Loan and financing diversification and bank stability in dual-banking systems

Our investigation of 46 conventional and 22 Islamic banks from the Gulf Cooperation Council (GCC) countries during 2008–2021 reveals that sectoral diversification effects on stability are nonlinear and different for the two bank types. While Islamic banks' stability is worsened only by moderate levels of diversification, conventional banks' stability is enhanced by high levels and impaired by low levels of diversification. Furthermore, diversification acted as a stabilizer during the global financial crisis but exacerbated the adverse effects of the Covid-19 pandemic. Although regulators usually call for bank diversification, our results imply that it can be a double-edged sword. © 2022

Colchicine anti-inflammatory therapy for non-intensive care unit hospitalized COVID-19 patients: results from a pilot open-label, randomized controlled clinical trial.

Systemic inflammation is a hallmark of severe coronavirus disease-19 (COVID-19). Anti-inflammatory therapy is considered crucial to modulate the hyperinflammatory response (cytokine storm) in hospitalized COVID-19 patients. There is currently no specific, conclusively proven, cost-efficient, and worldwide available anti-inflammatory therapy available to treat COVID-19 patients with cytokine storm. The present study aimed to investigate the treatment benefit of oral colchicine for hospitalized COVID-19 patients with suspected cytokine storm. Colchicine is an approved drug and possesses multiple anti-inflammatory mechanisms. This was a pilot, open-label randomized controlled clinical trial comparing standard of care (SOC) plus oral colchicine (colchicine arm) vs. SOC alone (control arm) in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. Colchicine treatment was initiated within first 48 hours of admission delivered at 1.5 mg loading dose, followed by 0.5 mg b.i.d. for next 6 days and 0.5 mg q.d. for the second week. A total of 96 patients were randomly allocated to the colchicine (n=48) and control groups (n=48). Both colchicine and control group patients experienced similar clinical outcomes by day 14 of hospitalization. Treatment outcome by day 14 in colchicine vs control arm: recovered and discharged alive: 36 (75.0%) vs. 37 (77.1%), remain admitted after 14-days: 4 (8.3%) vs. 5 (10.4%), ICU transferred: 4 (8.3%) vs. 3 (6.3%), and mortality: 4 (8.3%) vs. 3 (6.3%). The speed of improvement of COVID-19 acute symptoms including shortness of breath, fever, cough, the need of supplementary oxygen, and oxygen saturation level, was almost identical in the two groups. Length of hospitalization was on average 1.5 day shorter in the colchicine group. There was no evidence for a difference between the two groups in the follow-up serum levels of inflammatory biomarkers including C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), ferritin, interleukin-6 (IL-6), high-sensitivity troponin T (hs-TnT) and N-terminal pro b-type natriuretic peptide (NT pro-BNP). According to the results of our study, oral colchicine does not appear to show clinical benefits in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. It is possible that the anti-inflammatory pathways of colchicine are not crucially involved in the pathogenesis of COVID-19.

COVID-19 Mortality and Morbidity Rate in a Tertiary Care Hospital Swat, Pakistan

Background: Because of the recent outbreak of Covid-19, the globe is now facing a number of difficult challenges. The morbidity and mortality rate varies depending upon numerous factors. Objective: The objective of the study was to find out the mortality and morbidity rate of Covid-19 in a tertiary care hospital of Swat Methodology: This descriptive cross-sectional study was carried out at the Department of Pathology, Swat Teaching Hospital, Swat, Khyber Pakhtunkha Pakistan for duration of one year from April 2020 to March 2021. Nasopharyngeal or Oropharyngeal swabs were taken from all the enrolled patients and sent to the national institute of health Islamabad or swat public health laboratory for the diagnosis of Covid-19. The rate of morbidity and mortality for all the enrolled patients was recorded. All the data analysis was done by using IBM SPSS version 23. Results: In the current study, totally 11609 patients were enrolled. There were 7329 (63.13%) males and 4280 (36.87%) females. The overall morbidity rate of covid-19 was 18.25% (n= 2089) whereas the overall mortality rate was13.16% (n=275) patients. Conclusion: Our study concludes that the rate of morbidity and mortality of covid-19 is high in district Swat Khyber Pakhtunkhwa, Pakistan. The burden of covid-19 was high in males as compared to females and the mortality rate increases with the increase in age. All the people residing in the district Swat should be vaccinated to decrease both the morbidity and mortality rate of covid-19.

The new normal–pain control in COVID era

Pain is a universal phenomenon;every human being has experienced some type of and some degree of pain during his or her life span. Roughly one third to one half of the whole population has suffered from chronic pain. During the recent past the approach towards management of chronic pain has dramatically changed. The opioid epidemic created alarm in the developed countries, and forced the clinicians to seek new pharmaceutical agents with less side effects and less potential for abuse. The interventional pain management developed itself as an advanced branch of the pain management, thanks to the development of new and better technologies, e.g., radiological imaging including ultrasound use as well as fluoroscopic and even CT and MRI use for guided neural interventions. COVID-19 forced us initially to cease all interventions, only after a few months to modify patient selection and our routine management protocols. This editorial offers a glimpse of this transformation to ‘the new normal’.