Organizations rely heavily on audits and compliance related activities to prove their competency, credibility, and firm performance. Sustainability audits encompass entire supply chains and are very complex due to, firstly, the global nature of supply chains and, secondly, the expansive scope of sustainability, which may include financial, manufacturing, social, and environmental audits. Adding to this dilemma is the absence of a consensus on standards related to sustainability, resulting in differences, variations, and multiple interpretations. While the frequency, complexity, and scope of audits has increased, unfortunately so has the incident of audit fraud, which has seen increasing media coverage in recent times, often implicating major multinationals and their supply chains. We posit that this trend of increasing audit activity is causing “audit fatigue”, which, in turn, may influence the audit outcome, i.e., either audit fraud or a clean audit. This study proposes that audit fatigue is a genuine issue faced by organizations and needs to be conceptualized.

Background: Pediatric cataracts cause significant visual disability worldwide. The objectives of this study were to determine the distribution of pediatric cataracts by sex, age groups, laterality, type and presentation in population of D.I.Khan District, Pakistan. Materials & Methods: This descriptive study was carried out at Department of Ophthalmology, Gomal Medical College, D.I.Khan, Pakistan from January 2015 to December 2015. Sample was collected from Eye unit, DHQ Teaching Hospital, D.I.Khan. Pediatric cataract patients under 14 years of age were included in the study. Demographic variables were sex and age groups. Research variables were laterality, type and presentation. All variables being nominal were analyzed through frequency and percentages. The observed and expected distribution of pediatric cataract by sex, age groups, laterality, type and presentation were respectively tested by chi-square goodness of fit test. Results: Out of a sample of 47 patients, 29 (61.7%) were boys and 18 (38.3%) girls, 22 (46.81%) were <5 years and 25 (53.19%) 5-14 years of age. Thirty three (70.21%) had unilateral and 14 (29.79%) bilateral cataracts. Type was congenital/ developmental in 27 (57.45%) patients and traumatic in 20 (42.55%). Presentation was by defective vision in 23 (48.94%), leukocoria 14 (29.79%), strabismus 7 (14.89%) and screening in 3 (6.38%) cases. The observed distribution of pediatric cataract by sex (p=.0158), age groups (p=.00002), laterality (p=<.00001) and type (p=<.00001) was similar to expected, while for presentation, it was different than expected (p=.1033). Conclusion: The prevalence of pediatric cataract was higher for boys than girls and higher for older children (5-14 years) than younger (<5 years) children. Unilateral were more common than bilateral cataracts and the congenital/ developmental were more common than traumatic cataracts. Defective vision was the most common presentation of pediatric cataracts.

Background: Diabetic retinopathy (DR) is one of the leading cause of blindness worldwide and laser therapy has a basic role in the control of diabetic retinopathy. Green laser therapies are performed both for proliferative diabetic retinopathy and diabetic macular edema. The aim of our study was to determine the frequencies of different stages of diabetic retinopathy in patients undergoing laser in our setup. Materials & Methods: This descriptive study was conducted at the department of Ophthalmology, Gomal Medical College, D.I.Khan, Pakistan from January 2015 to December 2019.The sample consisted of all the diabetic patients undergoing green laser procedures during this period at Eye Unit, DHQ Teaching Hospital D.I.Khan Pakistan. Results: Out of a total of 1,893 green laser procedures performed for diabetic patients from January 2015 to December 2019, 1,011 were male and 882 were female. 969 (51.1%) patients were having relatively early stages of DR, 676 (35.7) patients had advanced DR and 248 (13.1%) had diabetic macular edema (DME). Conclusion: Laser therapy is frequently needed for the control of diabetic eye disease so keeping in mind the disease burden the laser facilities should be expanded in our setup.

Aim: Objective of the existing study is to find out the associated factor of which play significant role in financing OOPE in choice of delivery by households in district Rajanpur, Punjab, Pakistan. Background: In Pakistan health expenditure is a main issue when it commes to Out-of-pocket expenditure is considered as major challeneg. Housholds resort to different coping strategies with the increase in OOPE on health care, including maternal care. Material and Methods:Nature of the data was cross-sectional and study setting and location was in district Rajanpur, a predominantly rural district in Pakistan. Data was collected in time period of october 2020 to december 2020 from 368 mothers using multi-stage random sampling, in the selected Basic Health Unit areas were included in the study. Data were collected through a pretested inteview schedule translated in Urudu langage. Results: Savings or current income were the primary sources of financing OOPE on delivery care by 90% of respondents, followed by borrowing reported by 35% of respondents who borrowed money from friends and relatives to cope with the current expenditure on delivery. Low-income families used multiple sources to meet the burden of OOPE, and a significant proportion of them had resorted to borrowing (41.5%) and sale of household assets (23%) to meet OOPE on delivery care. The study concludes that despite various government initiatives to improve maternal healthcare services in Pakistan, most rural families have incurred OOPE in seeking delivery care.