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There is a gap in the literature related to understanding the relationship between outsourcing of accounting functions and financial performance (productivity and cost efficiency) of SMEs. This study examines the relationship between accounting outsourcing and financial performance in terms of cost efficiency and profitability in SMEs operating in Greater Sydney, Australia. An online survey of employees and managers (N = 80) of Australian SMEs using snowball sampling assessed the demographics, accounting outsourcing, organisational profitability, and cost-effectiveness of these SMEs. Data were analysed using linear regression and correlation analyses. The empirical analysis revealed that the outsourcing of tax services was related to a better financial performance of SMEs in terms of both cost efficiency and profitability. The outsourcing of management accounting functions was beneficial to the productivity of SMEs, whereas the outsourcing of general accounting was not related to higher productivity. Collectively, the findings of this study will assist SMEs in identifying resource gaps and the reasons for turning to external accountancy services to close the gaps and improve their financial performance.

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The article inform hearing loss is classified as conductive, sensorineural, or mixed, including the association between age-related hearing loss and dementia, and encourage patients to seek treatment for their hearing loss.

Endoscopic ear surgery (EES) is an exciting, rapidly developing and innovative field of otologic surgery. Technically and conceptually, EES is a significant departure from traditional microscopic transcanal approaches to the middle ear and canal that has shown very positive results with respect to patient outcomes. This review serves as a primer for the otologist and otology resident embarking on EES and discusses the theory surrounding the learning process, the optical chain for endoscopic surgery as well as other important underlying principles.

Background: Different types of space-occupying lesions can arise from the nasal cavity and nasopharynx. They can be neoplastic (benign and malignant) or nonneoplastic lesions producing wide range of clinical symptoms. The correlations of clinical, radiological and histopathological findings are necessary in these types of cases. Materials and methods: This was a prospective study conducted in a tertiary care hospital of Vadodara, Gujarat. A total 42 cases were included in the study. Clinical, demographic, radiological and histopathological details were noted in each case. Follow-up period was about 3 months to 18 months in the study. Observation: A total 42 cases were included in the study with 20 benign neoplastic lesions, 19 malignant lesions, and 3 nonneoplastic lesions. The incidence was noted between 8 and 75 years of age with a male to female ratio of 2:23. Angiofibroma was the most common benign neoplastic lesion. Squamous cell carcinoma was the most common malignant lesion noted. Thirty-three patients were successfully operated for the excision of tumour. The most common symptom was nasal obstruction present in 66.67% of cases followed by swelling over local site in 62% of cases followed by nasal discharge in our study. Discussion: The nasal cavity contains different types of epithelial (squamous, neural, olfactory) and mesenchymal (bone, cartilage, muscle and vascular) tissues. Tumours can arise from any of these tissues. Symptomatology is indistinguishable from nasal polypi, chronic rhinosinusitis and granulomatous diseases of the nose. Utmost care is needed in the examination and diagnosis of these cases before starting the treatment. Conclusion: Clinical, radiological and histopathological correlations are necessary in sinonasal masses as it will be helpful in deciding the treatment plan and any adjunctive treatment if necessary like chemoradiation in malignant lesions. Continuous follow-up is also necessary to look for patency of nasal cavity, any complication and recurrence.

Homo- and copolymers of 2-(N-phthalimido)ethyl methacrylate (NPEMA) and p-chlorophenyl methacrylate (PCPMA) were prepared in N,N-dimethyl formamide (DMF) solution at 70 °C using 2,2-azo-bisisobutyronitrile (AIBN) as initiator. The nano-CdS-doped polymer composite of NPEMA and PCPMA was prepared via in situ technique. The homo- and copolymers of NPEMA and PCPMA were characterized using FT-IR spectroscopy and gel permeation chromatography (GPC). The polymer nano composites were characterized using FT-IR spectroscopy, X-ray diffraction, and transmission electron microscopy. The reactivity ratios (r1and r2) were obtained from the various linear graphical methods. The values of r1(NPEMA) = 0.55 and r2(PCPMA) = 1.30 were found from the same graphical methods. The copolymer microstructures were found from the mean sequence length, run number, and dyad fraction. Thermal behavior of polymers and polymer nano composites under nitrogen atmosphere was studied. The activation energies of neat polymers were varied in the range of 56–85 kJ/mol, while 28–56 kJ/mol energies were found for nano-CdS-doped polymer composites. The thermodynamic parameters of thermal degradation were also obtained. Kinetic and thermodynamic parameters were confirming the stability of the neat polymers than polymer nano composites. The polymers were assessed on different microorganisms for obtaining the antimicrobial properties. Overall, the polymers permit 10–52, 20–58, and 18–56% growth of bacteria, fungi, and yeast, respectively.

