• The Journal of Industrial Distribution & Business
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• v.5 no.2
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• pp.13-20
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• 2014

Purpose - The purpose of this study is to empirically investigate the impact of capital structure on firm performance. Research design, data, and methodology - This study examined the impact of capital structure on the performance of cement companies listed on the Karachi Stock Exchange during the period 2009-2013. The authors hypothesize that there is a negative relationship between capital structure and firm performance. To examine the association, the authors run a Pearson correlation and multiple regression analysis. Results - Results reveal a strong negative relationship between debt to asset and firm performance variables (GPM, NPM, ROA, and ROE). Further, there is a positive relationship between debt to equity and firm performance variables (GPM and NPM), anda negative relationship between debt to equity and firm performance variables (ROA and ROE). Moreover, capital structure variables significantly impact firm performance. Conclusions - This study concluded that financial analysts and managers should emphasize on the optimal level of capital structure and efficient utilization and allocation of resources to achieve the targeted level of productive efficiency in business.

• The Journal of Asian Finance, Economics and Business
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• v.8 no.1
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• pp.81-91
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• 2021

This paper investigates the long run hedging ability of precious metals against the risks associated with adverse conditions of economic and financial variables for Pakistan, the USA, China, and India. Monthly data of gold, silver, platinum, stock returns, exchange rate, industrial production, and inflation was collected for the selected economies. Saikkonen and Lutkepohl (2002) unit root test was employed to access the unit root properties of the data series and identify the break dates. Furthermore, this study used the Johansen cointegration test with and without structural breaks to identify the long-run relationship between metals prices and different financial and economic variables. The findings suggest that the time series under study have unit root problem at level with and without structural breaks. Without considering structural breaks, the Johansen trace test indicates that in Pakistan and China, gold, silver, and platinum hold a cointegrating relationship with macroeconomic and financial variables. For the US, gold indicates cointegration which supports the hedging ability of gold against inflation, stock, and industrial production in the long run. The results of the cointegration test after incorporating the structural breaks provide even stronger evidence of the long-run relationship of precious metals and consumer prices, exchange rate, and stock prices.

• The Journal of Asian Finance, Economics and Business
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• v.8 no.3
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• pp.717-729
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• 2021

This paper examines the efficacy of the default risk factor in an emerging market context using the Fama-French five-factor model. Our aim is to test whether the Fama-French five-factor model augmented with a default risk factor improves the predictability of returns of portfolios sorted on the firm's characteristics as well as on industry. The default risk factor is constructed by estimating the probability of default using a hybrid version of dynamic panel probit and artificial neural network (ANN) to proxy default risk. This study also provides evidence on the temporal stability of risk premiums obtained using the Fama-MacBeth approach. Using a sample of 3,806 firm-year observations on non-financial listed companies of Pakistan over 2006-2015 we found that the augmented model performed better when tested across size-investment-default sorted portfolios. The investment factor contains some default-related information, but default risk is independently priced and bears a significantly positive risk premium. The risk premiums are also found temporally stable over the full sample and more recent sample period 2010-2015 as evidence by the Fama-MacBeth regressions. The finding suggests that the default risk factor is not a useless factor and due to mispricing, default risk anomaly prevails in the Pakistani equity market.

• The Journal of Asian Finance, Economics and Business
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• v.9 no.6
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• pp.219-230
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• 2022

The goal of this research is to look into the relationship between social media marketing activities and brand attachment in the online marketing business, based on the indirect effect of perceived value and self-brand connections. For this reason, the study has used self-administered questionnaires to collect the data from 425 males from the major cities of Pakistan including Islamabad, Karachi, Lahore, and Sialkot. Furthermore, based on the PLS-SEM technique the empirical findings show that social media marketing activities positively affect perceived value, self-brand connections, and brand attachment. Perceived value has a significant positive impact on brand attachment and mediates the influence of social media marketing activities on brand attachment. In addition to this, self-brand connections have a positive effect on brand attachment, and self-brand connections mediate the relationship between them. Thus, firms employing social media marketing activities successfully in their branding build upon a positive perception of the brand in the customer's mind resulting in customer attachment with the brand. This study can assist the e-commerce managers and brand managers in building strong customer attachment via perceived value and self-brand connections.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.3829-3849
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• 2014

