banks during the COVID-19 pandemic to identify the impact of the COVID-19 pandemic on the financial management efficiency of Jordanian banks during the pandemic. In addition, this research is based on a quantitative research approach as it incorporates financial management factors, including liquidity management, return on equity, return on assets, and financial performance, for identifying the efficiency of Jordanian banks during the COVID-19 pandemic. The analysis shows the financial indicators of banks listed on the Amman stock exchange. It has been found that the pandemic has affected the financial performance of these banks. On one side, although the total asset (size) of the banking sector is found to be increased on the other side, the debt ratio has also been increased, and it has created a significant negative impact on the financial performance. Hence, the findings indicate that the Jordanian government and the central bank of Jordan are still required to work on enhancing the financial performance of the financial sector in Jordan, as well as they should work on eliminating the impact of COVID-19 on the financial sector. Moreover, the reforms introduced by the Central bank of Jordan have a significant role in having this efficiency by the listed banks. This paper has highlighted that Jordan has a strong banking system that can cope with such uncertain situations due to its efficient financial management practices. The Jordanian government should further enhance the capabilities of the Jordanian banking sector through effective reforms to further contribute to the country's economic development. © 2022 Science Press. All rights reserved.
ABSTRACT
Introduction: Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem disorder characterized by asthma, prominent peripheral blood eosinophilia, and small-vessel vasculitis. We report a case of EGPA in an adolescent with uncontrolled asthma who was receiving montelukast. Case: A 12-year-old boy who is known to have asthma and allergic rhinitis which were previously controlled on ICS, intranasal steroids, and prolonged use of montelukast for 4 years. He presented with cough and nasal blockage for 2 months. He also reported an increase in the frequency of asthma attacks and received multiple courses of systemic steroids. Subsequently, his asthma controller medications were upgraded to ICS/LABA few weeks prior to admission. His symptoms were also associated with weight loss, diarrhoea and haematochezia. He was vitally stable and maintained oxygen saturation on room air. Physical examination revealed nasal polyps, purple skin flat lesions on palms and feet (Figure1), and bilateral crackles on chest auscultation. His blood investigations were significant for leukocytosis with marked eosinophilia (11x103/uL, (51%)), high inflammatory markers and total-IgE (1975 kU/L). Initial chest XR showed bilateral interstitial thickening and small pleural effusions (Figure2). Chest CT showed centrilobular nodules and peripheral ground-glass opacities, tree-in-bud appearance with no peripheral sparing in addition to moderate pericardial effusion and bilateral mild pleural effusion (Figure3). Sinus CT showed extensive sino-nasal polyposis with pansinusitis (Figure4). Initial echocardiography showed moderate pericardial effusion with normal biventricular function. Patient was started on IV furosemide. During his hospitalization, patient developed chest pain. His serial troponin was rising and LV contractility was depressed. ECG showed ST-segment depression. Therefore, EGPA with cardiac involvement was suspected. Cardiac MR showed features of a peri-myocarditis. IVIG was commenced for suspicion of coronary artery involvement, which was later disputed by cardiac cath. He was also started on IV pulse steroids at a dose of 30 mg/kg for 3 days which resulted in dramatic decrease in troponin level, eosinophil count and CRP. Skin biopsy, which was later performed after administration of steroids, showed perivascular non-necrotizing granulomas. His ANA, ANCA and COVID-19 PCR came negative. Serum chemistries and urine microscopy were unremarkable. Patient was later started on Rituximab with significant clinical, serological and radiological (Figure5,6) improvement after 10-months of follow-up. Discussion: EGPA is rare but should be considered in children with uncontrolled asthma, eosinophilia and rhino-sinusitis. This case shows the importance of being aware that montelukast could cause EGPA, in spite of the uncertainty about its mechanism. (Figure Presented).