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Aims To assess the predictors of 1 year mortality in patients treated with fibrinolytic therapy for ST-segment elevation myocardial infarction (STEMI) and to determine whether a strategy of early percutaneous coronary intervention (PCI) improves outcome. Methods and results Consecutive patients ( n =474) admitted to our unit (1998–2001) with STEMI were treated with fibrinolytic therapy. For each patient, age, gender, admission via mobile coronary care unit (MCCU), infarct location, initial systolic blood pressure and Killip class, prior history of ischaemic heart disease, hypertension, diabetes mellitus, smoking status, family history, hyperlipidaemia, and in-hospital PCI ( n =154) were recorded. Mortality at 1 year was obtained from medical records ( n =473). Binary logistic regression analysis was performed to determine independent predictors of 1 year mortality. Mortality in the non-PCI group was 21 vs. 7% in the PCI group. Independent predictors of 1 year mortality were age (risk ratio 1.12, 95% CI 1.08–1.15, P

In recent years, the central monetary authorities of some Gulf Cooperation Council countries have made several regulatory changes in order to achieve social & economic goals. The monetary authorities of these countries have strengthened prudential norms. Asset classifications and provisioning norms have moved closer to international standards. Banks are required to maintain capital to risk weighted assets ratios of 8 per cent required by the BIS. Local banks follow International Accounting Standards. Although the central monetary authorities of the GCC countries are active in supervising and monitoring their regulations on financial institutions, but not in a rapid way. In a global financial market, Islamic‐banking regulators that operate Islamic banks should think about the compatibility of the regulatory setting. Through a deep understanding of the nature of the Islamic banking business and the recent western banking supervisory framework, Islamic banking regulators will be able to develop a sound banking system without loosing its own distinction.

Much has been written about the need and importance of Non‐financial Performance/s (NFP) measures in modern technologically advanced competitive business organizations. But there is not an acceptable definition available on NFP, though recent corporate accounting scandals have been created greater need of ethical, moral viz a viz NFP measurement. However, all non‐monetary qualitative pieces of information are not same in considering an organization's strategy, objective, and even for the differences of organizational characteristics/particularities. Thus, this study attempts to identify the nature of NFP with references to financial institutions in Finland and Japan. According to the empirical evidence, this study classifies three different natures of NFP. The first type of NFP is the profit driven one, and the second one is for long‐term competitive advantage of business. The third type of NFP is independent in nature, i.e. they are not linked with the profitability of organization. This study also demonstrates the relative link of NFP with financial performances, and the weight and importance that management is giving to improve and measure NFP in the studied organizations. At the end some directions for further research are given in light of the recent corporate accounting scandals in the USA.

An analysis of domestic and foreign banks’ internal performance by investigating their financial ratios shows that banks in Bahrain, Oman, the United Arab Emirates (GCC countries) have improved their performance over the past several years. Commercial banks in these GCC economies are well capitalised and have adopted modern banking services. Most banks are found to be financially sound by international standards, measured by all key financial ratios. Their operations can be characterised by satisfactory asset quality, more than minimum BIS capital/asset ratio, and high level of profitability. External performance is measured by evaluating banks’ market shares, regulatory compliance and public confidence; and most of the banks show better progress. Harmonization of the banks’ supervisory and accounting systems towards IAS has contributed to the safety and competitiveness of the banking sector.

The inadequacies of traditional management accounting (MA) information indicate a need for management to find proper measuring tools for emerging non‐financial performance (NFP) in the highly competitive financial services, as well as in the manufacturing industry. Thus, the role of MA in measuring the performances of emerging NFP has been receiving increased emphasis in the increasingly important service industries. Considering the shortcomings of the traditional MA information system, particularly the measurement of new emerging NFPs, this empirical research is an attempt to investigate the role of MA in non‐financial as well as financial performance measurement (PM) in selected banks and financial institutions (BFIs) in Finland. The study demonstrates that the role of MA in non‐financial PM is insignificant. However, management is paying more attention to its measurement. This study identifies three different aspects of NFP: profit‐driven NFP; NFP for long‐term competitive advantage; and independent NFP (those not linked with the profitability of an organisation).

In recent years, there has been a growing tendency to establish closer ties among the Gulf Cooperation Council (GCC) countries (Bahrain, Saudi Arabia, Oman, Qatar, and United Arab Emirates) in economies and financial institutions. As a result, there is an increasing need for the harmonization of accounting regulations in order to improve cooperation and enhance the efficiency of the financial institutions among GCC countries. This study is an investigation of the accounting standards followed by the financial institutions in five GCC countries with some policy prescriptions for harmonization of the accounting regulations in GCC countries. This paper deals with accounting policies and practices, including loans and provisions, assets, investments, taxation, liabilities, foreign exchange, revenue recognization, and consolidation of GCC countries’ banking and other financial institutions.