Continued advances in the field of histo pathology (and cyto pathology) over the past two decades have resulted in dramatic changes in the manner in which these disciplines are now practiced. This is especially true in the setting of a large university hospital where the role of pathologists as clinicians (diagnosticians), undergraduate and postgraduate educators, and researchers has evolved considerably. The world around us has changed significantly during this period bringing about a considerable change in our lifestyles and the way we live. This is the world of the internet and the world-wide web, the world of Google and Wikipedia, of Youtube and Facebook where anyone can obtain any information one desires at the push of a button. The practice of histo (and cyto) pathology has also evolved in line with these changes. For those practicing this discipline in a poor, developing country these changes have been breathtaking. This is an attempt to document these changes as experienced by histo (and cyto) pathologists practicing in the biggest center for Histopathology in Pakistan, a developing country in South Asia with a large (180 million) and ever growing population. The Section of Histopathology, Department of Pathology and Microbiology at the Aga Khan University Hospital (AKUH) in Karachi, Pakistan's largest city has since its inception in the mid-1980s transformed the way histopathology is practiced in Pakistan by incorporating modern methods and rescuing histopathology in Pakistan from the primitive and outdated groove in which it was stuck for decades. It set histopathology in Pakistan firmly on the path of modernity and change which are essential for better patient management and care through accurate and complete diagnosis and more recently prognostic and predictive information as well.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.10039-10043
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• 2014

Background: In Pakistan thyroid cancer is responsible for 1.2% cases of all malignant tumors. Ultrasonography (US) is helpful in detecting cancerous thyroid nodules on basis of different features like echogenicity, margins, microcalcifications, size, shape and abnormal neck lymph nodes. We therefore aimed to calculate diagnostic accuracy of ultrasound in detection of carcinoma in thyroid nodules taking fine needle aspiration cytology as the reference standard. Materials and Methods: A cross-sectional analytical study was designed to prospectively collect data from December 2010 till December 2012 from the Department of Radiology in Aga Khan University Hospital, Karachi, Pakistan. A total of 100 patients of both genders were enrolled after informed consent via applying non-probability consecutive sampling technique. Patients referred to Radiology department of Aga Khan University to perform thyroid ultrasound followed by fine-needle aspiration cytology of thyroid nodules were included. They were excluded if proven for thyroid malignancy or if their US or FNAC was conducted outside our institution. Results: The subjects comprised 76 (76%) females and 24 males. Mean age was $41.8{\pm}SD$ 12.3 years. Sensitivity and specificity with 95%CI of ultrasound in differentiating malignant thyroid nodule from benign thyroid nodule calculated to be 91.7% (95%CI, 0.72-0.98) and 78.94% (0.68-0.87) respectively. Reported positive predictive value and negative PV were 57.9% (0.41-0.73) and 96.8% (0.88-0.99) and overall accuracy was 82%. Likelihood ratio (LR) positive was computed to be 4.3 and LR negative was 0.1. Conclusions: Ultrasonography has a high diagnostic accuracy in detecting malignancy in thyroid nodules on the basis of features like echogenicity, margins, micro calcifications and shape.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7409-7414
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• 2013

Background: Delay in diagnosis of breast cancer is associated with a poorer survival and a pivotal contribution to this delayed diagnosis comes from patient delay in presenting at a clinic. Reasons involved must be evaluated in order to decrease this reducible delay. Objectives: i) To evaluate the reasons for patient delay in diagnosis of breast cancer; ii) to investigate any association with other variables. Materials and Methods: A 6 month cross sectional study (from July 2012 to Dec 2012), was carried out in Surgical and Oncology Units of Civil Hospital, Karachi. A total of 100 females diagnosed with breast cancer of any histological type were interviewed after informed consent and relevant data were collected. Due ethical clearance was obtained. Results: Mean age was $47.5{\pm}12.1$ years with a range from 25-77 years. Mean duration of delay was $5.13{\pm}4.8$ months, from shortest 1 month to longest 36 months. Duration of delay was observed to be no delay (<1 month) in 28%, short delay (1-3 months) in 30% and long delay (>3 months) in 42% of patients. Considering the symptoms as "harmless" (39%) was the most frequent reason of delay followed by "temporary" (20%) and the "use of traditional methods" (12%). Most common reason for later approaches was an increase in the size of the lump (41%). Statistically significant association (p-value <0.05) of longer patient delay was obtained with being single, being illiterate, painless breast lump as the first symptom, negative family history of breast cancer and vague attribution of the symptoms. Conclusions: Significant delay in approach to health care facility was observed in our study due to variable reasons given by women. Sufficient awareness regarding breast cancer, its symptoms and favorable effects of a timely diagnosis on prognosis must be imparted to our general population.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6997-7005
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• 2013

