Mutations of fake weighted projective planes

In previous work by Coates, Galkin, and the authors, the notion of mutation between lattice polytopes was introduced. Such a mutation gives rise to a deformation between the corresponding toric varieties. In this paper we study one-step mutations that correspond to deformations between weighted projective planes, giving a complete characterisation of such mutations in terms of T-singularities. We show also that the weights involved satisfy Diophantine equations, generalising results of Hacking-Prokhorov.Comment: 14 pages, 2 figure

X-efficiency Analysis of Commercial Banks in Pakistan: A Preliminary Investigation

The emergence of a fast-paced dynamic environment in the business world in general, and in the financial services sector in particular, has highlighted the significance of competition and efficiency. The need for deregulation has become a touchstone of success in fostering both competition and efficiency especially in the economies, which are exposed to structural reforms. In addition to that, intense competition both among domestic and foreign banks, rapid speed of innovations and introduction of new financial instruments, changing consumer’s demands and desire for product augmentation have changed the way a bank conducts business and services its customers. Larger the degree of competition, it is perceived that the firms would become more efficient. However, when the structure of an industry is product of the government regulations, the degree of competition is impaired markedly implying that the efficiency suffers negatively. Banking industry acts as life-blood of modern trade and commerce acting as a bridge to provide a major source of financial intermediation. Thus, appraisal of its efficiency is vital in context of an efficient and competitive financial system. Study of x-efficiency is believed to be important in particular as Berger, et al. (1993) found that x-inefficiencies account for around 20 percent or more of banking costs. Similarly, recent drive among banks towards downsizing, rightsizing and rationalisation of banking costs also implicates for the assessment of x-efficiency analysis of banks. It becomes vital in Pakistani context as there appears to be no study in literature on efficiency or x-efficiency analysis of banks in Pakistan. “A great deal more work is needed on x-efficiency research in banking. Managerial efficiency, the concept of x-efficiency, appears to be a much more important strategic and policy consideration” [Molyneux, et al. (1960), p. 273]. Given

An Evaluation of Karachi Export Processing Zone: A Preliminary Investigation

The literature on EPZs shows that these are a second-best solution compared with generalised countrywide reforms, but that, where countrywide reforms are difficult to implement, they can be a useful weapon in the development arsenal [World Bank (2001)]. EPZs have been instrumental not only in increasing exports but also attracting export-oriented foreign direct investment (FDI). China is a classic example to be mentioned here where the levels of FDI have gone up massively over the last ten years. Added up with exports increase are also the benefits of employment generation, development of backward and forward linkages and strengthening the industrial base. The phenomenon of export-processing zones (EPZs) is a part of broader context of structural changes in global economic development. During the last few decades, there has been a tremendous increase in exports of manufactured goods especially from developing countries. EPZs have emerged as an important channel of export generation, especially of manufactured goods, from most of the developing countries e.g. East Asia, Mexico, Morocco etc. Their significance cannot be undermined because of the location-specific advantages and infrastructure facilities possessed by them.

Wound infiltration with Bupivacaine versus Ketorolac for postoperative pain relief in minor to moderate surgeries

OBJECTIVE: To compare the analgesic efficacy of Bupivacaine 0.25% wound infiltration with Ketorolac incisional infiltration in relieving postoperative pain for first twenty-four hours. METHODOLOGY: Analytical, interventional and comparative study was performed on seventy patients, of both sexes, with varied age groups. Patients underwent minor and moderate surgeries, confined to American Society of Anaesthesiologist ASA category 1-II. Patients were selected by convenience sampling and were divided into two groups i.e. Group I and Group II. Group-I comprised of thirty five patients and were infiltrated with Bupivacaine 0.25% at wound margins postoperatively. Group-II also comprised of thirty-five patients and were infiltrated with Ketorolac at wound margins 60 mg postoperatively. RESULTS: Bupivacaine 0.25% wound infiltration had onset of action within 4 +/- 2 minutes. Percentage pain relief was 80% in minor surgeries and 60% in moderate surgeries. Duration of action lasted for 8 +/- 2 hours regarding minor surgeries while it was 6 +/- 1 hours for moderate surgeries. Ketorolac incisional infiltration had onset of analgesic action within 10 +/- 5 minutes. Duration of action lasted for 6 +/- 1 hours regarding minor surgeries while it was 4 +/- 2 hours regarding moderate surgeries. Percentage pain relief was 60% in minor surgeries and 50% in moderate surgeries. CONCLUSION: Wound infiltration with Bupivacaine 0.25% was better for postoperative pain relief in comparison with Ketorolac regarding percentage pain relief, onset and duration of action

Success and failure of fast track extubation in cardiac surgery patients of tertiary care hospital: one year audit