Background: The use of polypharmacy in the present day clinical therapy has made the identification of clinical drug-drug interaction risk an important aspect of drug development process. Although many drugs can be metabolized to sulfoxide and/or sulfone metabolites, seldom is known on the CYP inhibition potential and/or the metabolic fate for such metabolites. Objective: The key objectives were: a) to evaluate the in vitro CYP inhibition potential of selected parent drugs with sulfoxide/sulfone metabolites; b) to assess the in vitro metabolic fate of the same panel of parent drugs and metabolites. Methods: In vitro drug-drug interaction potential of test compounds was investigated in two stages; 1) assessment of CYP450 inhibition potential of test compounds using human liver microsomes (HLM); and 2) assessment of test compounds as substrate of Phase I enzymes; including CYP450, FMO, AO and MAO using HLM, recombinant human CYP enzymes (rhCYP), Human Liver Cytosol (HLC) and Human Liver Mitochondrial (HLMit). All samples were analysed by LC-MS-MS method. Results: CYP1A2 was inhibited by methiocarb, triclabendazole, triclabendazole sulfoxide, and ziprasidone sulfone with IC50 of 0.71 µM, 1.07 µM, 4.19 µM, and 17.14 µM, respectively. CYP2C8 was inhibited by montelukast, montelukast sulfoxide, montelukast sulfone, tribendazole, triclabendazole sulfoxide, and triclabendazole sulfone with IC50 of 0.08 µM, 0.05 µM, 0.02 µM, 3.31 µM, 8.95 µM, and 1.05 µM, respectively. CYP2C9 was inhibited by triclabendazole, triclabendazole sulfoxide, triclabendazole sulfone, montelukast, montelukast sulfoxide and montelukast sulfone with IC50 of 1.17 µM, 1.95 µM, 0.69 µM, 1.34 µM, 3.61 µM and 2.15 µM, respectively. CYP2C19 was inhibited by triclabendazole and triclabendazole sulfoxide with IC50 of 0.25 and 0.22, respectively. CYP3A4 was inhibited by montelukast sulfoxide and triclabendazole with IC50 of 9.33 and 15.11, respectively. Amongst the studied sulfoxide/sulfone substrates, the propensity of involvement of CY2C9 and CYP3A4 enzyme was high (approximately 56% of total) in the metabolic fate experiments. Conclusion: Based on the findings, a proper risk assessment strategy needs to be factored (i.e., perpetrator and/or victim drug) to overcome any imminent risk of potential clinical drug-drug interaction when sulfoxide/sulfone metabolite(s) generating drugs are coadministered in therapy.

Background: The use of polypharmacy in the present day clinical therapy has made the identification of clinical drug-drug interaction risk an important aspect of drug development process. Although many drugs can be metabolized to sulfoxide and/or sulfone metabolites, seldom is known on the CYP inhibition potential and/or the metabolic fate for such metabolites. Objective: The key objectives were: a) to evaluate the in vitro CYP inhibition potential of selected parent drugs with sulfoxide/sulfone metabolites; b) to assess the in vitro metabolic fate of the same panel of parent drugs and metabolites. Methods: In vitro drug-drug interaction potential of test compounds was investigated in two stages; 1) assessment of CYP450 inhibition potential of test compounds using human liver microsomes (HLM); and 2) assessment of test compounds as substrate of Phase I enzymes; including CYP450, FMO, AO and MAO using HLM, recombinant human CYP enzymes (rhCYP), Human Liver Cytosol (HLC) and Human Liver Mitochondrial (HLMit). All samples were analysed by LC-MS-MS method. Results: CYP1A2 was inhibited by methiocarb, triclabendazole, triclabendazole sulfoxide, and ziprasidone sulfone with IC50 of 0.71 μM, 1.07 μM, 4.19 μM, and 17.14 μM, respectively. CYP2C8 was inhibited by montelukast, montelukast sulfoxide, montelukast sulfone, tribendazole, triclabendazole sulfoxide, and triclabendazole sulfone with IC50 of 0.08 μM, 0.05 μM, 0.02 μM, 3.31 μM, 8.95 μM, and 1.05 μM, respectively. CYP2C9 was inhibited by triclabendazole, triclabendazole sulfoxide, triclabendazole sulfone, montelukast, montelukast sulfoxide and montelukast sulfone with IC50 of 1.17 μM, 1.95 μM, 0.69 μM, 1.34 μM, 3.61 μM and 2.15 μM, respectively. CYP2C19 was inhibited by triclabendazole and triclabendazole sulfoxide with IC50 of 0.25 and 0.22, respectively. CYP3A4 was inhibited by montelukast sulfoxide and triclabendazole with IC50 of 9.33 and 15.11, respectively. Amongst the studied sulfoxide/sulfone substrates, the propensity of involvement of CY2C9 and CYP3A4 enzyme was high (approximately 56% of total) in the metabolic fate experiments. Conclusion: Based on the findings, a proper risk assessment strategy needs to be factored (i.e., perpetrator and/or victim drug) to overcome any imminent risk of potential clinical drug-drug interaction when sulfoxide/sulfone metabolite(s) generating drugs are coadministered in therapy.

The protympanum, a final common pathway between the tympanic cavity and external environment, is gaining relevance due to the ease and completeness of visualization with angled endoscopes. Two primary conformations are described, quadrangular and triangular, and new anatomic structures such as the protiniculum, subtensor recess, and protympanic spine are defined. Surgical relevance of the protympanum is described with respect to ventilation, cholesteatoma, cerebrospinal fluid leak, otic neuralgia, and surgical access to the eustachian tube.