Aim: To present an epidemiological and histological perspective of diseases of the gastrointestinal tract (including liver and biliary tract) at the Section of Histopathology, Department of Pathology, AKUH, Karachi, Pakistan. Materials and Methods: All consecutive endoscopic biopsies and resections between October 1 and December 31, 2012 were included. Results: A total of 2,323 cases were included. Carcinoma was overwhelmingly the commonest diagnosis on esophageal biopsies (69.1%); chronic helicobacter gastritis (45.6%) followed by adenocarcinoma (23.5%) were the commonest diagnoses on gastric biopsies; adenocarcinoma (27.3%) followed by ulcerative colitis (13.1%) were the commonest diagnoses on colonic biopsies; acute appendicitis (59.1%) was the commonest diagnosis on appendicectomy specimens; chronic viral hepatitis (44.8%) followed by hepatocellular carcinoma (23.4%) were the commonest diagnoses on liver biopsies; chronic cholecystitis was the commonest diagnosis (over 89%) on cholecystectomy specimens. Conclusions: Squamous cell carcinoma comprised 88.8% of esophageal cancers. About 67% were in the lower third and 56.5% were moderately differentiated; mean ages 49.8 years for females and 55.8 years for males; 66% cases were from South West Pakistan. Over 67% patients with gastric adenocarcinoma were males; mean ages 59 and 44 years in males and females respectively, about 74% gastric carcinomas were poorly differentiated; and 62.2% were located in the antropyloric region. About 63% patients with colorectal adenocarcinoma were males; mean ages 46.1 and 50.5 years for males and females respectively; tumor grade was moderately differentiated in 54%; over 80% were located in the left colon. In 21.2% appendicectomies, no acute inflammation was found. Acute appendicitis was most common in young people. Hepatitis C (66.3%) was more common than hepatitis B (33.7%); about 78% cases of hepatocellular carcinoma occurred in males; females comprised 76.7% patients with chronic cholecystitis; and 77.8% patients with gall bladder carcinoma. All resection specimens showed advanced cancers. Most cancers occurred after the age of 50 years.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1351-1355
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• 2014

Background: Ovarian sex-cord stromal tumours (SCST) are rare, and relatively infrequent in children. These have to be distinguished from more common germ cell tumors in children and also from benign epithelial neoplasms. Objectives: The purpose of our study was to report the clinical and pathological findings in young patients with these tumours in our population. Material and Methods: The present observational cross-sectional study included all subjects <21 years of age diagnosed with ovarian SCST, in Aga Khan University Hospital Histopathology Laboratory, Karachi, Pakistan, from January 1992 till July 2013. Results: Of the total of 513 SCSTs presented during the study period, 39 fulfilled inclusion criteria and were assessed. The age range was 4-250 months. Most of the tumours presented at stage-1 and an abdominal mass was the most common presenting symptom, along with menstrual disturbance. The left side ovary was slightly more affected (53.5%). Of the total, 15 were juvenile granulosa cell tumours (JGCT), 11 sclerosing stromal tumours (SST), 10 of the fibrothecomas spectrum, 2 Sertoli leydig cell tumours (SLCT) and one a sex cord tumour with annular tubules (SCTAT). Detailed immunohistochemical analyses were performed in 33 cases. Recurrence/metastasis was noted in 4/21 cases with follow-up data. Conclusions: Ovarian sex cord stromal tumours are very rare in young age in our population, and usually present at an early stage. Most common among these are juvenile granulosa cell tumours, although surprisingly sclerosing stromal tumours were also common. Clinical symptoms due to hormone secretion in premenstrual girls and menstrual disturbance in menstruating girls are common presenting features.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.603-606
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• 2013

Background: Ovarian cancer is the second most common malignancy in Pakistani women, accounting for 4% of all cancers in the female population. The aim of this study was to determine sensitivity, specificity, positive and negative predictive values and 95% confidence intervals for ultrasound in characterization of ovarian masses in patients presenting at public and private tertiary care hospitals in Karachi, Pakistan. Materials and Methods: We adopted a cross-sectional analytical study design to retrospectively collect data from January 2009-11 from medical records of two tertiary care hospitals. Using a non-probability purposive sampling technique, we recruited a sample of 86 women aged between 15 and 85 years fulfilling inclusion criteria with histopathologically proven ovarian masses presenting for an ultrasound examination in our radiology departments. Results: Our retrospective data depicted sensitivity and specificity of ultrasound to be 90.7%, 95%CI (0.77, 0.97) and 91.4%, 95%CI (0.76, 0.98) respectively. Positive predictive value was 93%, 95%CI (0.79, 0.98) and negative predictive value was 89%, 95%CI (0.73, 0.96). A total of 78 ovarian masses were detected, out of which 42 were malignant and 36 were benign. Conclusions: Results of our study further reinforce the conclusion that ultrasound should be used as an initial modality of choice in the workup of every woman suspected of having an ovarian mass. It not only results in decreasing the mortality but also avoids unnecessary surgical interventions.