OBJECTIVE: To identify the causes of delayed extubation in patients planned for fast tract extubation during cardiac surgery. METHODS: A prospective observational study was conducted at cardiothoracic unit of Aga Khan University Hospital for the period of one year. All elective coronary artery bypass graft (CABG) surgery patients, between the ages of 35-75 years with LVEF \u3e or = 40 percent were included. Patients with Intra aortic balloon pump, chronic renal failure, respiratory compromise and requiring high ionotropic support were excluded from this audit. A performa was designed and later filled by the primary investigator. Patient demographics and various reasons for delayed extubation were noted in this proforma. RESULTS: Total 614 patients underwent CABG surgery and 388 (63.19%) patients were planned for fast track extubation. A total of 196 (49.5%) patients could be extubated within six hours of arrival in the cardiac ICU. Common reasons for delayed extubation included deep sedation in 80 (46.5%), confusion 44 (25%), excessive bleeding in 20 (11.3%) and high inotropic support in 10 (5.68%). CONCLUSION: Major contributing factors for delayed extubation were identified by this audit. These factors need to be targeted accordingly by modifications in intra operative management

Magnesium, a drug of diverse use

Magnesium has evolved as a drug with diverse clinical applications. Mg++ is an important caution and its homeostasis is very important for normal body functioning. The physiological role of Mg is due to its calcium channel blocking properties at smooth muscle, skeletal muscle and conduction system levels. The analgesic properties are due to NMDA receptor blocking action. Mg++ is beneficial in acute Myocardial Infarction, protection during open heart surgery and treatment and prevention of heart rhythm disturbances. Mg has an established role in the management of preeclampsia and eclampsia. Magnesium prevents or controls convulsions by blocking neuromuscular transmission and decreasing the release of acetylcholine at the motor nerve terminals. The use of MgSO4 in treating tetanus and acute asthma is established. In conclusion, Mg is a cost effective, widely used drug with multidisciplinary applications. Its majority of physiological effects are attributed to calcium channel blocking properties

Anaesthetic challenges in emergency surgical repair of acute aortic dissection rupturing into the pericardium in a pregnant patient

Acute aortic dissection in pregnancy is a serious situation, because rapid and appropriate surgical decision making is required to save the life of both mother and baby. Aortic dissection is rare in young women but is likely during pregnancy (third trimester) secondary to the hyperdynamic and hypervolaemic circulatory state associated with pregnancy. A 35 years old 27 weeks pregnant patient weighing 90 kg presented in the emergency with severe chest pain. In the immediate post cardiopulmonary bypass period, the patient started bleeding profusely from the anastamotic sites irrespective of utilization of all the conventional methods of haemostasis including multiple units of whole blood, fresh frozen plasma, platelets, calcium and cryoprecipitates. As a last resort she was given low dose r FVIIa (1.2 mg containing 60 KIU of Factor VII). This stopped the bleeding and the haemodyramics were stabilized

Effectiveness of premedication at the time of separation from parent and mask induction in paediatric patients coming for congenital heart disease surgery

OBJECTIVE: To compare the effectiveness of oral midazolam and chloral hydrate on anxiety and sedation at various stages of pre-operative period in congenital heart surgery patients. STUDY DESIGN: Cross-sectional comparative study. PLACE AND DURATION OF STUDY: Operating rooms of The Aga Khan University Hospital, Karachi, from October 2009 to December 2010. METHODOLOGY: Sixty-six patients between the ages of 6 months and 6 years received either chloral hydrate (Group C) or midazolam (Group M) pre-operatively. All congenital heart disease patients coming for cardiac surgeries were included while cases of emergency surgery and those patients in whom premedication was not given were excluded. Effect of premedication observed and documented by Anaesthesia Consultant. Documentation included demographics, level of anxiety and sedation at the time of separation from parent and at the time of mask application. RESULTS: Forty study subjects were male (61%) and 26 were females (39%). Eleven patients received oral midazolam while 55 received oral chloral hydrate. Sixteen patients were tearful and anxious (24%) while rests were calm and asleep. Thirty patients in group C (60%) were well sedated at the time of separation. Mask induction was satisfactory in 76% of chloral hydrate patients. Increase dose was suggested in 23 patients by anaesthetizing physician. Out of these 6 belonged to group M (54.5%) while 17 to low dose chloral hydrate group (30.9%) [\u3c 40 mg/kg]. CONCLUSION: Chloral hydrate provides comparable anxiolysis but superior sedation and mask acceptance scores when compared with midazolam. Higher doses of chloral hydrate (50 mg/kg) were required to keep these patients calm and peaceful at the time of mask application for inhalation induction