Hyperprolactinemia is the most common endocrinologic disorder in causing menstrual irregularities. Although the correlation between hyperprolactinemia and menstrual dysfunction is widely known, the etiology of menstrual cycle disorders is not profoundly understood in patients with prolactinoma. We aimed to investigate the correlation between prolactin levels and insulin resistance and hyperandrogenism in patients with prolactinoma.Sixty-four patients with microprolactinoma and 33 healthy women were enrolled. Thirty-six of these patients with prolactinoma (group 1) had an estradiol (E2) level under 30 pg/mL, and 28 (group 2) had an E2 level greater than 30 pg/mL. Blood samples were drawn to measure the levels of the following hormones: Follicle stimulating hormone (FSH), luteinizing hormone (LH), E2, prolactin (PRL), total testosterone (TT), androstenedione (AS) and dehydroepiandrostenedione sulphate (DHEAS). Body Mass Index (BMI of ≥30 kg/m2) was excluded from the study. Insulin resistance (IR) was calculated by the HOMA-IR.BMI was higher in patients with prolactinoma than the control group (P=0.02, P=0.025, respectively). IR and glucose intolerance existence were higher in patients with prolactinoma (P=0.007, P=0.097, respectively) than the healthy women, but these differences did not exist between eugonadic and hypogonadic women with prolactinoma (P=0.020, P=0.032, respectively, Bonferroni correction). TT and AS were higher in eugonadic women with prolactinoma than the control group (P=0.004, P=0.003, Bonferroni correction, respectively).Our study revealed that the relationship between hyperprolactinemia and IR/glucose intolerance is irrespective of gonadal status in women with prolactinoma. Also, the study concluded that hyperandrogenism may be a cause of menstrual dysfunction in eugonadic women with prolactinoma.

BACKGROUND: Percutaneous Coronary Intervention (PCI) of coronary bifurcation lesion is technically quite demanding. It has been associated with a lower procedural success, higher rates of complication and restenosis. Side-branch occlusion and plaque shifting or 'snow plow' effect are not uncommon. Stenting of the main vessel may cause 'stent jail' of the side-branch. Modern stent design may allow passage of a balloon or stent into the side-branch through the struts of the stent placed in the main vessel. A newly developed 316 stainless steel tubular stent, the Rtrade mark stent is uniquely designed to provide flexibility, radial strength on deployment and conformability. Its large cell size facilitates PCI of bifurcation lesion. AIM: To assess the feasibility of R(trade mark) stent in the treatment of symptomatic patients with bifurcation coronary lesions. The main objective was to assess the ease of deployment, side-branch access and overall success of the R(trade mark) stent in this group of patients without any major adverse events. METHODS: Between December 1998 and September 2000 the R(trade mark) stent was used as a main stent in 28 consecutive patients with coronary bifurcation lesions, 46% of which had unstable angina. The mean age was 59 +/- 10 and 89% were male. Adjunctive medical therapy included clopidrogel, aspirin and intraprocedure heparin. Abciximab (ReoPro) was given to 9 patients. RESULTS: Successful stent deployment was achieved in all patients. Thirty-four R Stents and 16 other stents were used. Two patients had post-procedure rise in cardiac enzymes. There were no major adverse events at 30 days. LAD/D1 with LAD/diagonal was the target lesion in the majority of patients. Stenting of the side-branch was done in 18 and balloon dilatation in 9 patients. At 3-23 months (mean 11.8) follow-up, repeat angiography was done in 18 patients with restenosis in 4, two of them had repeat PCI and one had coronary artery bypass graft (CABG). CONCLUSION: Coronary bifurcation lesions are not uncommon. Current advances in stent technology offer a safe and effective revascularisation strategy for such complex lesions. The R(trade mark) stent appears to be a suitable device that provides good wall coverage, radial strength, conformability and easy side-branch access.

A 67 year old man presented with new-onset atrial flutter. He had a history of coronary artery bypass graft (CABG) surgery on two occasions. Subsequent investigation revealed the presence of a large saphenous vein graft (SVG) aneurysm compressing the right heart. We postulate that the SVG aneurysm was the precipitating cause for the atrial flutter. This case is the first in the literature to document an atrial arrhythmia as the presenting feature of a SVG aneurysm.

Renewable energy is being developed globally to overcome the depletion of natural resources and mitigating the global issue of climate change. The increasing energy crisis and environmental concerns make renewable energy more critical for a sustainable future. Renewable energy technologies have a great potential across the globe. Pakistan being a developing country is continuously facing energy crisis and an emphasis on industrialization is increasing carbon emissions. Renewable energy development provides necessary solutions, particularly in developing countries where energy demands have to be met through an economical and environmental friendly way. This paper explores the significance and potential of renewable energy development in developing countries i.e. Pakistan and how it can contribute to reduce the environmental impacts for mitigating climate change. It argues that the current policy measures and infrastructure is inadequate to implement renewable energy technologies, also discussing various renewable energy sources. The critical review of the literature and case-based experiences has been used as an overall approach to this paper. It will help in exploring renewable energy strategy and its implementation in developing countries in comparison to developed economies. It concludes with an integrated and comprehensive policy recommendations and possible solutions to develop a strategic approach to renewable energy.

3-(2-Furanyl)-2-propenoic acid has been used to prepare a new series of organotin complexes of general formula R3SnL (R=Me, Et, n-Bu, Ph and Cy) and R2SnL2 (R=Me and n-Bu). These complexes have been characterized by elemental analyses, IR, 1H-NMR, MASS and Mössbaure spectroscopy.